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Prostatitis is an acute or chronic inflammatory disease of the prostate.
While acute is always the result of an infection, in most chronic prostatitis the bacteria are not found in the urine, semen or prostatic excretion culture. The symptoms of acute prostatitis are mostly related to bladder irritation (frequent and urgent urination) or bladder obstruction (painful urination and weak urine flow) as well as general symptoms like malaise and fever.
Differently, the prevalent symptom of chronic prostatitis is a pain in the genital area.
The antibiotic treatment of acute prostatitis must be immediate and aggressive to cure and eradicate the infection because of the risk of serious generalized infection.
Inadequate or delayed treatment can lead to chronic disease. Then, the treatment will be more complicated and often partially effective.
What are the causes and symptoms of prostatitis? What about the possible complications and when is mandatory to see a doctor? What is the possible treatment?
Let’s go into more detail.
The symptoms onset can be gradual and progressive (in days) or sudden (in hours):
- Painful urination (dysuria);
- Frequent urination (frequency);
- Weak urine flow;
- A poorly localized pain in the genital area (lower abdomen, groin, testicles);
- General discomfort, malaise and fever.
In chronic prostatitis, the symptoms are less heavy than in acute. However, the predominant discomfort is pain at various locations. These include the perineum, scrotum, penis and inner part of the leg other than lower urinary tract symptoms like painful and frequent urination.
Prostatitis is always a complication of infection of the near parts of the lower urinary tract (urethra or bladder). The condition occurs when bacteria are infecting the urine leak into the prostate. The prostatitis is more likely to happen in the following situations:
- Previous prostatitis;
- pelvic trauma, such as an injury from bicycling or horseback riding;
- urinary catheter;
- after prostate biopsy
- immune system down (HIV/AIDS).
Complications can include:
- The bacterial infection spreads into the blood (septicemia);
- Epididymitis (the epididymis is directly connected with the prostate);
- prostatic abscess;
- Semen abnormalities and infertility.
The diagnostic workup includes urine analysis and culture. In most acute infections, the urine analysis shows evident inflammatory changes (pus cells). The culture is informative in most cases.
Different is chronic prostatitis, especially if non-bacterial. Urine analysis is mostly regular as well as the culture. The rectal examination may help to suspect chronic prostatitis. To diagnose chronic disease, it is often necessary to examine the culture test on the semen, or the expressed prostatic secretion after prostate massage. US scan suprapubic or transrectal is not determinant for the diagnosis but can help.
Symptoms questionnaires are helpful in the diagnosis and classifying chronic prostatitis. These are an essential diagnostic step that allows setting correct and multiple treatments.
Antibiotics for at least 14 days is the standard treatment. According to the clinical picture, we can prolong the treatment until the 4th week.