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Chronic Prostatitis Diagnosis and Further Treatment

Pathophysiology of acute prostatitis

Prostatitis is the inflammation of the prostate organ and the surrounding tissues. Urologists believe that 60-80% of men are affected by chronic prostatitis. Several physiological factors lead to the development of prostatitis in men. The prostatic bacterial factor (PAF) is the main biomarker in chronic prostatitis. In patients with this condition, the concentration of the PAF within the prostates is diminished (Hedelin, 2012).

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In young healthy men, the prostate pH is maintained at 6.6-7.6. However, aged males have an increase in prostate pH concentration. Alkaline secretions increase the development of prostatitis due to the nature of the secretions stimulated. These secretions increase the development of urinary tract infections and chronic prostatitis. Urethritis and epididymitis are also common in men suffering from chronic prostatitis (Buttaro, 2012).

Signs of prostatitis

Chronic prostatitis does not exhibit common symptoms as compared to other urinary infections. In most cases, symptoms of chronic prostatitis are confused with common urinary tract infections. Advanced chronic prostatitis is characterized by chills and a burning sensation during urination. Emptying the bladder also becomes painful if the level of infection is advanced. The frequency of urination increases at night accompanied by severe back pain. Aged victims of chronic prostatitis also experience severe pain during ejaculation. In aged patients, chronic prostatitis is accompanied by flare-ups and remissions.

Progression trajectory of chronic prostatitis

Chronic prostatitis emerges from infection with bacteria such as E. coli and other microorganisms. When urine flows into the prostate organ from the urethra, infectious bacteria are introduced. Devices such as the catheters that are inserted into the urethra also increase the occurrence of acute and chronic prostatitis. Infection of the pelvic nerves and muscles by chlamydia and mycoplasmas cause severe pain experienced by victims of chronic prostatitis. Chronic prostatitis begins with the acute form of the condition together with other urinary tract infections (Hedelin, 2012).

In most instances, acute prostatitis and urinary tract infections are treated with antibiotics and pain relievers. However, these medications have proved ineffective in most cases. Failure to follow up on the patient and determine the presence of acute tract infections gives room for the development of chronic prostatitis. Lack of accurate diagnosis and treatment of acute prostatitis and other common urinary tract infections also contribute to the development of acute prostatitis. The indistinct symptoms also make it difficult for the condition to be discovered without professional examination (Hedelin, 2012).

Diagnosis and treatment of chronic prostatitis

The diagnosis of chronic prostatitis is done through several approaches. First, the patient’s history must be examined to ascertain previous cases of prostatitis. A history of urinary tract infection and acute prostatitis is a positive indication of the presence of chronic prostatitis. An examination of the prostate gland also provides clues of the presence of the condition. A tender prostate gland is an indication of a previous infection with acute prostatitis or the presence of a chronic level of the disorder (Buttaro, 2012).

An examination of the patient’s history and the prostate gland can give indications of the disorder. However, further tests must be done for confirmation. To confirm the absence of other urinary infections, urine samples may be obtained. In this step, the presence of urinary tract infections is ruled out. However, flare-up chronic prostatitis may give a false negative with this test. At this stage, further examination of the kidney and the urinary tract may be done to confirm prostatitis infection. An ultrasound scan of the kidney is an advanced diagnosis approach used to confirm the presence of chronic prostatitis. Advanced urologist examination is sometimes conducted to fully diagnose chronic prostatitis.

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Chronic prostatitis is an indication of prolonged infection of the prostate gland. Effective management can be achieved through prolonged treatment with antibiotics and other medications. Antibiotic therapy for 12 weeks is effective in the elimination of chronic prostatitis. However, research has indicated that only 75% of the cases are eliminated. In some cases, recurrence occurs which can be treated through repetitive antibiotic therapy.

Differences between chronic prostatitis and normal prostate development

Normal prostate and chronic prostatitis have a number of pathological differences that can be used in the diagnosis of the condition. The cross-examination of the prostate glands and stroma is used in the diagnosis of the disorder. Among the aged healthy people, the prostate has a small concretion known as the corpora. Glands in normal prostate development originate from the stroma (Hedelin, 2012).

Chronic prostatitis is characterized by an inflamed prostate gland. Inflammation leads to an increase in lymphatic fluids in the prostate. This causes tenderness and dysuria on the prostrate which can be eliminated through prostate massage. The glands of chronic prostatitis patients have an abnormal concentration of neutrophils. These are granulated white blood cells that induce inflammation as a protective measure against further infection (Koh & Wang, 2014).

The physiological and physical demand of chronic prostatitis on patient and family members

Chronic prostatitis has major impacts on the physiological and physical wellbeing of the patient and the family members. During the management of the condition, the patient will be subjected to physical exercises and massage episodes. This will increase the physical pressure on the patient and affect his engineering career. Physiotherapy episodes will also require the input of the immediate family members. For example, daily exercises require the presence of his wife (Buttaro, 2012).

Extended antibiotic therapy has a number of physiological demands and consequences on the patient. Most of these drugs will be given orally or intravenously which affects the physiological state of the patients. The side effects of the medication will affect the physiological condition of the patient. Persistent nausea, vomiting, and hysteria are common with prolonged use of antibiotics. The family’s input in the administration of this medication will also be needed. This alters the normal life of the people close to the patient due to the prolonged use of the medication (Hedelin, 2012).

Information to be shared for optimal disorder management

Access to information by family members impact positively on the management of chronic prostatitis. As a condition that will be managed by extensive drug therapy, the wife will play a central role in the success of the therapy. Information on the nature of the medication, the expected side effects and the dosage must be given to the wife. This will enhance their ability to manage any eventuality and coordinate the therapeutic management of the condition (Koh & Wang, 2014).

Interdisciplinary personnel are needed for the management of chronic prostatitis

Different professionals contribute to the management of chronic prostatitis. First, physicians will be engaged in the examination of the patient to determine the presence of the condition. Urologists will be needed to conclusively confirm the presence of the condition. Upon confirmation of the condition, the pharmacists will prescribe the antibiotics based on the level of infection. Surgeons will be called upon to conduct a minor surgery on the urethra and prostate glands. Finally, nurses will provide in-patient and home-based care to the patient during medication and recovery.

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Barriers to optimal disorder management and outcomes

The management of chronic prostatitis can be affected by a number of challenges. These include lack of finances to undergo the diagnosis and treatment phase, cultural issues, and uncooperative family members. Lack of adequate facilities can also affect the conclusive diagnosis of the condition.

Strategies to overcome barriers

Medical insurance is helpful in the management of chronic prostatitis without undergoing financial difficulties. Patients with acute prostatitis should be encouraged to pay their health insurance policies to prevent financial challenges in the future. The wife should also be educated on the benefit of her involvement in the entire process (Buttaro, 2012).

Care plan synthesis and comprehensive recognition

The patient is a 60-year-old male with a decreased urinary flow. Before seeking medical intervention, the patient experienced urine obstruction and low-grade fever. The implementation of an integrated IDT approach is critical for the management of this condition. The patient’s urine will also be periodically collected and examined for the level of bacteria. Patient education is the final care plan aimed at enhancing the patient’s ability to follow medical instructions (Koh & Wang, 2014).

Impact of socio-cultural background

Culture collides with modern therapeutic management approaches and this affects the effective recovery of patients. In most instances, patients decline to take medication due to socio-cultural reasons. Inconsistencies in drug intake increase incidences of resistance to antibiotics.

Comprehensive disorder management approach

The management of the disorder identified in the case can be achieved through multiple therapies. These include massage, antibiotic therapy, and surgery. High-dose antibiotic treatment for a short period is only recommended for responsive chronic prostatitis which is not indicated in the case. Unresponsive chronic prostatitis requires low-dose antibiotic therapy for an extended period.

Fluoroquinolone antibiotics have a high absorption rate across the prostate walls. It is commonly used as the first line of defense in the management of chronic prostatitis. Other antibiotics commonly used include trimethoprim and sulfamethoxazole. However, the low rate of absorption across the prostate wall reduces their use in the management of unresponsive chronic prostatitis. Evidence of resistance in some parts of the United States has also discouraged the use of these antibiotics. Ciprofloxacin and levofloxacin will also be used in the management of gram-negative bacteria (Koh & Wang, 2014).

Other forms of treatment can be used in the management of nonbacterial chronic prostatitis infection. For example, prostate massage therapy has been developed for the management of nonbacterial chronic prostatitis. If the progress of the patient is dismal, surgery can be used to remove the affected tissues. As the patient suffers from hypertension, a special treatment approach must be developed. In this case, a four to six-week antibiotic therapy program is adopted. This is closely followed by suppressive antibiotics for a specified time. The patient should restrain from engaging in strenuous physical activities that may increase pressure on the lower abdomen. Bed rest is also recommended during the massage and antibiotic therapy period to aid incomplete recovery.

References

Buttaro, T. (2012). Primary care: A collaborative practice. Amsterdam, Netherlands: Elsevier Health Sciences.

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Hedelin, H. (2012). The chronic prostatitis/chronic pelvic pain syndrome and pain catastrophize: A vicious combination. Scandinavian Journal of Urology & Nephrology, 46(4), 273-278. Web.

Koh, J., & Wang, S. (2014). The association of personality trait on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome: an exploratory study. Journal of Psychosomatic Research, 76(2), 127-133. Web.

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