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| Micrograph showing an inflamed prostate gland, the histologic correlate of prostatitis. A normal non-inflamed prostatic gland is seen on the left of the image (source: wikipedia) |
Introduction
Prostatitis is a general term used to describe inflammation (-itis) of prostate. Because the term is so common, it does not adequately describe the range of abnormalities that may be associated with inflammation of the prostate. Therefore, four types of prostatitis recognized.
Types and Sympthomatic
There are four types of prostatitis:
- Acute bacterial prostatitis (acute bacterial prostatitis)
- Chronic bacterial prostatitis (chronic bacterial prostatitis)
- Chronic prostatitis without infection (chronic prostatitis without infection)
- Asymptomatic inflammatory prostatitis (asymptomatic inflammatory prostatitis)
Acute bacterial prostatitis is an infection of the prostate that is often caused by some of the same bacteria that cause infections of the bladder. These include E. coli, Klebsiella, and Proteus. While it may be acquired as a sexually transmitted disease, infection can also spread to the prostate through the bloodstream, directly from the adjacent organ, or as a complication of prostate biopsy.
Patients with acute bacterial prostatitis present with signs of infection and may have fever, palpitation, and shocks. Usually there is urgency and frequency of urinating and dysuria (painful or difficult urination).
The causes and Symptoms of Chronic Bacterial Prostatitis
Chronic bacterial prostatitis is an uncommon disease in which there is an ongoing bacterial infection in the prostate. Chronic bacterial prostatitis generally causes no symptoms, however, sometimes; low-grade infection may occur and related to a bladder infection.
The causes and Symptoms of Chronic Prostatitis Without Infection
Chronic prostatitis without infection, also known as chronic pelvic pain syndrome, is a condition where there is recurrence of pelvic pain, testicles, or rectal administration without evidence of bladder infections. There may be difficulties with ejaculation or kencng painful, and erectile dysfunction. The cause of chronic prostatitis without infection is not clearly understood.
The causes and Symptoms of Asymptomatic inflammatory prostatitis
Asymptomatic inflammatory prostatitis is exactly as described by its name. There are no symptoms. The cause of asymptomatic inflammatory prostatitis is not clearly understood.
Diagnosis
The diagnosis of prostatitis is made on history and physical examination by a physician carefully. The most important laboratory test is a urinalysis to help distinguish the types of prostatitis. The need for other blood tests or imaging studies (imaging studies) such as ultrasound, X-ray, and computerized tomography (CT) will depend on the circumstances and clinical presentation.
Diagnosis of Acute bacterial prostatitis
After taking a medical record, the doctor will likely have a directed physical examination that concentrates on the scrotum, looking for inflammation of the testicle (s) or epididymis, and the sides and back center, where the kidneys are located. If the rectal examination is performed, the prostate may be swollen and muddy, consistent with acute inflammation.
The laboratory tests may include urinalysis, looking for white blood cells and bacteria, which indicates infection. Urine may also be cultured to identify the bacteria responsible for infection, but results will take seven days to be returned. The results will help confirm that the antibiotic chosen is correct and it may help to choose a replacement of antibiotics if the illness progress.
Diagnosis of Chronic bacterial prostatitis
Diagnosis is made by finding an abnormal urinalysis. Occasionally, urinalysis collected after the examination of the prostate. This may allow some of the prostatic fluid to be expressed into the urine and cultured. A blood test called PSA (prostate surface antigen) may be elevated in this type of prostatitis. While PSA is used as a prostate cancer screening tool, it can also be elevated whenever the prostate is inflamed.
Diagnosis of Chronic prostatitis without infection
To make a diagnosis of chronic prostatitis without infection, the symptoms must be present for at least three months. The cause of chronic prostatitis without infection (chronic pelvic pain syndrome) is unknown. This is a frustrating condition of patients and physicians because there is controversy on the aggressiveness of the test, and exactly what tests should be done. Often, this is a diagnosis of penyampingan, which means that the blood tests, urine tests, x-rays and ultrasounds tend to be normal, but the patient continues to suffer.
Diagnosis of Asymptomatic inflammatory prostatitis
There are no symptoms with this type of prostatitis, however, when routine lab tests performed, white blood cells (sign of inflammation) was found in the urine, but no bacteria or infection-related.
Treatment
Acute bacterial prostatitis treatment
Treatment for acute bacterial prostatitis is a prescription oral antibiotics, usually ciprofloxacin (Cipro) or tetracycline (Achromycin). Nursing homes include drinking lots of fluids, pain control medications, and rest. If the patient is acutely ill or have an low immune system (for example, are taking chemotherapy or immune-suppressing drugs or have HIV / AIDS), hospitalization for intravenous antibiotics and treatments may be needed.
Chronic bacterial prostatitis treatment
Treatment of chronic bacterial prostatitis is a long-term antibiotics, up to eight weeks, with ciprofloxacin (Cipro, Cipro XR), sulfa drugs [for example, sulfamethoxazole and trimethoprim (Bactrim)], or erythromycin. Even with appropriate therapy, this type of prostatitis may recur. It is uncertain why, but it may be due to poor bladder emptying. A small amount of urine that stagnant allow the potential for recurrence of infection. This situation can be caused by benign prostatic hypertrophy (BPH), bladder stones, prostate stones ata.
Chronic prostatitis without infection treatment
Treatment of chronic prostatitis without infection leads to chronic pain control and may include physical therapy and relaxation techniques (relaxation) and the tricyclic antidepressant drugs. Other treatment possibilities include alpha-adrenergic blockers. Tamsulosin (Flomax) and terazosin (Hytrin) are drugs that block adrenaline receptors are not the heart and is used in treating BPH and bladder outlet hurdles. Allow bladder emptying better may help minimize symptoms.
Asymptomatic inflammatory prostatitis treatment
Treatment is not required for this type of prostatitis.In patients who undergo infertility assessment, this inflammation may be treated with a trip of nonsteroidal anti-inflammatory drugs (ibuprofen, Motrin, Advil) or antibiotics.
Prognosis of Prostatitis
- Acute bacterial prostatitis can be cured by a short treatment of antibiotics.
- Chronic bacterial prostatitis is often recur even with appropriate therapy. Fortunately, the disease tends to asymptomatic.
- Chronic pelvic pain syndrome will be challenging for patients and physicians. The symptoms tend to remain alive and difficult to control.
- Asymptomatic inflammatory prostatitis is clinically insignificant and require no treatment.
