Weidner W
Urologische Universitäts-Klinik, Universität Göttingen, Germany.
Infection. 1992;20 Suppl 3:S227-31; discussion S235. doi: 10.1007/BF01704386.
Infections of the prostate may occur despite the numerous host defences of the male urogenital tract. It is important to distinguish patients with genuine inflammation of the gland from the larger number of men with symptoms but no signs of an inflammatory response (prostatodynia). To define prostatitis, the degree of the inflammatory reaction must first be determined. Increased numbers of leucocytes in expressed prostatic secrections (EPS) are essential for this diagnosis. Careful lower urinary tract studies may then be used to classify the patients into two major groups of bacterial and nonbacterial prostatitis. Chronic bacterial prostatitis is primarily due to Escherichia coli. Gram-positive prostatitis is debatable. In chronic bacterial prostatitis, secretory dysfunction is common. The increased alkalinity of the pH of expressed prostatic secretions is one of the reasons for poor results of antibiotic therapy. Uncommon microorganisms, such as Chlamydia trachomatis and Ureaplasma urealyticum may be involved in some cases of the "nonbacterial" form. Routine culture for these microorganisms is not recommended.
尽管男性泌尿生殖道有众多宿主防御机制，但前列腺仍可能发生感染。将真正患有前列腺炎症的患者与大量有症状但无炎症反应迹象（前列腺痛）的男性区分开来很重要。要定义前列腺炎，必须首先确定炎症反应的程度。前列腺按摩液（EPS）中白细胞数量增加对该诊断至关重要。然后，仔细的下尿路研究可用于将患者分为细菌性和非细菌性前列腺炎两大组。慢性细菌性前列腺炎主要由大肠杆菌引起。革兰氏阳性菌引起的前列腺炎存在争议。在慢性细菌性前列腺炎中，分泌功能障碍很常见。前列腺按摩液pH值的碱性增加是抗生素治疗效果不佳的原因之一。在某些“非细菌性”形式的病例中，可能涉及不常见的微生物，如沙眼衣原体和解脲脲原体。不建议对这些微生物进行常规培养。
