Chronic Bacterial Prostatitis

Chronic Bacterial Prostatitis is the chronic inflammation of the prostate gland. This disorder occurs mostly in young and mature man, younger than 50. It follows an acute prostatitis or a chronic posterior urethritis. Thus, Chronic bacterial prostatitis is always accompanied by the inflammation of periurethral glands. A certain number of symptoms and complications, in the history of chronic prostatitis, belong to the posterior urethritis.

Causes

Apart from the Genococcus (the most frequent cause of chronic bacterial prostatitis) there are also: Staphilococcus, Streptococcus, Escherichia Coli, Proteus etc. Chronic infection of the prostate can also have a different cause than a posterior urethritis: from the teeth, tonsils, appendix, epididymus etc.

The ways of the infection are various.

Anatomic structure of the prostatic gland. 1. Prostatic gland. 2. Urinary bladder. 3. Seminal vesicles. 4. Posterior urethra. 5. Seminal tubercle. 6. Excretory lobular ducts. 7. Normal lobes.

The picture of chronic prostatitis (morphological and ultrasonic evidence).1.Prostatic gland. 2. Urinary bladder. 3. Seminal vesicles. 4. Posterior urethra. 5. Seminal tubercle. 6. Excretory lobular ducts. 7. Normal lobes. 8. Moderately ectatic lobes. 9. Significantly ectatic lobes. 10. Significantly ectatic lobes with "plugs". 11. Microabscess with liquid pus. 12. Microabscess filled with dense inflammatory detritis. 13. Electrode-catheter.

1. the main path is posterior urethritis;
2. the hematogenous path brings microbes to the prostate from a focal of infection inside the body (teeth, tonsils etc). This path is possible to produce chronic prostatitis, but is more frequent in acute prostatitis.
3. the lymphatic path allows to propagate the infection in the nearby of the prostate (perirectal suppurations).
4. descendent path (urethral) is also admitted in the prostatic infection mechanism: the microbes start from a chronic pielonefritis and reach the posterior urethritis, and later the prostate gland. This path is mostly proven for tuberculosis.

The congestion of the prostate gland favors the settlement in the prostate of microbian germs. The congestion of the prostate is produced by:

• sexual excesses
• irregular sexual activity
• abstinence
• sitting for long periods of time
• chronic constipation
• prostate calculi
• food with lots of condiments
• alcoholic drinks
• coldness
• copious meals
• horseback riding
• bicycle riding for long time
• urethral strictures etc.

The chronic infection of seminal vesicles accompanies chronic prostatitis in most cases, and the bacteria found here is the same.

The prostatic infection, at its turn, can serve as primary focal for other infections, such as endocarditis, irititis, conjunctivitis, miozitis, arthritis etc. Whenever these infections are present, the prostate gland should always be checked, as a primary focal. The proof of the existence of this possibility is the burst an acute metastatic infection while the prostate is being massaged. For this reason the prostate massage is nowadays much limited in indications. The general reaction after a prostate massage can be either soft or severe, accompanied by high fever and shivers.

Staging

Chronic bacterial prostatitis or chronic nonbacterial prostatitis can have the following typology:

1. follicular prostatitis in which the gland is increased in volume and from the dilated acini pours a milky liquid, abundant in pus;
2. suppurated prostatitis where the gland is the seat of smaller or larger abscesses, inside of which there can sometimes be found calculi;
3. sclerous prostatitis, where predominates the scar like tissue. The prostate gland is little and tough.

Posterior urethritis always shows an infection of the periurethral glands, of the veru montanum, and the ejaculatory ducts, inflammatory polypi and even small ulcerations. The capture of the ejaculatory ducts and of the veru montanum in the inflammatory process, can produce fibrosis or stricture of these ducts.

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