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Prostatitis
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Prostatitis is inflammation of the prostate gland and may be caused by bacterial infection. There are four types of prostatitis: acute bacterial prostatitis.chronic bacterial prostatitis.chronic non-bacterial prostatitis.asymptomatic inflammatory prostatitis.
Pharmacotherapeutic interventions for the treatment of bacterial prostatitis
Published in Expert Opinion on Pharmacotherapy, 2022
Ester Marquez-Algaba, Joaquin Burgos, Benito Almirante
Prostatitis is one of the most common urogenital diseases in men, and approximately 1 of 6 men will receive a diagnosis of prostatitis in their lifetime [1]. It is characterized by voiding symptoms and genitourinary pain and is sometimes associated with sexual dysfunction [2]. Although it is rarely serious or fatal, prostatitis is associated with significant morbidity, and it substantially impairs quality of life. Since 1994, the National Institute of Health consensus has classified prostatitis into four categories based on clinical characteristics: I, acute bacterial prostatitis (ABP); II, chronic bacterial prostatitis (CBP); III, chronic prostatitis/chronic pelvic pain syndrome (CP/CPSS); and IV, asymptomatic inflammatory prostatitis [3] (Table 1). This scheme clarified that a minority of men with prostatitis, approximately 20%, have a bacterial infection (acute or chronic). However, there is still a lack of agreement about how to define acute and chronic prostatitis, including debates over the relative importance of various clinical, microbiological, radiological, and histopathological findings.
Prostatic chronic inflammation and prostate cancer risk at baseline random biopsy: Analysis of predictors
Published in Arab Journal of Urology, 2020
Alessandro Tafuri, Marco Sebben, Giovanni Novella, Marco Pirozzi, Tania Processali, Aliasger Shakir, Riccardo Rizzetto, Nelia Amigoni, Riccardo Bernasconi, Matteo Brunelli, Maria A. Cerruto, Salvatore Siracusano, Alessandro Antonelli, Walter Artibani, Antonio B. Porcaro
In daily clinical practice, the presence of prostatic inflammation is under-estimated [2]. Prostate biopsy may reveal different types of prostatitis, such as acute prostatic inflammation, prostatic chronic inflammation (PCI), and non-specific granulomatous prostatitis. Moreover, PCI has also been classified clinically into four categories by the National Institutes of Health (NIH) [3]. The last category, ‘asymptomatic inflammatory prostatitis’, which is also coded as ‘type IV’ is a kind of PCI detected after biopsy in patients who have no history of genitourinary tract complaints but present with increased PSA levels and/or abnormal DRE [3]. The risk of PCa has been related to multiple factors that influence the prostate microenvironment. Here, PCI may have a pivotal role in the initial phase leading to PCa. In addition, the recent development of immunotherapy and vaccines against PCa underline the pivotal role of the immune system in PCa biology [4]. Our group has previously shown an inverse association between PCI and PCa [5]. On the contrary, clinical studies have shown that a personal history of prostatitis, as well as symptom duration were significantly associated with an increased risk of PCa [6]. Further, Gurel et al. [7] reported that PCI was associated with a 30% increase in the risk of PCa.
Increased risk of prostatitis in male patients with depression
Published in The World Journal of Biological Psychiatry, 2020
Chi-Shun Lien, Chi-Jung Chung, Cheng-Li Lin, Chao-Hsiang Chang
Prostatitis accounts for 8% of the cases in urology outpatient clinics and causes lifetime suffering of approximately 16% of men in the United States. According to the National Institutes of Health’s consensus classification, prostatitis is divided into four categories: acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/pelvic pain syndrome (CP/CPPS), and asymptomatic inflammatory prostatitis. Acute bacterial prostatitis is an acute urinary tract infection related to the prostate. Chronic bacterial prostatitis is a recurrent urinary tract infection with the same bacteria cultured in prostatic secretions during asymptomatic periods (Krieger et al. 1999). Approximately 10% of men with acute prostatitis will eventually develop chronic prostatitis. Similarly, chronic prostatitis comprises approximately 10% of all prostatitis cases (Krieger and Egan 1991). The guideline defines CP/CPPS as that which presents chronic pelvic pain and possible voiding symptoms without the evidence of infection (Nickel et al. 1999). The aetiology of chronic prostatitis and chronic pelvic pain syndrome is poorly understood but may involve an infectious or inflammatory initiator that results in neurological injury, and eventually in pelvic floor dysfunction in the form of increased pelvic tone (Murphy et al. 2009). One study also found that the synergistic interaction of benign prostatic hyperplasia and prostatitis is a risk factor for prostate cancer (Hung et al. 2013).