Prostatitis: Man's hidden infection.

Prostatitis exists when inflammation of prostatic glands and tissues results from infection or allergy. Gram-positive and negative bacteria cause most prostatic infections, but infections may also be caused by fungi, mycoplasma, viruses, and other nonbacterial infecting agents. Precise diagnostic localization of infection to prostatic glands is accomplished by obtaining divided urinary specimens and prostatic fluid and observing numbers of bacteria (or other infecting agents) present in each specimen. Treatment of prostatitis remains difficult because of several factors: patients may lack the normal prostatic antibacterial factors and only a few commonly used antibiotics pass the plasma-prostate barrier and enter prostatic fluid. For proper therapy, one must select antibiotics known to penetrate into prostate tissue and fluid and to which the infecting organism is demonstrated to be sensitive. Even so, optimal cure rates following antibiotic therapy seem no better than 33 per cent. Nonspecific methods of treatment such as surgical excision of prostatic tissue, prostatic massage, sitz baths, relaxants, and supportive psychologic therapy contribute to the rehabilitation of patients with prostatitis. Relapse or recurrence of prostatitis is frequent. Longterm (in excess of six months) follow-up is required to ascertain cure.