Prostatitis is characterized by inflammation of the prostate, which is a small gland responsible for the production of seminal fluid, which is the fluid that contains sperm, which leads to an increase in its size, and can cause symptoms such as pain, burning when urinating and fever, for example.
The main cause of prostatitis is infection by bacteria, mainly Escherichia coli, Klebsiella spp. and Proteus spp., however it can have non-infectious causes.
Therefore, it is important that the urologist is consulted so that the cause of prostatitis is identified and thus be initiated the most appropriate treatment, which may involve the use of analgesic and anti-inflammatory drugs, to relieve symptoms, and the use of antibiotics, if it is confirmed that the inflammation of the prostate is caused by bacteria.
Symptoms of prostatitis
The main symptoms of prostatitis are:
- Decrease in the urine stream;
- pain when urinating;
- Frequent desire to urinate;
- Pain in the perineum, which is the region between the scrotum and the rectus;
- Fever,
- Chills;
- The clouded urine;
- Presence of blood in the urine and/or sperm.
In the presence of signs and symptoms suggestive of prostatitis, it is important that the urologist is consulted so that tests are indicated that help identify the cause of the symptoms and, thus, the most appropriate treatment be initiated.
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The symptom test is only a guidance tool, not serving as a diagnosis or replacing the consultation with the urologist.
Possible causes
Although there are different causes that can result in inflammation of the prostate, most prostatitis is caused by an infection, especially by bacteria such as Escherichia coli, Klebsiella spp. or Proteus mirabilis. For this reason, it is relatively common for prostatitis to be treated with the use of antibiotics, which should be indicated by the urologist.
In some cases, prostatitis may be caused by surgery or injury in the region and there are still situations in which it is not possible to identify the cause.
Types of prostatitis
Prostatitis can be classified according to its cause in bacterial and non-bacterial and according to the time of onset of symptoms and duration in water or chronic. Thus, prostatitis can be classified into 4 main types:
- Acute bacterial prostatitis, which is caused by bacteria, most often Escherichia coli or belonging to the genus Klebsiella spp. or Proteus spp., and has sudden onset and symptoms are more general, and prostatitis can be easily confused with a urinary tract infection;
- Type II – Chronic bacterial prostatitis, which happens when the bacteria remains in the urinary tract, causing infection and progressive inflammation, so that the symptoms have slow evolution and treatment is more complicated;
- Type III A – pelvic pain syndrome, also known as chronic inflammatory prostatitis, which has no infectious cause and that inflammatory symptoms have a slow evolution, and are therefore called chronic;
- Type III B – Chronic non-inflammatory prostatitis or prostatodynia, in which there are prostate changes but no inflammatory and/or infectious signs are not verified;
- Asymptomatic inflammatory prostatitis, in which although the prostate is inflamed, there are no characteristic symptoms, but that on microscopic examination cells indicative of tissue inflammation are identified.
Although chronic and acute prostatitis present the same symptoms, in chronic prostatitis symptoms develop slowly and last more than 3 months, in addition to being associated with greater difficulty in treatment.
How the diagnosis is made
The diagnosis of prostatitis is made by the urologist taking into account the symptoms reported by the patient and which are usually related to difficulty in urinating.
In addition, the doctor may indicate blood, urine and seminal fluid collection and recommend tests such as ultrasound and flowmetry, rectal touch, blood test (haemogram and PSA) or, in some cases, prostate biopsy due to increased PSA in those asymptomatic patients (to exclude prostate cancer).
Treatment for prostatitis
Treatment for prostatitis should always be indicated by a urologist who, in most cases, identifies an infection and therefore prescribes the use of antibiotics in tablets or, in more severe cases, remedies that are applied directly to the vein, in the hospital.
In addition, the doctor may also prescribe painkillers and anti-inflammatory drugs to relieve alpha symptoms or blockers, such as tansulosin, which helps to relax the bladder neck and muscle fibers where the prostate joins the bladder.
In chronic bacterial prostatitis, treatment with antibiotics is longer, being performed for about 3 months, however, when antibiotics do not treat inflammation, it may be necessary to have surgery to remove the prostate abcess that causes the symptoms.
Learn more about the treatment of prostatitis.
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Bibliography
- BRASILIAN SOCIETY OF UROLOGY. Prostatitist. Available at: “http://sbu-sp.org.br/public or incas/prostatite/?. Access on 27 Nov 2019
- FEDERAL UNIVERSITY OF RIO GRANDE DO SOUTH. Chronic prostatitis/ Chronic Pelvic Pain Syndrome. I’ve a! Available at: ?https://www.ufrgs.br/telessauders/documents/telecondutas/tc_ProstatiteCronica.pdf. Access on 27 Nov 2019
- SHARP, Victoria J.; TAKACS, Elizabeth B.; POWELL, Charles R. Prostatitis: Diagnosis and Treatment. The American Family Physician. Vol 82. 4 ed; 397-406, 2010
