| Abstract | Prostata je žlijezda oblika kestena koja pripada muškom spolnom sustavu. Uloga prostate je stvaranje prostatičnog sekreta koji čini oko petinu ejakulata. Prostatični sekret sadrži vodu, elektrolite, lipide, proteine, kiselu fosfatazu, fibrinolizin, prostaglandine, cink i druge tvari. Upala prostate, prostatitis, obuhvaća akutni i kronični bakterijski prostatitis, sindrom kronične zdjelične boli i asimptomatski upalni prostatitis.
Prostatitis mogu uzrokovati infektivni i neinfektivni čimbenici. Od infektivnih čimbenika najčešće su gram negativne bakterije kao što su Proteus mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa, a posebno Escherichia coli koja uzrokuje i do 80% slučajeva infekcija. Mogu biti prisutne i gram pozitivne bakterije, Trichomonas vaginalis, Candida spp., Neisseria gonorrhoeae i drugi. Kao neinfektivni čimbenici navode se promjene u sastavu prostatične tekućine, anatomske ili neurofiziološke opstrukcije, refluks urina te različiti imunološki, psihološki i endokrini mehanizmi.
U dijagnostici prostatitisa najčešće se koriste upitnici simptoma, mikrobiološki pregled urina, brisa uretre, ejakulata, rjeđe eksprimata prostate. Svi uzorci se nasijavaju na hranjive podloge koje se čuvaju u određenim uvjetima te se prati porast bakterija. Osim nasijavanja rade se i mikroskopski preparati na kojima se promatra prisutnost bakterija ili leukocita koji upućuju na upalne procese i infekcije. Zlatni standard dijagnostike je metoda četiri čaše koja se zbog skupoće i složenosti rijetko koristi u rutinskom radu, dok se češće primjenjuje pojednostavljena metoda dvije čaše.
Liječenje bakterijskog prostatitisa provodi se primjenom antibiotske terapije. Najčešće se koriste cefalosporini, fluorokinoloni, azitromicin, beta-laktamski antibiotici uz supresivnu terapiju za otklanjanje simptoma kod kroničnog bakterijskog prostatitisa, antipiretike, analgetike, mišićne relaksanse. |
| Abstract (english) | Prostate gland is a chestnut shaped gland in male reproductive system. The role of prostate gland is the production of prostatic secretion which takes about a fifth of ejaculate. The prostatic secretion contains water, electrolytes, lipides, acid phosphatase, fibrinolysin, prostaglandins, zinc and other substances. The inflammation of the prostate gland, prostatitis, includes acute and chronic bacterial prostatitis, chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis.
Prostatitis can be caused by infectious and non-infectious factors. Infectious factors are usually gram-negative bacteria such as Proteus mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa, and especially Escherichia coli which can cause up to 80% cases of infections. Aside from the gram-negative bacteria, gram-positive bacteria, Trichomonas vaginalis, Candida spp., Neisseria gonorrhoeae and other microorganisms can also be present. Changes in the structure of the prostatic fluid, anatomic or neurophysiological obstructions, urinary reflux and various immunological, psychological and endocrinological mechanisms are considered non-infectious factors of prostatitis.
For the diagnostic of prostatitis, symptoms questionnaires, microbiologial evaluation of urine, urethral swab, ejaculate, and rarely EPS (expressed prostatic specimen) are used. All of the specimens are cultured on culture media and kept in different conditions to be evaluated once the bacteria have grown. Aside from the culturing, prepared microscope slides are also used to discover the presence of bacteria or leukocytes that indicate inflammation or infection. The four glass method is the gold standard of diagnostic, but it is expensive and complicated so it is rarely used. The simplified version of the method, the two glass test, is used more often.
Bacterial prostatitis is treated with antibiotics. Usually, cephalosporins, fluoroquinolones, azithromycin, beta-lactam antibiotics in conjuction with symptoms supressive therapy in chronic prostatitis, antipyretics, analgesics, muscle relaxants. |
