Prostatitis is a complex disease. However, you will be surprised by the serious and varied implications it can have for men’s health.
Last update: November 12, 2021
Prostatitis involves inflammatory or infectious processes that affect the gland called prostate. This is part of the male reproductive system. It is located under the bladder, next to the rectum, surrounding the urethra.
Prostatitis occurs most frequently between the ages of 20 and 40. This does not mean that it cannot happen at any time. In fact, it affects 10 to 14 out of every 100 men.
Causes of prostatitis
Prostatitis has diffuse causes. Delayed diagnosis and nonspecific treatment remain a problem.
Although there are several classifications of the pathology, the most used is the one that divides it into bacterial and non-bacterial. Let’s see.
Acute bacterial prostatitis
Acute bacterial prostatitis is a infection of the prostate caused by bacteria that travel up the urinary tract inferior or lymphatic route from the rectum. In these cases, the infection is said to be retrograde, since the bacterial elements rise from outside the urogenital system.
Bacterial prostatitis due to urinary infections
In men, unlike women, the urethra is part of the reproductive system. The prostate gland has several mechanisms to defend itself against infection. From its entrainment and evacuation during urination and ejaculation to the production of antimicrobial substances.
However, poor drainage of secretions or backflow of urine into the prostate leads to inflammation of the gland. This is how most bacterial prostatitis have their origin in recurrent urinary infections.
Generally, only one type of microorganism causes the infection. In 50% to 87% of cases, this bacteria will be Escherichia coli.
Bacterial prostatitis and sexually transmitted infections
Bacterial prostatitis they can also be a consequence of sexually transmitted diseases. Bacteria such as Gardnerella vaginalis,Chlamydia trachomatis and Neisseria gonorrhoeae.
Along with this, these germs can trigger autoimmune events, aggravating the condition. Such is the case of infection by C. trachomatis in which antibodies are generated that attack sperm.
As for non-bacterial prostatitis, its origin is less clear. In this regard, there are several theories.
One of them is that there is a backflow of urine that causes irritation and chronic inflammation of the prostate. Another is that microorganisms or the substances produced by them stimulate an autoimmune response.
Another theory links chronic prostatitis to hemorrhoids and varicocele. All due to a malfunction of the veins in the pelvic area.
There are different factors that can favor the appearance of prostatitis. These include medical conditions such as urinary catheter use and dialysis treatment. Likewise, suffering from diabetes and infection by the human immunodeficiency virus are added that increase the risk.
Secondly, sexual habits are substantial determinants for the development of prostatitis. Thus, having multiple sexual partners without the use of a condom is considered high-risk behavior.
Depression as a risk factor for prostatitis
According to some theories, chronic prostatitis can behave like a psychosomatic illness. This entity has been linked to stress, anxiety, and increased sensitivity to pain.
Along these lines, Lien et al. Conducted a study in which they found that men with depression had almost twice the risk of suffering from acute and chronic prostatitis compared to those without. The mechanisms by which this happens are still a matter of investigation.
Men with prostatitis present a series of nonspecific lower genitourinary tract symptoms. Among them, the pain between the scrotum and the rectum that radiates to the groin and even the genitals stands out. In some cases, pain in the lower back.
Other common symptoms are fever, general malaise, increased urination or urinary retention, as well as discomfort when urinating. Including pain during sexual intercourse and premature ejaculation.
In some patients the most noticeable symptoms are urinary symptoms. While in others, the manifestations are evident in sexual life.
Many men with prostatitis are asymptomatic. This leads to the condition becoming chronic. Occasionally, in men over 50 years of age, the diagnosis is made accidentally, due to abnormal findings on a urine test.
Diagnosing prostatitis is not straightforward. A complete medical history and a detailed physical examination will always be important. The survey of prostatitis symptoms proposed by the National Institutes of Health of the United States may be of help.
In acute bacterial prostatitis, the prostate is enlarged, tender, and very painful to palpation. The Asian Association of Urinary Tract Infection and Sexually Transmitted Infection (AAUS) recommends performing a urinalysis that would show leukocytes and bacteria, as well as a urine culture.
The determination of the prostate antigen (PSA) is not a routine test for the diagnosis of prostatitis. But if you do, it will be elevated. In such a circumstance, post-treatment follow-up should be done.
For its part, in chronic prostatitis digital rectal examination is not helpful. Minimally high magnification and sensitivity will be found.
In this case, other tests are helpful, such as sperm culture and semen culture. Occasionally, a biopsy may be required to make the diagnosis.
Jointly, a prostate ultrasound is key in the diagnosis of acute and chronic prostatitis. It will serve to rule out the presence of complications, such as a prostate abscess.
The range of complications of prostatitis is wide. A poorly treated bacterial variant can have serious consequences, such as abscess, testicular infection, or sepsis.
Meanwhile, when the problem becomes chronic, it brings with it chronic pain and sexual dysfunction. Even infertility is an expected result.
Sexual dysfunction and psychological problems derived from prostatitis
Failure to consult in time leads to symptoms becoming chronic and worse. The intensity of pain due to prostatitis can be such that it compromises male sexual performance. Relationships can become a traumatic and painful experience.
Considering that this is a taboo subject, men do not share it with anyone. Such a situation leads to disorders of a psychological nature.
Prostatitis and male infertility
The prostate is a gland that secretes a prostate fluid rich in zinc, which represents between 25% to 30% of the volume that is ejaculated. The accessory glands secrete proteins such as semenogelin, which released by the seminal vesicle produce viscosity in the semen.
The above is the reason why prostatitis can prevent fertilization or hinder it. Since the semen conditions must be perfect for an efficient process.
Prostatitis and prostate cancer
According to the American Cancer Society, several researchers have found an association between prostatitis and prostate cancer. This is how, in the inflamed tissue of the prostate, cancer cells have been found.
Although additional studies are needed to confirm this hypothesis, this makes us think about the care and dedication with which we must diagnose patients. The management and good treatment of prostatitis will be the basis to avoid fatal outcomes.
3 tips to prevent prostatitis
There are simple measures that can prevent prostatitis. Its application is easy and does not require too many complications.
1. Wash your hands
Wash your hands before and after urinating decreases the number of microorganisms found in the extremities. Therefore, with this measure, we can avoid infections.
2. Healthy sex life
All actions that help prevent sexually transmitted infections also prevent urinary tract infections and prostatitis. Among them, the correct use of condoms stands out.
3. Healthy body, healthy prostate
For the care of the prostate apply all those actions that promote well-being. Avoid stress, do physical activity, and eat a balanced diet.
The most important message is to consult with any symptoms. Overlooking, hiding, or ignoring annoyances will only compound the problem. It is crucial to put aside the embarrassment and go to the doctor on time.
It might interest you …
About The Author
Catherine A. Johnson