Prostatitis is an
inflammationInflammation is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. Inflammation is not a...
of the
prostateThe prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have prostate glands...
gland, in men. A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits in the
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
.
The term
prostatitis refers, in its strictest sense, to histological (microscopic)
inflammationInflammation is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. Inflammation is not a...
of the tissue of the
prostateThe prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have prostate glands...
gland, although it is loosely (and confusingly) used to describe several completely different conditions.
Prostatitis is an
inflammationInflammation is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. Inflammation is not a...
of the
prostateThe prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have prostate glands...
gland, in men. A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits in the
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
.
Classification
The term
prostatitis refers, in its strictest sense, to histological (microscopic)
inflammationInflammation is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. Inflammation is not a...
of the tissue of the
prostateThe prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have prostate glands...
gland, although it is loosely (and confusingly) used to describe several completely different conditions. To remedy this, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system in 1999, comprising four categories of prostatitis:
Category I
Acute prostatitis is a bacterial infection of the prostate gland that requires urgent medical treatment.
Category II
Chronic bacterial prostatitis is a relatively rare condition that usually presents as intermittent
urinary tract infectionA urinary tract infection is a bacterial infection that affects any part of the urinary tract.The main causitive agent is:Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it usually does not have bacteria in it. When bacteria get into the bladder or kidney...
s.
Category III
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS), accounting for 90%-95% of prostatitis diagnoses, is also known as
chronic nonbacterial prostatitis. The prevalence in the population of this disorder is 0.5%. Men in this category have no known infection, but do have extensive pelvic pain lasting more than 3 months. There are no standard diagnostic tests; diagnosis is by exclusion of other disease entities. Multimodal therapy is the most successful treatment option, and includes α-blockers,
phytotherapyPhytotherapy is the study of the use of extracts from natural origin as medicines or health-promoting agents. Even though phytotherapy is usually regarded as "alternative medicine" in the Western countries, when critically carried out, is considered an essential component of modern pharmacognosy.-...
, and protocols aimed at quieting the pelvic nerves through
myofascialMyofascial release is a form of soft tissue therapy used to treat somatic dysfunction and accompanying pain and restriction of motion. This is accomplished by relaxing contracted muscles, increasing circulation, increasing venous and lymphatic drainage, and stimulating the stretch reflex of muscles...
trigger pointTrigger points or trigger sites are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. Trigger point researchers believe that palpable nodules are small contraction knots and a common cause of pain. Compression of a...
release with psychological re-training for
anxietyAnxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry....
control. Antibiotics are not recommended.
Category IV
Asymptomatic inflammatory prostatitis patients have no history of genitourinary pain complaints, but
leukocytosisLeukocytosis is a raised white blood cell count above the normal range. This increase in leukocytes is usually accompanied by a "left shift" in the ratio of immature to mature neutrophils...
is noted, usually during evaluation for other conditions. Between 6-19% of men have pus cells in their semen but no symptoms.
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