What is prostatitis and Types of prostatitis?

Created for the National Cancer Institute,

Prostatitis is the most common urologic condition in men under 50 years of age. Its symptoms are varied, although the most characteristic is pelvic pain, urinary disorders, and sexual dysfunction. Know how it is solved.

The term prostatitis is used in a generic way to refer to a condition that includes a wide variety of alterations that range from an acute or subacute bacterial infection to nonspecific symptoms of the lower genitourinary tract, characterized mainly by perianal or genital pain, voiding symptoms such as dysuria (difficult, painful and incomplete expulsion of urine) and frequency (increased number of urination during the day, which are usually small), or sexual dysfunction in its various manifestations.

Who is affected by prostatitis

However, its diagnosis is difficult due to the limitations of the diagnostic methods and the confusion with the rest of the prostate pathology. 

It would represent the most common urological diagnosis in those under 50 years of age. The third most frequent in those over 50 years after benign hyperplasia: prostate (BPH) and prostate cancer.

Epidemiological data from North America, Europe, and Asia suggest that 2-10% of adults present with symptoms consistent with chronic prostatitis at some point in their life.

The different prevalence of the different types of prostatitis is 62% for category III (the most frequent), followed by I / II with 19% and IV with 10%.

Types of prostatitis

Clinically there are several prostate syndromes; The US National Institute of Health (NIH) proposed a classification, which is the current one, dividing the prostatic inflammation syndrome into the following types of prostatitis :

  • Category II. Chronic bacterial prostatitis (recurrent urinary tract infection and chronic prostate infection).
  • Category III. Chronic abacterial prostatitis / chronic pelvic pain syndrome (perineal or pelvic pain, minimum three months, with variable voiding or sexual symptoms without proven infection).
  1. Subcategory III a. Chronic inflammatory pelvic pain syndrome.
  2. Subcategory III b. Non-inflammatory chronic pelvic pain syndrome.
  • Category IV. Asymptomatic inflammatory prostatitis (evidence of inflammation on biopsy, semen, post-massage prostatic discharge, or post-massage urination in the absence of symptoms).

Acute and chronic prostatitis

The pathogenesis of acute prostatitis differs from the rest of the chronic entities. In the former, there is an actual acute parenchymal infection of the prostate gland (of its glandular tissue), generally by common uropathogens (microorganisms with the ability to infect the urinary tract) (mainly E. coli ), and that can cause, if allowed to evolve without treatment, bacterial shedding leading to life-threatening urinary sepsis or prostate abscess.

On the contrary, different hypotheses have been considered about the origin of its causes in chronic prostatitis.

Symptoms of a prostatitis

The different infectious or inflammatory processes that affect the urethra-prostate-vesicular area present similar symptoms. The most common urinary disorders are represented by dysuria (burning or pain when urinating), urgency (sudden and uncontrollable urge to urinate), and frequency (urge to urinate more frequently than normal), both day and night, painful urination, and even acute retention of urine.

In chronic prostatitis syndromes, the symptoms are sometimes scarce or non-existent, only involving alterations in the semen that condition infertility. On other occasions, sexual symptoms such as decreased libido, total or partial loss of erection, painful ejaculation, premature ejaculation, hemospermia (blood in semen), or infertility predominate.

The pain is referred to disparate areas: suprapubic, perineal, lumbosacral, scrotal, penile, and inner thighs.

Of all the symptoms of prostatitis mentioned, none of them are specific to a certain type of prostate disease, except for the acute form of infection of this gland, in which the clinic presents very well-defined characteristics with fever, poor general condition, dysuria, spontaneous perineal pain or pain with urination, and occasionally acute urinary retention.


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