The male and female bodies, which are similar in terms of texture and functions, are actually different from each other in many important points. Some internal organs, such as the prostate gland, are only found in the male body, and the disturbances in this area cause serious problems in the future.
One of these health problems that negatively affect daily life is the disease called prostatitis. This disease, also known as prostate fever, is among the urological problems seen especially in sexually active men. Prostate inflammation, which negatively affects sexual life, often occurs with symptoms of pain and voiding disorders.
What is prostatitis?
The prostate gland is located just below the bladder as part of the male reproductive system. This gland, which has channels opening to the urinary tract, basically gives the semen fluid, which contains sperm, its white color.
It is also responsible for the secretion of prostate fluid, which contains various nutrients that are very important for sperm health. Inflammation of the prostate gland, which is associated with urine, for various reasons is called prostatitis.
Prostatitis can also occur due to urinary tract infections. Prostatitis, which is a common and painful health problem that can be seen in men of all ages, is basically considered in four different types. According to this:
- Asymptomatic inflammatory prostatitis: It is an inflammatory condition that does not cause any clinical symptoms. It usually occurs coincidentally in diagnostic tests performed for any reason.
- Chronic bacterial prostatitis: It occurs as a result of prolonged infection of the prostate gland invaded by microorganisms. This situation also causes recurrent attacks of acute prostatitis.
- Acute bacterial prostatitis: It is a painful inflammation that develops suddenly when the prostate gland is infected by various microorganisms.
- Chronic pelvic pain syndrome: This condition, also known as chronic prostatitis, is the most common type of prostatitis. Complaints are similar to those seen in chronic bacterial prostatitis and usually last more than 3 months. Since bacteria cannot be detected in samples taken from the prostate gland, semen or urine, diagnosis and treatment are very difficult. It is a serious disease that causes pain and discomfort throughout the pelvis as a result of inflammation of the prostate gland and the surrounding plexus.
Who gets prostatitis?
Prostatitis risk factors include young and middle-aged men, especially those who have had prostatitis before. However, the patient’s infection from unprotected sexual intercourse is also an important reason. In the patient who does not have the treatment on time, the inflammation settles into the prostate gland from the urethra and this makes the treatment very difficult.
On the other hand, prostatitis can also be seen due to cold. The disease is much more common in skiers and swimmers exposed to the cold for a long time. Chronic prostatitis, which is usually seen in young men, is not common in men over the age of 45. This disease occurs more frequently between the ages of 20-45.
How does prostatitis develop?
Prostatitis basically occurs as a result of the development of an inflammatory reaction in and around the prostate gland. This reaction may also develop in response to a significant bacterial infection or due to stress, nerve damage, interventional methods applied to the area, traumatic injuries or previously developed infections.
In bacterial prostatitis, infections usually reach the prostate gland after the urinary tract. Urinary tract infection can cause prostatitis in this sense. In addition, sexually transmitted diseases are also effective in the emergence of prostatitis.
In prostatitis, which occurs without any infection, nerve damage as a result of trauma causes chronic inflammation. In these cases, no microorganism is encountered during the diagnosis process. However, muscle and nerve inflammations in the prostate gland and the surrounding area cause general pelvic region complaints.
There are also situations that can directly cause infection. These are as follows:
- Infection in the bladder or urethra,
- Some sexually transmitted infectious agents such as chlamydia,
- Anomalies such as narrowing of the urinary tract due to various reasons and the appearance of scar tissue in the region,
- Polygamy and continuous unprotected sexual intercourse,
- Injury as a result of catheter placed in the urinary tract, surgical procedures or imaging studies,
- Diabetes and some chronic diseases,
- Blockages caused by stones,
- Being HIV/AIDS positive,
- Having had a prostate biopsy.
Chronic prostatitis develops differently from acute prostatitis. The underlying cause is not always infection. On the other hand, the underlying causes of chronic pelvic pain syndrome are not fully known.
What symptoms occur in prostatitis?
The clinical symptoms caused by prostatitis may vary depending on the type of disease. In this regard, it is necessary to examine the symptoms according to the type of prostatitis. Asymptomatic inflammatory prostatitis does not cause any obvious clinical symptoms.
However, infertility may develop due to various dysfunctions in the prostate gland, where long-term inflammation is observed. In acute bacterial prostatitis that develops suddenly, symptoms such as high fever, groin pain, painful urination, difficulty in urination, dark and inflamed urination and inflammatory discharge occur.
In chronic bacterial prostatitis, in which the acute condition turns into a long-term condition, a burning sensation during urination, the need to urinate frequently, getting up to urinate at night and a feeling of heaviness behind the testis can be seen. However, pain occurs in the groin, anus, genital area and the area above the bladder.
In 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 or pain during ejaculation can be seen.
It should not be forgotten that acute and chronic prostate inflammatory diseases occur with different symptoms, even if they are similar to each other. In the case of chronic prostatitis, blood can also be seen in the semen and urine.
How is prostatitis diagnosed?
It is important to evaluate the prostate gland in detail during the diagnosis process. After a detailed disease history and detailed physical examination taken by the specialist doctor, various imaging methods such as ultrasound and computed tomography and laboratory tests can be applied.
In this process, microorganisms in urine and semen samples are investigated. At the same time, during the examination of the prostate gland, a manual examination of the anus may be required. In the light of the data obtained after all these examinations, the diagnosis of prostatitis is made and the type of prostatitis is determined in the patient. Afterwards, an appropriate treatment plan is created depending on the type of prostatitis.
In this process, the symptoms in the patient are always guiding. Accordingly, urinalysis and urine culture are also frequently used diagnostic methods. In addition, sperm culture and urethral swab culture may be requested if necessary. In patients with voiding complaints, uroflowmetry, ultrasonography and infection values should be checked. A PSA test may be requested, especially from patients over the age of 40.
Is prostatitis dangerous?
Urinary problems persist in untreated benign prostatic enlargement. In the later stages, recurrent urinary tract infections, bleeding in the urine, dysfunction in the kidneys and bladder stones may develop.
Does prostatitis cause prostate cancer?
Prostatitis does not carry cancer cells and does not increase the risk of cancer. However, inflammation from prostatitis can sometimes increase the level of prostate-specific antigens in the blood. Different tests can help determine what is causing high PSA levels, regardless of cancer.
How is prostatitis treated?
Although the treatment of prostatitis is basically determined according to the type of prostatitis in question, it is possible to talk about some common methods. Accordingly, patients are often treated with antibiotics. The type of antibiotic to be given is determined by the type 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 in the hospital. Oral antibiotic therapy can last from 2 weeks to 12 weeks, depending on the severity of the disease. Again at this stage, anti-inflammatory drugs are often used to control inflammation.
Alpha-blockers, on the other hand, are effective in widening the urinary tract and eliminating problems with urination. In some patients, the prostatic massage method can also be applied with the guidance of the specialist doctor.
Prostatic massage is the process of evacuating the inflamed secretion fluid by massaging the prostate gland over the rectum through the anus. In chronic abacterial prostatitis, shock wave therapy (ESWT) is among the methods applied today.
In addition to all these, some changes in the lifestyle of the patient 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 doing exercises to relax the pelvic muscles.
How does prostatitis become chronic?
Prostatitis becomes chronic if the microbe causing prostatitis cannot be fully treated or if the microbe re-enters the body regularly. In this process, prostate abscess may develop and is usually bacterial.
The patient may need to be hospitalized for treatment. So much so that, although rarely, the most appropriate treatment in this situation, which occurs as a result of chronicity of acute bacterial prostatitis, is long-term low-dose antibiotic therapy.
Does prostatitis affect sexuality?
Chronic prostatitis often causes psychological problems in patients. Therefore, it affects the sexual life negatively. The fact that men with chronic prostatitis have pain in their genital areas can cause erection problems in these people. It is also known that prostatitis and erection problem can be caused by the same reason.
Accordingly, inflammations that cause erectile dysfunction in the body can also lead to prostatitis. On the other hand, it is a well-known fact that the hormone treatments of the inflammation in prostate cancer affect the male hormone.
This may be another reason why the patient has erection problems. In addition, changes in the semen due to chronic prostatitis may also cause infertility by disrupting the living conditions of sperm cells.
