It is an inflammation of the prostate gland that causes a series of symptoms characterized by micturition, sexual and perineal disorders to a greater or lesser extent, depending on the cause, whether it is infectious or not.
Prostatitis is usually caused by a bacterial infection of the prostate gland. Any bacteria that can cause a urinary infection can cause acute bacterial prostatitis.
Some sexually transmitted diseases can cause bacterial prostatitis.
Acute prostatitis should be completely relieved with medication and minor changes to your diet and behavior.
Acute prostatitis can come back or turn into chronic prostatitis.
What are the symptoms of prostatitis?
The different infectious or inflammatory processes in the urethro-prostate-seminal area present with similar symptoms.
The most frequent urinary disturbances are: dysuria (difficulty urinating), frequency and urgency or urination imperiousness, both day and night, painful urination and even acute urinary retention.
On other occasions, sexual symptoms predominate: decreased desire, total or partial loss of erection, painful ejaculation, sometimes premature, hemospermia (blood with semen) and infertility. The most common, along with voiding disorders, is the presence of perineal pain that can radiate to the pubis, lumbosacral region, scrotum, penis, and inner thighs.
Of all the clinical signs mentioned, none of them is specific to a specific type of prostate condition, except for the acute form of prostate infection in which the symptoms present very well-defined characteristics: fever, poor general condition, dysuria, spontaneous perineal pain or pain with urination, and sometimes acute urinary retention.
What are the causes of prostatitis?
There are various theories about the causes that originate the symptoms of prostatitis
1. Obstructive Theory: Caused by a narrowing of the urethra and the neck or wall of the bladder.
2. Theory of intraductal flow: caused because part of the urine leaks into the prostate gland.
3. Autoimmune theory: caused by a reaction of the immune system caused by the bacteria themselves or urine.
4. Venous theory: caused by impaired venous return, eg. for hemorrhoids or varicocele.
5. Infectious theory: caused by germs entering the prostate through the urethra. It could also occur through the blood.
Who can suffer from it?
In men over the age of 35, E. coli and other common bacteria typically cause prostatitis.
Men age 50 and older who have an enlarged prostate (benign prostatic hyperplasia) are at increased risk of prostatitis.
How is prostatitis diagnosed?
The diagnosis of prostatitis will be made based on the clinical history, examination, fractional urine culture, semen culture, ultrasound, blood test (elevated PSA in acute prostatitis) and prostate biopsy in some cases of chronic prostatitis.
How is prostatitis treated?
Treatment of prostatitis
In acute prostatitis bactericidal antibiotics suitable for gram negative bacteria, administered parenterally.
In chronic prostatitis, antibiotics that penetrate well into the prostate tissue (liposoluble). They diffuse adequately to the prostatic fluid: tobramycin, netilmicin, trimethoprim, doxycycline, ciprofloxacin, fosfomycin and ceftriaxone among others. Treatment guidelines from 6 to 12 weeks.
Other adjuvant treatments: phytotherapy, alpha-blockers, muscle relaxants, 5-alpha-reductase inhibitors, anti-inflammatories, changes in lifestyle.