Prostate

The prostate (from Greek προστάτης - prostates, literally "one who stands before", "protector", "guardian") is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have a prostate gland, although females do have tiny paraurethral Skene's glands connected to the distal third of the urethra in the prevaginal space that are homologous to the prostate.

The prostate differs considerably among species anatomically, chemically, and physiologically.

Asymptomatic inflammatory prostatitis

No treatment required. It is standard practice for men with infertility and category IV prostatitis to be given a trial of antibiotics and/or anti-inflammatories however evidence for efficacy are weak. Since signs of asymptomatic prostatic inflammation may sometimes be associated with prostate cancer, this can be addressed by tests that assess the ratio of free-to-total PSA. The results of these tests were significantly different in prostate cancer and category IV prostatitis in one study

Chronic bacterial prostatitis

Chronic bacterial prostatitis is a relatively rare condition — occurs in less than 5% of patients with prostate-related non-BPH lower urinary tract symptoms (LUTS) — that usually presents with an intermittent UTI-type picture and that is defined as recurrent urinary tract infections in men originating from a chronic infection in the prostate. Dr. Weidner, Professor of Medicine, Department of Urology, University of Gießen, has stated: "In studies of 656 men, we seldom found chronic bacterial prostatitis. It is truly a rare disease. Most of those were E-coli."Symptoms may be completely absent until there is also bladder infection, and the most troublesome problem is usually recurrent cystitis.

Acute prostatitis

Acute prostatitis is relatively easy to diagnose due to its symptoms that suggest infection. The organism may be found in blood or urine, and some times in both.Common bacteria are Escherichia coli, Klebsiella, Proteus, Pseudomonas, Enterobacter, Enterococcus, Serratia, and Staphylococcus aureus. This can be a medical emergency in some patients and hospitalization with intravenous antibiotics may be required. A complete blood count reveals increased white blood cells. Sepsis from prostatitis is very rare, but may occur in immunocompromised patients; high fever and malaise generally prompt blood cultures, which are often positive in sepsis. A prostate massage should never be done in a patient with suspected acute prostatitis, since it may induce sepsis. Since bacteria causing the prostatitis is easily recoverable from the urine, prostate massage is not required to make the diagnosis. Rectal palpation usually reveals an enlarged, exquisitely tender, swollen prostate gland, which is firm, warm, and, occasionally, irregular to the touch. C-reactive protein is elevated in most cases.

Classification

The term prostatitis refers, in its strictest sense, to histological (microscopic) inflammation of the tissue of the prostate gland, although it is loosely (and confusingly) used to describe several completely different conditions. To remedy this, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system in 1999, comprising four categories of prostatitis: