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. This is a very common disease that affects men of all ages. Prostatitis is the most common urological disease in men under the age of 50 and the third most common in men over the age of 50. There are different types of prostatitis:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic nonbacterial prostatitis
- Asymptomatic inflammatory prostatitis
What are the causes and symptoms of prostatitis?
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. Microbes can be transmitted sexually, as well as through the blood, urine, lymph, or as a complication after a prostate biopsy. In acute prostatitis, intense symptoms of infection are observed - fever, trembling, 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 a 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 anus)
- Frequent urination and urge to defecate
- Feeling of incomplete emptying of the bladder
- Difficulty urinating
- Burning during urination
- Pain in the testicles and groin area
- Erectile disorders
- Dyspareunia (painful intercourse)
- Premature or even painful ejaculation
- Frequent urination at night
- Psychological discomfort
Asymptomatic inflammatory prostatitis
This type of prostatitis is called asymptomatic because it has no clinical manifestations. It is usually diagnosed incidentally, for example during a prostate biopsy for another reason unrelated to prostatitis. The cause of this prostatitis is not yet fully understood.
How is prostatitis diagnosed?
Diagnosis is based on the patient's medical history and a thorough clinical examination. Urine culture is necessary to identify the cause and determine the type of prostatitis. At the appointment, 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 medical 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
Diagnosis is made based on the patient's medical history and clinical examination. A urine test may not identify the bacteria causing this specific type of prostatitis. Sometimes you need to take a urine test several times, or take a urine test after performing a prostate massage.
Chronic nonbacterial prostatitis - chronic pelvic pain
The diagnosis of chronic nonbacterial prostatitis is made after excluding other types of prostatitis and if symptoms persist for more than 3 months. This 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, since blood and ultrasound appear normal, and a urologist requires a lot of experience to make a diagnosis.
How is prostatitis treated?
The therapy recommended by your doctor 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. Treatment lasts from 3 to 8 weeks to minimize the risk of relapse. At the same time, the causes of chronic urinary tract infection are being clarified. Such conditions are urolithiasis, benign prostatic hyperplasia with residual urine and various diseases affecting the nerves of the bladder. The urologist will advise you on how to cure these diseases 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 combined with changes in the patient's lifestyle.
This complex disease requires the experience of a physician who must 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, drugs that improve urinary flow and regulate urinary frequency (α-blockers, anticholinergics), drugs that improve erectile function, natural / herbal extracts, as well as antipsychotics in patients with chronicpain. Sometimes collaboration with a mental health psychiatrist may also be required.
What is the prognosis for prostatitis?
Acute bacterial prostatitis is completely curable with antibiotics taken over a short period of time (usually 3 weeks). Although relapses are common, chronic bacterial prostatitis responds well to antibiotics, and the patient becomes symptom-free 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. Asymptomatic inflammatory prostatitis is not clinically important and does not require treatment.