Chronic bacterial prostatitis is an inflammation of the prostate gland with a history of at least 3 months. This disease is most common in young men aged 20-40 years. This is one of the most common diseases of the male reproductive system. Occurs in 5-15% of cases.
- What causes chronic bacterial prostatitis?
The most common cause of chronic bacterial prostatitis is gram-negative bacteria from the Enterobacteriaceae group (Escherichia Colli, Klebsiella spp., Enterobacter spp., Proteus spp.) Escherichia Colli is isolated in approximately 65-80% of cases in studies. Along with them, there are other pathogens: Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma genitalium. There are, etc. specific prostate infections caused by Neisseria gonorrhoeae and Mycobacterium tuberculosis.
- What factors contribute to the disease?
Predisposing factors for infection are:
- urinary tract infections;
- reflux of urine from the urethra into the tubules of the prostate;
- foreign bodies and interventions in the urinary tract;
- acute epididymitis;
- violations and dysfunctions of the lower urinary tract;
- have anal sex.
It is important to know that bacterial prostatitis caused by an infection is not a contagious disease and is not dangerous to others.
A risk factor for the onset of the disease is also disturbances in the local defense mechanisms of the prostate gland, disturbances in the immune system, including autoimmune disorders.
- What are the routes of infection?
Ways of the spread of infection in the prostate gland include:
the urethra and ducts connecting it to the prostate gland;
lymphatic vessels in contact with the wall of the rectum;
bloodstream from other sources of infection in the body.
- How is it diagnosed?
The diagnosis of the disease is established after a thorough medical examination, including palpation of the prostate gland, rectal douching, ultrasound examination of the kidneys, bladder, prostate and seminal vesicles, functional examination of the bladder or uroflowmetry, electromyography of the pelvic organs. floor muscles and laboratory research.
The presence or absence of infection in the urinary tract is determined by microscopic and bacteriological examination of urine. In patients older than 45 years, prostate-specific antigen (PSA) is also examined for the purpose of early diagnosis of prostate cancer. In chronic bacterial prostatitis, it should be negative. Microscopic examination of secretions and urine reveals the presence or absence of an increased number (more than 10 times) of leukocytes. A bacteriological study will show the type of infectious agent and its sensitivity to various antibiotics.
- What is the clinical picture?
The most characteristic symptom of this type of prostatitis is pain or discomfort in the pelvic floor (between the anus and testicles) for about 3 months. Symptoms periodically increase and then subside.
Pain after ejaculation is also a specific symptom that distinguishes prostatitis from benign prostatic hyperplasia. Very rarely, there may be symptoms such as frequent urination with burning and pain, as well as difficulty urinating.
Sexual function is preserved, but some men may experience psychogenic erectile dysfunction (psychological sexual weakness without damage to the body). Discharge from the urethra or discharge from the prostate (otorrhea), especially after a bowel movement, is a less common symptom.
The duration of complaints and physical discomfort lead to mental disorders characterized by depression, restless sleep, and increased irritability.
- What can be mistaken for chronic non-bacterial prostatitis?
Diseases that have similar symptoms: prostatitis, including benign prostatic hyperplasia (prostate adenoma), and prostate cancer.
- What is the treatment?
In the presence of an infectious agent, long-term antibiotic treatment is mandatory. The existing opinion regarding the antibiotic therapy of chronic prostatitis is that the best results can be expected from the use of drugs from the group of fluoroquinolones, tetracyclines, macrolides and trimethoprim/sulfamethoxazole.
Recently, alpha1-blockers have also been used, which affect the pain symptom and improve urination. Treatment with these drugs should continue for at least 3 months.
Combining antibiotic treatment with physical therapy, diet, lifestyle changes, herbal medicine, and appropriate nutritional supplements improves treatment outcomes.