Prostatitis is a general term 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 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 non-bacterial 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. The germs can be transmitted sexually, as well as through blood, urine, lymph or as a complication after a prostate biopsy. In acute prostatitis, intense symptoms of infection are observed - fever, shivering, weakness, fatigue, frequent and painful urination or retention of urine.
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, mycoplasma and fungi are 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:
- A feeling of tension or heaviness in the perineum (the area between the testicles and the anus)
- Frequent urination and urge to defecate
- Sensation of incomplete emptying of the bladder
- Difficulty urinating
- Burning during urination
- Pain in testicles and groin
- 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 there are no clinical manifestations. It is usually diagnosed incidentally, such as during a prostate biopsy for another reason unrelated to prostatitis. The cause of this prostatitis is still not fully understood.
How is prostatitis diagnosed?
The diagnosis is made based on the patient's medical history and a thorough clinical examination. A urine culture is necessary to determine the cause and determine the type of prostatitis. When enrolling, the doctor assesses 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
The 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 non-bacterial 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. 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, since the blood and ultrasound look normal, and the urologist requires a lot of experience to make the diagnosis.
How is prostatitis treated?
The therapy recommended by your doctor depends on the type of prostatitis:
In acute bacterial prostatitis
Antibiotics, antipyretics and anti-inflammatory drugs are chosen. Increased fluid intake is recommended and hospitalization for intravenous fluids and antibiotics is often required.
In 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. In parallel, the causes of chronic uroinfection are 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 protect yourself from urinary tract infections.
In chronic non-bacterial prostatitis (synonym - chronic pelvic pain)
Until the cause is identified, there is no one-size-fits-all treatment. The disease often progresses 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 urine flow and regulate urination frequency (α-blockers, anticholinergics), drugs that improve erectile function, natural/herbal extracts, and antipsychoticsin patients with chronic pain. Sometimes collaboration with a mental health psychiatrist may also be necessary.
What is the prognosis for prostatitis?
Acute bacterial prostatitis is completely treatable with antibiotics taken for a short period of time (usually 3 weeks). Although recurrences are common, chronic bacterial prostatitis responds well to antibiotics, and the patient becomes symptom-free after antibiotic treatment. 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 has no clinical significance and does not require treatment.