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Prostatitis - chronic
Alternative namesChronic bacterial prostatitis
DefinitionChronic prostatitis is an inflammation of the prostate gland that develops gradually, continues for a prolonged period, and typically has subtle symptoms.
Causes, incidence, and risk factors
Chronic prostatitis is usually caused by a bacterial infection. It may be associated with or follow urinary tract infection , urethritis , epididymitis , or acute prostatitis . The most common causes are Escherichia coli and proteus, enterobacter, and klebsiella bacteria.
The disorder is diagnosed in 5 of every 1,000 outpatient visits. It is estimated that as many as 35% of men older than 50 may have chronic prostatitis.
Increased risk is associated with age over 30. Certain factors may predispose a person to develop chronic prostatitis, such as excessive alcohol intake, perineal injury, and certain sexual practices (particularly anal sex without a condom). These factors may cause congestion of the prostate gland, which produces an excellent breeding ground for various bacteria.
Signs and tests
A physical examination may reveal an enlarged, mildly tender prostate. The examination may reveal enlarged and/or tender lymph nodes in the groin area, scrotal swelling and tenderness, and a urethral discharge.
A urinalysis reveals increased white blood cells (WBCs) and bacterial growth upon culture of urine #3. Culture of prostatic secretions shows in increased levels of WBCs and more concentrated bacterial growth.
A semen analysis may also show increased numbers of white blood cells and decreased numbers of sperm, with poor motility.
Treatment options for chronic prostatitis include a combination of medication, surgery, and lifestyle changes.
The course of antibiotic therapy is long -- frequently 6 to 8 weeks but may be continued much longer. Most antibiotics are not able to adequately penetrate the prostate tissue. Often, infectious organisms persist despite long periods of treatment.
After antibiotic treatment has ended, recurrence of symptoms is common.
Increasing the intake of fluids (64 to 128 ounces per day) encourages frequent urination that will help flush the bacteria from the bladder.
Expectations (prognosis)Recurrence of symptoms is common.
ComplicationsIf the enlarged prostate restricts the flow of urine through the urethra, urinary retention may cause kidney damage.
Calling your health care provider
Call your health care provider if symptoms of chronic prostatitis occur.
Prevention includes avoiding urinary tract infections and sexually transmitted diseases. Completion of the full course of antibiotic treatment decreases chance of recurrence.
Update Date: 5/25/2002Young Kang, M.D., Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT