Urethral dysbacteriosis as an underlying, primary cause of chronic prostatitis: potential implications for probiotic therapy.

Chronic prostatitis (CP) is a common urological condition with a controversial etiology. Some clinical and experimental evidence could signify the presence of nonculturable, fastidious organisms involved in the etiology of CP. In addition, Gram positive bacteria, which basically constitute the urethral normal bacterial floras, may be pathogens of patients with CP. However, the role of this urethral bacterial flora as a possible nidus for apparent or latent infection of the prostate has long been neglected. We hypothesize that urethra dysbacteriosis may be an underlying, primary cause of CP and the wide use of antibiotics may be an initiating risk factor for CP. The hypothesis may provide an interesting new insight into the causes and mechanisms of pathogenesis in CP. Furthermore, far more important, if this is true, it would provide us with fundamental basis for possible probiotic-based therapeutic strategies for CP. To confirm the hypothesis, further study should focus on the development of a novel animal model of antibiotic-induced urethral dysbacteriosis and its role in the pathogenesis of CP.