PROSTATITIS - 03/09/11

Doi : 10.1016/S0733-8627(05)70210-8

William E. Lummus, MD ^a, Ian Thompson, MD ^b

^a Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee (WEL)

^b Division of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (IT)

Résumé

Prostatitis is a pervasive condition that accounts for up to 25% of all visits to a urologist.^{29 Lipsky B.A. Urinary tract infections in man Ann Int Med 1989 ; 110 : 138-150 [cross-ref]

Cliquez ici pour aller à la section Références} There are more visits to urologists for prostatitis than benign prostatic hypertrophy or prostate cancer.^{43 National Kidney and Urologic Diseases Advisory Board Long-range Plan Window on the 21st Century Bethesda, Maryland: United States Department of Health and Human Services (1990).
20 NIH publication number 90–583,.

Cliquez ici pour aller à la section Références} It is the most common urologic diagnosis in men below the age of 50, and the third most common in men greater than 50.^{4 Barbalias G.A. Prostatodynia or painful male uretheral syndrome? Urology 1990 ; 36 : 146

Cliquez ici pour aller à la section Références} Additionally, autopsy results reveal inflammation in the prostate in 6.3% of males.^{40 Moore P.R. Inflammation of the prostate gland J Urol 1937 ; 38 : 173

Cliquez ici pour aller à la section Références} As many as 50% of men will experience an episode of prostatitis in their life.^{69 Stewart C. Prostatitis Emerg Med Clin North Am 1988 ; 6 : 391-402

Cliquez ici pour aller à la section Références} Of these men, 5% will have bacterial prostatitis, 64% nonbacterial prostatitis, and 31% prostatodynia.^{11 Brunner H., Weidner W., Schiefer H.G. Studies on the role of Ureaplasma urealyticum and Mycoplasma hominis in prostatitis J Infect Dis 1983 ; 147 : 807-813 [cross-ref]

Cliquez ici pour aller à la section Références, 55 Pewitt E.B., Scharffer A.J. Urinary tract infection in urology, including acute and chronic prostatitis Infect Dis Clin North Am 1997 ; 11 : 623-646 [inter-ref]

Cliquez ici pour aller à la section Références} Because this disease is so common, the impact on the patient has been compared to coronary artery disease or Crohn's disease.^{72 Wenninger K., Heiman J.R., Rothman I. , et al. Sickness impact on chronic nonbacterial prostatitis and its correlates J Urol 1996 ; 155 : 965-968 [cross-ref]

Cliquez ici pour aller à la section Références}

The precise pathogenic mechanism causing prostatitis remains unclear. The most prevalent theory is that reflux of urine from the urethra into the intraprostatic ducts promotes ascending infection and leads to chemical or bacterial prostatitis. Treatment can be quite challenging. Many antimicrobial agents do not effectively diffuse into prostatic tissue or cannot function in the acidic pH within the prostate. In addition, most cases of prostatitis are found not to have an infectious etiology.

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