MEDICAL SECOND OPINION

Prostatitis

As part of the male reproductive system, the prostate gland is a hazelnut-sized gland with ducts that open to the urinary tract, located just below the bladder. The prostate gland, which gives the semen fluid its white color, is responsible for the secretion of the prostate fluid, which contains various nutrients, which is an essential element for the health of sperm.

Inflammation of the prostate gland, which is associated with urine, due to various factors is called Prostatitis. This may occur due to urinary tract infections related to the region of the organ. Prostatitis, which is a common and painful health problem that can be seen in men of all ages, basically appears in four different types:

• Asymptomatic inflammatory prostatitis: Inflammation of the prostate gland without causing any clinical signs. It is detected incidentally during clinical examination.
• Acute bacterial Prostatitis is the name given to the painful inflammation that develops suddenly when various microorganisms infect the prostate gland.
• Chronic bacterial prostatitis: It can be defined as a prolonged infection of the prostate gland occupied by microorganisms or causing recurrent episodes of acute prostatitis.
• Chronic prostatitis/chronic pelvic pain syndrome (KP/KPAS): This is the most common type of Prostatitis. It is a condition characterized by pain and discomfort throughout the pelvic region due to inflammation of the nerve net around the gland and the prostate gland.

How does Prostatitis develop?

Prostatitis results from an inflammatory reaction in and around the prostate gland. This reaction may develop spontaneously without microorganisms, in response to an overt bacterial infection, or secondary to stress, nerve damage, interventional methods applied to the area, traumatic injuries, or pre-existing infections.
Bacterial Prostatitis, on the other hand, usually occurs due to the progression of the infectious agent reaching the urinary tract into the body and then getting to the prostate gland. In this sense, urinary tract infections, which are common in society, can cause Prostatitis, and various sexually transmitted diseases can lead to the emergence of Prostatitis.
Prostatitis cases that develop without infection often progress in the form of chronic inflammation as a result of traumatic damage or nerve damage in the region. In these cases, no microorganism is encountered during the diagnostic process. Complaints may occur throughout the pelvis area with inflammation of the muscles and nerves around the prostate gland.

What are the causes of Prostatitis?

Bacterial or inflammatory Prostatitis can occur under the influence of various health problems. Conditions that cause prostatitis discomfort can be listed as follows:
• Urinary tract infections: Infectious agents that are common in the community and can affect the urinary tract at various levels can cause inflammation in the prostate gland.
• Sexually transmitted infections: Some sexually transmitted diseases, such as chlamydia, can cause inflammation of the prostate gland along with urinary tract infection.
• Interventions in the urinary tract: A catheter placed in the urinary tract, surgical procedures, or imaging studies may cause injury to the area and result in inflammation.
• Anomalies developing in the urinary tract: In cases such as narrowing the urinary tract for various reasons and the appearance of scar tissue in the region, inflammation of the prostate gland becomes easier.
• Physical trauma: Various external physical trauma factors can also cause prostatitis by damaging the prostate gland and its surroundings.
• Stress: Some studies have shown that men who experience intense stress can develop inflammation due to damage to the nerves around the prostate.
• Nerve damage: Various conditions affecting the prostate gland's nerve network can result in inflammation, although there is no bacterial infection.
• Immune system impairment: Prostatitis may occur in the course of diseases that cause immune deficiency, such as HIV infection.
• Some chronic diseases: Chronic diseases, such as chronic fatigue syndrome and irritable bowel syndrome, can also cause Prostatitis.

What are the Symptoms of the Prostatitis?

The clinical symptoms caused by Prostatitis may vary depending on the type of disease. In this regard, the most frequently observed symptoms according to the kind of Prostatitis are as follows:
• Asymptomatic inflammatory Prostatitis does not cause any apparent clinical symptoms. However, infertility may develop due to various dysfunctions in the prostate gland, where long-term inflammation is observed.
• Sudden onset of acute bacterial Prostatitis; it manifests itself with symptoms such as high fever, groin pain, painful urination, difficulty urinating, dark-colored, inflamed urination, and inflamed discharge.
• In chronic bacterial Prostatitis, where the acute condition turns into a long-term condition, symptoms such as a burning sensation during urination, the need to urinate frequently, getting up to urinate at night, a feeling of heaviness behind the testicles and pain in the groin, anus, genital area and the area above the bladder are seen.
• In chronic prostatitis/chronic pelvic pain syndrome, painful and difficult urination for more than three months, pain around the anus along with the groin and genital area, and difficulty and discomfort during ejaculation (ejaculation) can be seen.

How is Prostatitis diagnosed?

In the diagnostic process, a specialist doctor should evaluate the prostate gland. After a detailed disease history and detailed physical examination taken by the doctor, various imaging methods such as ultrasound and computerized tomography can be used for laboratory tests. The presence of microorganisms in urine and semen samples can be investigated. At the same time, rectal palpation may be required during prostate gland examination.
Based on the data obtained after all these examinations, the diagnosis of Prostatitis is made, and the type seen in the patient is determined. Establishing an appropriate treatment plan, depending on the kind of Prostatitis, is critical.

How is Prostatitis treated?

Although the treatment of Prostatitis is mainly determined by the type of Prostatitis in question, the following methods are often used in the treatment of Prostatitis:
• Patients are often treated with antibiotics. The type of antibiotic to be given is determined by the kind of microorganism detected in the culture study on the urine sample. In patients with severe clinical manifestations, antibiotic therapy may need to be administered intravenously in the hospital, and the patient may need to stay there. Oral antibiotic therapy can last from 2 weeks to 12 weeks, depending on the severity of the disease.

• Anti-inflammatory drugs are often used to control inflammation. Pain relievers and muscle relaxants may also be given.
• Medications called alpha-blockers are another treatment method used to widen the urinary tract and solve problems with urination.
• In some patients, with the decision of the specialist doctor, prostatic massage can be applied to relieve inflammation in the prostate gland. Prostatic massage is the process of evacuating the inflamed secretion fluid by massaging the prostate gland over the rectum through the anus.
• In addition to all these, some changes in the patient's lifestyle are also critical. These changes include applying a hot compress to the aching area, taking a hot sitz bath, avoiding acidic drinks and spicy foods, consuming plenty of fluids, and exercising to relax the pelvic muscles. Prostatitis can result in various complications if not treated effectively and correctly. Complications that may occur in this case are as follows:
• Sepsis, also known as blood poisoning, may develop due to the mixing of the prostatitis infection into the blood. It can lead to severe, potentially life-threatening illness.
• The infection in the prostate gland can continue to progress and infect the sperm ducts, leading to a condition called epididymitis.
• Inflammatory fluid accumulating in the prostate gland can lead to an abscess.
• Infertility can occur as a result of the destruction of the prostate gland or sperm ducts due to infection.

Created at 11.10.2023 06:20
Updated at 05.04.2024 09:06
Medical Second Opinion
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