Bacterial Prostatitis - Causes, Symptoms And Treatment Of Bacterial Prostatitis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Bacterial prostatitis: causes, symptoms and treatment

Bacterial prostatitis is an infectious disease of the prostate gland with an acute or chronic course. An acute inflammatory reaction manifests itself with severe pain in the perineal region, an increase in body temperature to high values, intoxication of the body and other symptoms. Such a condition of the patient requires urgent hospitalization, as it can pose a threat to the health and life of the patient.

According to data provided by the National Institutes of Health, bacterial prostatitis is not common and averages 5% of all cases of prostatitis. The disease affects men between the ages of 25 and 50 at a time when their sexual activity is at a high level.

The National American Institutes of Health classifies acute bacterial prostatitis in the first category of four prostatitis.

Content:

• Causes of bacterial prostatitis
• Bacterial Prostatitis Symptoms
• Complications of bacterial prostatitis
• Diagnosis of bacterial prostatitis
• Bacterial Prostatitis Treatment

Causes of bacterial prostatitis

The causes of bacterial prostatitis lie in the penetration of pathogenic agents into the male prostate gland, since a healthy organ is free of any microorganisms.

The following microorganisms are infectious agents causing acute inflammation:

• Staphylococcus aureus;
• Enterobacter;
• Enterococcus;
• Pseudomonas aeruginosa;
• Proteus;
• E. coli, which causes the development of acute bacterial prostatitis in 65-80% of cases;
• Klebsiella.

The vast majority of these microorganisms are conditionally pathogenic for humans and can lead to the development of prostatitis only if there are predisposing factors for this.

These include:

• Phimosis of the prostate gland.
• Anal-genital intercourse without a condom.
• Urinary tract infections.
• Continuous urethral catheterization.
• Transurethral surgery performed without prior antibiotic therapy.
• Acute epididymitis.
• Violation of the process of urination caused by anatomical abnormalities of the bladder neck.
• Urethroprostatic and intraprostatic reflux with the introduction of bacterial flora into the prostate ducts. In this case, the following three factors must be present: the presence of pathogenic bacteria directly in the urethra, or in the urinary tract, organic or functional obstruction of the urinary tract, the presence of any form of duct reflux.
• Immunosuppressive conditions (diabetes mellitus, AIDS, undergoing hemodialysis, etc.).
• Urethral strictures.
• Difficulty urinating against the background of prostate adenoma.
• Other bacterial infections of the body in which pathogenic agents enter the prostate gland by the lymphatic and hematogenous route.

After the bacteria enter the prostate gland, an inflammatory infiltrate is formed in the organ, with the involvement of the stroma and epithelium, which is responsible for the production of prostate secretion, in the process. As a result, the exudate becomes more viscous, lingers longer in the lumen of the glands. The existing bacterial flora begins to multiply actively, which causes the progression of the inflammatory process.

Bacterial Prostatitis Symptoms

Symptoms of bacterial prostatitis most often begin acutely, so it is impossible not to notice the manifestation of the disease.

The following clinical picture is characteristic:

• Fever with chills.
• Increased body temperature. At the same time, the temperature measured in the armpit can reach low levels, and the body temperature measured in the anus will be much higher. The difference can be up to 0.5 degrees.
• Pain in the lower back, lower abdomen, perineum. Possible irradiation of pain in the pelvis, groin, scrotum, anus.
• Urination becomes frequent, painful. This is especially troubling for the patient at night. During the emptying of the bladder, cramps occur, a burning sensation along the urethra.
• Sometimes urination, on the other hand, becomes difficult. Complete urinary retention is possible.

• Due to the compression of the enlarged prostate gland of the anus, constipation may develop, as well as the occurrence of severe pain during bowel movements.
• General intoxication of the body, headache, a feeling of irresistible weakness and weakness arises. Muscles, bones, and joints may aches.
• It is possible that discharge of various colors from the urethra, from colorless to yellowish-green, is possible. In addition, there may be blood impurities in the semen.

You should also consider the symptoms of bacterial prostatitis, depending on the stage of the course of the disease:

• For the first stage, which is called catarrhal, it is characteristic that only the ducts of the prostate gland are involved in the inflammatory process. The patient experiences painful sensations in the perineum with irradiation to the sacrum. Possibly painful urination, which becomes more frequent.

• For the second stage, which is called follicular (damage to the lobules of the prostate occurs), an increase in pain with irradiation into the anus is characteristic. Urination is difficult, urine comes out in a thin stream, up to a complete retention of biological fluid. The temperature is kept at subfebrile levels.
• The third stage, which is called parenchymal, is characterized by the involvement of both lobules of the organ in the pathological process with inflammation of the gland tissue. In this case, the man suffers from severe intoxication of the body with an increase in body temperature up to 40 ° C. There is an acute urinary retention, sharp throbbing pains in the perineum, severe constipation.

Complications of bacterial prostatitis

Complications of bacterial prostatitis with untimely medical care can be serious enough and threaten the patient's life. The most dangerous complication is sepsis, when a person often dies against the background of blood poisoning.

It is possible that the infection will rise from the prostate higher and provoke the development of pyelonephritis and cystitis.

It is possible that bacterial prostatitis will become chronic, which is difficult to treat and causes many health problems, including: infertility, prostate adenoma, impotence, etc.

The lack of therapy also threatens the development of an abscess of the prostate gland. If a purulent focus is formed, then this increases the body temperature to hectic levels. Rarely, but there is a spontaneous opening of an abscess with the release of purulent masses into the rectum or urethra. In this case, the urine acquires a sharp unpleasant odor, pus and mucus are present in the feces.

Since complications of bacterial prostatitis are life-threatening, with the existing risk of their accession, the patient must be hospitalized without fail.

Diagnosis of bacterial prostatitis

Diagnosis of bacterial prostatitis, as a rule, is not complicated, since patients present with characteristic complaints. Rectal examination of the prostate is performed if bacterial prostatitis is not acute. In this case, the doctor gently probes the prostate and takes the secretion of the prostate gland. Subsequently, the collected material is sent for bacterial inoculation. In addition, urine culture is required. This will identify the bacterial agent causing the inflammation and determine its drug sensitivity.

A contraindication to digital rectal examination is acute bacterial prostatitis with high body temperature and general intoxication of the body, since there is a risk of spreading the infection through the blood and developing sepsis. In addition, it is often simply physically impossible, since the patient is in severe pain.

In this case, research methods such as:

• Clinical blood test;
• Analysis of urine;
• Urine culture;
• Scraping of the urethral epithelium, which is sent to the laboratory for a PCR study;
• PSA of blood, to differentiate bacterial prostatitis from prostate cancer.

Ultrasound examination of the prostate is necessary for a more detailed study of the structural changes in the prostate gland. It is carried out after the elimination of acute inflammation.

Bacterial Prostatitis Treatment

Treatment of bacterial prostatitis requires antibiotic therapy, which must be carried out without fail. Antibiotics are prescribed for acute and chronic bacterial prostatitis, since it will not be possible to get rid of the disease in other ways.

There is no universal antibacterial agent for the treatment of bacterial prostatitis. The drug is selected based on the sensitivity of the specific microorganism that provoked the inflammation. Only a urologist or andrologist can correctly select a drug, determine its dosage, and establish specific terms of treatment. Self-therapy is unacceptable.

The average course of treatment is 4-8 weeks. In this case, therapy should be comprehensive, it includes the use of antibiotics, NSAIDs, immunostimulating drugs, vitamin therapy. It is possible that the man will need to take antidepressants and sedatives.

If acute bacterial prostatitis is mild and there is no threat of complications, outpatient treatment is possible. With severe intoxication, as well as if there is a suspicion of a purulent process, hospitalization is indicated without fail. In this case, the issue of intravenous administration of antibacterial drugs is considered.

As for the choice of a specific antibiotic, the following drugs can be used:

• Fluoroquinolones, to which most bacteria are sensitive. However, these drugs have a number of antibiotic-specific side effects as well as phototoxicity and neurotoxicity. They can be prescribed only when the doctor is 100% sure that there is no tubercle bacillus in the patient's body. Of the fluoroquinolones used: Levofloxacin (Eleflox, Tavanik), Ofloxacin (Zanocin, Ofloxin), Ciprofloxacin (Tsiprobay, Tsifran, Tsiprinol).
• In recent years, tetracyclines have been used quite rarely, since they are difficult to tolerate. The drug with the least side effects is Doxycycline.
• Penicillins. The most effective drugs in this group are protected penicillins. These can be: Augmentin, Flemoklav solutab, Amoxiclav.
• In the acute phase of bacterial prostatitis, intramuscular drugs are often prescribed - these are cephalosporins. Such agents can be Ceftriaxone, Suprax, Cefotaxime, etc.
• Macrolides for the treatment of bacterial prostatitis are rarely prescribed, since there is no data on the use of drugs of this group for the treatment of this disease. At the same time, these agents are highly active against many bacteria, so their appointment is not excluded. These can be drugs such as Clarithromycin, Azithromycin.

Read more: List of antibiotics for prostatitis

Often, doctors use several antibiotic drugs to treat acute bacterial prostatitis, which allows them to optimize the therapy regimen and quickly relieve the patient of inflammation. In addition to the appointment of conservative therapy, the patient is shown complete rest in bed rest. Analgesics and antipyretics are prescribed depending on the symptoms of the disease.

The patient must observe the drinking regimen, since abundant urination is a preventive measure in terms of the development of an ascending infection. It also allows you to quickly remove intoxication. For patients with acute urinary retention, bladder catheterization is indicated. To relax the muscles of the pelvic floor, drugs are used such as: Diazepam, Baclofen, Gabapentin, Pregabalin.

Massage, any thermal procedures for the prostate area, androgen intake during acute bacterial prostatitis are strictly prohibited. This greatly increases the risk of developing sepsis.

The prognosis for recovery without any health consequences is quite favorable. In some cases, the process may be chronized, which most often occurs with incorrect or inadequate treatment. The same applies to all possible complications of the disease.

Author of the article: Lebedev Andrey Sergeevich | Urologist

Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.