Prostatitis

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Prostatitis
Other namesProstatosis
Inflammation of prostate.jpg
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. H&E stain.
Specialty Urology

Prostatitis is an umbrella term for a variety of medical conditions that incorporate bacterial and non-bacterial origin illnesses in the pelvic region. In contrast with the plain meaning of the word (which means "inflammation of the prostate"), the diagnosis may not always include inflammation. Prostatitis is classified into acute, chronic, asymptomatic inflammatory prostatitis, and chronic pelvic pain syndrome.

Contents

In the United States, prostatitis is diagnosed in 8% of all male urologist visits and 1% of all primary care physician visits for male genitourinary symptoms. [1]

Classification

The term prostatitis refers to inflammation of the tissue of the prostate gland. It may occur as an appropriate physiological response to an infection, or it may occur in the absence of infection. [2]

In 1999, the National Institutes of Health devised a new classification system. [3] [4] For more specifics about each type of prostatitis, including information on symptoms, treatment, and prognosis, follow the links to the relevant full articles.

CategoryCurrent nameOld namePainBacteria WBCs Description
I Acute prostatitis Acute bacterial prostatitisYesYesYesBacterial infection of the prostate gland that requires urgent medical treatment.
II Chronic bacterial prostatitis Chronic bacterial prostatitis±YesYesA relatively rare condition that usually presents as intermittent urinary tract infections.
IIIa Inflammatory CP/CPPS Nonbacterial prostatitis YesNoYesAccounts for 90–95% of prostatitis diagnoses, [5] formerly known as chronic nonbacterial prostatitis'.
IIIb Noninflammatory CP/CPPS Prostatodynia YesNoNo
IV Asymptomatic inflammatory prostatitis (none)NoNoYesNo history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions. Between 6 and 19% of men have pus cells in their semen but no symptoms. [6]

In 1968, Meares and Stamey determined a classification technique based upon the culturing of bacteria. [7] This classification is no longer used.

The conditions are distinguished by the different presentation of pain, white blood cells (WBCs) in the urine, duration of symptoms and bacteria cultured from the urine. To help express prostatic secretions that may contain WBCs and bacteria, prostate massage is sometimes used. [8]

See also

Related Research Articles

<span class="mw-page-title-main">Interstitial cystitis</span> Medical condition

Interstitial cystitis (IC), a type of bladder pain syndrome (BPS), is chronic pain in the bladder and pelvic floor of unknown cause. It is the urologic chronic pelvic pain syndrome of women. Symptoms include feeling the need to urinate right away, needing to urinate often, and pain with sex. IC/BPS is associated with depression and lower quality of life. Many of those affected also have irritable bowel syndrome and fibromyalgia.

<span class="mw-page-title-main">Urinary tract infection</span> Infection that affects part of the urinary tract

A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyelonephritis). Symptoms from a lower urinary tract infection include suprapubic pain, painful urination (dysuria), frequency and urgency of urination despite having an empty bladder. Symptoms of a kidney infection, on the other hand, are more systemic and include fever or flank pain usually in addition to the symptoms of a lower UTI. Rarely, the urine may appear bloody. Symptoms may be vague or non-specific at the extremities of age.

<span class="mw-page-title-main">Prostate</span> Gland of the male reproductive system

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 in all male 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.

<span class="mw-page-title-main">Prostate massage</span> 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.

<span class="mw-page-title-main">Epididymitis</span> Inflammation of the epididymis, part of the testicle

Epididymitis is a medical condition characterized by inflammation of the epididymis, a curved structure at the back of the testicle. Onset of pain is typically over a day or two. The pain may improve with raising the testicle. Other symptoms may include swelling of the testicle, burning with urination, or frequent urination. Inflammation of the testicle is commonly also present.

<span class="mw-page-title-main">Nitrofurantoin</span> Antibacterial drug

Nitrofurantoin, sold under the brand name Macrobid among others, is an antibacterial medication of the nitrofuran class used to treat urinary tract infections (UTIs), although it is not as effective for kidney infections. It is taken by mouth.

<span class="mw-page-title-main">Urinary retention</span> 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.

<span class="mw-page-title-main">Mycoplasmataceae</span> Family of bacteria

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Urethral syndrome is defined as symptoms suggestive of a lower urinary tract infection but in the absence of significant bacteriuria with a conventional pathogen. It is a diagnosis of exclusion in patients with dysuria and frequency without demonstrable infection. In women, vaginitis should also be ruled out.

Prostatic congestion is a medical condition of the prostate gland that happens when the prostate becomes swollen by excess fluid and can be caused by prostatosis. The condition often results in a person with prostatic congestion feeling the urge to urinate frequently. Prostatic congestion has been associated with prostate disease, which can progress due to age. Oftentimes, the prostate will grow in size which can lead to further problems, such as prostatitis, enlarged prostate, or prostate cancer.

<span class="mw-page-title-main">Acute prostatitis</span> 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).

<span class="mw-page-title-main">Mepartricin</span> Chemical compound

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.

Odynorgasmia, or painful ejaculation, also referred to as dysejaculation, dysorgasmia, and orgasmalgia, is a physical syndrome described by pain or burning sensation of the urethra or perineum during or following ejaculation. Causes include: infections associated with urethritis, prostatitis, epididymitis; use of anti-depressants; cancer of the prostate or of other related structures; calculi or cysts obstructing related structures; trauma to the region.

<span class="mw-page-title-main">Bacteriuria</span> Presence of bacteria in urine

Bacteriuria is the presence of bacteria in urine. Bacteriuria accompanied by symptoms is a urinary tract infection while that without is known as asymptomatic bacteriuria. Diagnosis is by urinalysis or urine culture. Escherichia coli is the most common bacterium found. People without symptoms should generally not be tested for the condition. Differential diagnosis include contamination.

<span class="mw-page-title-main">Chronic bacterial prostatitis</span> Bacterial infection of the prostate gland

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

<span class="mw-page-title-main">Chronic prostatitis/chronic pelvic pain syndrome</span> 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).

<span class="mw-page-title-main">Asymptomatic inflammatory prostatitis</span> Medical condition

Asymptomatic inflammatory prostatitis is a painless inflammation of the prostate gland where there is no evidence of infection. 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). It is a common finding in men with benign prostatic hyperplasia.

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 ongoing bladder pain in either sex, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men and interstitial cystitis or painful bladder syndrome (IC/PBS) in women.

<span class="mw-page-title-main">Prostatic calculi</span> Medical condition

Prostatic calculi (PC), prostatic stones, prostatic calcification or prostatic lithiasis, are hyper-echoic mineral deposits in the prostate that are frequently detected incidentally during transabdominal ultrasonography, transrectal ultrasonography, or computed tomography.

References

  1. ↑ Collins MM, Stafford RS, O'Leary MP, Barry MJ (1998). "How common is prostatitis? A national survey of physician visits". J. Urol. 159 (4): 1224–8. doi:10.1016/S0022-5347(01)63564-X. PMID   9507840.
  2. ↑ Kirby, Roger; Carson, Culley C. (January–February 2015). "Editor's Comment on Diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome". Trends in Urology and Men's Health. 6 (1): 17. doi: 10.1002/tre.434 .
  3. ↑ Krieger JN, Nyberg L, Nickel JC (July 1999). "NIH consensus definition and classification of prostatitis". JAMA. 282 (3): 236–7. doi:10.1001/jama.282.3.236. PMID   10422990.
  4. ↑ J. Curtis Nickel (1999). Textbook of prostatitis. Taylor & Francis. pp. 27–. ISBN   978-1-901865-04-2 . Retrieved 18 April 2010.
  5. ↑ Habermacher GM, Chason JT, Schaeffer AJ (2006). "Prostatitis/chronic pelvic pain syndrome". Annu. Rev. Med. 57: 195–206. doi:10.1146/annurev.med.57.011205.135654. PMID   16409145.
  6. ↑ Korrovits P, Ausmees K, Mändar R, Punab M (June 2008). "Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis". Urology. 71 (6): 1010–5. doi:10.1016/j.urology.2007.12.082. PMID   18455767.
  7. ↑ Meares EM, Stamey TA (March 1968). "Bacteriologic localization patterns in bacterial prostatitis and urethritis". Invest Urol. 5 (5): 492–518. PMID   4870505.
  8. ↑ "Prostatitis: Benign Prostate Disease: Merck Manual Professional". Archived from the original on 2011-09-25. Retrieved 2011-07-11.
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