Prostatitis

General description

Prostatitis – is a term that defines inflammation of the prostate gland. It can be described as infection, but in some cases the inflammation happens without any infection. Only around 5-10% of cases are caused by bacterial infection, which prevents the risk of getting prostate cancer.

The prostate gland is a purely male organ, which looks like tubular-alveolar exocrine gland.

Prostatitis can be a problem for men of all ages. But according to a general medical data, prostatitis affects about 50% of men older than 50 years. In the same time, The National Institute of Health is convinced that up to 25% of doctor’s visits are caused by problems with genital and urinary systems in middle-aged or young men.

Types of prostatitis

According to the studies of National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) there are four categories of prostatitis:  

I – Acute bacterial prostatitis – is a sudden inflammatory disease of the prostate caused by bacterial infection. Acute prostatitis may be caused by different microorganisms. The most often prostate is affected by bacteria such as E. coli, Klebsiella, Proteus, Pseudomonas aeruginosa, Enterobacter, and Staphylococcus aureus serratsii.

It’s not the most common form of disease and it has very serious symptoms: acute urinary infection with increased urinary frequency, pain in the pelvic and genital area, fever, chills, high temperature, pain in the lower back, lower abdomen or perineum, nausea, vomiting and others.

Acute prostatitis requires immediate treatment as it can cause additional problems as blocked urine flow, bladder infections, low blood pressure, and even confusion. It usually treated by intravenous antibiotics and pain relievers.

II – Chronic bacterial prostatitis – is an inflammation of the prostate gland which is a result of recurrent urinary tract infections. It can exist a few years and doesn’t show any symptoms. Actually, the symptoms can be the same as during acute prostatitis, but less severe and may cause problems which are hard to treat by just medicaments like psychological deviations or changes in sexual sphere. The treatment includes antibiotic therapy for at least 2 weeks, relief of pain and antidepressants.

III – Chronic nonbacterial prostatitis/chronic pelvic pain syndrome – is marked by urinary and genital pain for three and more months, but patients don’t have bacteria in their urine but doesn’t exclude the signs of inflammation. Sometimes it has an additional symptom interstitial cystitis (chronic inflammation of a bladder).

This type is known as the most common one, accounting 90-95% of cases used to be diagnosed as chronic nonbacterial prostatitis.

IV – Asymptomatic inflammatory prostatitis – usually doesn’t include specific symptoms. The only signs of this type of disease could be persistent bacteriuria and leukocyturia, which are the main features in the diagnosis of this pathology.

Treatment options include the appointment of antimicrobial and anti-inflammatory drugs. It should be noted that in some cases prostate cancer’s clinical picture is similar to a chronic asymptomatic prostatitis. In order to distinguish one from another disease is assigned a PSA (prostate specific antigen) analysis.

It’s useful to know that prostatitis is considered chronic if it lasts more than three months. But in some cases, chronic prostatitis follows an attack of acute prostatitis.

Causes of prostatitis

In most cases, the cause of prostatitis is genital infections. Most of all, there are chlamydia, bacterial vaginosis, trichomoniasis, gonorrhea and other urinary tract infections. Pathogenic microorganisms permeate from urethra, bladder or bowel into the prostate gland. The method of penetration can be blood or lymph.

As for non-bacterial prostatitis forms, the bacteria cannot be identified, although it does not exclude its presence.

Some time before, the prostatitis was considered as sexually transmitted disease, but nowadays researches proved that only small number of cases are passed on through sex. A lot of different conditions and medical intervention may cause prostatitis.

The aggravating and developing factors of prostatitis are:

  •        Hypothermia
  •        Stagnant processes in the pelvic organs
  •        Reduced immune defense
  •        Irregular sexual life
  •        Frequent change of sexual partners and unprotected sex
  •        Recently having a medical instrument such as urinary catheter
  •        Abnormal urinary tract
  •        Recent bladder infection
  •        Rectal intercourse
  •        Enlarged prostate

Symptoms of prostatitis

When the disease is coming to an organism is might be that a person doesn’t feel any changes and in other case he may suffer so much that it obviously requires emergency medical care. The earliest symptoms of prostatitis are mostly connected with urinary disorders like difficulty to urinate, frequent urge to urinate, pain or burning during urination, feeling of incomplete emptying, fever and chills.

Over time, a sexual dysfunction starts to develop and cause lack of an erection, pain along the urethra, painful sexual intercourse, premature ejaculation and other.

Other symptoms may include pain in the abdomen, in the groin, around the anus, in back. Also, the sign of prostatitis is less forceful urine stream as a prostate can swell and cause this, or blood in the urine and painful ejaculation.

Diagnostics of prostatitis

If a man suspects that he might have prostatitis by comparing his troubles with mentioned above symptoms, he should be immediately diagnosed by a professional.

Diagnosis of the prostate begins with introduction of a patient's complaints and inspection. Urological prostate examination includes:

  •        Blood and urine test
  •        Investigation of prostatic secretions
  •        Digital rectal examination
  •        Tests for infections, sexually transmitted
  •        Ultrasound of the kidneys and bladder, transrectal ultrasonography
  •        Uroflowmetry
  •        A blood test for PSA
  •        Prostate biopsy (optional)
  •        Voiding studies (the collection and analysis of urine to define which part of urinary system is affected by infection).

Treatment for prostatitis

Treatment of this disease will depend on what type of prostatitis you have. Also, it’s important to ensure that your prostatitis is not caused by urethritis (inflammation of the urethra), because this will change the prescribed treatment.

Generally, treatment of prostatitis should be comprehensive and have a diverse range of therapeutic measures. It can include:

  •        Anti-inflammatory drugs along with warm sitz baths for chronic prostatitis
  •        Antibiotics course for infectious prostatitis (it usually lasts for 14 days)
  •        Antibiotics course for chronic prostatitis (it takes much more time like 4-12 weeks)
  •        Muscle relaxants
  •        Surgical removal of infected part of the prostate
  •        Prostate massage or stool softeners.

Concurrently it’s assigned to take immunomodulatory, anti-inflammatory and analgesic drugs, vitamins, and dietary supplements.

In case of not timely treatment a person can be in risk to gain other complications like chronic prostatitis, obstruction of the bladder, development of infertility, recurrent cystitis, narrowing of the urethra, pyelonephritis, prostate abscess, sepsis.

 
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