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The term prostatitis is applied to a series of disorders, ranging from acute bacterial infection to chronic pain syndromes, in which the prostate gland is inflamed. Patients present with a variety of symptoms, including urinary obstruction, fever, myalgias, decreased libido or impotence, painful ejaculation and low-back and perineal pain. Physical examination often fails to clarify the cause of the pain. Cultures and microscopic examination of urine [url=http://www.jimin-togane.jp/cgi-bin/aska/aska.cgi?ref=hikayee.net]mfwtlkpdp%3C/a%3E]mulberry sale The Truth About[/url] and prostatic secretions before and after prostatic massage may help differentiate prostatitis caused by infection from prostatitis with other causes. Because the rate of occult infection is high, a therapeutic trial of [url=http://www.golfwithashotgun.co.uk]barbour uk[/url] antibiotics is often in order even when [url=http://www.fayatindia.com/giuseppe-zanotti.html]giuseppe zanotti pas cher[/url] patients do not appear to have bacterial prostatitis. If the [url=http://www.lotogame.fr/hollisterfrance.php]hollister pas cher[/url] patient [url=http://www.muvilav.it]woolrich sito ufficiale[/url] responds to therapy, antibiotics are continued for at least three to four weeks, although some men require treatment for several months. A patient who does not respond might be evaluated for chronic nonbacterial prostatitis, in which nonsteroidal anti-inflammatory drugs, alpha-blocking agents, anticholinergic agents or other therapies may provide symptomatic relief.
Prostatitis is inflammation of the prostate gland. In [url=http://www.nitafrymeece.com/louboutin/]louboutin chaussures soldes[/url] clinical practice, the term prostatitis encompasses multiple diverse disorders that cause symptoms related to the prostate gland. One author has described prostatitis as "a wastebasket of clinical ignorance"1 because so many poorly characterized syndromes are diagnosed as prostatitis. The spectrum of prostatitis ranges from straightforward acute bacterial prostatitis to complex conditions that may not even involve prostatic inflammation. These conditions can often be frustrating for the patient and the clinician.
Prostatitis is a common condition. In a survey of National Guard members (20 to 49 years of age) using a self-reported diagnosis of prostatitis, a 5 percent lifetime prevalence was noted.2 A population-based study of men (40 to 79 years of age) in Olmstead County, Minn., suggests a lifetime prevalence close to 9 percent. The latter study used a medical record review to confirm physician diagnosis of prostatitis. Patients with a previous episode of prostatitis were at significantly increased risk for subsequent episodes.3 In a nationwide review of data from outpatient physician visits, it was noted that 15 percent of men who saw a physician for genitourinary complaints were diagnosed with prostatitis.4 Every year, approximately 2 million physician visits include the diagnosis of prostatitis. Despite its widespread prevalence, prostatitis remains a poorly studied and little understood condition.
Diagnosis
Prostatitis is not easily diagnosed or [url=http://www.orlando-apts.com/cheapnfljerseys/]nfl jerseys[/url] classified. Patients with prostatitis often present with varied, nonspecific symptoms, and the physical examination is frequently not helpful. The traditional diagnostic test for differentiating types of prostatitis is the Stamey-Meares four-glass localization method.5 It includes bacterial cultures of the initial voided urine (VB1), midstream urine (VB2), expressed prostatic secretions (EPS), and a postprostatic massage urine specimen (VB3). The VB1 is tested for urethral infection or inflammation, and the VB2 is tested for urinary bladder infection. The prostatic secretions are cultured and examined for white blood cells (more than 10 to 20 per high-power field is [url=http://www.sandvikfw.net/shopuk.php]hollister sale[/url] considered abnormal). The postmassage urine specimen is believed to flush out bacteria from the prostate that remain in the urethra.
Although widely described [url=http://www.lotogame.fr/hollisterfrance.php]hollister france[/url] as the gold standard for evaluation for prostatitis, this diagnostic technique has never been appropriately tested to assess its usefulness in the diagnosis or [url=http://www.lotogame.fr/louboutin-pas-cher/]louboutin pas cher[/url] treatment of prostatic disease. The expression of prostatic secretions can be difficult and uncomfortable. In addition, the test is somewhat cumbersome and expensive, which may [url=http://www.mamlekabu.co.uk/mulberry/index.php]mulberry outlet[/url] explain its [url=http://www.renaissancedestoiles.fr]louboutin[/url] infrequent use by primary care [url=http://www.fayatindia.com/giuseppe-zanotti.html‎]www.fayatindia.com/giuseppe-zanotti.html‎[/url] physicians and urologists.3,6
An alternative diagnostic test, called the pre- and postmassage test (PPMT) has been proposed. Although easier to carry out, this test has also not been validated; in retrospective studies, it performed about as well as the four-glass method. 7
The technique is straightforward. The patient retracts the foreskin, cleanses the penis and then obtains a midstream urine sample. The examiner performs a digital rectal examination and vigorously massages the prostate from the periphery toward the midline. The patient collects a second urine sample, and both specimens are [url=http://neco-t.co.jp/aska/aska.cgi/summary]abercrombie milano The Rise o[/url] sent for microscopy and culture. See Table 1 for interpretation [url=http://www.nitafrymeece.com/louboutin/]louboutin pas cher[/url] of results of the four-glass test and the PPMT.
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Prostatitis and prostatitis treatmentArticle Summary: The term prostatitis is [url=http://www.ttcarpets.co.uk]mulberry sale[/url] applied to a series of disorders, ranging from acute bacterial infection to chronic pain syndromes, in which the prostate gland is inflamed.
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