It is a diagnosis of exclusion. Chlamydia, Ureaplasma, and Mycoplasma infection and autoimmune processes are suspected but not proved. Consider also tuberculosis, mycotic infections, viral infections, or Cryptococcus infection in AIDS patients. Signs and symptoms. Same as for chronic bacterial prostatitis.
Prostatic secretions reveal inflammatory cells but no bacteria.
Since nonbacterial prostatitis usually does not respond to antibiotics, their continued empirical use is not justified. The recurrent symptoms can often cause significant emotional stress, anxiety, and depression resulting in significant morbidity. It is a syndrome of variable cause. In some men urodynamic testing discloses voiding dysfunction associated with apparent functional obstruction of the bladder neck and urethra. In such cases there is a favorable response to an alpha-blocker such as prazosin 2 to 4 mg orally twice daily or terazosin 5 to 10 mg orally once daily.