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 DEFINITION
The prostatitis is the inflammation of the prostate gland that is between the genital organs of the male and that is placed about the conduit of exit of the urine. Males older than 35 years usually affect.
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CAUSES
The most frequent prostatitis is for a bacterial infectious cause for local transmission, but sometimes it is secondary to sexually transmitted diseases (gonorrhea, clamidia, and tricomonas).
In other occasions the prostatitis is secondary to medical performances like the urinal poll, the cistoscopia, or for traumatism, obstruction of the exit of the bladder for litiasis, etc...
The prostatitis is a quite frequent illness, since it can affect more than 1 of every 10.000 persons who come to the doctor.
The benign hypertrophy of prostate that usually affects major persons they have a major risk of suffering of prostatitis.
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SYMPTOMS
The initial symptoms of the sharp prostatitis with the presence of discomfort in the low abdomen, pain in the periné, inconveniences on having urinated and fever with shakes. If the picture persists the gland increases of size and begins to obstruct the urine exit with reduction and difficulty of his exit. As the area is affected there are usually problems of pain on having ejaculated or on having defecated. Sometimes if it stems the prostatitis to infections of sexual transmission usually accompanies herself of symptoms of epididimitis and orchitis.
For it it can present other symptoms accompanists as the blood presence in the urine, the increase of the frequency and urgency of urinating, pain in the testicles, and the blood presence in the semen.
DIAGNOSIS
The initial history with compatible prostatitis symptoms they will face the diagnosis. His doctor will do an exploration to him, by means of a rectal tact, of the prostate to evaluate if the prostate is inflamed, there lasts, warmly, sensitively, the size and the possible presence of pain and inflammation of the lymphatic ganglions inguinales. Also an exploration of the testicles is realized to evaluate the sensibility, the possible edema of the scrotum, and the secretions uretrales.
Later a finished study of the urine will be realized with the collection of three samples, one of the initial jet, other one of half of the jet and the third one on having ended in the one that will force by means of a prostate massage the exudado uretral/portático exit.
The urine sample if a protatitis exists will appear with abundant leukocytes and he attends of bacteria, which can be cultivated and do an antibiograma to know his sensibility to antibiotics.
When there is a prostatitis it can happen that the results of other analyses falter as it can be the PSA for detection of cancer of prostate, or the studies of the semen in sterility.
TREATMENT
The treatment of the prostatitis is by means of antibiotics adapted to the bacterium found like causer of the inflammation. The most used medicines are the trimetropin sulfametoxazol, the quinolonas fluoradas and the tetraciclinas, for 4 weeks. In case rebels to the treatment the treatment extends up to 8 weeks.
If the prostatitis is secondary to sexually transmitted disease it usually apply a rule of a monodose of ceftriaxona and then 10 days of doxiciclina or of a quinolona.
The treatment is effective but the recurrence is quite frequent in the same persons once they have had a sharp prostatitis. To improve the pain perineal it can be useful the seat baths with moderate water.
It must drink abundant water and fruit juices.
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