Tommaso Cai and Truls E. Bjerklund Johansen (eds.)Prostatitis and Its Management10.1007/978-3-319-25175-2_15

15. The Prostatitis Patient: “A Clinical Dialogue”

Tommaso Cai¹ and Truls E. Bjerklund Johansen^{2, 3}

(1)

Department of Urology, Santa Chiara Regional Hospital, Trento, Italy

(2)

Department of Urology, Oslo University Hospital, Oslo, Norway

(3)

Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark

Tommaso Cai

Email: ktommy@libero.it

Truls E. Bjerklund Johansen (Corresponding author)

Email: tebj@medisin.uio.no

In this section we would like to give the readers a practical approach to the management of the prostatitis patient. The scene is a urologist who is discussing a prostatitis patient with a colleague, a general practitioner.

Legend:
GP: General practitioner
UR: Urologist

GP. What is the prevalence of prostatitis in the outpatient setting?
UR. The prevalence of patients with prostatitis-like symptoms is reported to be about 8–13 % of all visits in an outpatient setting. Recent evidence showed an increasing prevalence of prostatitis patients during the last years. This is probably due to improved diagnostic facilities and to a better understanding of the presentation forms of the prostatitis syndrome. However, there are still aspects of the diagnostic workup that need to be improved, in particular the microbiological evaluation. In this sense, the prevalence of prostatitis patients should be considered a “tip of the iceberg” only. The recent study of the epidemiological characteristics of the disease is a very important step in the understanding of the natural history of this disease. Moreover, the analysis of epidemiological characteristics may help us improve our management of the complications of this clinical condition.

GP. You talk about the complications of prostatitis. What kind of complications can that be?
UR. The patient suffering from prostatitis can develop numerous complications related to sexual function and fertility. In more detail, a patient with bacterial prostatitis due to Chlamydia trachomatis infection (that is a sexually transmitted pathogen) can develop a reduction of semen quality, unless he is properly treated and cured. Other sexually transmitted pathogens, such as HPV and mycoplasmas, may also impair fertility. Therefore a thorough microbiological investigation is strongly recommended. On the other hand, some patients affected by prostatitis present with sexual symptoms like premature ejaculation and erectile dysfunction. Hence, the management of the prostatitis patient is very important in order to avoid future complications.

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