Bacterial Chronic Prostatitis: Symptoms, Treatment, and Concerns

Chronic bacterial prostatitis

On January 10, I had protected sexual intercourse (including oral sex), and two days later, I started experiencing frequent urination and my semen became watery.
However, I have been having unprotected sex with my girlfriend for over three months, and she has not shown any discomfort.
Since January, I have been seeing doctors and getting urine tests, and each time the bacteria and white blood cell counts were normal.
At the end of January, I tested for Chlamydia, which was negative, and for Gonorrhea; the doctor said there was no significant pain and no discharge, so further testing was unnecessary.
Today, a semen analysis revealed the presence of bacteria, specifically Escherichia coli, and another bacterium that the doctor couldn't explain in Chinese.
He also mentioned that I have prostatitis.
When I asked the doctor if this is contagious, he said it is not considered a sexually transmitted infection.
1.
Should I get tested for Trichomoniasis?
2.
Can I continue having unprotected sex with my girlfriend? The doctor said it is fine, but I am worried about transmitting anything to her.
3.
Is this treatment effective? I have not taken antibiotics since January, but my symptoms have improved.
Today, I started a one-month treatment course.
4.
What could have caused this infection? Is it related to hygiene after sexual activity?

Mr. Zhang, 20~29 year old female. Ask Date: 2021/04/20

Dr. Li Xinyi reply Urology

Trichomoniasis in men often presents with fewer symptoms, so it is advisable to get tested.
In terms of sexually transmitted infections (STIs), women typically show fewer symptoms, which means that self-reporting is not reliable; a thorough examination and follow-up by a gynecologist are necessary.
The key point regarding STIs is that partners should be treated simultaneously; otherwise, the infection can be transmitted back and forth like a ping-pong ball, which makes it difficult to address the second question.
For chronic prostatitis, oral medication may take 4 to 6 weeks.
Regarding the last question, while it sounds like safe sexual practices, the presence of unusual symptoms and infections cannot be assessed online; it is essential to schedule an appointment to discuss these concerns with a physician.

Reply Date: 2021/04/20

More Info

Chronic bacterial prostatitis, particularly when caused by bacteria such as Escherichia coli (E. coli), can be a challenging condition to manage. Your situation raises several important points regarding symptoms, treatment, and concerns about transmission and infection.

Understanding Symptoms and Diagnosis
Chronic bacterial prostatitis often presents with a variety of symptoms, including pelvic pain, urinary frequency, urgency, and changes in semen consistency. In your case, the presence of E. coli in your semen culture indicates a bacterial infection, which can contribute to the symptoms you are experiencing. It's important to note that while your symptoms may have improved without antibiotic treatment, the underlying infection may still be present and could potentially lead to further complications if left untreated.

Treatment Considerations
The standard treatment for chronic bacterial prostatitis typically involves a prolonged course of antibiotics, often lasting 4 to 12 weeks, depending on the severity of the infection and the patient's response to therapy. Since you have not yet started antibiotics, it is crucial to follow your doctor's recommendations and complete the prescribed course once you begin. This will help ensure that the infection is adequately addressed.

In addition to antibiotics, supportive measures such as warm baths, pelvic floor exercises, and lifestyle modifications (like avoiding irritants such as caffeine and alcohol) can help alleviate symptoms. Regular follow-up with your healthcare provider is essential to monitor your progress and make any necessary adjustments to your treatment plan.

Concerns About Transmission
Regarding your concerns about transmission, chronic bacterial prostatitis is not classified as a sexually transmitted infection (STI). Your doctor is correct in stating that it is not typically transmitted through sexual contact. However, maintaining good hygiene practices after sexual activity is important to minimize the risk of introducing bacteria into the urinary tract.

If you are considering having unprotected sex with your girlfriend, it is advisable to discuss this with your healthcare provider. While the risk of transmission is low, open communication with your partner about your health status is essential. If you have any doubts or concerns, using protection until you have completed your treatment and received clearance from your doctor may be a prudent choice.

Potential Causes of Infection
Infections like chronic bacterial prostatitis can arise from various factors, including:
1. Bacterial Ascension: Bacteria can ascend from the urethra into the prostate, often following sexual activity or urinary tract infections.

2. Urinary Retention: Incomplete bladder emptying can create an environment conducive to bacterial growth.

3. Pelvic Floor Dysfunction: Issues with pelvic floor muscles can contribute to urinary symptoms and discomfort.

4. Hygiene Practices: Inadequate hygiene after sexual activity can increase the risk of introducing bacteria.

Conclusion
In summary, it is crucial to adhere to your treatment plan, including completing the antibiotic course as prescribed. While the risk of transmission of your condition to your girlfriend is low, maintaining open communication and practicing good hygiene is essential. If you have further concerns about your symptoms or treatment, do not hesitate to reach out to your healthcare provider for personalized advice and support. Regular follow-ups will help ensure that your condition is managed effectively and that any complications are addressed promptly.

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