The prostate is a male gland about the size of a chestnut that surrounds the initial part of the urethra below the bladder.
Under the influence of hormones, the prostate forms a liquid, cloudy secretion that is released into the urethra during ejaculation. There it mixes with the fluid from the seminal glands and the sperm to form semen.
If the prostate is inflamed, this leads to, among other things
This is referred to as prostatitis or inflammation of the prostate.
In principle, there are two groups of inflammation of the prostate, depending on the cause:
- bacterial prostatitis, which is caused by bacteria, and the so-called
- abacterial prostatitis, which is not of bacterial origin but has other causes.
In the case of bacterial prostatitis, a distinction is also made depending on the course of the disease between
- acute, i.e. sudden onset, and
- a chronic, i.e. gradually developing, persistent form of prostatitis,
form of prostatitis.
According to the classification of the National Institutes of Health (NIH), prostatitis is therefore divided into the following four forms:
- acute (bacterial) prostatitis (NIH I)
- chronic bacterial prostatitis (NIH II)
- chronic bacterial prostatitis (CPPS) or chronic pelvic pain syndrome with or without signs of inflammation (NIH III)
- asymptomatic inflammatory prostatitis (NIH IV)
Among other things, prostatitis leads to swelling and thus to urethral constriction and pain © Alila Medical Media | AdobeStock
Prostatitis is a relatively common disease. It is estimated that around half of all men are affected at least once in their lifetime.
The most common form of prostatitis is chronic abacterial prostatitis.
Bacterial prostatitis is usually caused by bacteria that enter the prostate via the urethra or the blood. There they trigger an infection.
In most cases, these are intestinal bacteria such as Escherichia coli or Enteroccocus faecalis.
Abacterial inflammation of the prostate can be caused by, among other things
- Bladder emptying disorders,
- prostatic reflux (reflux) and constrictions in the
- constrictions in the prostatic ducts - for example due to prostate stones, a tumor or urethral stricture
may be responsible.
If no clear cause for prostatitis can be determined, psychological factors are often suspected as the cause of the disease.
Typical symptoms include pain, discomfort or a feeling of pressure in the bladder region
- in the bladder region,
- in the perineum,
- in the area between the scrotum and anus
- in the testicles,
- the penis,
- in the lower abdomen,
- in the lumbar region and
- in the lower spine area.
In addition
- urination may be painful or cause a burning sensation,
- erection and ejaculation may be difficult or painful,
- frequent urge to urinate and urination with a weakened urinary stream.
Other possible symptoms of inflammation of the prostate are
- Fever,
- chills,
- frequent urge to defecate,
- painful bowel movements,
- Blood in the urine or semen,
- discharge from the urethra and
- potency and libido disorders.
Bacterial prostatitis can lead to an accumulation of pus (abscess) in the prostate or inflammation of the epididymis. If prostatitis becomes chronic, it is also possible for the affected man to become infertile.
Acute prostatitis is usually diagnosed by the treating urologist based on the typical symptoms.
They also carry out a physical examination in which they palpate the prostate from the rectum with their finger. The doctor can determine whether the prostate feels swollen and is sensitive to touch.
As part of this rectal examination, the urologist can also remove some fluid by pressing the prostate. This can then be examined in the laboratory for signs of inflammation and bacteria.
A urine test can also be used to determine whether
- the urine has undergone inflammatory changes and
- contains bacteria or white blood cells.
An ultrasound examination of the prostate can help to further clarify prostatitis. For example, prostate stones can be detected as the cause of prostatitis or the formation of an abscess in the prostate.
Which therapy is used depends on whether the disease is of bacterial or non-bacterial origin.
Treatment of bacterial prostatitis
In this case, treatment usually consists of taking antibiotics. These kill the causative pathogens and prevent the bacteria from multiplying further.
The doctor must first determine the exact pathogen with the help of a bacterial culture. Only then is it possible to choose the right antibiotic.
In the case of uncomplicated acute bacterial prostatitis, a ten-day course of antibiotics is usually sufficient.
However, a chronic bacterial prostate infection may also require a longer course of antibiotics.
Always follow your doctor's instructions. For example, do not stop taking antibiotics early: This can lead to relapses and the bacteria developing resistance.
Treatment of abacterial prostatitis
Abacterial prostatitis is usually difficult to cure. However, treatment can include
- Prostate massages,
- heat applications such as warm sitz baths,
- muscle relaxation exercises,
- autogenic training and
- medication for muscle relaxation
can relieve pain, as they have an antispasmodic effect on the pelvic muscles.
Drug treatment for prostatitis
In addition to painkillers, the medications that can provide relief from prostatitis include
- anti-inflammatory agents and
- Alpha blockers to relax the muscles and improve urine flow.
In addition, herbal medicines such as rye pollen extract and pumpkin seeds are often used for abacterial prostatitis.
Surgical treatment of prostatitis
If the treatment methods described do not help, partial or complete surgical removal of the prostate(prostatectomy) may be considered as a last resort.
Alternatively, it is also possible to destroy the inflamed prostate tissue using microwave or laser treatment.
Inflammation of the prostate can be prevented by, among other things
- a balanced diet,
- sufficient fluid intake and
- sufficient physical activity
prevent it. In addition, an active sex life can also protect against a prostate infection: If the prostate is emptied regularly through ejaculation, the risk of prostate inflammation is also lower.
