Prostate Inflammation (Prostatitis) Treatment – Dr. Tepeler

Prostatitis is one of the urological problems especially seen in sexually active men, and it is popularly known as prostate fever.

Inflammation of the prostate, which is expressed as prostatitis in the medical language, is commonly manifested by complaints of pain and urination, and negatively affects the quality of life and sexual life.

So what is prostatitis, what causes it?


What is Prostate Inflammation?

The prostate is the name of a reproductive organ located at the exit of the urinary bladder in men and produces sperm-enhancing secretions. Prostatitis that develops in this organ is a disease that usually occurs in young sexually active men with severe pain.

Prostatitis is a problem that closely concerns daily life, as it causes complaints such as frequent urination, difficulty and burning during urination, and pain. Prostatitis can be observed in approximately 5% to 10% of men in the community. It has been determined that 14% of men with chronic prostatitis also have problems in business life.

Prostatitis is often associated with a fear of impotence and is caused by inflammation or infection in the prostate gland. Men of all age groups are at risk for this disease. Prostatitis is divided into two in itself, and the treatment and symptoms of each type are different.

Prostatitis is basically divided into 2 classes as acute and chronic. Chronic prostatitis is also divided into 2 in itself: chronic bacterial prostatitis and chronic pelvic pain syndrome.

  • Acute Prostate Inflammation (acute prostatitis): Acute prostatitis, which emerges quickly among the types of prostatitis, manifests itself with severe symptoms. In this disease, bacterial infection develops suddenly in the prostate gland tissue, as a result, sudden urinary tract infections and pain in the pelvic region, extending to the root and tip of the penis, extending to the breech region occur in the patients. Although it is mostly seen in sexually active young people, it can be seen in all age groups and is easier to diagnose. With treatment, relief and disappearance of the symptoms are observed.
  • Chronic Bacterial Inflammation of the Prostate: Chronic prostatitis is a disease with a much milder symptom severity than acute prostatitis. It is usually seen in young and middle-aged men. It occurs when recurrent urinary tract infections affect the prostate gland, has a severe course and in some cases does not show any symptoms. It can be asymptomatic for years in some patients, so it is extremely risky and dangerous.

What are the Symptoms of Prostate Inflammation?

Although acute and chronic prostate inflammatory diseases are similar to each other, they are two diseases that occur with different symptoms.

In acute prostatitis:

  • Symptoms begin suddenly (within days) and severe.
  • High fever, nausea, vomiting, chills and chills are observed.
  • Urine becomes cloudy in color. In some cases, bloody urine is seen.
  • Severe pain and burning occur during urination. Urinating becomes a very painful act.
  • Problems such as difficulty urinating or not being able to urinate at all occur.
  • Colored turbid discharge can be seen out of the urinary canal.
  • The pain, which starts from the root of the penis and spreads to the tip, extends to the anus, ovaries and legs.
  • Sexual reluctance, erectile dysfunction, premature ejaculation can be seen.
  • Pain may occur in the joints and muscles
  • A feeling of frequent urination develops.

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Symptoms in chronic prostatitis are similar to acute prostatitis. However, symptoms and complaints in general are much less. In case of chronic prostatitis:

  • Blood is observed in semen and urine.
  • The person becomes irritable and nervous.
  • Premature ejaculation and impotence problems occur.
  • Pain is felt during ejaculation.
  • Pain develops in joints and muscles.
  • Slight strain and burning occur during urination.
  • The need to urinate, especially at night, increases.
  • There is a sudden need to urinate.
  • Fever, chills and weakness are not observed.

How Does Prostatitis Develop?

Acute prostatitis occurs by the transport of bacteria from the external urinary tract to the urinary tract or by the spread of bacteria to the prostate by the blood stream. As a result of the weakening of the immune system, the infection becomes much more effective and the patient's complaints increase. There are also situations that may be facilitating or direct cause of infection:

  • Polygamy, unprotected sexual contact
  • Urinary tract procedures (catheter insertion, endoscopic interventions)
  • Prostate biopsy
  • Prostate enlargement or urethral stricture that impairs the flow of urine
  • Stones causing blockage
  • Diabetes

Chronic prostatitis may develop on a different basis from acute. Infection is not always the underlying cause. In particular, the underlying causes of chronic pelvic pain syndrome are not fully known.

How is Prostatitis Diagnosed?

The patient's complaints are always guiding. It starts with a simple urinalysis and (midstream) urine culture. Prostate massage is not recommended in acute bacterial prostatitis. Especially in the diagnosis of chronic bacterial prostatitis, secretion and urine analysis and culture taken after prostate massage can be used.

This method is called the 4 cup test. Sperm culture (infectious agent is investigated in semen sample), urethral swab culture (especially in those with urethral discharge) will help.

In patients with voiding complaints, uroflowmetry (voiding test), ultrasonography, control of infection values, PSA (especially in men over 40) should be performed. Transrectal ultrasonography (prostate abscess? cyst?) is recommended in treatment-resistant cases.

How Is Prostatitis Treated?

In order to treat prostate inflammation, it is first necessary to determine which type the patient has. It is usually easy to find out which type of disease is present with the patient's history and symptoms. Then, a suitable treatment method is started.

The primary treatment for acute prostatitis is antibiotics. Antibiotic therapy can be changed according to the culture result. Parenteral (intravenous) treatment can be started in patients with poor clinical and laboratory values. Some patients may even require hospitalization.

Untreated prostatitis can cause much more serious health problems for the patient in the future. E.g; The inflammation in the prostate gland can mix with the blood and affect other tissues and organs. For this reason, it is extremely vital to consult a specialist doctor as soon as possible with the appearance of the symptoms of the disease.

In patients with treatment-resistant abscess, drainage (evacuation of the abscess with ultrasound) can be performed.

Regular use of antibiotics in chronic prostatitis patients eliminates the infection over time. In some patients with prostatitis, the treatment plan may differ according to the severity of pain and symptoms. In some patients, the severity of strain during urination is high and this must be eliminated first.

Therefore, in addition to the treatment of inflammation, solutions for the underlying cause should also be considered. For example, if there is an obstructing prostate, infection treatment should be started quickly and appropriate treatment should be planned for the prostate (such as prostate drugs, catheterization or cystostomy)

In the treatment of prostatitis, antibiotherapy should be given in an appropriate time (4-6 weeks). Painkillers, prostate medications, anti-depressants, constipation medications, etc. that will relieve the patient's current complaints can be added to the treatment. Shock wave therapy (ESWT) is currently used in chronic abacterial prostatitis.

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