Prostatitis is a general name used to describe inflammation of the prostate gland, as well as the clinical manifestations associated with inflammation of the prostate gland. It is a very common disease that affects men of all ages. Prostatitis is the most common urological disease in men under 50 years of age, and the third most common disease in men over 50 years of age. There are different types of prostatitis:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic non-bacterial prostatitis
- Symptomatic inflammatory prostatitis
What are the causes and symptoms of prostatitis?
The causes and symptoms vary depending on the type of prostatitis.
Acute bacterial prostatitis
Acute bacterial prostatitis is an infectious inflammation of the prostate caused by bacteria. The most common bacteria are E. coli, Klebsiella and Proteus. Germs can be transmitted sexually, through blood, urine, lymph, or as a complication after a biopsy of the prostate gland. In acute prostatitis, symptoms of intense infection are observed - fever, chills, weakness, fatigue, frequent and painful urination or urinary retention.
Chronic prostatitis (bacterial and non-bacterial)
Chronic bacterial prostatitis is usually caused by the same bacteria that cause acute bacterial prostatitis. In rare cases, other microorganisms such as gonococci, chlamydia, mycoplasmas and fungi are also to blame. Chronic prostatitis often occurs as a complication of chronic bladder infection.
The cause of chronic nonbacterial prostatitis is unclear. Symptoms are similar in both types and include:
- Feeling of tension or heaviness in the perineum (the area between the testicles and the anus)
- Frequent urination and the urge to defecate
- A feeling that the bladder is not completely empty
- Difficulty urinating
- Burning during urination
- Pain in testicles and groin
- Erectile disorders
- Dyspareunia (painful intercourse)
- Early or even painful ejaculation
- Frequent urination at night
- Psychological discomfort
Symptomatic inflammatory prostatitis
This type of prostatitis is called asymptomatic because there are no clinical manifestations. It is usually diagnosed incidentally, for example, during a biopsy of the prostate gland for another reason unrelated to prostatitis. The cause of this prostatitis is not yet fully understood.
How is prostatitis diagnosed?
The diagnosis is based on the patient's medical history and a thorough clinical examination. A urine culture is needed to determine the cause and type of prostatitis. At the time of admission, the doctor decides whether more specialized screening tests are needed, such as ultrasound of the bladder, prostate gland, cystoscopy, MRI.
Acute bacterial prostatitis
Based on the patient's history and clinical examination, the doctor will determine whether the disease is acute prostatitis. A general blood test will confirm the diagnosis and a urine test will determine the bacterial strain of the infectious agent.
Chronic bacterial prostatitis
The diagnosis is based on the patient's medical history and clinical examination. A urine test may not identify this specific prostatitis-causing bacteria. Sometimes it is necessary to perform a urine test several times or to perform a urine test after doing a prostate massage.
Chronic non-bacterial prostatitis - chronic pelvic pain
The diagnosis of chronic non-bacterial prostatitis is made after excluding other types of prostatitis and if symptoms persist for more than 3 months. It is a chronic disease that significantly affects the patient's quality of life. The main difficulty is that this type of prostatitis cannot be proven by laboratory tests, because blood and ultrasound appear normal, and a urologist needs a lot of experience to make a diagnosis.
How is prostatitis treated?
The therapy your doctor recommends depends on the type of prostatitis:
For acute bacterial prostatitis
Antibiotics, antipyretic and anti-inflammatory drugs are selected. Increased fluid intake is recommended, and hospitalization for intravenous fluids and antibiotics is often required.
For chronic bacterial prostatitis
Antibiotic therapy is also indicated for this type of prostatitis. To minimize the risk of relapse, treatment lasts from 3 to 8 weeks. At the same time, the causes of chronic urinary tract infection are clarified. Such conditions are urolithiasis, benign hyperplasia of the prostate gland with residual urine, and various diseases affecting the nerves of the bladder. A urologist will advise you on how to treat these conditions or how to prevent urinary tract infections.
For chronic non-bacterial prostatitis (synonym - chronic pelvic pain)
Until the cause is known, there is no single treatment for all cases. The disease often occurs with periods of exacerbation and remission, and the triggering factors are different for each patient. Therapy is usually long-term and is combined with changes in the patient's lifestyle.
This complex disease requires the expertise of a physician who has to individualize and adjust treatment methods depending on the situation. Treatments are usually combined to relieve symptoms and improve quality of life. As with bacterial prostatitis, treatment includes antibiotics, anti-inflammatory drugs, muscle relaxants, medications that improve urinary flow and frequency (α-blockers, anticholinergics), drugs that improve erectile function, natural/plant extracts, and antipsychotics. patients with chronic pain. Sometimes collaboration with a mental health psychiatrist may also be required.
What is the prognosis for prostatitis?
Acute bacterial prostatitis is completely treated with antibiotics taken for a short period of time (usually 3 weeks). Although relapses are common, chronic bacterial prostatitis responds well to antibiotics and the patient is free of symptoms after treatment with antibiotics. Chronic bacterial prostatitis is a problem for both the patient and the doctor. Symptoms usually do not go away completely; There are exacerbations and remissions. The goal of treatment is to improve the patient's quality of life. Symptomatic inflammatory prostatitis is not clinically significant and does not require treatment.