Prostatitis

Prostatitis: Types, Symptoms, Diagnosis and Treatment of Prostatitis

Prostatitis is the general term used to describe prostate inflammation . Because the term is so general, it does not adequately describe the range of abnormalities that can be associated with prostate inflammation. Therefore, four types of prostatitis are recognized.

Prostatitis often causes painful or difficult urination. Other symptoms of prostatitis include pain in the groin, pelvic area or genitals, and sometimes, flu-like symptoms.

What are the types and symptoms of prostatitis?

Types of prostatitis include:

Acute bacterial prostatitis. This may be caused by a bacterial infection marked by inflammation of the prostate. This is the least common form of prostatitis but the symptoms are usually severe. Patients with this conditions have an acute urinary tract infection with increased urinary frequency and urgency, need to urinate a lot at night, and have pain in the pelvis and genital area. They often have fever, chills, nausea, vomiting, and burning when urinating.
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Chronic bacterial prostatitis. This is the result of recurrent urinary tract infections that have entered the prostate gland. It is thought to exist for several years in some men before producing symptoms. The symptoms are similar to acute bacterial prostatitis, but are less severe and can fluctuate in intensity. The diagnosis of this condition is often challenging.
· Chronic prostatitis/chronic pelvic pain syndrome. This is the most common but least understood form of prostatitis. It may be found in men of any age. Its symptoms go away and then return without warning, and it may be inflammatory or noninflammatory. In the inflammatory form, urine, semen, and prostatic fluid contain the kinds of cells the body usually produces to fight infection, but no bacteria can be found. In the noninflammatory form, not even the infection-fighting cells are present.

· Asymptomatic inflammatory prostatitis is the diagnosis given when the patient does not complain of pain or discomfort but has infection-fighting cells in his prostate fluid and semen. Doctors usually find this form of prostatitis when looking for causes of infertility or testing for prostate cancer.

Diagnosis of prostatitis
A doctor performs a digital rectal exam (DRE) by inserting a gloved and lubricated finger into the patient’s rectum, just behind the prostate. The doctor can feel the prostate to see if it is swollen or tender in spots.

The doctor can perform tests and diagnosis of the bacterial forms of prostatitis by examining a urine sample with a microscope. The sample may also be sent to a laboratory to perform a culture. In a urine culture, the bacteria are allowed to grow so they can be identified and tested for their resistance to different types of antimicrobials.

To confirm the prostate infection, the doctor may obtain two urine samples—before and after prostate massage. To perform a prostate massage, the doctor will insert a gloved and lubricated finger into the rectum, as in a DRE, and stroke the prostate to release fluids from the gland. The post-massage urine sample will contain prostate fluid. If that second urine sample contains bacteria or infection-fighting cells that were not present in the premassage urine sample, this suggests the prostate contains infection.

Treatment of prostatitis
The bacterial forms of prostatitis are treated with antibiotics like antimicrobials. The Acute prostatitis treatment may require a short hospital stay so that fluids and antimicrobials can be given through an intravenous, or IV, tube. After the initial therapy, the patient will need to take antimicrobials for 2 to 4 weeks.

Chronic bacterial prostatitis requires a longer course of therapy. The doctor may prescribe a low dose of antimicrobials for 6 months to prevent recurrent infection. If a patient has trouble emptying his bladder, the doctor may recommend medicine or surgery to correct blockage.

Antimicrobials will not help nonbacterial prostatitis. Each patient will have to work with his doctor to find an effective treatment. Changing diet or taking warm baths may help. The medical expert may prescribe a medicine called an alpha blocker to relax the muscle tissue in the prostate. No single solution works for everyone with this condition.

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