|
Prostatitis
Overview
Prostatitis is a term used to describe inflammatory conditions of the
prostate gland. It is thought that most cases of prostatitis result from
bacterial infection, but evidence of infection is not always found. An
infected or inflamed prostate can cause painful urination and ejaculation,
and if left untreated, serious complications.
Incidence and Prevalence
Prostatitis can affect men of any age and it is estimated that 50% of men
experience the disorder during their lifetime. Prostatitis is the most
common urological disorder in men over the age of 50 and the third most
common disorder in men younger than 50.
According to the National Institutes of Health, prostatitis accounts for
25% of all office visits involving the genitourinary system by young and
middle-aged men.
Nonbacterial prostatitis and prostatodynia, which is also called chronic
pelvic pain syndrome (CPPS), are the most common diagnoses. Bacterial
prostatitis (acute and chronic) accounts for less than 5–10% of cases. Acute
bacterial prostatitis occurs most often in men under age 35, and chronic
bacterial prostatitis primarily affects men between the ages of 40 and 70.
Anatomy
The prostate is a walnut-sized gland located below the bladder and in front
of the rectum. It secretes seminal fluid, a milky substance that combines
with sperm to form semen. During sexual climax, muscles in the prostate
propel the semen through the urethra and out through the penis.
Types
There are four types of prostatitis: acute bacterial prostatitis, chronic
bacterial prostatitis, nonbacterial prostatitis, and prostatodynia.
Acute bacterial prostatitis (ABP) is inflammation of the prostate
gland caused by bacteria such as Escherichia coli and Klebsiella.
Severe complications may develop if not promptly treated. ABP can be fatal
if the bacterial infection is untreated and travels to the bloodstream
(sepsis).
Chronic bacterial prostatitis (CBP) is a recurrent infection and
inflammation of the prostate and urinary tract. Symptoms are less severe
than those associated with acute bacterial prostatitis.
Nonbacterial prostatitis is an inflamed prostate without bacterial
infection.
Prostatodynia, sometimes called chronic pelvic pain syndrome (CPPS),
is the occurrence of prostatitis symptoms, without inflammation or bacterial
infection.
Risk Factors
Risk factors include bladder outlet obstruction (e.g., stone, tumor, BPH),
diabetes mellitus, a suppressed immune system, and urethral catheterization
(small tube inserted into the bladder through the urethra to drain urine).
Some sexually transmitted diseases (STDs) (e.g., nongonnococcal urethritis,
gonorrhea increase the risk for developing bacterial prostatatis).
Unprotected anal and vaginal intercourse can allow bacteria to enter the
urethra and travel to the prostate.
Causes
Bacterial prostatitis is caused by the growth of bacteria that are
normally found in prostatic fluid, such as Escherichia coli and
Klebsiella. Urine reflux (urine that flows back into the urethra) that
enters the prostate can also cause the condition. There is no known cause
for nonbacterial prostatitis or prostatodynia, but atypical organisms
(viruses, chlamydial organisms) have recently been suggested. |