Prostatitis

When a urinary tract infection spreads to the prostate, prostatitis develops. In most cases, an enlarged prostate is the main factor favouring the development of urinary tract infections in men.

Under the influence of the male sex hormone, the prostate enlarges with increasing age. This is referred to as benign prostatic enlargement. Incidentally, this condition has nothing to do with prostate cancer.

Most people are unaware that the urethra runs right through the middle of the prostate after leaving the bladder. If the prostate is enlarged, it can therefore constrict the urethra. This can then lead to difficulties urinating and the formation of residual urine, which means that the bladder no longer empties properly. Bacteria like to settle in this environment. This is also the reason why prostatitis tends to occur at an advanced age.

As prostatitis usually develops on the basis of a urinary tract infection, it is often preceded by symptoms such as frequent urination and burning. Fever is then usually the first sign that the prostate is involved. Pain in the anal area may also occur. Over time, the general condition can also be severely impaired, with headaches and fatigue.

The urologist usually makes the diagnosis on the basis of the classic symptoms. In addition to a physical examination and ultrasound diagnostics, a laboratory test is also carried out. This shows an increase in the PSA value in the blood. However, in this case this value, which is otherwise used in prostate cancer screening, is an expression of the acute inflammation and not an indication of malignant processes.

Treatment is with antibiotics; if residual urine forms, it may also be necessary to insert a catheter. It is important to take the medication for a sufficiently long time, as otherwise chronic courses can develop. The PSA value is then often permanently elevated, which makes cancer screening more difficult.

If symptoms persist for longer than 3 months and germs are repeatedly found in the urine, this is referred to as chronic prostatitis. If symptoms exist without detection of germs, this is referred to as abacterial prostatitis or chronic pelvic pain syndrome, which can have many causes. Treatment can be with medication, and physical therapies are also effective. Despite an often months-long course, the prognosis is generally good.