Prostate infections

Prostatitis involves inflammatory involvement of the prostate tissue associated or not with an infectious process and includes various clinical entities that are divided into: acute bacterial prostatitis, chronic bacterial prostatitis, chronic abacterial prostatitis and chronic pelvic pain syndrome.

Prostatitis is the most common parenchymal urinary infection in men between the second and fourth decade of life.

Cause

Acute prostatitis is usually due to infection by gram-negative germs, basically E.coli, as in uncomplicated urinary tract infections, presenting an infection of the gland, and evolving, if left untreated, to sepsis. Chronic bacterial prostatitis is a chronic infection of prostatic acini, the possible causes that produce it are highly variable. It may be due to an infravesical obstructive process, intraductal reflux, or even neuromuscular dysfunction of the pelvic floor muscles.

Symptoms

Clinically, it produces voiding syndrome typical of urinary infection, associated with pain in the perineal, hypogastric and scrotal areas with high fever. It produces an enlargement of the prostate due to acute inflammation and can cause acute retention of urine. The digital rectal examination should be avoided during the acute process because it could produce septicemia, and a very painful and inflamed prostate is evaluated on the examination.

It usually causes a milder and larval clinical picture with hypogastric pain and pain in the perineal area, hemospermia, pain with ejaculation and diffuse voiding discomfort without presenting fever. The digital rectal examination is slightly painful but without any other alteration.

Diagnosis

Urine culture should be performed in all patients with suspected acute prostatitis. Diagnosis is made through urine and semen culture, requiring prolonged antibiotic treatment and with different antibiotic associations.

antibiotic for semen infection

antibiotic treatment should be carried out with fluoroquinolones for 21 days, associated with analgesic and anti-inflammatory treatment.

If acute or chronic bacterial prostatitis does not progress favorably, especially in immunocompromised or diabetic patients, the possibility of a complication in the form of a prostatic abscess may be considered. Diagnosis is made by transrectal ultrasound, CT or MRI. Treatment of the abscess is drainage, by surgery or with perineal puncture of the abscess.

Abacterial prostatitis and chronic pelvic pain syndrome are non-infectious pathologies, in which there is an alteration in urination and ejaculation associated with a discomfort in the perineal area, being difficult to find the cause of it. There are multiple treatments for these pathologies without the ideal drug to treat them.