Prostatitis and its Management

Benelli, Andrea; Hossain, Hamid; Pilatz, Adrian; Weidner, Wolfgang (2017)

Journalartikel

Erschienen in

European urology

Bandnummer

Heftnummer

ISSN

1569-9056

Seiten

132-137

DOI

10.1016/j.eursup.2016.03.001

Abstract

Classification of Prostatitis Syndrome

The diagnosis of symptomatic prostatitis refers to a variety of entities which may be related to infection and inflammation of the prostate gland (bacterial prostatitis), inflammatory and non-inflammatory chronic pelvic pain syndrome, and pelvic pain not related to prostatitis.

Clinical Diagnostics

In acute bacterial prostatitis, clinical symptoms are typical. Infection is defined by midstream urine analysis. In CBP, the key point of diagnosis is the use of a 2-glass test, with or without additional ejaculate analysis. The same test is used to define or exclude inflammation and / or infection in CPPS. In CPPS, symptomatic evaluation is based on a validated NIH-CPSI questionnaire. Additional phenotyping may be helpful in characterizing the predominant symptoms.

Therapy

Antibiotics surely play a fundamental role in bacterial prostatitis therapy. They should be introduced empirically in acute prostatitis with a high intravenous dose and always guided by resistance determination in chronic cases. Thanks to their pharmacokinetic properties and antimicrobial spectrum, fluoroquinolones remain the most highly recommended antibiotics. The most appropriate treatment for chronic pelvic pain syndrome is a multimodal approach based on phenotyping including alpha-blockers, antibiotics, anti-inflammatory medication, hormonal therapy, phytotherapy, antispasmotics and non-drug-related strategies, such as psychotherapy and attempts to improve relaxation of the pelvic floor. The response can be evaluated by a drop in symptoms, using the scoring of the NIH-CPSI.

THM Autoren

Prof. Dr. Hamid Hossain

Zitieren:

Benelli, A., Hossain, H., Pilatz, A., & Weidner, W. (2017). Prostatitis and its Management. European Urology, 16(4), 132–137. https://doi.org/10.1016/j.eursup.2016.03.001