Asymptomatic inflammatory prostatitis

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Asymptomatic inflammatory prostatitis
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Specialty Urology

Asymptomatic inflammatory prostatitis is a painless inflammation of the prostate gland where there is no evidence of infection. [1] It should be distinguished from the other categories of prostatitis characterised by either pelvic pain or evidence of infection, such as chronic bacterial prostatitis, acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS). [2] It is a common finding in men with benign prostatic hyperplasia. [3]

Contents

Signs and symptoms

These patients have no history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions.[ citation needed ]

Diagnosis

Diagnosis is through tests of semen, expressed prostatic secretion (EPS) or prostate tissue that reveal inflammation in the absence of symptoms. [4]

Treatment

No treatment required. It is standard practice for men with infertility and category IV prostatitis to be given a trial of antibiotics and/or anti-inflammatories, although evidence of efficacy are weak. [5] Since signs of asymptomatic prostatic inflammation may sometimes be associated with prostate cancer, this can be addressed by tests that assess the ratio of free-to-total PSA. The results of these tests were significantly different in prostate cancer and category IV prostatitis in one study. [6]

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Related Research Articles

Urinary tract infection A type of infection

A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney infection (pyelonephritis). Symptoms from a lower urinary tract infection include pain with urination, frequent urination, and feeling the need to urinate despite having an empty bladder. Symptoms of a kidney infection include fever and flank pain usually in addition to the symptoms of a lower UTI. Rarely the urine may appear bloody. In the very old and the very young, symptoms may be vague or non-specific.

Prostatitis Medical condition

Prostatitis is inflammation of the prostate gland. Prostatitis is classified into acute, chronic, asymptomatic inflammatory prostatitis, and chronic pelvic pain syndrome.

Prostate Gland of the male reproductive system in most mammals

The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder, with the urethra passing through it. It is described in gross anatomy as consisting of lobes, and in microanatomy by zone. It is surrounded by an elastic, fibromuscular capsule and contains glandular tissue as well as connective tissue.

Benign prostatic hyperplasia Noncancerous increase in size of the prostate gland

Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems.

Prostate massage Massage of the prostate gland via the rectum or perineum

Prostate massage is the massage or stimulation of the male prostate gland for medical purposes or sexual stimulation.

Rectal examination medical assessment or diagnostic procedure

Digital rectal examination is an internal examination of the rectum, performed by a healthcare provider.

Dysuria refers to painful or difficult urination.

Urinary retention Inability to completely empty the bladder

Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of urinary tract infections.

Urethral syndrome is characterised by a set of symptoms typically associated with lower urinary tract infection, such as painful urination (dysuria) and frequency. It is a diagnosis of exclusion, made when there is no significant presence of bacteriuria with a conventional pathogen ruling out urinary tract infection, and when cystoscopy shows no inflammation of the bladder, ruling out interstitial cystitis and cystitis cystica. In women, vaginitis should also be ruled out.

Hematospermia Presence of blood in ejaculation

Hematospermia is the presence of blood in ejaculation. It is most often a benign symptom. Among men age 40 or older, hematospermia is a slight predictor of cancer, typically prostate cancer. No specific cause is found in up to 70% of cases.

Pelvic pain Medical condition

Pelvic pain is pain in the area of the pelvis. Acute pain is more common than chronic pain. If the pain lasts for more than six months, it is deemed to be chronic pelvic pain. It can affect both the male and female pelvis.

Acute prostatitis Serious bacterial infection of the prostate gland

Acute prostatitis is a serious bacterial infection of the prostate gland. This infection is a medical emergency. It should be distinguished from other forms of prostatitis such as chronic bacterial prostatitis and chronic pelvic pain syndrome (CPPS).

Mepartricin

Mepartricin is a macrolide polyene compound that is useful for urethra, prostate, and bladder function. It has been studied for use in treating chronic pelvic pain syndrome and benign prostatic hyperplasia.

Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and, in men, the prostate. Although LUTS is a preferred term for prostatism, and is more commonly applied to men, lower urinary tract symptoms also affect women.

Chronic bacterial prostatitis Bacterial infection of the prostate gland

Chronic bacterial prostatitis is a bacterial infection of the prostate gland. It should be distinguished from other forms of prostatitis such as acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS).

Chronic prostatitis/chronic pelvic pain syndrome Medical condition

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), previously known as chronic nonbacterial prostatitis, is long-term pelvic pain and lower urinary tract symptoms (LUTS) without evidence of a bacterial infection. It affects about 2–6% of men. Together with IC/BPS, it makes up urologic chronic pelvic pain syndrome (UCPPS).

Urologic diseases or conditions include urinary tract infections, kidney stones, bladder control problems, and prostate problems, among others. Some urologic conditions do not affect a person for that long and some are lifetime conditions. Kidney diseases are normally investigated and treated by nephrologists, while the specialty of urology deals with problems in the other organs. Gynecologists may deal with problems of incontinence in women.

Urologic chronic pelvic pain syndrome (UCPPS) is an umbrella term adopted for use in research into urologic pain syndromes associated with the male and female pelvis. UCPPS specifically refers to chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men and interstitial cystitis or painful bladder syndrome (IC/PBS) in women.

References

  1. "Prostatitis: Benign Prostate Disease: Merck Manual Professional". Archived from the original on 28 April 2010. Retrieved 2010-04-17.
  2. Holt JD; et al. (2016). "Common Questions About Chronic Prostatitis". Am Fam Physician. 93 (4): 290–6. PMID   26926816.
  3. Nickel JC; Downey J; Young I; Boag S. (Dec 1999). "Asymptomatic inflammation and/or infection in benign prostatic hyperplasia". BJU International . 84 (9): 976–81. doi:10.1046/j.1464-410x.1999.00352.x. PMID   10571623.
  4. Clemens JQ, Meenan RT, O'Keeffe Rosetti MC, Gao SY, Calhoun EA (2005). "Incidence and clinical characteristics of National Institutes of Health type III prostatitis in the community". J. Urol. 174 (6): 2319–22. doi:10.1097/01.ju.0000182152.28519.e7. PMID   16280832.
  5. Weidner W, Krause W, Ludwig M (1999). "Relevance of male accessory gland infection for subsequent fertility with special focus on prostatitis". Hum. Reprod. Update. 5 (5): 421–32. doi: 10.1093/humupd/5.5.421 . PMID   10582781. Several inflammatory and reactive alterations of sperm quality seem to be proven; nevertheless, the impact of these findings on male fertility remains in many cases unclear."
  6. Stancik I, Lüftenegger W, Klimpfinger M, Müller MM, Hoeltl W (2004). "Effect of NIH-IV prostatitis on free and free-to-total PSA". Eur. Urol. 46 (6): 760–4. doi:10.1016/j.eururo.2004.08.003. PMID   15548444.
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