ВТОРОЕ МЕДИЦИНСКОЕ ЗАКЛЮЧЕНИЕ
Prostatitis

Although the male and female bodies are largely similar in terms of tissue and functions, they differ from each other in various aspects. For example, some internal organs such as the prostate gland are unique to the male body, and some disorders may occur in the prostate gland, as in all other organs. One of these health problems that negatively affect daily life is the disease called prostatitis.

What is Prostatitis?

As part of the male reproductive system, the prostate gland is a hazelnut-sized gland with ducts that open to the urinary tract, located just below the bladder. Basically, the prostate gland, which gives the semen fluid its white color, is responsible for the secretion of the prostate fluid, which contains various nutrients, which is a very important element for the health of sperm.

Inflammation of the prostate gland, which is associated with urine, due to various factors is called prostatitis. This may occur due to urinary tract infections related to the region of the organ. Prostatitis, which is a common and painful health problem that can be seen in men of all ages, basically appears in four different types:

• Asymptomatic inflammatory prostatitis: Inflammation of the prostate gland without causing any clinical signs. It is detected incidentally during clinical examination.

• Acute bacterial prostatitis: It is the name given to the painful inflammation that develops suddenly when the prostate gland is infected by various microorganisms.

• Chronic bacterial prostatitis: It can be defined as a prolonged infection of the prostate gland occupied by microorganisms or causing recurrent episodes of acute prostatitis.

• Chronic prostatitis/chronic pelvic pain syndrome (KP/KPAS): It is the most common type of prostatitis. It is a condition characterized by pain and discomfort throughout the pelvic region as a result of inflammation of the nerve net around the gland, along with the prostate gland.

How does Prostatitis develop?

Prostatitis basically occurs as a result of the development of an inflammatory reaction in and around the prostate gland. This reaction may develop spontaneously in the absence of microorganisms, in response to an overt bacterial infection or secondary to stress, nerve damage, interventional methods applied to the area, traumatic injuries, or pre-existing infections.

Bacterial prostatitis, on the other hand, usually occurs due to the progression of the infectious agent reaching the urinary tract into the body and then reaching the prostate gland. In this sense, urinary tract infections, which are common in society, can cause prostatitis, and various sexually transmitted diseases can lead to the emergence of prostatitis.

Prostatitis cases that develop without infection often progress in the form of chronic inflammation as a result of traumatic damage or nerve damage in the region. In these cases, no microorganism is encountered during the diagnostic process. With inflammation of the muscles and nerves around the prostate gland, complaints may occur throughout the pelvis area.

What are the causes of Prostatitis?

Bacterial or inflammatory prostatitis can occur under the influence of a wide variety of health problems. Conditions that cause prostatitis discomfort can be listed as follows:

• Urinary tract infections: Infectious agents that are common in the community and can affect the urinary tract at various levels can cause inflammation in the prostate gland.

• Sexually transmitted infections: Some sexually transmitted infections, such as chlamydia, can cause inflammation of the prostate gland along with urinary tract infection.

• Interventions in the urinary tract: Catheter placed in the urinary tract, surgical procedures or imaging studies may cause injury in the area and result in inflammation.

• Anomalies developing in the urinary tract: In cases such as narrowing of the urinary tract due to various reasons and the appearance of scar tissue in the region, inflammation of the prostate gland becomes easier.

• Physical trauma: Various external physical trauma factors can also cause prostatitis by damaging the prostate gland and its surroundings.

• Stress: Some studies have shown that men who experience intense stress can develop inflammation due to damage to the nerves around the prostate.

• Nerve damage: Various conditions that affect the nerve network around the prostate gland can result in inflammation, although there is no bacterial infection.

• Impairment of the immune system: Prostatitis may occur in the course of diseases that cause immune deficiency such as HIV infection.

• Some chronic diseases: Various chronic diseases such as chronic fatigue syndrome, irritable bowel syndrome can also cause prostatitis.

What are the Symptoms of the Prostatitis?

The clinical symptoms caused by prostatitis may vary depending on the type of disease. In this regard, the most frequently observed symptoms according to the type of prostatitis are as follows:

• Asymptomatic inflammatory prostatitis does not cause any obvious clinical symptoms. However, infertility may develop due to various dysfunctions in the prostate gland, where long-term inflammation is observed.

• Sudden onset of acute bacterial prostatitis; It manifests itself with symptoms such as high fever, groin pain, painful urination, difficulty urinating, dark colored, inflamed urination and inflamed discharge.

• In chronic bacterial prostatitis, where the acute condition turns into a long-term condition, symptoms such as burning sensation during urination, the need to urinate frequently, getting up to urinate at night, a feeling of heaviness behind the testicles and pain in the groin, anus, genital area and the area above the bladder are seen.

• In chronic prostatitis/chronic pelvic pain syndrome, painful and difficult urination for more than three months, pain around the anus along with the groin and genital area, and difficulty and pain during ejaculation (ejaculation) can be seen.

How is Prostatitis diagnosed?

In the diagnostic process, the prostate gland should be evaluated by a specialist doctor. After a detailed disease history and detailed physical examination taken by the doctor, various imaging methods such as ultrasound and computerized tomography can be used for laboratory tests. The presence of microorganisms in urine and semen samples can be investigated. At the same time, rectal palpation may be required during examination of the prostate gland.

In the light of the data obtained after all these examinations, the diagnosis of prostatitis is made and the type of prostatitis seen in the patient is determined. Establishing an appropriate treatment plan, depending on the type of prostatitis, is critical.

How is Prostatitis treated?

Although the treatment of prostatitis is mainly determined by the type of prostatitis in question, the following methods are often used in the treatment of prostatitis:

• Patients are often treated with antibiotics. The type of antibiotic to be given is determined by the type of microorganism detected in the culture study on the urine sample. In patients with severe clinical manifestations, antibiotic therapy may need to be administered intravenously in the hospital and the patient may need to stay in the hospital. Oral antibiotic therapy can last from 2 weeks to 12 weeks, depending on the severity of the disease.

• Anti-inflammatory drugs are among the drugs often used to control inflammation. Pain relievers and muscle relaxants may also be given.

• Medications called alpha blockers are another treatment method used to widen the urinary tract and solve problems with urination.

• In some patients, with the decision of the specialist doctor, prostatic massage can be applied to relieve inflammation in the prostate gland. Prostatic massage is the process of evacuating the inflamed secretion fluid by massaging the prostate gland over the rectum through the anus.

• In addition to all these, some changes in the lifestyle of the patient are also critical. These changes include applying a hot compress to the aching area, taking a hot sitz bath, avoiding acidic drinks and spicy foods, consuming plenty of fluids, and doing exercises to relax the pelvic muscles. Prostatitis can result in various complications if not treated effectively and correctly. Complications that may occur in this case are as follows:

• Sepsis, also known as blood poisoning, may develop due to the mixing of the prostatitis infection into the blood. Sepsis can lead to serious infection that can be life-threatening.

• The infection in the prostate gland can continue to progress and infect the sperm ducts and lead to a condition called epididymitis.

• Inflammatory fluid accumulating in the prostate gland can lead to an abscess.

• Infertility can occur as a result of destruction of the prostate gland or sperm ducts due to infection.

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