PROSTATITIS

Prostatitis is a general diagnosis which describes the inflammation in the prostate gland.

It appears with a wide spectrum of clinical manifestations, which differ in symptom duration and type.

It may develop in men of all ages, but it is more frequent among men above the age of 50.

There are several types of prostatitis:

  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Chronic nonbacterial prostatitis
  • Asymptomatic (histological) prostatitis

Causes and symptoms of prostatitis

They differ according to the type of prostatitis.

Acute bacterial prostatitis

This is caused by colonization (infection) of the prostate gland by microorganisms.

The bacteria most commonly responsible for acute bacterial prostatitis are E.coli, Proteus and Klebsiella.

Microorganisms are transferred through sexual contact or after a diagnostic prostate biopsy.

Symptoms usually manifest themselves in the form of fever with shivering, difficulty in urination and urinary frequency (frequent micturition).

Chronic prostatitis

This may be caused by the same microorganisms responsible for acute prostatitis.

Nevertheless, other microbes, such as gonococcus, chlamydia, mycoplasma, ureaplasma and some fungi, have been considered as “suspects”.

Chronic prostatitis symptoms are:

  • Sense of heaviness between the testicles and the anus
  • Difficulty in urination
  • Frequent need to urinate
  • Painful ejaculation
  • Premature ejaculation
  • Erectile dysfunction

Asymptomatic prostatitis

It is asymptomatic.

The diagnosis is typically delivered after biopsy or transurethral resection of the prostate gland.

Diagnosis

Diagnosis is made based on patient medical history and clinical examination findings.

Urinalysis may be useful in detecting the microorganism responsible for the infection.

In case of acute prostatitis, blood tests may be ordered to confirm the diagnosis.

In acute prostatitis, the establishment of the diagnosis is a more difficult process and is delivered based on the symptoms, and by excluding all other types of prostatitis.

Treatment

It depends on the type of prostatitis:

Acute bacterial prostatitis

It requires antibiotic administration, oral or intravenous, as well as plenty of fluids and taking antipyretics.

Chronic bacterial prostatitis

The disease is treated with long-term antibiotic administration up to two months.

At the same time, conditions predisposing for the disease (lithiasis, prostate hypertrophy) must be investigated and managed.

Chronic nonbacterial prostatitis

The disease is multifactorial and its causes are not very clear, thus treatment must be personalized.

The triggering factors of the symptoms must be identified and lifestyle changes should be made.

Medications commonly used are antibiotics, anti-inflammatory, drugs against erectile dysfunction, as well as drugs improving urinary flow and frequent voiding.