Prostate inflammation is one of the most common urogenital diseases in the male population: about 10% of men suffer from prostatitis once in their life. It occurs preferentially between the ages of 20 and 50, but can ultimately affect older men. In general, the prostate is a relatively inflammation-prone organ, due to the strong blood circulation, the large number of glands and the direct connection with the urethra, the latter being an entry point for potential pathogens.
The inflammation of the prostate is often accompanied by simultaneous inflammation of the epididymis or ureter (urethritis). A distinction is made between an acute course of inflammation and a chronic inflammation of the prostate, whereby the chronic form can often develop from an unhealed, acute one. If no causative pathogen can be detected in the course of the examination and diagnosis, the disease is referred to as abacterial prostatitis or chronic pelvic pain syndrome. This form of prostate inflammation occurs most frequently. If no organic causes for the patient’s complaints can be found, it can also be a prostate odynia, which is counted among the psychosomatic form circle.
Causes
Among the most common causes of inflammation of the prostate are pathogens in the context of urethritis, cystitis or epididymitis, which ascend to the prostate in the form of a transmitted urinary tract infection and infect it. In the course of the inflammatory process, an accumulation of defense cells (white blood cells, leukocytes) in the tissue of the prostate occurs, which leads to swelling and tissue irritation. In young men, these are mainly chlamydia and ureaplasma, whereas older men more often suffer from an inflammation of the prostate gland, which is caused by the gram-negative rod bacteria Escherichia coli (E. coli) that are normally found in the intestine.
Klebsiellae and mycobacteria in the context of tuberculosis belong to the rather rarer pathogens. In this respect also causes for the emergence of a urinary tract infection with men are considered always at the same time also as large risk factor for a Prostatitis: so for example also kidney and bladder stones, diabetes mellitus, a weakened immune system, tumors, too little drinking and cold weather (seats on cold surfaces, wet bathing pants etc.). The latter leads to reduced blood circulation in the area of the small pelvis, which makes it more difficult for immune cells to be quickly washed away when bacteria penetrate, thus promoting inflammation.
It is always possible for pathogens to be introduced during urological examinations or interventions, as may be the case, for example, when a bladder catheter is placed and positioned, a prostate biopsy is taken or a cystoscopy is performed. A narrowing or relocation of the urethra – by – also favours the colonisation of the urinary tract with bacteria, so that the risk of a forwarded infection of the prostate increases significantly. The spread of pathogens from inflammation foci outside the urogenital system via the blood and lymphatic system is rarer, but should nevertheless always be taken into account in diagnostics.
The cause of chronic pelvic pain syndrome or abacterial prostate inflammation has not yet been fully clarified. According to some theories, certain microorganisms that cannot be cultivated and therefore cannot be detected, can be a possible trigger, as well as bladder voiding disorders. Over time, urine flow disturbances from the bladder lead to an accumulation of urine and an increase in the volume of the bladder, which can then exert pressure on the immediately adjacent prostate.
This chronic pressure can eventually lead to tissue irritation and eventually to bacterial inflammation. Likewise, an inflammation of the bladder itself can spread to the prostate or nerve irritation in the immediate vicinity of the prostate can lead to adulterated prostate pain. It is even possible that an overactive immune system attacks the prostate tissue as part of an autoimmune reaction and leads to inflammatory damage. The cause for the occurrence of the so-called prostate dysplasia, which is neither caused by an organic disease nor by bacteria, is suspected to be an overexcitability of the pelvic floor muscles, which tends to cramp and can thus cause the pain symptomatology.
