Prostatitis is an infection or inflammation of the prostate gland. When symptoms such as pelvic pain, problems urinating and sexual dysfunction develop gradually and persist of a period of many months or years, the condition is considered chronic. Though sometimes caused by a detectable bacterial infection, chronic prostatitis can often develop and persist for complex and unclear reasons.
Bacteria
Chronic bacterial prostatitis typically develops after the prostate gland becomes infected with certain bacteria. According to Medline Plus, the most common bacteria that cause chronic prostatitis include Escherichia coli, Klebsiella pneumonia and Enterobacter cloacae. Some species of Proteus bacteria may also underlie long-term bouts of prostate infection. According to the Urology Center of Colorado, Chlamydia trachomatis--the sexually transmitted bacteria that cause Chlamydia--and mycoplasmas--bacteria that lack a cell wall and are resistant to many traditional antibiotics--may also less commonly cause chronic prostatitis.
Genitourinary Damage
Bacterial infection can't account for all types of prostatitis. For example, doctors believe that a specific type of prostate infection called chronic nonbacterial prostatitis, or chronic pelvic pain syndrome, occurs as a result of a complex combination of factors that damage genitourinary tissues and stoke a chronic inflammatory response. According to the Harvard Medical School, a triggering event--such as physical injury to the pelvic region after surgery or trauma, or undetectable infection by a pathogen--causes inflammation of the nerves, connective tissues or organs surrounding the prostate gland. Left untreated, inflammation can worsen, triggering a heightened sensitivity response in some men. As a result, pelvic pain and urinary and sexual problems may develop and persist chronically.
Autoimmune Condition
Based on results from blood tests and cultures, doctors know that some men with chronic prostatitis have an increased white blood cell count in the absence of a bacterial infection. Elevated white blood cells are a sign of infection. Though it's possible that the underlying cause of prostatitis is a non-bacterial pathogen or bacteria that can't be detected through available cultures, some medical professionals theorize the condition is more likely the result of a non-infectious cause such as an autoimmune disorder, according to the Prostatitis Foundation. Autoimmune disorders are the result of a faulty immune system, which mistakes the body’s own cells as foreign invaders. The immune system recruits white blood cells to attack these tissues, leading to symptoms of pain and inflammation. There is some early evidence based on studies with animals and humans that supports the theory that chronic prostatitis may be an autoimmune disease. More research is needed.
