Symptoms
The symptoms of acute inflammation of the prostate are primarily the occurrence of high fever (with possiblechills), pain during bowel movement and burning sensation when urinating (alguria, dysuria), a frequent urge to urinate (pollakisuria), although only small amounts of urine can be passed. It is possible that a complete urinary retention occurs. In addition, pain in the anal, perineal, testicular, limb, groin, back or pubic region as well as pain during and/or after ejaculation may occur. In addition, blood admixtures in the urine and/or ejaculate may be noticeable. Chronic prostatitis, on the other hand, is more unspecific in terms of its symptoms: a slight feeling of pressure in the perineal area, impaired sexual function (erectile dysfunction) and – as with acute inflammation – a constant urge to urinate with painful sensation when urinating.
Diagnosis
There are several ways to diagnose an inflammation of the prostate. As part of the physical examination at the doctor’s office, a digital-rectal examination (in which the attending physician manually examines the last section of the bowel and can also palpate the prostate) can already provide information about the size and condition of the prostate: an inflamed prostate is usually slightly enlarged and painful to palpate. If an abscess has already formed on the prostate during the course of the inflammation, this can also be palpated.
Another quick and easy way to get an indication of an inflammation of the prostate is to take a blood sample. In acute prostatitis, the inflammation values in the blood can be significantly elevated, as can the inflammatory cells (leukocytes) and the prostate-specific antigen (PSA) as an organ-specific marker. In the case of chronic prostatitis, on the other hand, it is quite possible that no pathological changes in the patient’s blood are evident.
In addition to the blood sample, a urine sample can also indicate an inflammation of the prostate: acute prostatitis becomes apparent in the form of masses of inflammatory cells (leukocytes), bacteria and red blood cells in the urine, whereas the chronic form of prostatitis can also be inconspicuous. The so-called four-glass sample is also known, in which both the first urine and the medium-stream urine, the urine after prostate massage and the prostate secretion are examined for signs of inflammation and for pathogen diagnostics. The examination of a sample of ejaculate can also serve to determine inflammation.
Ultrasound (sonography) is primarily used as an imaging diagnostic tool, during which inflammatory changes in the prostate tissue, the size of the prostate and abscesses can be visualized. The ultrasound examination is usually performed through the anus. Another possibility of examination is the MRT.
Uroflowmetry can be used as an additional examination to check for urine flow and micturition disorders. Here, the maximum urine flow and the amount of urine discharged in a given time are measured. If a urethral narrowing is suspected, a so-called urethrography can also be performed, in which a contrast medium is injected into the urethra and an X-ray of the urinary drainage system is taken In order to rule out possible differential diagnoses such as benign prostate enlargement or prostate carcinoma, a prostate biopsy can be performed if the findings are unclear beforehand.
Acute and chronic inflammation of the prostate differ in individual aspects of the therapeutic procedure. Acute bacterial inflammation is primarily treated with a high dose of an antibiotic prescribed by the respective physician to combat the causative pathogen (e.g. cotrimoxazole, cephalosporins, gyrase inhibitors). The exact choice of antibiotic depends on the exact determination of the pathogen and pathogen resistance in the course of the diagnosis.
It may be necessary to drain urine from the bladder temporarily using a catheter (bladder catheter). If a purulent abscess has developed in or around the prostate during the inflammation, it must be surgically opened. In addition, painkillers and antispasmodic drugs can be given.
A chronic form of prostatitis is also attempted to counteract with antibiotics, although this often does not lead to the desired success. This is usually a long-term antibiotic therapy, which can also be combined with analgesic and antispasmodic drugs, as in the acute form. However, alternative therapeutic approaches achieve better results, such as the administration of phytotherapeutics (drugs made from medicinal plants) such as quercetin (natural dye from certain fruits and herbs that acts as a free radical scavenger and antioxidant) or pollen extracts.Alpha-blockers (e.g.
tamsolusin), 5-alpha-reductase inhibitors (e.g. finasteride) and the antimycotic mepartricin can also improve the symptoms of chronic inflammation of the prostate. As an accompanying therapy for acute or chronic inflammation of the prostate gland, the use of warm hip baths or the wearing of warm clothing is always possible, which can lead to a reduction in swelling and relief of pain and tension due to improved blood circulation in the pelvis. Other home remedies that can be used to treat the symptoms include drinking willow herb tea, a vegetarian diet and plant-based alternatives such as nettle root, pumpkin seeds, rye pollen, pumpkin and saw palmetto fruit. Also in homoeopathy specific therapy approaches are found with Prostataleiden in the context of an inflammation: for this the income of Aristolochia, Clematis or Sabal Serrulatum (welfare plants) in a dosage prescribed by the welfare practical man counts.
