br br When it comes to prostate trouble, the lion’s share of attention goes to prostate cancer and an enlarged prostate. A third condition, prostatitis, flies under the radar even though it affects up to one in six men at some point in their lifetimes. It triggers more than two million visits to doctors and untold agony each year. br br Prostatitis, which means inflammation of the prostate gland, is an equal opportunity disorder. Unlike prostate cancer and benign prostatic hyperplasia (BPH), which predominantly affect older men, prostatitis affects men of all ages. br br Prostatitis refers to a loose assemblage of syndromes characterized by urinary problems such as burning or painful urination, the urgent need to urinate, trouble voiding, difficult or painful ejaculation, and pain in the area between the scrotum and rectum (known as the perineum) or lower back. Although it causes some of the same symptoms as BPH and can occur at the same time, prostatitis is a separate condition. br br Some types of prostatitis are caused by bacterial infection. These cases are often accompanied by the classic symptoms of infection, such as fever, chills, and muscle pain along with urinary problems. As a result, they are relatively easy to diagnose and treat, and they usually respond well to antibiotics. Unfortunately, such straightforward forms of prostatitis are the minority. br br Physicians aren’t sure what causes the rest. Potential culprits include difficult-to-detect bacteria, inflammation, depression and stress, and mechanical or neuromuscular problems in the pelvic muscles that irritate the general area. This uncertainty is what can make the treatment of prostatitis so maddening.