Prostatitis is a general name that describes inflammation of the prostate as well as the clinical manifestations associated with inflammation of the prostate. This 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 in men over 50 years of age. 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 blood, urine, lymph, or as a complication after a prostate biopsy. In acute prostatitis, severe symptoms of infection 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, mycoplasma and fungi are also to blame. Chronic prostatitis often occurs as a complication of chronic cystitis.
The cause of chronic nonbacterial prostatitis is unclear. Symptoms are similar for 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 when urinating
- Pain in the testicles and groin area
- Erectile dysfunction
- Dyspareunia (painful intercourse)
- Premature or even painful ejaculation
- Frequent urination at night
- Psychological complaints
Asymptomatic inflammatory prostatitis
This type of prostatitis is called asymptomatic because it has no clinical manifestations. The diagnosis is usually made by chance, for example during a prostate biopsy for another reason that has nothing to do with 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. To determine the cause and determine the type of prostatitis, a urine culture is required. At the appointment, the doctor will decide whether more specialized screening tests such as bladder ultrasound, prostate, cystoscopy or MRI are necessary.
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 made based on the patient's medical history and clinical examination. A urine test may not identify the bacteria that cause this particular type of prostatitis. Sometimes you need to take a urine test several times or take a urine test after a prostate massage.
Chronic nonbacterial prostatitis – chronic abdominal pain
The diagnosis of chronic nonbacterial prostatitis is made after exclusion of other forms of prostatitis and when 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 detected by laboratory tests, as blood and ultrasound appear normal and a urologist needs 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 form of prostatitis. Treatment lasts 3 to 8 weeks to minimize the risk of relapse. At the same time, the causes of chronic urinary tract infections are clarified. Such diseases include urolithiasis, benign prostatic hyperplasia with residual urine, and various bladder nerve diseases. The urologist will advise you on how to cure these diseases or prevent urinary tract infections.
For chronic nonbacterial prostatitis (synonym: chronic abdominal pain)
As long as the cause is not known, there is no uniform treatment for all cases. The disease often progresses with phases of exacerbation and remission, with the triggering factors being different for each patient. Therapy is usually long-term and involves a change in the patient's lifestyle.
This complex disease requires the experience of a doctor who must individualize and adapt treatment methods depending on the situation. Typically, treatments are 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, and antipsychotics in patients with chronicPains. Sometimes it is also necessary to work with a psychiatrist.
What is the prognosis of prostatitis?
Acute bacterial prostatitis is completely curable by taking antibiotics for 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 poses a problem for both the patient and the doctor. Symptoms usually do not disappear completely; Exacerbations and remissions occur. The aim of treatment is to improve the patient's quality of life. Asymptomatic inflammatory prostatitis is not clinically significant and does not require treatment.