From the Guidelines
Acute bacterial prostatitis risk factors include urinary tract infections, urinary catheterization, and immunocompromised states, as highlighted in the 2024 European Association of Urology guidelines 1. The condition typically occurs when bacteria from the urinary tract or rectum ascend to the prostate gland, causing infection.
- Key risk factors for acute bacterial prostatitis include:
- Urinary tract infections
- Urinary catheterization
- Urinary tract instrumentation (such as cystoscopy or prostate biopsy)
- Unprotected anal intercourse
- Urinary tract abnormalities
- Immunocompromised states Men with diabetes, HIV infection, or chronic bacterial prostatitis are at higher risk, as noted in the guidelines 1. Age is also a factor, with older men being more susceptible. The most common causative organism is Escherichia coli, followed by other gram-negative bacteria like Proteus, Klebsiella, and Pseudomonas species, as well as gram-positive bacteria such as Enterococcus. Recognizing these risk factors is important for prevention, particularly in high-risk individuals who may benefit from prophylactic antibiotics before procedures involving the urinary tract, although the optimal approach is still debated 1. Patients with recurrent urinary tract infections should be evaluated for underlying structural abnormalities that might predispose them to prostate infection. Given the limited quality of evidence for certain aspects of acute bacterial prostatitis management 1, a cautious approach is warranted, prioritizing prevention and prompt treatment in high-risk individuals.
From the Research
Risk Factors for Acute Bacterial Prostatitis
- Patient populations who are at especially high risk of acute prostatitis include those with diabetes, cirrhosis, and suppressed immune systems 2
- A history of recurrent urinary tract infections is a key feature of chronic bacterial prostatitis, which can increase the risk of developing acute bacterial prostatitis 3
- Transurethral manipulation procedures, such as urethral catheterization, cystoscopy, or transrectal prostate biopsy, can also increase the risk of developing acute bacterial prostatitis 4, 2
- Sexual activity can be a risk factor for uncomplicated urinary tract infections, which can lead to acute bacterial prostatitis 5
Underlying Conditions that May Contribute to Acute Bacterial Prostatitis
- An underlying anatomic or functional condition can complicate urinary tract infections in men, increasing the risk of developing acute bacterial prostatitis 5
- Pelvic floor muscle abnormalities, altered neuroendocrine pathways, chemically induced inflammation, bacterial infection, autoimmune processes, dysfunctional voiding, and intraprostatic ductal reflux mechanisms have all been identified in men with chronic pelvic pain syndrome, which can increase the risk of developing acute bacterial prostatitis 3