Treating Prostatitis Effectively from freeamfva's blog
Prostatitis, which affects 5% to 9% of males and occurs mostly in middle age, is classified based on signs and symptoms, with urinary urgency, frequency, and pain typical in nearly all categories. Most physicians are not familiar with prostatitis, particularly chronic prostatitis associated with chronic pelvic pain syndrome (CP/CPPS). Accordingly, patients are often misdiagnosed and receive ineffective treatment, resulting in poor quality of life. CP/CPPS is challenging to treat, as its causes are not clearly defined and the antibiotics used for therapy have low effective rates. Clinical pharmacists can contribute significantly to patient care by advising physicians and other medical professionals regarding drug efficacy, adverse drug reactions, and drug interactions, and by assisting in the selection of optimal antibiotics and/or treatment regimens for prostatitis.To get more news about chronic prostatitis cure, you can visit our official website.
Prostatitis (inflammation of the prostate gland), which occurs in 5% to 9% of males aged 18 years and older, most often develops in middle age.1 In the early 1990s, prostatitis accounted for about 1% and 8% of office visits to family practitioners and urologists, respectively.1
In most cases, patients with prostatitis experience urinary urgency, frequency, and pain, all of which significantly impact quality of life (QOL).1-8 It is believed that the QOL of patients with prostatic pain is similar to that of patients with acute myocardial infarction, unstable angina, or active Crohn’s disease.1 A 2009 survey of 556 primary care physicians in Boston, Chicago, and Los Angeles found that only 62% saw patients for prostatitis; surprisingly, 48% of physicians surveyed were not familiar with prostatitis and 16% were unfamiliar with chronic prostatitis associated with chronic pelvic pain syndrome (CP/CPPS).4 Consequently, the diagnosis and effective treatment of prostatitis, especially CP/CPPS, pose a challenge for clinicians.
Signs and Symptoms
The National Institutes of Health (NIH) classifies prostatitis into four categories based on signs and symptoms (TABLE 1).1-8 Category I (acute bacterial prostatitis [ABP]) is rare, accounting for fewer than 0.02% of prostatitis patients. Approximately 5% of prostatitis cases are category II (chronic bacterial prostatitis [CBP]). Most chronic prostatitis patients (90%-95%) fall into category III (CP/CPPS), which is subdivided into IIIA (inflammation) and IIIB (no inflammation). Category IV (asymptomatic inflammatory prostatitis) is accidentally discovered during a physical examination or office visit for other genitourinary disorders (e.g., benign prostatic hyperplasia, prostate cancer, infertility, overactive bladder, and elevated prostate-specific antigen level).
ABP is characterized by the acute onset of frequency, urgency (irritative and obstructive voiding), and severe pelvic pain (perineum, suprapubic area, and external genitalia), which are caused by inflammation of the prostate. In addition, patients may have bacteremia (fever, chills, and rigors) and possibly signs of sepsis. If ABP is not treated properly, about 5% of patients progress to CBP.1-8
CBP is typically associated with recurrent urinary tract infections (UTIs) with mild-to-moderate pelvic pain symptoms. Symptoms of CBP differ from those of ABP, as the levels of pain and systemic infection are milder (low-grade fever with back or pelvic discomfort) and may occur off and on.1-8
CP/CPPS is characterized by irritative urination (frequency and urgency) and chronic pelvic pain, with no evidence of UTI for at least 3 months in the previous 6 months. Chronic pelvic pain is the hallmark of CP/CPPS.4 In addition, in inflammatory CP/CPPS (category IIIA), leukocytes are found in expressed prostatic secretions (EPS), post–prostatic massage urine, or semen.1-8
Pathophysiology
Because ABP is an uncommon complication of UTI, urinary tract pathogens are typically the cause of category I prostatitis. Escherichia coli is most common, followed by Proteus, Klebsiella, and Pseudomonas species. Enterococci and Staphylococcus aureus are also found, but anaerobes are rare in ABP.1,2,5-7,9
CBP is associated with recurrent UTI, urethritis, bacteriospermia, and epididymitis. The most common gram-negative bacterium detected is E coli (65%-80% of infections), followed by Klebsiella and Pseudomonas species.9 Gram-positive enterococcus is also found in CBP, but only transiently. Based on experiments in animals, it appears that pathogens form colonies in the prostate, with special growth conditions leading to off-and-on episodes.1,3,9
The causes of CP/CPPS are not clearly understood or defined. Many hypotheses have been proposed to explain CP/CPPS pathology, but no single theory can adequately explain all CP/CPPS symptoms. A microorganism-based etiology has been proposed, but is controversial (infection detected only in 8% of patients).3 It is believed that Lactobacillus and Corynebacterium species and diphtheroids may be linked to inflammatory prostatitis (category IIIA). Coagulase-negative Staphylococcus, Chlamydia, and Ureaplasma species and anaerobes have been found localized to the prostate, but it is unclear whether these bacteria cause CP/CPPS.1,9 According to recent molecular biologic research, hidden bacterial infection of the prostate could be a cause of prostatitis. It is also theorized that interactions between psychological factors and immune-, neurologic-, and endocrine-system dysfunction may contribute to CP/CPPS exacerbation.
Prostatitis (inflammation of the prostate gland), which occurs in 5% to 9% of males aged 18 years and older, most often develops in middle age.1 In the early 1990s, prostatitis accounted for about 1% and 8% of office visits to family practitioners and urologists, respectively.1
In most cases, patients with prostatitis experience urinary urgency, frequency, and pain, all of which significantly impact quality of life (QOL).1-8 It is believed that the QOL of patients with prostatic pain is similar to that of patients with acute myocardial infarction, unstable angina, or active Crohn’s disease.1 A 2009 survey of 556 primary care physicians in Boston, Chicago, and Los Angeles found that only 62% saw patients for prostatitis; surprisingly, 48% of physicians surveyed were not familiar with prostatitis and 16% were unfamiliar with chronic prostatitis associated with chronic pelvic pain syndrome (CP/CPPS).4 Consequently, the diagnosis and effective treatment of prostatitis, especially CP/CPPS, pose a challenge for clinicians.
Signs and Symptoms
The National Institutes of Health (NIH) classifies prostatitis into four categories based on signs and symptoms (TABLE 1).1-8 Category I (acute bacterial prostatitis [ABP]) is rare, accounting for fewer than 0.02% of prostatitis patients. Approximately 5% of prostatitis cases are category II (chronic bacterial prostatitis [CBP]). Most chronic prostatitis patients (90%-95%) fall into category III (CP/CPPS), which is subdivided into IIIA (inflammation) and IIIB (no inflammation). Category IV (asymptomatic inflammatory prostatitis) is accidentally discovered during a physical examination or office visit for other genitourinary disorders (e.g., benign prostatic hyperplasia, prostate cancer, infertility, overactive bladder, and elevated prostate-specific antigen level).
ABP is characterized by the acute onset of frequency, urgency (irritative and obstructive voiding), and severe pelvic pain (perineum, suprapubic area, and external genitalia), which are caused by inflammation of the prostate. In addition, patients may have bacteremia (fever, chills, and rigors) and possibly signs of sepsis. If ABP is not treated properly, about 5% of patients progress to CBP.1-8
CBP is typically associated with recurrent urinary tract infections (UTIs) with mild-to-moderate pelvic pain symptoms. Symptoms of CBP differ from those of ABP, as the levels of pain and systemic infection are milder (low-grade fever with back or pelvic discomfort) and may occur off and on.1-8
CP/CPPS is characterized by irritative urination (frequency and urgency) and chronic pelvic pain, with no evidence of UTI for at least 3 months in the previous 6 months. Chronic pelvic pain is the hallmark of CP/CPPS.4 In addition, in inflammatory CP/CPPS (category IIIA), leukocytes are found in expressed prostatic secretions (EPS), post–prostatic massage urine, or semen.1-8
Pathophysiology
Because ABP is an uncommon complication of UTI, urinary tract pathogens are typically the cause of category I prostatitis. Escherichia coli is most common, followed by Proteus, Klebsiella, and Pseudomonas species. Enterococci and Staphylococcus aureus are also found, but anaerobes are rare in ABP.1,2,5-7,9
CBP is associated with recurrent UTI, urethritis, bacteriospermia, and epididymitis. The most common gram-negative bacterium detected is E coli (65%-80% of infections), followed by Klebsiella and Pseudomonas species.9 Gram-positive enterococcus is also found in CBP, but only transiently. Based on experiments in animals, it appears that pathogens form colonies in the prostate, with special growth conditions leading to off-and-on episodes.1,3,9
The causes of CP/CPPS are not clearly understood or defined. Many hypotheses have been proposed to explain CP/CPPS pathology, but no single theory can adequately explain all CP/CPPS symptoms. A microorganism-based etiology has been proposed, but is controversial (infection detected only in 8% of patients).3 It is believed that Lactobacillus and Corynebacterium species and diphtheroids may be linked to inflammatory prostatitis (category IIIA). Coagulase-negative Staphylococcus, Chlamydia, and Ureaplasma species and anaerobes have been found localized to the prostate, but it is unclear whether these bacteria cause CP/CPPS.1,9 According to recent molecular biologic research, hidden bacterial infection of the prostate could be a cause of prostatitis. It is also theorized that interactions between psychological factors and immune-, neurologic-, and endocrine-system dysfunction may contribute to CP/CPPS exacerbation.
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| By | freeamfva |
| Added | Apr 7 '22 |
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