Chlamydia in prostatite cronica

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This is a corrected version of the article that appeared in print. See related patient education handout on prostatitiswritten by Chlamydia in prostatite cronica authors of this article. 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 Chlamydia in prostatite cronica 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 Chlamydia in prostatite cronica the pain. Cultures and microscopic examination of urine 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 Chlamydia in prostatite cronica high, a therapeutic trial of antibiotics is often in order even when patients do not appear to have bacterial prostatitis.

If the patient 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 clinical practice, the term prostatitis encompasses multiple diverse disorders that cause symptoms related to the prostate gland. 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.

The latter study used a medical record review to confirm physician diagnosis of prostatitis. Patients with a previous episode of prostatitis were at Chlamydia in prostatite cronica increased risk for subsequent episodes. Despite its widespread prevalence, prostatitis remains a poorly studied and little understood condition. Prostatitis is not easily diagnosed or 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. 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 Chlamydia in prostatite cronica considered abnormal.

The postmassage urine specimen is believed to flush out bacteria from the prostate that remain Chlamydia in prostatite cronica the urethra. Although widely described as the gold standard for evaluation for prostatitis, this diagnostic technique has never been appropriately tested to assess its usefulness in the diagnosis or 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 explain its infrequent use by primary care physicians and urologists. 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.

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 sent for microscopy and culture.

Stamey-Meares four-glass test. Traditionally, prostatitis has been divided into four subtypes based on the chronicity of symptoms, the presence of white blood cells in the prostatic fluid and culture results.

These subtypes are acute bacterial prostatitis, chronic bacterial prostatitis, chronic nonbacterial prostatitis and prostadynia. At a recent National Institutes of Health Chlamydia in prostatite cronica conference, a new classification system was proposed that Chlamydia in prostatite cronica account for patients who do not clearly fit into the old system.

This category can be subdivided further based on the presence or absence of white blood cells in prostatic secretions. A fourth and final category of asymptomatic prostatitis was added to the classification system. A large-scale study is in progress in an attempt to validate the new classification system. Table Chlamydia in prostatite cronica compares the two classification systems. Pathogenesis and treatment of urinary tract infections.

Acute bacterial prostatitis Chlamydia in prostatite cronica may be considered a subtype of urinary tract infection. Two main etiologies have been proposed. The first is reflux of infected urine into the glandular prostatic tissue via the ejaculatory and prostatic ducts. The second is ascending urethral infection from the meatus, particularly during sexual intercourse. The most commonly found organism is Escherichia coli. Other species frequently found include Klebsiella, Proteus, Enterococci and Pseudomonas.

On occasion, cultures grow Staphylococcus aureusStreptococcus faecalisChlamydia or anaerobes such as Bacteriodes species. Because acute infection of the prostate is often associated with infection in other parts of the urinary tract, patients may have findings consistent with cystitis or pyelonephritis.

Patients with ABP may present with fever, chills, low back pain, perineal or ejaculatory pain, dysuria, urinary frequency, urgency, myalgias and varying degrees of obstruction. Typically, the prostate gland is tender and may be warm, swollen, firm and irregular.

A standard recommendation is to avoid vigorous digital examination of the prostate, because, theoretically, that may induce or worsen bacteremia.

Although no test is diagnostic for acute bacterial prostatitis, the infecting organism can often be identified by culturing the urine. Patients respond well to most antibiotics, although many cross the blood-prostate barrier poorly. The inflammation caused by ABP may actually allow better penetration of antibiotics into the organ.

It is difficult to interpret the few controlled trials of antibiotic treatment for bacterial prostatitis because of poor case definition, low rates of follow-up and small numbers. Based on case series and laboratory studies of antibiotic penetration in animal models, standard recommendations usually include the use of a tetracycline, trimethoprim-sulfamethoxazole TMP-SMX [Bactrim, Septra] or a quinolone. Men at increased risk for sexually transmitted disease might benefit from medications that also cover Chlamydia infection.

The most commonly recommended regimens are listed in Table 3. Other medications that are labeled for treatment of prostatitis include carbenicillin Miostatcefazolin Ancefcephalexin Keflexcephradine Velosef and minocycline Minocin. Montvale, N. Cost to the patient may be greater, depending on prescription filling fee. The duration of therapy Chlamydia in prostatite cronica also not been well studied. If the patient is responding clinically and the pathogen is sensitive to treatment, most experts recommend that antibiotic therapy be continued for three to four weeks to prevent relapse, although a longer course is sometimes necessary.

About 40 percent of urologists and 65 percent of primary care physicians treated patients for only two weeks. Extremely ill patients, such as those with sepsis, should be hospitalized to receive parenteral antibiotics, usually a broad-spectrum cephalosporin and an aminoglycoside.

Supportive measures, such as antipyretics, analgesics, hydration and stool softeners, may also be needed. The possibility of a Chlamydia in prostatite cronica abscess should be considered in patients Chlamydia in prostatite cronica a prolonged course that does not respond to appropriate antibiotic therapy.

The examiner can often detect an abscess as a fluctuant mass on rectal examination. Computed tomography, magnetic resonance imaging or transrectal ultrasonography usually provide an adequate image of the prostate to evaluate for abscess. Transurethral drainage or resection is usually required. Chronic bacterial prostatitis CBP is a common cause of recurrent urinary tract infections in men.

Patients typically have recurrent urinary tract infections with persistence of the same strain of pathogenic bacteria in prostatic fluid or Chlamydia in prostatite cronica.

Symptoms can be quite variable, but many men experience irritative voiding symptoms, possibly with pain in the back, testes, epididymis or penis, low-grade fever, arthralgias and myalgias.

Many patients are Chlamydia in prostatite cronica between episodes of acute cystitis. Signs may include urethral discharge, hemospermia and evidence of secondary epididymoorchitis. No single clinical finding is diagnostic, although urine or prostatic secretion cultures can aid in the evaluation. Classically, Chlamydia in prostatite cronica presents with negative pre-massage urine culture results, and greater than 10 to 20 white blood cells per high-power field in both the pre- and the postmassage urine specimen.

Significant bacteriuria in the postmassage urine specimen suggests chronic bacterial prostatitis Table 1. Chlamydia in prostatite cronica efficacy of antibiotic treatment is probably limited by the inability of many antibiotics to penetrate the prostatic epithelium when it is not inflamed.

Because the prostatic epithelium is a lipid membrane, more lipophilic antibiotics can better cross that barrier. In laboratory studies of dogs, the antibiotics that reached the highest concentrations in the prostate were erythromycin, clindamycin Cleocin and trimethoprim Proloprim.

The cure rate over variable periods has been reported to range from 33 to 71 percent. In one case series, 16 mg of norfloxacin Noroxin taken twice a day for 28 days achieved a cure rate in 64 percent of patients who had failed Chlamydia in prostatite cronica with TMP-SMX, carbenicillin, or both. In a limited randomized trial of patients with acute and chronic prostatitis, it was found that ofloxacin Floxin had a higher cure rate than carbenicillin five weeks after therapy.

The results of this study were limited because those evaluating clinical outcomes were not blinded to the drug, and the follow-up rate was only 50 percent. Because of the expense of an extended course of the newer antimicrobial agents, it may be reasonable to try TMP-SMX as a first agent, changing to a fluoroquinolone in the event of antibiotic failure.

Some men probably require long-term antibiotic suppression to prevent recurrent urinary tract infections. No studies adequately address how to select these patients or what agent or dosage to use, although TMP-SMX and nitrofurantoin Furadantin are often recommended.

Rarely, transurethral prostatectomy can be curative if all of the infected prostatic tissue is removed; however, infection often is harbored in the more peripheral tissues. In extreme cases, total prostatectomy may provide a definitive cure, although the potential complications of surgery limit its application in this benign but troublesome disease. Because of these referral biases, the true incidence and prevalence of these syndromes are unknown. It is likely that multiple disorders are being lumped together in this diagnosis.

At least some cases represent chronic bacterial prostatitis not diagnosed as such because of limited sampling techniques. In a study 18 using transperineal needle biopsy for culture of prostate tissue, it was found that there is frequently an occult bacterial prostatitis, especially in men with leukocytes in prostatic secretions 52 percent had positive culture of organisms.

A variety of other possible etiologies have been proposed in the medical literature. Some authors have noted increased uric acid levels in prostate secretions in men with chronic nonbacterial prostatitis. Patients usually have symptoms consistent with prostatitis, such as painful ejaculation or pain in the penis, testicles or scrotum.

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Chronic bacterial prostatitis is a rare condition that Chlamydia in prostatite cronica recurring infections in the prostate and results in swelling, inflammation, and frequent urinary tract infections UTIs. The prostate is a small gland located directly below the bladder in men. Even with treatment, bacteria may still survive in the prostate and symptoms often return.

Prolonged use of antibiotics is often necessary to effectively treat this condition. Bacterial infections in the prostate can be very painful. The symptoms begin slowly and last three months or longer. See your doctor if you have any Chlamydia in prostatite cronica the following symptoms:. Chlamydia in prostatite cronica include:. Chronic bacterial prostatitis is caused by a bacterial infection.

Even when the primary symptoms of infection have been treated, bacteria may continue to Chlamydia in prostatite cronica in the prostate. To make a diagnosis, your doctor will review your medical history and perform a physical exam to look for swollen lymph nodes near the groin or fluid discharge from the urethra. Your doctor will also perform a rectal exam to examine the prostate. During this test, your doctor will insert a lubricated and gloved finger into Chlamydia in prostatite cronica rectum to look for signs of infection, such as a soft or enlarged prostate.

Antibiotics are the main course of treatment for this condition. However, because the infection can return, you may need to take antibiotics for 12 weeks or longer. It may take six months to a year for symptoms to go away Chlamydia in prostatite cronica.

In the meantime, certain home remedies may be able to ease your symptoms. Home remedies include:. This condition is very treatable. Make sure to schedule follow-up appointments with your doctor, so that they can make sure your treatments are effective.

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Cea mai recenta clasificare a suferintelor inflamatorii ale prostatei, sugerand complexitatea problemei, Chlamydia in prostatite cronica astfel:. Inainte de utilizarea antibioticelor pe scara larga Gonococul era 'actorul principal' in prostatitele acute. Caile prin care germenii patrund in prostata sunt diverse:. O cauza determinanta majora o constituie, fara indoiala, manevrele endoscopice introducerea unei sonde in vezica, dilatatia instrumentala, cistoscopia, operatiile endoscopice etc efectuate fara respecterea regulilor de asepsie.

Nu trebuie uitate nici situatiile favorizante ale acestei patologii: stricturi uretrale, prostatita cronica, litiaza prostatica si mai ales hiperplazia benigna de prostata. Tuseul rectal este hotarator pentru diagnostic: prostata este mai calda decat tesuturile din jur, marita de volum, foarte sensibila la atingere.

Uneori, dupa tuseu apare o secretie uretrala redusa care trebuie recoltata pentru identificarea germenilor. Daca la tuseul rectal prostata este fluctuenta, putem fi siguri ca au aparut abcese prostatice.

Urocultura - efectuata inainte de inceperea oricarui tratament! Examenul bacteriologic al unei eventuale secretii prostatice spontane poate fi de ajutor in identificarea rapida a germenului. Acestea se refera la tratamentul antibioticpilonul principal al edificiului terapeutic. In asteptarea rezultatului la urocultura care vine la 48 de ore de la recoltarea probei de urina vom incepe antibioterapia avand prezumtia de vinovatie a unui germen Gram negativ si vom recomanda asocierea unui aminoglicozid Kanamicina, Gentamicina, Amikacin cu Ampicilina sau o cefalosporina pentru zile.

Alte medicamente recomandate ce pot fi utilizate cu succes: Ciprofloxacin ciprinolde mg de doua ori pe zi, Pefloxacin Chlamydia in prostatite cronicade mg de doua ori pe zi, Ofloxacin Chlamydia in prostatite cronicade Chlamydia in prostatite cronica de doua ori pe zi timp de minimum10 zilelevofloxacin Chlamydia in prostatite cronica, o tableta pe zi, 14 zile Dupa aceasta 'perioada de atac' de zile, unii autori recomanda un tratament de intretinere cu Biseptol sau Nitrofurantoin 1 tableta pe zi de pana la o luna de zile pentru a preveni cronicizarea.

In cazul prostatitelor cu evolutie spre supuratie drenajul abcesului prostatic este obligatoriu. Abordul acestuia se poate face prin perineu, transrectal sau transuretral. Germenii care produc aceasta suferinta sunt aceiasi care determina si prostatita acuta: E. Din punctul de vedere al tabloului clinic cei mai multi pacienti prezinta, in diferite grade, semnele unei disfunctii iritative vezicale polakiurie, disurie, mictiuni imperioase.

Se adauga scurgerile uretrale matinale sau dupa scaundureri scrotale cu iradiere in burse, Chlamydia in prostatite cronica inghinala sau gland si perineala, hematurie initiala cel mai frecvent sau terminala, epididimita asociata sau secundara. Febra si frisoanele nu sunt caracteristice, dar cand apar, semnaleaza o reacutizare a procesului inflamator acut.

Fluxul urinar strabate in viteza uretra prostatica de aceea urocultura este frecvent negativa. Iata de ce a fost pusa la punct o metodologie pentru a identifica atat germenul cat si locul de unde provine. Acest set de analize denumit si 'proba celor 4 pahare' a fost pus la punct de meares si stamey si este reprezentata schematic mai jos:. Proba 1 - primii ml urina eliminati 'urina uretrala' -FU 1.

Proba 2 - urina din jetul mediu-FU 2. Proba 3 - lichid prostatic exprimat-LPE. Proba 4 - urina dupa masajul prostatic-FU 3. Astfel, daca in proba 1 infectia este prezenta ne aflam in fata Chlamydia in prostatite cronica uretrite, daca din proba 2 se dezvolta semnificativ germeni este o infectie urinara cistitadaca Chlamydia in prostatite cronica proba 3 sau 4 se certifica infectia ne aflam in fata unei prostatite jetul urinar care contituie proba 4 'spala' uretra antrenand secretiile care au ajuns pe uretra prostatica.

Daca culturile din ejaculat semnaleaza prezenta germenilor ne aflam in fata unei prostato-veziculite. Desigur, in prim plan este tratamentul antimicrobian care trebuie sa aiba in vedere atat antibiograma - care precizeaza germenul si la ce este sensibil - cat si o particularitate deloc neglijabila: modul in care agentul antimicrobian ajunge la tinta, altfel spus difuzia intraprostatica a lui.

Daca in prostatita acuta Chlamydia in prostatite cronica tesutului prostatic inflamat permite o buna difuzie a majoritatii antibioticelor, in prostatita cronica permeabilitatea epiteliului glandular scade si medicamentul nu mai ajunge la tinta sau nu mai are concentratia minima inhibitorie care sa distruga complet si definitiv germenii.

Buna penetratie in tesutul prostatic are biseptolul ce contine Sulfamethoxazol si Trimethoprimrecomandat acolo unde infectia cu germeni gram-negativi din familia Enterobacter Chlamydia in prostatite cronica fost demonstrata E. Coli, Proteus, Klebsiella etc - doua tablete de 2 ori pe zi timp de 2 saptamani. Pacientul va fi reevaluat ulterior, iar tratamentul continuat pana la 4 - 6 saptamani daca rezultatele culturilor au fost pozitive - inainte de inceperea tratamentului - sau daca pacientul remarca efecte pozitive in cursul lui.

Masurile cu caracter general au ca exponent principal tratamentul antiinflamator supozitoarele cu Diclofenac, Ketoprofen si, pentru cei ce nu agreeaza acest mod de administrare, tabletele de Chlamydia in prostatite cronica au darul de a ameliora simptomele alaturi de baile calde de sezut, microclismele cu ceai de musetel si antipirina, supozitoarele de Hemorzon. Vom face recomandari vizand stimularea diurezei, evitarea constipatiei, a consumului de alcool, condimente si a expunerilor Chlamydia in prostatite cronica frig.

Efecte benefice are Chlamydia in prostatite cronica cu alfa blocante selective xatral sromnic efectuat pentru o perioada de luni. Prostatita bacteriana acuta 2. Prostatita bacteriana cronica 3. Sindromul dureros pelvin cronica a. Asistenta sociala. Medicina veterinara. Politica de confidentialitate. Plan de ingrijire Nursing a pacientilor cu insuficienta renala. Metode folosite pentru examenul citologic in microscopie.

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Aguda prostatite é un infecciosas, inflamación da próstata, acompañada por inchazo e a formación de purulenta focos Chlamydia in prostatite cronica próstata. Manifestacións de aguda prostatite dependen da etapa catarro, folicular, parenchymatous, abscessed e poden incluír dysuric trastornos, dor no períneo, febre, intoxicación. Para aguda prostatite é acompañado por trastornos da función sexual e a fertilidade, trastornos do estado psicoemocional e social disadaptation.

Axentes causantes de aguda prostatite son, Chlamydia in prostatite cronica todo, non-específico axentes infecciosos que penetrar nos tecidos da próstata, a gram-negativas Escherichia coli, Klebsiella, Proteus ou gram-positivas estafilococos, enterococci, estreptococos.

Polo tanto, a uretrite de calquera orixe é moi moitas veces complicado con aguda prostatite. Adicionalmente, aguda prostatite pode resultar de hematogenous infección, facilitada polas condicións da subministración de sangue de próstata con un sistema ben desenvolvido de arterial e venosa anastomoses. Cando chamado hematogenous Chlamydia in prostatite cronica xermes pode entrar na próstata tecidos distantes focos en purulenta amigdalite, sinusite, cari, colecistite, bronquite, pyoderma, etc.

Pode lymphogenous infección de próstata do intestino Chlamydia in prostatite cronica anal fisuras, proctite, colite. No aguda catarral fase de prostatite sentir o peso e dor no períneo. Corpo a temperatura é mantida dentro do rango normal, pode ser lixeiramente elevada; intoxicación falta.

O estudo de cancro de próstata secreción detecta un aumento en células brancas do sangue, a acumulación de Muco-purulenta temas. Na urina durante o baleirado do excretor dutos de acini aparecen as células brancas do sangue. Masaxe de próstata é xeralmente imposible por mor da dor. O tratamento comezou no catarral fase aguda de prostatite, leva a recuperación de días. O acto de defecación aguda folicular prostatite tamén é difícil por mor do expresa a dor.

Masaxe para obter próstata secreción na fase folicular do aguda prostatite é contra-indicada. Con vigoroso tratamento de aguda folicular prostatite pode ser resolto favorablemente; se non, el pasa ao seguinte, parenchymal fase. Clínica de aguda parenchymatous prostatite desenvolve rapidamente. Tenta baleirar a vexiga ou do intestino son acompañada por dor intensa.

A dor se estende para o recto, é de un latejante personaxe, forzando o paciente a tomar unha forzada posición — deitado coas pernas cruzadas. Co desenvolvemento de reactivo de inflamación do recto desde o ano de moco.

Chlamydia in prostatite cronica de próstata en parenchymal fase aguda prostatite é contra-indicado fortemente. O resultado da aguda parenchymatous prostatite pode servir como resolución da enfermidade, a formación dun absceso da próstata ou crónica prostatite. Exame de próstata través do recto permite que para determinar o tamaño, a coherencia, homoxeneidade, simetría, cancro, dor de reacción, focos de destrución, signos de purulenta fusión de tecidos.

A natureza e gravidade dysuric trastornos aguda prostatite estímase usando uroflowmetries. Ecografía de próstata con moderada síndrome de dor pode ser realizada transrectal; no caso de pronunciada dor de reacción — transabdominal. Anoscopically estimado forma, a magnitude do cancro, a presenza de focal ou difusa cambios, el define a fase aguda de prostatite. O uso do Doppler studium permite unha detallada e diferenciada para avaliar o vascularization de próstata. No complexo terapia de aguda prostatite son usados Aines, encimas, imunomodulador, vitaminas, infusión de solucións.

Fisioterapia en aguda prostatite é realizado despois da diminución dos síntomas agudos. En aguda prostatite mostrado para cumprir co repouso, aforrando dieta, sexual paz. Cando a retención urinaria no fondo do aguda prostatite evitar a realización cateterismo da Chlamydia in prostatite cronica, preferindo trocar inflation cystostomy.

Cando abscesso de próstata ocorre a necesidade de aceiro intervención - apertura e drenaxe de abscesos cavidade. Como regra xeral, unha oportuna e razoable causal tratamento leva a escavación de sinais de aguda prostatite. O absceso de próstata ou crónica inflamación ocorre en casos Chlamydia in prostatite cronica. Prevención de aguda prostatite debe incluír debridement de focos infecciosos no corpo, transporte e endourethral endovesical manipulacións, de conformidade coas normas de asepsia, oportuno tratamento de enfermidades de transmisión sexual e uretrite, a normalización da actividade sexual e a actividade física.

Aguda prostatite - causas, síntomas, diagnóstico e tratamento ProstEro Artigo Aguda prostatite Aguda prostatite é un infecciosas, inflamación da próstata, acompañada por inchazo e a formación de purulenta focos na próstata. Causas de aguda prostatite Axentes causantes de aguda prostatite son, sobre todo, non-específico axentes infecciosos que penetrar nos tecidos da próstata, a gram-negativas Escherichia coli, Klebsiella, Proteus ou gram-positivas estafilococos, enterococci, estreptococos Moitas veces aguda prostatite pode ser causada por axentes patóxenos urogenital infeccións: chlamydia trichomoniasis, Chlamydia in prostatite cronica, gonorrea, mycoplasmosis, candidíase etc.

O prognóstico e a prevención Como regra xeral, unha oportuna e razoable causal tratamento leva Chlamydia in prostatite cronica escavación de sinais de aguda prostatite.