Prostatitis
An inflammation of the prostate gland, prostatitis may be acute or chronic. Acute prostatitis most commonly results from gram-negative bacteria and is easy to recognize and treat. However, chronic prostatitis, the most common cause of recurrent urinary tract infection (UTI) in men, is less easy to recognize. As many as 35% of men older than age 50 have chronic prostatitis.
Causes
About 80% of bacterial prostatitis cases result from infection by Escherichia coli; the rest, from infection by Klebsiella, Enterobacter, Proteus, Pseudo-monas, Streptococcus, or Staphylococcus. These organisms probably spread to the prostate by the bloodstream or from ascending urethral infection, invasion of rectal bacteria via lymphatics, reflux of infected bladder urine into prostate ducts or, less commonly, infrequent or excessive sexual intercourse or such procedures as cystoscopy or catheterization. Chronic prostatitis usually results from bacterial invasion from the urethra. It’s a major cause of recurrent UTI in men.
Signs and symptoms
Acute prostatitis begins with fever, chills, low back pain, myalgia, perineal fullness and discomfort, and arthralgia. Urination is frequent and urgent. Dys-uria, nocturia, and urinary obstruction may also occur. The urine may appear cloudy. When palpated rectally, the prostate is tender, indurated, swollen, firm, and warm.