Prostate Cancer Information
Advanced Prostate Cancer
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Prostatitis
- Prostatitis
PROSTATITIS
To put
it simply, prostatitis is inflammation of the prostate gland.
There
are three main classifications of prostatitis
Acute
bacterial prostatitis -- acute infection of the prostate gland,
usually occurs in men aged 40 to 60 years.
Chronic
bacterial prostatitis -- recurrent infection of the prostate,
occurs in men aged 50 to 80 years. It is associated with chronic
urinary infection and, commonly, calcifications in the prostate
(prostatic stones). In the cases of bacterial prostatitis,
the culprit usually is a bacteria known as Escherichia coli.
The cause of bacterial prostatitis is not well--defined, but
one theory suggests a reflux of urine from the bladder into
prostatic ducts. This reflux of urine may lead to prostatitis.
Nonbacterial
prostatitis -- inflammation without any evidence of infection
present, occurs in men aged 30 to 50 years. The cause of chronic
nonbacterial prostatitis is unknown.In addition, there is
another condition termed prostatodynia. The symptoms are similar
to prostatitis, but there is no evidence of prostate inflammation.
Each
form has a slight variation in signs and symptoms.
SYMPTOMS
OF PROSTATITIS
Each form
of prostatitis has a slight variation in signs and symptoms.
Acute
bacterial prostatitis
- Sudden
onset of fever and chills
- Pain
in lower back or rectum
- Irritative
or obstructive urinary symptoms
- Prostate
is warm, swollen, and tender upon examination
Chronic
bacterial prostatitis
- Relapsing
urinary tract infections
- Painful
urination or other voiding problems
- Ejaculatory
pain
- Pelvic
or genital pain
Some men
may not have any symptoms
Nonbacterial
prostatitis
- Chronic
pelvic pain (testicular, penile, lower abdominal, ejaculatory)
- Persistent
inflammation of the prostate
- Absence
of infectious bacteria in urine
DIAGNOSING
PROSTATITIS
The gold
standard for diagnosing prostatitis would be to perform a
biopsy of the prostate, but this is rarely done. Instead,
doctors may diagnose prostatitis by examining prostatic secretions
for bacteria. To do this, a "four-cup" test may
be conducted. To start, the patient must have a full bladder.
The doctor will clean the glans penis with soap and water
and will then collect two cups of urine. Next, the prostate
will be massaged by a digital rectal examination (DRE) to
allow prostatic fluid to travel through the urethra. Two more
cups of urine will be collected, and the expressed prostatic
secretion (EPS) in the urine is examined for the presence
of bacteria. Some physicians may not perform the "four-cup"
test, and may just obtain urine before and after massaging
the prostate. Sometimes EPS secretions from the urethra can
be collected from the tip of the penis after massaging the
prostate. After the physician collects these secretions, they
can be examined under a microscope.Nonbacterial prostatitis
is more difficult to diagnose. With these patients, the EPS
will have evidence of inflammation, but bacteria will not
be present. The lack of recurrent urinary tract infections
distinguishes nonbacterial prostatitis from chronic bacterial
prostatitis.
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