Prostatitis is the general name for inflammation of the prostate and the clinical manifestations associated with prostatitis. It is a very common disease that affects men of all ages. Prostatitis is the most common urological disease in men under 50 and the third most common in men over 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. Microbes can be spread sexually, as well as through blood, urine, lymph, or as a complication after a prostate biopsy. In the case of acute prostatitis, intense infection symptoms are observed - fever, tremors, 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 non-bacterial prostatitis is unclear. Symptoms are similar in both types and include:
- A feeling of tightness or heaviness in the perineum (the area between the testicles and the anus)
- Frequent urge to urinate and defecate
- A feeling of incomplete emptying of the bladder
- Difficulty urinating
- Burning during urination
- Pain in 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, as it has 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 not yet fully understood.
How is prostatitis diagnosed?
The diagnosis is based on the patient's history and thorough clinical examination. Urine culture is necessary to identify the cause and type of prostatitis. At the appointment, the doctor decides whether more specialized screening tests are needed, such as bladder, prostate ultrasound, cystoscopy, MRI.
Acute bacterial prostatitis
Based on the patient's medical history and clinical examination, the doctor determines whether the disease is acute prostatitis. A general blood test confirms the diagnosis, and a urine test determines 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 does not necessarily identify the bacteria that cause this type of prostatitis. Sometimes multiple urinalysis is required, or a urinalysis is performed after prostate massage.
Chronic non-bacterial prostatitis - chronic pelvic pain
Chronic non-bacterial prostatitis is diagnosed after ruling out 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 appear normal, and the urologist needs a lot of experience to make the diagnosis.
How is prostatitis treated?
The therapy recommended by the doctor depends on the type of prostatitis:
In case of acute bacterial prostatitis
Antibiotics, antipyretics and anti-inflammatory drugs are prescribed. Increased fluid intake is recommended, and hospitalization is often required for intravenous fluids and antibiotics.
In case of chronic bacterial prostatitis
Antibiotic therapy is also recommended for this type of prostatitis. In order to minimize the risk of relapse, the treatment lasts 3-8 weeks. At the same time, the causes of chronic urinary tract infections are also being clarified. Such conditions are urolithiasis, benign prostatic hyperplasia with residual urine, and various diseases affecting the nerves of the bladder. Your urologist will advise you on how to cure these diseases or prevent urinary tract infections.
In case of chronic, non-bacterial prostatitis (synonym - chronic pelvic pain)
Until the cause is known, there is no one-size-fits-all treatment. The disease often presents with periods of exacerbation and remission, and the triggers are different for each patient. Therapy is usually long-term and is combined with changing the patient's lifestyle.
This complex disease requires medical experience, who must determine the treatment methods individually and modify them 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 to improve urine flow and control urinary frequency (α-blockers, anticholinergics), drugs to improve erectile function, natural/plant extracts, and antipsychotics. patients with chronic pain. Sometimes it may also be necessary to work with a mental health psychiatrist.
What is the prognosis for prostatitis?
Acute bacterial prostatitis can be completely cured with antibiotics taken in a short time (usually for 3 weeks). Although relapses are common, chronic bacterial prostatitis responds well to antibiotics and the patient becomes asymptomatic 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 aim of the treatment is to improve the patient's quality of life. Asymptomatic inflammatory prostatitis is not clinically significant and does not require treatment.