Prostatitis: Symptoms, Diagnosis, Treatment

Prostatitis is a general term used to describe inflammation of the prostate and 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 urinary tract disease in men under the age of 50 and the third most common urinary tract disease 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 prostatitisAcute bacterial prostatitis is an infectious inflammation of the prostate caused by bacteria. The most common bacteria are E. coli, Klebsiella and Proteus. The microorganism can be spread sexually, through blood, urine, lymph fluid, 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 often caused by the same bacteria that cause acute bacterial prostatitis. In rare cases, other microorganisms such as gonococcus, chlamydia, mycoplasma and fungi are also the culprits. Chronic prostatitis is often a complication of chronic bladder infection.The cause of chronic nonbacterial prostatitis is unknown. Symptoms of both types are similar and include:

• Feeling tight or heavy in the perineum (the area between the testicles and anus)
• Frequent urination and urge to have a bowel movement
• The feeling that the bladder is not completely empty
• Difficulty urinating
• burning sensation when urinating
• pain in the testicles and groin area
• erectile dysfunction
• Dyspareunia (painful intercourse)
• Premature ejaculation or even painful ejaculation
• Frequent urination at night
• psychological discomfort

asymptomatic inflammatory prostatitisThis type of prostatitis is called asymptomatic because it has no clinical manifestations. It is often diagnosed incidentally, such as during a prostate biopsy for other reasons unrelated to prostatitis. The cause of this type of prostatitis is not completely understood.

How is prostatitis diagnosed?

Diagnosis is based on the patient's history and thorough clinical examination. A urine culture is necessary to determine the cause and type of prostatitis. At the time of the appointment, the doctor decides whether more specialized screening tests are needed, such as bladder ultrasound, prostate, 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 identify the bacterial strain that is the source of the infection.

chronic bacterial prostatitis

Diagnosis is made based on the patient's history and clinical examination. A urine test may not identify the bacteria that cause this specific type of prostatitis. Sometimes you will need multiple urine tests, or a urine test after prostate massage.

Chronic nonbacterial prostatitis – chronic pelvic pain

Chronic nonbacterial prostatitis is diagnosed when other types of prostatitis are excluded and symptoms persist for more than 3 months. This is a chronic disease that seriously 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 tests appear normal, and the urologist needs a lot of experience to make a diagnosis.

How is prostatitis treated?

The treatment your doctor recommends depends on the type of prostatitis:For acute bacterial prostatitisChoose antibiotics, antipyretic and anti-inflammatory drugs. Increased fluid intake is recommended, often requiring hospitalization for intravenous fluids and antibiotics.For chronic bacterial prostatitisAntibiotic treatment is also appropriate for this type of prostatitis. Treatment lasts 3 to 8 weeks to minimize the risk of recurrence. Meanwhile, the causes of chronic urinary tract infections are being elucidated. These conditions include urolithiasis, benign prostatic hyperplasia with residual urine, and various conditions that affect the nerves in the bladder. Your urologist can advise you on how to treat these conditions or how to prevent urinary tract infections.For chronic nonbacterial prostatitis (synonym - chronic pelvic pain)Until the cause is identified, there is no one way to treat all cases. The disease often has phases of exacerbation and remission, and triggers vary from patient to patient. Treatment is usually long-term and incorporates changes in the patient's lifestyle.This complex disease requires a physician's experience, and treatment must be individualized and adapted to the situation. Treatments are often combined to relieve symptoms and improve quality of life. As with bacterial prostatitis, treatment includes antibiotics, anti-inflammatory drugs, muscle relaxants, drugs to improve urinary flow and regulate urinary frequency (alpha-blockers, anticholinergics), drugs to improve erectile function, natural/Herbal extracts and antipsychotic drugs. Patients with chronic pain. Sometimes it may also be necessary to work with a mental health psychiatrist.

What is the prognosis of prostatitis?

Acute bacterial prostatitis can be completely cured with just a short period of antibiotics (usually 3 weeks). Although relapses are common, chronic bacterial prostatitis responds well to antibiotics, and patients experience resolution of symptoms after antibiotic treatment. Chronic bacterial prostatitis is a problem for both patients and physicians. Symptoms usually do not go away completely; they may worsen or remit. The goal of treatment is to improve the patient's quality of life. Asymptomatic inflammatory prostatitis is clinically unimportant and does not require treatment.