Most men would prefer not to have to think about having an organ like the prostate gland at all – the main thing is that it works. But it’s not enough that half of all men experience discomfort from an enlarged prostate after the age of 60; even at younger ages, the prostate gland can draw unpleasant attention to its existence.
Definition of prostatitis syndrome.
The chestnut-sized prostate is one of the internal male sex organs and contributes to sperm formation, closure of the urinary bladder and seminal ducts, and hormone metabolism. The disorders described below are grouped under the term prostatitis syndrome:
- Acute or chronic bacterial prostatitis: like any other organ, the prostate can become inflamed, especially since it has a direct connection to the urethra and thus to the outside world, through which germs can enter the body. Rarely, pathogens also migrate via the bloodstream or lymphatic system. However, prostatitis caused by germs account for only 10% of all prostatitis cases.
- Chronic abacterial prostatitis: the remaining 90% are disorders that are not caused by pathogens. Since pain is the main feature of these, they are also called chronic pelvic pain syndrome (CPPS), which may or may not be accompanied by signs of inflammation (abacterial inflammatory or non-inflammatory prostatitis). Previously, the term prostatopathy was also used.
- Asymptomatic prostatitis: in this there is detectable inflammation, but no symptoms are present. It is diagnosed, for example, in the search for causes of infertility.
What are the causes of prostatitis?
As complicated as the names are, the underlying causes are diverse:
Acute or chronic bacterial prostatitis: although the organism has a number of protective mechanisms, these can lose effectiveness in some situations. These include narrowing of the urethra (e.g. due to scars), interventions such as cystoscopy or the insertion of a bladder catheter, but also diabetes or immune disorders.
The pathogens are predominantly Escherichia coli (which make up a large proportion of stool bacteria) and other intestinal bacteria, now and then also Pseudomonas aeruginosa, a widespread soil and water germ that also resides in the intestines of many people and particularly likes to take advantage of a weakened immune system. The various pathogens of sexually transmitted diseases, such as chlamydia, gonococcus and mycoplasma, can also cause prostate infection. Tuberculosis bacteria are more likely to be washed in through the blood.
Chronic abacterial prostatitis: Although this form is very common, the exact causes remain unknown. In recent years, various triggers have been suspected, including narrowing of the urethra with fluid backing up into the prostate, restricted release of prostatic secretions (which then back up), autoimmune disease, or germs for which there are simply no detection methods. Dysfunction of the pelvic floor muscles and psychological influences are also discussed.
Recently, chronic “interstitial cystitis” has been held responsible for the symptoms, an inflammation of the urinary bladder caused by an altered mucosal permeability to harmful substances. Presumably, several factors must come together to produce a chronic pelvic pain syndrome.