What is prostatitis?

Prostatitis is the inflammation of the prostate gland, a walnut-sized gland located directly below the bladder in men. Common size of prostatitis is 432, men with larger size may have a bigger gland. The prostate gland produces fluid (semen) that nourishes and transports sperm. Prostatitis often causes painful or difficult urination. Other symptoms of prostatitis include pain in the groin, pelvic area or genitals, and sometimes, flu-like symptoms.
What are prostatitis types?

There are four types of prostatitis:

Acute bacterial prostatitis is a bacterial infection of the prostate gland that requires urgent medical treatment. It is the least common of the four types and its potentially life-threatening. Fortunately, it is the easiest to diagnose and treat effectively.

Chronic bacterial prostatitis is a bacterial infection that occurs repeatedly, it occurs when bacteria find a spot on the prostate where they can survive. Treatment with antimicrobials do not always cure this condition.

Chronic nonbacterial prostatitis is the most common form of prostatitis. It may be found in men of any age. Its symptoms go away and then returns without warning, and it may be inflammatory or noninflammatory.

Chronis prostate pain syndrome(CPPS) is the diagnose given when the patient does not complain of pain or discomfort but has infection-fighting cells in his prostate fluid and semen. It usually is found in prostate cancer tests.
What are prostatitis causes?

Bacterial infections cause only about 5%-10% of cases of prostatitis. In the other 90%-95%, due to chronic pelvic pain syndrome or asymptomatic inflammatory prostatitis described above, the cause is not known. Prostate infectious agents are as follows for both acute and chronic infectious prostatitis:

- Escherichia coli (E coli) is the bacterium most often the cause of prostate infections and approximately 80% of the bacterial pathogens are gram-negative organisms (for example, Escherichia coli, Enterobacter, Serratia, Pseudomonas, Enterococcus, and Proteus species).

- Sexually transmitted disease-causing organisms also may cause infectious prostatitis especially in sexually active men under 35 years of age; the most usually identified organisms are Chlamydia, Neisseria, Trichomonas, and Ureaplasma.

- Rarely staphylococcal and streptococcal organisms have been found to be the cause, and infrequently different organisms such as fungi, genital viruses, and parasites have been implicated.

- The infectious agent (usually bacteria) may invade the prostate in two main ways.
The bacteria from a previous urethral infection move through prostatic ducts into the prostate (occasionally termed retrograde infection).

- Movement of infected urine into the glandular prostate tissue can infect via ejaculatory ducts (occasionally termed antegrade infection).

Infectious organisms, as previously stated, cause two of the four main types of prostatitis; acute infectious prostatitis and chronic infectious prostatitis.

You are at higher risk for getting prostatitis if you:
- Recently have had a medical instrument, such as a urinary catheter (a soft, lubricated tube used to drain urine from the bladder) inserted during a medical procedure
- Engage in rectal intercourse
- Have an abnormal urinary tract
- Have had a recent bladder infection
- Have an enlarged prostate
What are prostatitis symptoms?

Prostatitis can cause many symptoms, including the following:
- Difficult or painful urination
- Frequent/urgent urination
- Fever
- Low-back pain
- Pain in the penis, testicles or perineum (the area between the testicles and the anus)
- Pain with/after ejaculation
- Inability to get an erection
- Decreased interest in sex
How is prostatitis diagnosed?

Diagnosing prostatitis involves ruling out other conditions that may be causing your symptoms and determining what kind of prostatitis you have. Diagnosis may include the following:

Questions from your doctor. Your doctor will want to know about your medical history and your symptoms. You may be asked to fill out a questionnaire that can help your doctor make a diagnosis and see whether treatment is working.

Physical examination. Your doctor will examine your abdomen and genitals and will likely preform a digital rectal examination (DRE). During a digital rectal exam, your doctor will gently insert a lubricated, gloved finger into your rectum. Your doctor will be able to feel the surface of the prostate and judge whether it is enlarged, tender or inflamed.

Blood culture. This test is used to see whether there are signs of infection in your blood.
Urine and semen test. Your doctor may want to examine samples of your urine or semen for signs of infection. In some cases, the doctor may take a series of samples before, during and after massaging your prostate with a lubricated, gloved finger.

Examination with a viewing scope (cystoscopy). Your doctor may use an instrument called a cystoscope to examine the urethra and bladder. A cystoscope is a small tube with a light and magnifying lens or camera that's inserted through the urethra and into the bladder. This test is used to rule out other conditions that could be causing your symptoms.

Bladder tests (urodynamic tests). Your doctor may order one or more of these tests, which are used to check how well you can empty your bladder. This can help your doctor understand how much prostatitis is affecting your ability to urinate.
How is prostatitis treated?

Treatments vary among urologists and are tailored to the type of prostatitis you have. Correct diagnosis is crucial and treatments vary. It's important to make sure your symptoms are not caused by urethritis (inflammation of the urethra) or some other condition that may lead to permanent bladder or kidney damage.

Treatments can include:

- Anti-inflammatory medicines along with warm sitz baths (sitting in two to three inches of warm water). This is the most conservative treatment for chronic prostatitis.

- Antibiotic medicine for infectious prostatitis. These drugs are not effective treatments for noninfectious prostatitis. For acute infectious prostatitis, patients usually need to take antibiotic medicine for 14 days. Almost all acute infections can be cured with this treatment.

- For chronic infectious prostatitis, antibiotic medicine is taken for a longer period of time, usually four to 12 weeks. About 75% of all cases of chronic infectious prostatitis clear up with this treatment. For cases that don't, taking antibiotics at a low dose for a long time may be recommended to relieve the symptoms.

- Alpha blockers. These medications help relax the bladder neck and the muscle fibers where your prostate joins your bladder. This treatment may lessen symptoms, such as painful urination. Examples include tamsulosin (Flomax), terazosin (Hytrin), alfuzosin (Uroxatral) and doxazosin (Cardura). Common side effects include headaches and a decrease in blood pressure.

- Pain medications.

- Muscle relaxants.

- Surgical removal of the infected portions of the prostate. A doctor may advise this treatment for severe cases of chronic prostatitis or for men whose swollen prostate is blocking the flow of urine.

- Herbal medicines like diuretic and anti-inflammatory pill.

- Supportive therapies for chronic prostatitis, including stool softeners and prostate massage.

What is PID (Pelvic Inflammatory Disease)?

Pelvic inflammatory disease, commonly called PID, is an infection of the female reproductive organs. PID is one of the most serious complications of a sexually transmitted disease in women: It can lead to irreversible damage to the uterus, ovaries, fallopian tubes, or other parts of the female reproductive system, and is the primary preventable cause of infertility in women.

Each year, more than 1 million women in the U.S. experience an episode of PID. As a result of PID, more than 100,000 women become infertile each year. In addition, a large proportion of the 100,000 ectopic (tubal) pregnancies that occur each year can be linked to PID. The rate of infection is highest among teenagers.
What causes PID?

PID occurs when bacteria move upward from a woman's vagina or cervix (opening to the uterus) into her reproductive organs. Many different organisms can cause PID, but many cases are associated with gonorrhea and chlamydia, two very common bacterial STDs. A prior episode of PID increases the risk of another episode because the reproductive organs may be damaged during the initial bout of infection.

Sexually active women in their childbearing years are most at risk, and those under age 25 are more likely to develop PID than those older than 25. This is partly because the cervix of teenage girls and young women is not fully matured, increasing their susceptibility to the STDs that are linked to PID.

The more sex partners a woman has, the greater her risk of developing PID. Also, a woman whose partner has more than one sex partner is at greater risk of developing PID, because of the potential for more exposure to infectious agents.

Women who douche may have a higher risk of developing PID compared with women who do not douche. Research has shown that douching changes the vaginal flora (organisms that live in the vagina) in harmful ways, and can force bacteria into the upper reproductive organs from the vagina.

Women who have an intrauterine device (IUD) inserted may have a slightly increased risk of PID near the time of insertion compared with women using other contraceptives or no contraceptive at all. However, this risk is greatly reduced if a woman is tested and, if necessary, treated for STDs before an IUD is inserted.

A number of factors may increase your risk of pelvic inflammatory disease, including:
- Being a sexually active woman younger than 25 years old
- Having multiple sexual partners
- Being in a sexual relationship with a person who has more than one sex partner
- Having unprotected sex
- Having had an IUD inserted recently
- Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and may mask symptoms that might otherwise cause you to seek early treatment
- Having a history of pelvic inflammatory disease or any sexually transmitted infection
What are PID symptoms?

Signs and symptoms of pelvic inflammatory disease may include:
- Pain in your lower abdomen and pelvis
- Heavy vaginal discharge with an unpleasant odor
- Irregular menstrual bleeding
- Pain during intercourse
- Low back pain
- Fever, fatigue, diarrhea or vomiting
- Painful or difficult urination

PID may cause only minor signs and symptoms or none at all. Asymptomatic PID is especially common when the infection is due to chlamydia.
How is PID diagnosed?

PID is difficult to diagnose because the symptoms are often subtle and mild. Many episodes of PID go undetected because the woman or her health care provider fails to recognize the implications of mild or nonspecific symptoms. Because there are no precise tests for PID, a diagnosis is usually based on clinical findings. If symptoms such as lower abdominal pain are present, a health care provider should perform a physical examination to determine the nature and location of the pain and check for fever, abnormal vaginal or cervical discharge, and for evidence of gonorrheal or chlamydial infection. If the findings suggest PID, treatment is necessary.

The health care provider may also order tests to identify the infection-causing organism (e.g., chlamydial or gonorrheal infection) or to distinguish between PID and other problems with similar symptoms. A pelvic ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the pelvic area to see whether the fallopian tubes are enlarged or whether an abscess is present. In some cases, a laparoscopy may be necessary to confirm the diagnosis. A laparoscopy is a surgical procedure in which a thin, rigid tube with a lighted end and camera (laparoscope) is inserted through a small incision in the abdomen. This procedure enables the doctor to view the internal pelvic organs and to take specimens for laboratory studies, if needed.
How is PID treated?

PID is commonly treated with several types of antibiotics. A health care provider will determine and prescribe the best therapy. However, antibiotic treatment does not reverse any damage that has already occurred to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is critical that she seek care immediately. Prompt antibiotic treatment can prevent severe damage to reproductive organs. The longer a woman delays treatment for PID, the more likely she is to become infertile or to have a future ectopic pregnancy because of damage to the fallopian tubes.

Because of the difficulty in identifying organisms infecting the internal reproductive organs and because more than one organism may be responsible for an episode of PID, PID is usually treated with at least two antibiotics that are effective against a wide range of infectious agents. These antibiotics can be given by mouth or by injection.  The symptoms may go away before the infection is cured. Even if symptoms go away, the woman should finish taking all of the prescribed medicine. This will help prevent the infection from returning. Women being treated for PID should be re-evaluated by their health care provider three days after starting treatment to be sure the antibiotics are working to cure the infection. In addition, a woman’s sex partner(s) should be treated to decrease the risk of re-infection, even if the partner(s) has no symptoms. Although sex partners may have no symptoms, they may still be infected with the organisms that can cause PID.

Hospitalization to treat PID may be recommended if the woman (1) is severely ill (e.g., nausea, vomiting, and high fever); (2) is pregnant; (3) does not respond to or cannot take oral medication and needs intravenous antibiotics; (4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess); or (5) needs to be monitored to be sure that her symptoms are not due to another condition that would require emergency surgery (e.g., appendicitis). If symptoms continue or if an abscess does not go away, surgery may be needed. Complications of PID, such as chronic pelvic pain and scarring are difficult to treat, but sometimes they improve with surgery.

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What is chlamydia infection?

Chlamydia is one of the most common sexually transmitted diseases in the U.S and the UK. This infection is easily spread because it often causes no symptoms and may be unknowingly passed to sexual partners. In fact, about 75% of infections in women and 50% in men are without symptoms.

How is chlamydia infection acquired?

The infection is transmitted in 2 ways:
- From one person to another through sexual contact (oral, anal, or vaginal).
- From mother to child with passage of the child through the birth canal. Chlamydia can cause pneumonia or serious eye infections in a newborn, especially among children born to infected mothers in developing countries.

What are chlamydia symptoms?

Most people who have chlamydia don’t notice any symptoms.

If you do get signs and symptoms, these usually appear between one and three weeks after having unprotected sex with an infected person. For some people the symptoms occur many months later, or not until the infection has spread.

Chlamydia symptoms in women

Around 70-80% of women with chlamydia don't notice any symptoms. If women do get symptoms, the most common include:
- pain when urinating (peeing)
- a change in vaginal discharge
- pain in the lower abdomen
- pain and/or bleeding during sex
- bleeding after sex
- bleeding between periods
- heavier periods than usual

If left untreated, chlamydia infection will greatly threatens women's health: it can spread to the womb and cause pelvic inflammatory disease (PID). PID is a major cause of infertility, miscarriage and ectopic pregnancy (when a fertilised egg implants itself outside the womb, usually in one of the fallopian tubes).

Chlamydia symptoms in men

Around half of all men with chlamydia don't notice any symptoms. If men do get symptoms, the most common include:
- pain when urinating (peeing)
- discharge from the tip of the penis (this can be a white, cloudy or watery discharge)
- pain in the testicles

Chlamydia in the rectum, throat or eyes

Some men have mild symptoms that disappear after two or three days. Even if the symptoms disappear you will still have the infection and be able to pass it on. If chlamydia is left untreated in men they are at risk of complications such as orchitis (swollen testicles), reactive arthritis (inflammation of the joints) and infertility.

If possible complications (like PID, prostatitis, etc. ) are triggered by chlamydia infection, more symptoms would develop.

Chlamydia can infect the rectum, eyes or throat if you have unprotected anal or oral sex. If infected semen or vaginal fluid comes into contact with the eyes you can also develop conjunctivitis.
Infection in the rectum can cause discomfort, pain, bleeding or discharge. In the eyes chlamydia can cause irritation, pain, swelling and discharge the same as conjunctivitis. Infection in the throat is less common and usually causes no symptoms.

How is chlamydia infetion diagnosed?

The test for chlamydia is simple. Most people can have the test carried out on a urine sample. Some people have a swab test (a small cotton bud). The swab is used to gently wipe the area where you might have chlamydia, to collect some cells. The cells are then tested for infection.

The doctor or nurse will explain which is the best test for you to have. You don’t always have to be examined by the doctor or nurse – this will depend on your situation and where you go to get tested.
People who have had anal or oral sex might have a swab taken from their rectum or throat. This isn’t done on everyone.

If you have symptoms in your eye, such as discharge or inflammation, a swab test might be taken to collect cells from your eyelid.

Tests for women

Chlamydia tests on women can be done with a urine sample or swab test. If a woman has a swab test, it can be taken from the cervix, or inside the lower vagina. Occasionally the doctor or nurse may advise you to have a swab test from the urethra (where urine comes out). Usually you can do a lower vaginal swab yourself, although sometimes a nurse or doctor may do it.

If you have had anal or oral sex you might also be offered a swab test taken from the rectum or throat. This isn’t done on everyone.

Routine cervical screening tests (smear tests) do not detect chlamydia. You will need to tell the doctor or nurse if you would also like to be tested for chlamydia at the same time.

Tests for men

Men will usually have a chlamydia test on a urine sample. Occasionally, a swab test may be taken from the urethra (the tube where urine comes out) at the tip of the penis.

If you have had anal or oral sex you might also be offered a swab test taken from the rectum or throat. This isn’t done on everyone.

How reliable is a chlamydia test?

The accuracy of tests varies, depending on the type of test that is used. Recommended tests are 90-95% sensitive. This means that they will detect chlamydia in most people who have the infection. Some tests you can buy may be less reliable.

Remember that no test is 100% accurate. There is a small chance that a test may show negative even when you have chlamydia. This is called a false negative test result. It is also possible for a test to be positive even when you do not have chlamydia. This is called a false positive test result. Both of these false tests are very rare but can sometimes explain why you get a different result to your sexual partner.

How is chlamyda infection treated?

Chlamydia infection is often treated with antibiotics. A convenient single-dose therapy for chlamydia is 1 gm of azithromycin (Zithromax, Zmax) by mouth. Alternative treatments are often used, however, because of the high cost of this medication. The most common alternative treatment is a 100 mg oral dose of doxycycline (Vibramycin, Oracea, Adoxa, Atridox and others) twice per day for seven days. Unlike gonorrhea, there has been little, if any, resistance of chlamydia to currently used antibiotics. There are many other antibiotics that also have been effective against chlamydia. As with gonorrhea, a condom or other protective barrier prevents the spread of the infection. Latest researches show that genital chlamydia infection can be treated with appropriate herbal formulas as well.

source : http://www.drleetcmclinic.com/Health_Conditions/29.html