Prostatitis

Prostatitis is swelling and inflammation of the prostate gland.

 Types–

  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Chronic prostatitis without infection
  • Asymptomatic inflammatory prostatitis

Causes—

Acute bacterial prostatitis

  • Ascending infection through the urethra
  • Direct extension /lymphatic spread from the rectum
  • Indwelling urethral catheters
  • Refluxing urine into prostate ducts

Chronic bacterial prostatitis

  • Primary voiding dysfunction
  1. primary vesical neck obstruction
  2. pseudodyssynergia
  3. impaired detrusor contractility
  4. acontractile detrusor muscle
  • E coli (most common), M tuberculosis, Coccidioides, Histoplasma, and Candida species
  • Human immunodeficiency virus (HIV)
  • Cytomegalovirus
  • Inflammatory conditions (sarcoidosis)

Chronic prostatitis without infection( chronic pelvic pain syndrome)

  • Ejaculatory duct obstruction
  • Increased pelvic side wall tension
  • Immune system disorders
  • Nervous system dysfunctioning
  • Infection with a virus or bacteria

Asymptomatic inflammatory prostatitis

Causes are similar to those of chronic inflammatory Prostatitis but without any symptoms.

Symptoms And Signs–

Acute Bacterial  Prostatitis  

  • Arthralgias
  • Chills
  • Fever
  • Malaise
  • Myalgias
  • Perineal prostatic pain
  • Obstructive urinary tract symptoms
    1. Dysuria
    2. Frequency
    3. Hesitancy
    4. Incomplete voiding
    5. Nocturia
    6. Urgency
    7. Weak Stream
  • Low back pain
  • Spontaneous urethral discharge
  • Gland feels tender, nodular, hot, boggy or normal
  • Suprapubic abdominal tenderness
  • Enlarged tender bladder due to urinary retention
  • History of sclerotherapy for rectal prolapse

Chronic Bacterial  Prostatitis 

  • Gland feels tender, nodular, or normal
  • Intermittent obstructive urinary tract symptoms
  • Recurrent urinary tract infections
  • Suprapubic tenderness during acute episodes

Chronic Prostatitis and Chronic Pelvic Pain Syndrome

  • Pelvic pain or discomfort( perineal, suprapubic, coccygeal, rectal, urethral, and testicular/scrotal pain)
  • Obstructive urinary tract symptoms 
  • Ejaculatory pain
  • Erectile dysfunction
  • Mildly tender or normal prostate
  • Tight anal sphincter

Asymptomatic inflammatory prostatitis

Normal or calcified prostate.

Investigations—

  • Urinalysis
  • Ultrasound
  • X-ray
  • Computerized tomography (CT)

Treatment—-

Acute bacterial prostatitis

  • Drink plenty of fluids
  • Ayurvedic Medicines
  • Rest

Chronic bacterial prostatitis

Long-term medicines

Chronic prostatitis without infection

  • Physical therapy
  • Relaxation techniques
  • Medicines

Asymptomatic inflammatory prostatitis

Ayurvedic Medicines

Complications

  • Bladder outlet obstruction/urinary retention
  • Abscess
  • Infertility
  • Recurrent cystitis
  • Pyelonephritis
  • Renal damage
  • Sepsis

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