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Diagnosis involves ruling out other potential causes of the symptoms such as bacterial prostatitis, benign prostatic hyperplasia, overactive bladder, and cancer. [2] [5] Recommended treatments include multimodal therapy, physiotherapy, and a trial of alpha blocker medication or antibiotics in certain newly diagnosed cases. [6]
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 .
Asymptomatic inflammatory prostatitis is a painless inflammation of the prostate gland where there is no evidence of infection. [1] It should be distinguished from the other categories of prostatitis characterised by either pelvic pain or evidence of infection, such as chronic bacterial prostatitis, acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS). [2]
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.
Antibiotics are the first line of treatment in acute prostatitis. Antibiotics usually resolve acute prostatitis infections in a very short time, however a minimum of two to four weeks of therapy is recommended to eradicate the offending organism completely. [5] Appropriate antibiotics should be used, based on the microbe causing the infection.
Pelvic pain is a general term that may have many causes, listed below. The subcategorical term urologic chronic pelvic pain syndrome (UCPPS) is an umbrella term adopted for use in research into urologic pain syndromes associated with the male and female pelvis. [9]
This method has been historically used as a treatment for prostatitis, as prostatic congestion has been commonly associated with prostatitis. [10] There is still limited information available on prostatic congestion treatment, however, there have been studies that combined therapies to address prostatic congestion in the presence of prostatitis.
Large studies of patients have also failed to show any correlation between lower urinary tract symptoms and a specific diagnosis. [11] Also, recently a report of lower urinary tract symptoms even with malignant features in the prostate failed to be associated with prostate cancer after further laboratory investigation of the biopsy. [10]