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PROSTATITA !

PROSTATITA !


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Maladie clinică evidentă ce implică inflamaţia, sau infecţia localizată la nivelul prostatei .
Agenţii etiologici: bacteriile Gram negative – E. Coli (65 % -85%):

– Pseudomonas Aeruginosae
– Serratia
– Klebsiella
– Enterobacter

Factorii de risc ce permit bacteriilor patogene să colonizeze prostata:
– Fimoza;
– Disfuncţii ale micţiunii – obstructive, iritative, neurologice;
– Infecţii urinare netratate;
– Cateterizare intermitentă;
– Infecţii chirurgicale transuretrale.

În functie de debutul simptomatologiei se clasifică în 2 forme:
– Acută;
– Cronică (debut cu peste 3 luni în urmă).

ACUZE ALE PACIENTULUI:

– Urinări frecvente;
– Usturimi micţionale;
– Jet urinar slab, întrerupt;
– Febra, frisoane;
– Retenţie acută de urină;
– Dureri în timpul micţiunii cu iradiere în organele genitale externe, perineu.

Diagnostic paraclinic:

– Urocultura;
– Cultura din secretia uretrală;
– Spermocultura;
– Hemoleucograma;
– Proteina C reactivă;
– Procalcitonina.

Tratamentul:
Iniţierea antibioterapiei este crucială în evoluţia bolii, fiind necesară antibioterapie empirică până la apariţia rezultatelor culturilor
bioumorale (urocultura, secreţie uretrală, spermocultura).
TERAPIA ASOCIATA CU ALFA – BLOCANŢI – îmbunătăţeşte fluxul urinar, reduce obstrucţia subvezicală şi diminuează refluxul ductal
intraprostatic.
DE REŢINUT:
Din populatia masculină de peste 20 ani 2-12% pot avea simptomatologie specifică prostatitei, iar între 9-16% dintre bărbaţi primesc
acest diagnostic de-a lungul vieţii.
Evaluarea pacienţilor include obligatoriu anamneza, examen fizic complet şi local al prostatei, sumar de urină şi urocultura.
Tratamentul este prin excelenţă antibiotic, în funcţie de categorie şi de simptomatologia pacientului se poate asocia alfa – blocante,
antiinflamatorii.


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