One word covering several different problems, only some of which are infections.
The categories
Acute bacterial prostatitis is a true infection with fever, chills and severe symptoms. It needs treating promptly.
Chronic bacterial prostatitis is a persistent infection, often behind recurrent urinary infections in men, and it needs a longer course.
Chronic pelvic pain syndrome is the category most men end up in, and it is defined largely by what standard testing failed to find.
Asymptomatic inflammatory prostatitis is the fourth category: inflammation found incidentally on a biopsy or a semen analysis in a man with no symptoms at all. It usually needs no treatment, just the knowledge that it exists.
The problem with that third category
It is called non-bacterial because cultures came back negative. That is a statement about the test, not about the patient.
The standard urine culture was designed to grow a small number of common organisms in large numbers. Plenty of bacteria do not grow well on it, and infections involving several organisms at once are routinely missed.
How the third category gets treated now
Modern treatment stopped pretending chronic pelvic pain syndrome is one disease. The UPOINT system sorts each man's actual picture into domains: Urinary symptoms, Psychosocial stress, Organ specific findings, Infection, Neurologic pain and Tenderness of the pelvic floor, with Sexual dysfunction sometimes added as its own letter.
Treatment then targets the domains that man actually has: bladder medications for the urinary domain, pelvic floor physical therapy for the tenderness an examination reveals in so many of these men, and real attention to the nervous system and the stress that amplify pain. Treating the phenotype instead of the label is what finally moved the results.
For the organ specific domain, pollen extract has real trial support, and the product I recommend is ProstatePQ from Theralogix. You can get it directly from my store: ProstatePQ at the Peri Health & Hormones store.
The infection domain, done properly
The I in UPOINT is the domain standard testing serves worst, because a negative culture is how most of these men got filed under non-bacterial in the first place. This is where PCR and next generation sequencing earn their place. They look for bacterial DNA rather than waiting for something to grow on a plate, and in men carrying a chronic pelvic pain label they sometimes find organisms a culture never would.
Some of what has been classified as non-bacterial prostatitis turns out to be bacterial with a negative culture. That changes the treatment entirely, and it changes the conversation for a man who has been told for years that nothing is there.
Sequencing does not explain every case, and it is not supposed to. Its job is to make sure the infection letter gets answered with real data before antibiotics are given or withheld.
What a real evaluation covers
Symptom pattern and duration, full culture history, PCR and sequencing where cultures have been unhelpful, whether the bladder empties, and pelvic floor assessment. Treatment then follows what was actually found.
Being told nothing is wrong is common here and it is rarely the whole story.