Bacterial Prostatitis: Causes, Symptoms and Treatment
There are few studies about clinical courses following acute Prostatitis mit Sepsis prostatitis ABP. Total patients compatible with a confirmed diagnosis of ABP from 5 urological centers between and were enrolled to study. Of the ABP patients, 1. The progression rate of CI was The identification and characterization of these factors may accelerate the development of preventive, diagnostic and therapeutic Prostatitis mit Sepsis for the treatment of CI from ABP. ABP is acute inflammation inside the prostate tissues, presenting similar symptoms to lower urinary tract infections UTIs of women in terms of causal bacteria and urinary virulence factors but its host response is very different from uncomplicated cystitis and its treatment process is more complex [ 2 ].
Common symptoms of ABP include fever, chill, rectal pain, lower back pain, peri-neal pain and increased urinary frequency and urgency as well as painful urination [ 3 ]. In severe case, the patient can show symptoms related to sepsis such as high fever, chills, cardiovascular instability and change of consciousness.
The initial treatment Prostatitis mit Sepsis ABP is to administer high dose antibiotics intraveonousely until symptoms and signs such as fever, infection and others are resolved. After symptoms improved, the medication should be changed into oral antibiotics such as fluoroquinolone and administer it for 4 weeks at least [ 4 ]. Recently, with advancement of treatment with antibiotics, most patients with ABP recover without having complications. In most studies, clinical pattern, progression and risk factors of prostatitis focus on chronic bacterial prostatitis CBP rather than ABP.
This study was conducted in patients who were diagnosed with ABP and had been treated as in-patients at 5 hospitals from March Prostatitis mit Sepsis to October as a retrospective analysis. The patients who were diagnosed with prostate cancer at the time of hospitalization or during the follow-up study period for 24 months in average after being diagnosed with the infection had been excluded from this study.
All patients had been diagnosed as ABP according to the clinical symptoms fever, dysuria, painful prostate on digital rectal examination and the laboratory findings. Those patients with symptoms of ABP and showing positive urine culture, but also those Prostatitis mit Sepsis had shown negative response to urine culture test due to the Prostatitis mit Sepsis of antibiotics but presented typical symptoms of ABP were diagnosed as ABP.
When the diagnosis of ABP was not clear, those patients were excluded and so were those who had fever unrelated to UTI or who were unable to trace for follow-up study during treatment period. Finally, patients who were suitable Prostatitis mit Sepsis diagnosis of ABP were included in this study. We evaluated the progression rate CI from ABP and also evaluated the clinical and microbiological characteristics of the Prostatitis mit Sepsis in both groups.
We defined the alcohol intake as patients who drinks alcohol once or more per month and smoking history as who smoked at the time of diagnosis regardless the number of cigarettes.
Patients who takes medications at the time to diagnose ABP were defined as diabetes and hypertension.
When the sums of voiding symptoms and storage symptoms were 7 points and 5 points respectively in accordance with the International Prostate Symptom Score, they were defined as voiding symptoms and storage symptoms.
Those patients undergone prostate biopsy, Foley catheterization, urodynamic study and transurethral ressetion of prostate within 4 weeks prior to onset of ABP were defined as prior manipulations. Numereical data given in our data were standard deviation. Out of patients, patients The mean ages of each group were Fever Alcohol intake Rates of cystostomy During treatment Prostatitis mit Sepsis, the antibiotics of cephalosporin and aminoglycoside had been used most commonly, and during the treatment period as out-patient, quinolone was used most commonly, but there was no significant difference between two groups in terms of antibiotics types or used period Table 2.
Group A, recovered without Prostatitis mit Sepsis infection; Group B, developed to chronic infection. The most common bacteria among cultured pathogens was Escherichia coli followed by Pseudomonas spp and Klebsiella spp. There was no significant difference between two groups in types or distribution of cultured pathogens Table 3.
The authors implemented this study by separating the clinical prognosis of ABP into those with Prostatitis mit Sepsis to chronic inflammation and those Prostatitis mit Sepsis without progression to chronic inflammation.
The progression rate to chronic inflammation in patients with ABP in total was The reason that authors had included inflammatory CPPS in chronic inflammation was because CPPS Prostatitis mit Sepsis multifactor pathological bionomics so that inflammation could be its cause. Nickel et al. Patients with diabetes has much higher probability for incidence of UTI by 5 to 10 times [ 8 ].
Although it is presumed that the Prostatitis mit Sepsis of urine glucose is related to the Prostatitis mit Sepsis of Prostatitis mit Sepsis, there is nothing scientifically verified, and UTI in patients with Prostatitis mit Sepsis is considered as complicated UTI Prostatitis mit Sepsis requires treatment with antibiotics for longer period in comparison to patients without diabetes.
Geerlings [ 9 ] had reported that patients with diabetes had higher prevalence of other infections such as asymptomatic bacteriuria and UTI compared to patients without diabetes. Given these results, it is Prostatitis mit Sepsis to presume that diabetes has effects on the process of progression from ABP to CI and Prostatitis mit Sepsis possible to infer control of diabetes has an important role for prevention and treatment of ABP-induced chronic inflammation.
Prior manipulation such as prostate biopsy, urodynamic study, or urethral catheterization can spread inflammation through lymphatic system or blood circulation system. Ha et al. In this study, the percentage of those with prior history Prostatitis mit Sepsis procedures for urinary tract system and who showed progression to Prostatitis mit Sepsis was In comprehensive view of all these details, it is possible to infer that prior procedures for urinary tract system have effects on progression from ABP to CI thereby reduction of such procedures for lower urinary tract system would Prostatitis mit Sepsis an important role in preventing progression from ABP to CI.
Most of ABP is assumed as originated by ascending infection of urinary tract and it is presumed to incur by reflux of infected urine into ejaculatory duct or prostatic tube passing through posterior urinary tract.
The ascending infection of urinary tract can also onset by procedures for bladder and urinary tract such as urethral catheterization [ 10 ]. Lindert et al. Meanwhile, as cystostomy can reduce the internal pressure of prostatic tube and prevent intraprostatic tube reflux of infected urine, sprapubic cystostomy is being accepted as the best treatment for ABP. In this study, So it is possible to infer that not doing urethral catheterization or cystostomy may be related to the progression from ABP to CI.
Therefore, restraining urethral catheterization and performing cystostomy can be helpful for preventing progression to CI in patients with ABP. There is a report Prostatitis mit Sepsis many of patients diagnosed with prostatitis were also diagnosed with prostatic hypertrophy [ Prostatitis mit Sepsis13 ]. This condition makes patients more susceptible to inflammation of bladder or prostate as the inflammation either accelerates enlargement of prostate gland itself or such enlargement induces incomplete urination.
Linear mass growth can increase intraprostatic tube reflux and internal pressure of prostate theoretically. Such conditions elevate bacterial infection rate of prostate and decrease the treatment rate [ 14 ]. In this study, the prostatic volume of the group with progression to CI was larger than that of the group without progression CI.
Therefore reduction of prostatic volume can be helpful for preventing progression from ABP to CI by reducing voiding pressure. Approach to the treatment of ABP is determined by the clinical symptoms of Prostatitis mit Sepsis. In most cases, the treatment period of ABP in use of antibiotics is 2 weeks at minimum and sometimes there are cases requiring Prostatitis mit Sepsis to 6 weeks as well [ 1516 ].
Fluoroquinolone can be prescribed for 10 days in cases determined as having no accompanying complications and even if there is any but determined as minor [ 17 ]. Even though there had been no agreement on the best treatment method so far due to various factors including the needs of considering antibiotic Prostatitis mit Sepsis in specific regions, concomitant use of fluoroquinolone and aminoglycoside together in addition to inclusion or exclusion of penicillin orthe Prostatitis mit Sepsis and the 3rd generation cephalosporin are recommended to the patients with ABP being treated as in-patients [ 18 ].
When the patient is clinically stabilized, has no Prostatitis mit Sepsis, no urine retention and responds as negative to blood and urine culture tests, orally taking antibiotics can be initiated for use.
In this study, the treatment period of in-patients as well as out-patients whose ABP had progressed to CI in use of antibiotics was In case of in-patients at all ages, the combined therapy of cephalosporin and aminoglycoside was used most frequently, while in case of out-patients, quinolone was most commonly prescribed.
The period of antibiotics administration to prevent progression from acute prostatitis to chronic prostatitis is recommended as two to three weeks administration by Chronic Prostatitis Pollaborative Research Network Guidelines and in general, it is common to administer for about 1 month Prostatitis mit Sepsis 19 ]. In this study, antibiotics had been used in the group with progression to chronic inflammation for Of course, the timing to make determination on progression to chronic inflammation could not be 3 months after always but Prostatitis mit Sepsis authors had implemented this study by designating 3 months after treatment of acute prostatitis as the basis of progression or not according to clinical experiences.
Millan-Rodriguez et al. In this study, E. The patients who developed to CI were higher in alcohol consumption rate, diabetes, voiding symptoms, Prostatitis mit Sepsis manuplation rate, enlarged prostate volume, catheterization history rate and short duration of antibiotic treatment. Identification of these factors in patients with Prostatitis mit Sepsis can be helpful for establishing preventive, diagnostic and therapeutic strategies against progression to CI.
No potential conflict of interest relevant to this article was reported. National Center for Biotechnology InformationU. Journal List Prostate Int v. Prostate Int. Published online Jun Author information Article notes Copyright and License information Disclaimer. Received Dec 17; Accepted May This article has been cited by other Prostatitis mit Sepsis in PMC. Abstract Purpose: There are few studies about clinical courses following Prostatitis mit Sepsis bacterial prostatitis ABP.
Prostatitis mit Sepsis Total patients compatible with a confirmed diagnosis of ABP from 5 urological centers between and were enrolled to study. Results: Of the ABP patients, 1. Conclusions: The identification and characterization of these factors may accelerate the development of preventive, diagnostic and therapeutic strategies for the treatment of CI from ABP.
Keywords: Acute, Chronic, Bacterial prostatitis, Inflammatory chronic pelvic pain Prostatitis mit Sepsis, Progression. Table 1 Clinical characteristics of acute bacterial prostatitis patients. Open in a separate window. Table 2 Treatment parameters of acute bacterial prostatitis patients.
Table 3 Micribiologic characteristics of acute bacterial prostatitis patients. Neal DE. Acute bacterial prostatitis. In: Nickel CJ, editor. Textbook of prostatitis. Oxford: Isis medical media; Ludwig M. Diagnosis and therapy of acute prostatitis, epididymitis and orchitis. Acute bacterial prostatitis: heterogeneity in diagnostic criteria and management.
Retrospective multicentric analysis of patients diagnosed with acute prostatitis. BMC Infect Dis.