Prostate Inflammation

Prostate gland inflammation, when confirmed by laboratory tests, becomes diagnosed as "prostatitis." It is one of the most frequently diagnosed pathologies of the male reproductive system, which also leads to a sharp decrease in a man's quality of life, affecting many areas of their health and daily activities. In the urological profile of men over 50, only benign prostatic hyperplasia (BPH) and prostate cancer occur more frequently.

Prostatitis is globally divided into acute and chronic forms. Acute cases represent a sudden process arising against the backdrop of general well-being, while chronic ones often involve a recurrent infectious infection, leading to obscured clinical forms of the disease.

There's also a widely accepted classification proposed by the US National Institutes for Health:

1. Acute bacterial prostatitis – a suddenly occurring disease with pronounced clinical symptoms;
2. Chronic bacterial prostatitis – a long-term inflammatory process with constant recurrences of infectious seeding;
3. Chronic nonbacterial prostatitis or chronic pelvic pain syndrome (CPPS) – pain sensations in the absence of pathogenic microflora in the prostate secretion;
   1. Inflammatory etiology;
   2. Non-inflammatory etiology;
4. Asymptomatic inflammatory prostatitis – inflammation in the prostate gland confirmed by laboratory or instrumental means without any clinical manifestations.

Benign prostatic hyperplasia (BPH) or adenoma and prostate cancer are separately categorized; they are not directly related to infectious damage to the prostate, arising instead from age-related, genetic, and hormonal disorders.

Inflammation in acute or chronic bacterial, as well as often in asymptomatic inflammatory prostatitis, arises due to the penetration of pathogenic microflora into the prostate secretion. Among the bacteria that can cause acute or chronic processes are:

• Escherichia coli – the most common pathogen, also known as E. coli;
• Proteus spp. – gram-negative facultative anaerobic bacteria not forming spores;
• Klebsiella spp. – a type of gram-negative facultative anaerobic rod-shaped capsulated bacteria, rarely causing disease in healthy patients and often in hospital conditions;
• Pseudomonas spp. – the most common cause of nosocomial (hospital-acquired) infections;
• Enterococcus spp. – cause various infections, including endocarditis, urinary tract infection, prostatitis;
• Staphylococcus aureus – a common bacterium living even on the skin of healthy individuals;
• Bacteroides spp. – part of the normal flora of the vagina and vulva, oral cavity and throat, upper respiratory tract of humans, thus can easily cause disease during unprotected sexual intercourse.

Microorganisms can enter the prostate from the distant part of the urethral canal and also infiltrate from the bladder via hematogenous (through blood) and lymphogenous (through lymph) routes.

Within the scope of abacterial diseases (CPPS), various theories of origin are considered:

• Infectious – possible bacterial penetration occurred, but at the moment, their isolation or cultivation is impossible for various reasons;
• Decrease in local or general protective properties of the body – immunity simply cannot cope with harmful factors;
• Anatomical features leading to urinary reflux, which causes chemical damage and irritation of the prostate tissues.

For BPH and prostate cancer, mainly age-related, genetic, and hormonal causes of the disease are considered.

The manifestations of prostate diseases usually differ little from each other:

• Various urination disorders (frequency, sensation of incomplete emptying, straining at the start of urination);
• Pain sensations that may radiate to the perineum, rectum, sacral or suprapubic area;
• Erectile dysfunction – the inability to maintain an erection from the beginning to the end of sexual intercourse, most often due to pain sensations or psychological blocks;
• For acute conditions, an increase in overall body temperature and even muscle and joint pains may be characteristic;
• Chronic conditions manifest with a mixed clinical picture, sometimes even with asymptomatic progression.

Doctors also often use special questionnaires: NIH-CPSI, IPSS, AMS, etc., to determine the severity of the patient's condition.

The treatment of the disease fundamentally differs depending on the cause of the disease and its symptoms:

• Bed rest and adequate hydration during the acute process;
• Antibacterial agents for infectious etiology of the disorder (when a specific pathogen is present);
• Nonsteroidal anti-inflammatory drugs – for the presence of pain sensations and extensive inflammatory process;
• Alpha-blockers for severe urinary process disorders;
• 5-alpha-reductase inhibitors – help reduce hyperplasia in the case of prostate adenoma;
• Phosphodiesterase type 5 inhibitors (PDE-5) – help cope with emerging erectile dysfunction;
• Surgical treatment – used for large adenomas resistant to conservative therapy and malignant processes.

However, for all diseases, lifestyle changes are recommended:

• Quit all bad habits (smoking, alcohol, and drugs), as they negatively affect the overall condition of the body and, particularly, the vascular system, accelerating the deterioration of the disease;
• Normalize the diet and hydration – exclude fried, smoked, fatty dishes;
• Normalize the amount of physical activity – avoid a sedentary lifestyle.