Prostatitis and STIs: When Prostate Inflammation Is Sexually Transmitted vs. Non-Infectious
Prostatitis (prostate inflammation) is a clinical syndrome; only a subset is sexually transmitted.
NIH Prostatitis Classification
| Category | Type | Etiology | STI-Related? |
|---|
| I | Acute bacterial | E. coli, Klebsiella, Proteus (ascending urethral) | Rarely (GC/CT possible) |
| II | Chronic bacterial | Recurrent UTI pathogens; biofilm | Rarely |
| III | Chronic pelvic pain syndrome (CP/CPPS) | Non-bacterial; neuromuscular, immune, psychosocial | No |
| IV | Asymptomatic inflammatory | Incidental finding (biopsy, semen) | No |
STI-Associated Prostatitis
- Neisseria gonorrhoeae & Chlamydia trachomatis can ascend urethra → prostate.
- Present as acute (Cat I) or chronic (Cat II) bacterial prostatitis.
- Transmissible to partners via unprotected sex.
- Diagnosis: urine/urethral PCR, expressed prostatic secretions (EPS) culture/PCR.
- Treatment: Ceftriaxone 500 mg IM + Doxycycline 100 mg BID × 7d (GC); Doxycycline 100 mg BID × 14d (CT). Fluoroquinolones if susceptible.
Non-STI Prostatitis
- Most chronic prostatitis (Cat III) is not infectious and not transmissible.
- Management: α-blockers, anti-inflammatories, pelvic floor PT, neuromodulators, stress reduction.
Prevention & Partner Notification
- Condoms reduce STI acquisition.
- If STI-prostatitis diagnosed: treat patient + notify/test/treat partners (expedited partner therapy where legal).
- Abstain until both cured.
Prostate Cancer - Related Articles
