Asymptomatic inflammatory prostatitis

Asymptomatic inflammatory prostatitis (Category IV according to the NIH classification) is a histologically confirmed, clinically latent bacterial or abacterial inflammation of the prostate that is detected during examination for other diseases.

[1],

Epidemiology

The prevalence of this variant of inflammation of the prostate gland among men of older age groups is 32%.

[2], [3], [4], [5]

Causes of asymptomatic inflammatory prostatitis

Presumptive causes of asymptomatic inflammation of the prostate gland are bacterial pathogens, which are possible or impossible to detect using modern diagnostic methods.

Pathomorphologically, with this form of disease, lymphohistiocytic infiltration of the prostate gland and its ducts in combination with the sclerosis foci is detected.

[6], [7]

Symptoms of asymptomatic inflammatory prostatitis

Clinically, this form of the disease is completely latent. Patients with asymptomatic inflammatory prostatitis do not complain. Anamnestic indication of an increase in total PSA (an occasion for performing a biopsy of the prostate) is possible .

Palpation of the prostate gland can help to identify the increase, soreness, asymmetry and heterogeneity of the organ.

Treatment of asymptomatic inflammatory prostatitis

The goal of the treatment is to normalize the total PSA as it increases. In other cases, treatment is not required.

Indications for hospitalization

Treatment of asymptomatic inflammatory prostatitis is performed on an outpatient basis.

Non-drug treatment

During treatment, it is advisable to lead an active lifestyle, exclude immunosuppressive effects (hypothermia, insolation). It is necessary to carry out a regular (at least 3 times a week) and protected sexual activity, adhere to a diet aimed at eliminating alcohol, carbonated drinks, spicy, pickled, salty and bitter food.

Medication

Given data on the possible infectious nature of the disease, antibacterial therapy with fluorohipoles (ofloxacin, levofloxacin, moxifloxacin), tetracyclines (doxycycline) or sulfonamides (sulfamethoxazole / trimethoprim) is carried out. The duration of taking antibacterial drugs is 4-6 weeks. The criterion of effective treatment with an increase in total PSA is its normalization within 3 months after the end of therapy. If the pathological changes in the LL and PM 3 are detected in a 4-glass sample, the indicators should be normalized.

Diagnostics

Laboratory studies in the diagnosis of asymptomatic inflammatory prostatitis are not necessary due to the presence of a primary histological diagnosis. When a 4-glass sample is performed, it is possible to detect or not to detect an increase in the number of leukocytes and bacteria in the LSR and PM 3.

[8], [9], [10], [11]

Instrumental methods

TRUZI is permissible not to perform due to the lack of typical for this form of the disease changes. The ultrasonographic pattern does not differ significantly from that in chronic bacterial prostatitis (a non-uniform echostructure of the prostate with areas of increased echo density),

Differential diagnostics

Differential diagnosis is not carried out due to the presence of histological examination of prostate tissue.

Example of the formulation of the diagnosis

• Asymptomatic inflammatory prostatitis.

[12], [13], [14]

Prevention

Prevention of asymptomatic inflammatory prostatitis is not developed.

Forecast

Persistently flowing asymptomatic inflammatory prostatitis significantly increases the level of total PSA, which increases the need for repeated biopsies of the prostate gland. 

[15], [16], [17], [18], [19], [20]