Prostatitis, a very common urological problem in men, is an inflammation of the prostate that occurs from puberty until about age 50. It is after this age that other conditions usually appear, such as benign prostatic hyperplasia and prostate cancer.
The prostate is a gland of the reproductive system located at the base of the bladder and “hugging” the urethra. It is actually at the junction of the urinary and reproductive systems. It has a chestnut-like shape and size and its function is to produce a part of the seminal fluid. Therefore, prostatitis can cause problems with urination and also with fertility.

Where is it caused and how does it appear?

“Prostatitis is usually caused by germs that reach the prostate through the urethra. It is one of the few diseases of the urinary system that trouble the patient so much. This is due to the fact that it is not exactly a disease but a syndrome that appears in various clinical forms. Given that these forms have different therapeutic approaches, the clinical evaluation of prostatitis must be particularly detailed and meticulous”, points out the Mr. Konstantinos Karamanis Director Urologist at Metropolitan Hospital And it continues:
“The first separation of the types of prostatitis was made in 1978 by two American microbiologists Stamey and Meares and these are: Acute Microbial Prostatitis, Chronic Microbial Prostatitis, Non-Microbial Prostatitis and Prostatodynia (discomfort or pain in the prostate area or pelvic area). All forms appear with varying degrees of symptoms such as nocturia, frequent urination, varying degrees of difficulty urinating and ejaculating, urinary urgency (sudden strong desire to urinate that is difficult to suppress), pain that can appear in various parts of the genitals during urination. urination and ejaculation, sometimes blood in the semen, difficulty in erection, while fever and chills are usually related to acute prostatitis. It should also be noted that the existence of prostatitis for a long period of time can affect the quality of sperm with the final result of infertility.”

How is the diagnosis made?

“The simplest but also the most accurate method for distinguishing Microbial from Non-Microbial Prostatitis is the culture of prostatic secretion with four samples as proposed in 1968 by Stamey-Meares and is still the basis for diagnosis and treatment of inflammation. This culture gives us information on the presence or absence of a microbe, on the type of microbe as well as on its sensitivity to antibiotics, i.e. those that “catch” the specific microbe. This is very important because several times and depending on the type of microbe, long-term treatment is required, which makes the choice of the right antibiotic crucial.
The culture is done as follows: first we take samples of first and second urination (“flushing”) from the urethra, then a sample of prostatic fluid by massaging the prostate, and then another urine sample. Essentially, that is, it is about three urine samples and one massage. All these shots are done painlessly, without the use of tools,” explains the expert.

Treatment

“Treatment is based on the culture described above. Having its results, we can now administer the appropriate antibiotic in a targeted manner in combination with anti-inflammatory and drugs that facilitate urination.
It is advisable to repeat the culture after the end of the treatment to check/confirm the elimination of the microbe. The treatment is usually satisfactory, however, people with a history of prostatitis should be checked more often, in case of recurrence”, concludes Mr. Karamanlis.