Chronic – Acute Prostatitis
Chronic prostatitis is caused by a variety of germs or may be due to an incorrect or incomplete treatment of acute prostatitis.
Introduction
Chronic prostatitis is an inflammation of the prostate gland. It is usually a urinary tract infection and in particular a genital infection found in the prostate.
In these cases, the cause is a germ or urinary tract or a sexually transmitted disease. In many cases, however, chronic prostatitis is a non-microbial inflammation. It is a remnant of an older microbial infection that remained as a lesion and damage to the prostate tissue even though the germs were fought or is initially a tissue inflammation due to various reasons (immune etc.) but without the involvement of germs.
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Cause
Chronic prostatitis is caused by a variety of germs or may be due to incorrect or incomplete treatment of acute prostatitis. The germs end up in the prostate because the infected urine regresses from the pressure coming from urethra’s narrowing.
Diagnosis
In order for the doctor to diagnose chronic prostatitis and proceed with examinations, the patient must have symptoms for 3 months. The disease may be bacterial or non-bacterial.
For bacterial prostatitis, diagnosis is made via rectal examination and urine tests (of 4 urine samples according to Meares and Stamey) and/or a urine culture that accurately identifies the germ after an antibiogram.
Symptoms of Chronic Prostatitis
A man suffering from chronic prostatitis may have no symptoms at all, he may have few and minor symptoms or many and painful symptoms that affect his quality of life causing problems in urination, erection or even fertility problems.
These symptoms may vary: frequent urination, strong urge to urinate but often with disproportionately small amount of urine, pain in the penis glans, burning along the urethra, pain in the perineum, heaviness or indefinite testicular pain, blood in the urine, blood in the sperm, erectile dysfunction or disturbances in the quality and fertility of the sperm.
Men often have a diffuse indefinite discomfort in the lower abdomen, at the base of the penis or even behind it in the perineum or even inside the thighs without being able to pinpoint exactly what is bothering them. Chronic prostatitis is often associated with chronic pelvic pain syndrome which is a series of symptoms like those described above.
Treatment of Chronic-Acute Prostatitis
Chronic prostatitis treatment is quite complex. It can be just a prolonged treatment of the germs involved and if the prostate is not significantly affected, healing is successful. Cases of non-microbial chronic prostatitis are a more specific case. In this case, treatment is needed to suppress the annoying symptoms but also to repair the tissue damage caused by the inflammation. Antibiotics have been used in this case as well, but mainly anti-inflammatory medication, painkillers, a-blockers are used, while there are more modern treatments using even PDE-5is or phytoestrogens or combinations of all the above.
Particular emphasis should be given on both the involvement of the mental state and the overall condition of the body in chronic prostatitis. The symptoms of prostatitis can occur in stressful situations but prostatitis itself causes upset and discomfort to a man by worsening the symptoms. More often in the past and less often nowadays, mild anxiolytics were used in order to break this vicious circle.
Often, a man’s andrological problems such as erection or fertility disorders can be due to an inflammation of the prostate.
Prostate Cancer & Prostatitis
A common concern of men with chronic prostatitis is whether they have prostate cancer. Symptoms like those caused by prostatitis are not common in prostate cancer. The differential diagnosis of prostate cancer and chronic prostatitis are relatively easy and so the fear of these patients may and can be ruled out by appropriate examinations.
Another fear of men is that their prostatitis may develop into prostate cancer. We should highlight the fact that prostatitis is not a precancerous condition nor does it develop into prostate cancer. Although there are studies showing an increased association between prostate cancer and chronic prostatitis, the causes are not clear and the studies express concerns about the outcome. A man suffering from chronic prostatitis should, like any other man interested in preventing the health of his prostate, regularly monitor PSA and perform an ultrasound and rectal examination of the prostate. No other specific treatment is currently recommended.
Andrological Problems
Often, a man’s andrological problems such as erection or fertility disorders can be due to an inflammation of the prostate. The tissue of the penis and prostate, although having a different histological structure, have some common features and so prostate diseases may eventually reflect on the penis’ function. Often, this cause goes beyond diagnosis and there are men who suffer from long-term and expensive treatments for their erectile dysfunction while the problem is not in the penis but in their prostate. Similarly, due to the fact that prostatic secretions are necessary for the proper fertilization function of the sperm, chronic prostatitis changes the characteristics of prostatic secretions, which affects spermozoons and their fertility ability.
Complications
The complications that may occur to the patient due to chronic prostatitis are mainly two. Firstly infertility due to reduced sperm mobility and secondly due to various urinary tract infections.
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