Prostatitis is a medical term that encompasses several disorders that all cause inflammation or infection of the prostate gland in men. General symptoms of this disease include fever, malaise, pain in the low back and perineum, issues with sexual function including lowered sexual libido and even impotence. Prostatitis can cause an obstruction of the urinary tract and impede the flow of urine from the bladder through the urethra and out of the body.
This is a very common problem with men over the age of 20. It frequently occurs with men who are older than 40. Every year over 2 million men will be diagnosed with this condition. Even though it is very common and wide spread in the male community, there is much that is not known about prostatitis. Many men will present to their physician with nonspecific complaints and the severity can vary wildly in nature in this disease. In addition physical examination rarely reveals this disease is present. It takes specific lab testing in order to diagnose this disease and to properly decide which type of prostatitis a man has.
The most widely accepted laboratory test that can differentiate the type of prostatitis that a man is dealing with is called the Stanley Mears four glass localization method. In this specialized study four different lab values are done. The first test that is done is a voided urine sample which is cultured for bacterial infection. This sample is tested to see if there is infection or inflammation in the urethra. The second test is done on a mid stream urine specimen which is also cultured for the presence of bacteria. This test will check for the presence of bacterial infection in the bladder area. The third test is done on expressed prostatic secretions. This sample is tested for the presence of white blood cells. The presence of a high number of white cells in the prostate can help doctor in diagnosing this disease. The fourth test is done on a urine sample after prostatic massage is done.
Depending on the results of the tests listed above a diagnosis is made. The first type of prostatitis that we will discuss today is acute bacterial prostatitis. This disease is characterized by the reflux of urine from the urethra into the prostate gland. It also includes an infectious process going on in the meatus of the penis. The most common bacteria that causes this problem is E coli. Other bacteria that can cause this disease include klebsiella, proteus, enterococci and pseudomonas. Acute bacterial prostatitis can be effectively treated with antibiotics such as Bactrim, Vibramycin and Cipro. Antibiotic therapy needs to be long term for this problem as most drugs have issues being able to cross the epithelium of the prostate to kill the bacteria that is present. Antibiotic therapy is much more successful in prostatitis when inflammation is present. Therapy will need to be continued for at least three to four weeks. Some antibiotic therapy for prostatitis may last for several months before it is completely taken care of.
Symptoms of this problem include low back pain, fever, chills, painful urination, frequency in urination, decreased flow of urine, and pain upon ejaculating. Acute bacterial prostatitis is diagnosed when bacteria is grown out of the first urine cultures that were obtained. Prostate massage is contraindicated in acute bacterial prostatitis.
Chronic bacterial prostatitis is another type of prostatitis. This type of prostatitis is one of the most common causes of urinary tract infections in adult men today. The symptoms of chronic bacterial prostatitis include painful urination, low grade fever, myalgias and low back pain. Some men have reported discharge from the penis as well as certain difficulties in urination such as hesitation to start the stream of urine and having frequency of urination.
This disease will not reveal any bacteria on the urine samples that are obtained prior to the prostatic massage. This disease shows itself by the presence of white blood cells in the specimens that were obtained after prostatic massage was performed. In addition bacteria will be in the post massage specimens that have been obtained. If both things are present then chronic bacterial prostatitis will be diagnosed. This disease can be treated by antibiotics as well. However, there is little or no inflammation present in chronic bacterial prostatitis so there will be much more resistance to the therapy being able to cross the epithelium of the prostate gland in order to kill the bacteria there. Antibiotic therapy can be given for a very long period of time due to this in order to remove any and all of the offending bacteria in the body.