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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by pelvic or perineal pain without evidence of urinary tract infection, [8] lasting longer than 3 months, [9] as the key symptom. Symptoms may wax and wane. Pain can range from mild to debilitating.
In chronic bacterial prostatitis, there are bacteria in the prostate, but there may be no symptoms or milder symptoms than occur with acute prostatitis. [9] The prostate infection is diagnosed by culturing urine as well as prostate fluid (expressed prostatic secretions or EPS) which are obtained by the doctor performing a rectal exam and putting pressure on the prostate.
Men with acute prostatitis complicated by urinary retention are best managed with a suprapubic catheter or intermittent catheterization. Lack of clinical response to antibiotics should raise the suspicion of an abscess and prompt an imaging study such as a transrectal ultrasound (TRUS).
Treatment will depend on the cause, if one is found. For example; with a UTI, a course of antibiotics would be given [medical citation needed]; appropriate medication would be administered to treat benign prostatic hyperplasia.
The discovery of antimicrobial agents contributed significantly to UTI management during the 20th century. Nitrofurantoin emerged as the first practical and safe urinary antimicrobial agent, but it was with limited spectrum of activity. [48] Subsequently, in the 1970s, beta-lactam antibiotics and TMP/SMX became available for UTI therapy. [48]
Prostatitis is an umbrella term for a variety of medical conditions that incorporate bacterial and non-bacterial origin illnesses in the pelvic region. In contrast with the plain meaning of the word (which means "inflammation of the prostate"), the diagnosis may not always include inflammation .
A post-void residual urine greater than 50 ml is a significant amount of urine and increases the potential for recurring urinary tract infections. [citation needed] In adults older than 60 years, 50-100 ml of residual urine may remain after each voiding because of the decreased contractility of the detrusor muscle. [7]
A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. [1] Lower urinary tract infections may involve the bladder ( cystitis ) or urethra ( urethritis ) while upper urinary tract infections affect the kidney ( pyelonephritis ). [ 10 ]