Causes of Chronic Nonbacterial Prostatitis

The cause of chronic nonbacterial prostatitis is very complex, and the main cause may be pathogen infection, inflammation and abnormal pelvic floor neuromuscular activity and immune abnormalities.

 

1. Pathogenic infection

 

Although the pathogen could not be separated by routine bacterial examination, it may still be related to some special pathogens, such as anaerobic bacteria, L-shaped Proteus, nanobacteria, or Chlamydia trachomatis, mycoplasma and other infections.

 

Some studies have shown that the detection rate of local prokaryote DNA in this type of patient can be as high as 77%; some clinical "aseptic" prostatitis with chronic inflammation, recurrent or aggravating, may be related to these pathogens.

 

Other pathogens such as parasites, fungi, viruses, trichomoniasis, Mycobacterium tuberculosis and so on may also be important pathogenic factors of this type, but there is no reliable evidence, so far there is no consensus.

 

2. Dysuria

 

Some factors cause excessive contraction of urinary sphincter, leading to obstruction of the bladder outlet and formation of residual urine, cause urine to flow back into prostate, not only bring pathogen into the prostate but also directly stimulate the prostate, induce chemical prostatitis without bacterial infection, resulting in urinary issues and pain in pelvic area, etc.

 

Many prostatitis patients have a variety of urodynamic changes, such as decreased urinary flow rate, functional urinary tract obstruction, detrusor sphincter coordination disorder, and so on. These functional abnormalities may only be a clinical phenomenon, and their nature may be related to a variety of potential pathogenic factors.

 

3. Psychological factors

 

The research shows that more than half of the patients with prostatitis who have not been cured for a long time have obvious changes in mental and psychological factors and personality characteristics, such as anxiety, depression, hypochondria, hysteria, and even suicidal tendencies.

 

The changes of these mental and psychological factors may cause the disorder of autonomic nerve function, the disorder of neuromuscular function in the posterior urethra, the pain in the pelvic area and the disorder of urination function, or the functional changes of hypothalamus pituitary gonad axis may affect the sexual function, further aggravate the symptoms, and the elimination of mental tension may alleviate or cure the symptoms.

 

However, it is not clear whether the mental and psychological change is the direct cause or secondary performance.

 

4. Neuroendocrine factors

 

The fluctuation of heart rate and blood pressure often occurs in patients with prostatic pain, indicating that it may be related to autonomic nervous response. The local pathological stimulation of prostate and urethra reflex to other parts through triggering the spinal nerve by afferent nerve of the prostate, then the astrocytes in the lumbosacral spinal cord will be activated.

 

It can lead to dysfunction of bladder and urethra, abnormal activities of the perineum and pelvic floor muscles, and persistent pain and involvement pain in corresponding areas outside the prostate.

 

5. Abnormal immune response

 

In recent years, studies have shown that immune factors play an important role in the occurrence and development of type III prostatitis and the evolution of the disease course. In patients with prostatic fluid and/or seminal plasma and/or tissue and / or blood, there may be some changes in the level of cytokines, such as IL-2, IL-6, IL-8, IL-10, TNF - α and MCP-1.

 

Moreover, the level of IL-10 is positively correlated with the pain symptoms of type III prostatitis Conclusion: immunosuppressive therapy has a certain effect.

 

When you are suffering from chronic prostatitis, timely mental counseling is needed, patients can seek the help of psychological doctors, so as to maintain an optimistic attitude. At the same time, in addition to the necessary treatment, alcohol, smoking and other bad habits should also be avoided.

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