|
CURRENT CLASSIFICATION (Drach et al, 1978):
- Acute form:
- Chronic forms:
- Chronic bacterial prostatitis
- Nonbacterial prostatitis
- Prostatodynia
I. ACUTE PROSTATITIS
This form of prostatitis is very unfrequent. It is
a quite severe disease characterized by high fever, chills, severe pain
in the lower abdominal region and in the perineum, burning at voiding
or difficulties to void. This disease is unfrequent, easily recognizable
and has to be treated like other severe bacterial urinary infections.
II. "CHRONIC PROSTATITIS"
This is a very diffuse term, commonly used to describe a collection
of symptoms characterized by the presence of pain or discomfort in the
perigenital area (perineum, groin, testicular region) often radiating
to the lower back or the inside of the thigh. The location of discomfort
may vary from individual to individual, and in the same individual at
different occations. A variety of micturitional symptoms
from the lower urinary tract (frequent necessity to void, urgency, burning
sensation at voiding, feeling of uncomplete emptying of the bladder,
difficulties to keep completely tight, etc) may accompany the pain or
dominate the picture. Many times, ejaculation is painful, or a crampy
discomfort follows ejaculation. Regrettably, in every day's urological
slang, the term "chronic prostatitis" is used very loosely by the professionals:
from a patho-anatomical point of view, chronic prostatitis
is a real inflammatory condition of the prostate which can be verified
by histological examination of prostatic tissue; in every day's urological
slang, however, the term is often used to describe the collection of
symptoms listed above, even if there is to evidence of inflammation
in the prostate. In fact, chronic prostatitis (= inflammation
of the prostate) can produce a "chronic prostatitis syndrome"
(i e the symptoms), but there are other conditions,
not associated with inflammation, which can lead to identical symptom.
In order to avoid such confusion, I will consistently use citation marks
("chronic prostatitis syndrome" or "chronic
prostatitis") when I am referring to the more or less characteristic
complaints mentioned above.
The subdivision according to Drach and colleagues is based on the analysis
of the prostatic fluid (presence of white blood cells and/or micro-organisms):
- Chronic Bacterial Prostatitis (CBP): presence of
white blood cells and micro-organisms
- Nonbacterial Prostatitis (NBP): presence of white
blood cells, but no bacteria
- Prostatodynia (PDy) ="painful prostate": normal
count of white blood cells and absence of bacteria
Whereas acute bacterial prostatitis is rare, "chronic
prostatitis" is very common, some reports estimate about half
of the masculine population to be affected at least once in their life-time,
others report even higher figures. Chronic bacterial prostatitis
(CBP) is the least frequent condition whith only around 5% of all patients
affected by "chronic prostatitis". The occurrence of nonbacterial prostatitis
(NBP) and prostatodynia (PDy) varies in different reports, but both
share more or less half of the remainder. In office practice and in
younger men, prostatodynia is probably dominating.
|
