The bugs might show up in urine or in fluid the doctor expresses from the prostate by massaging it with a finger inserted through the anus. All too often, though, the symptoms are back months or even years later. Antibiotics may become a part of man's lifestyle just to keep the infection at bay. Even more often, however, tests turn up no bacteria. In some cases, the cause seems to be muscle spasms, a problem called prostatosis.
Some doctors throw antibiotics at it, and sometimes that helps.
Earlier this year, at the urging of the Prostatitis Foundation, the National Institutes of Health officially recognized prostatitis as a significant problem worthy of research. It was also a topic of lively discussion at this year's meeting of the American Urological Association. A small but vocal minority is convinced that all or nearly all cases of prostatitis actually are bacterial. Antibiotics are simply unable to reach the recesses of the prostate and stamp them out entirely. Clinical trials are planned to study the effectiveness of alternative treatments based on this approach.