PROSTATITIS

DEFINISI
• Penyakit akibat inflamasi pada kel.prostat Infeksi sal.urinari. • Gejala iritaif nyeri pada perineum, suprabubis, penis, testis, inguinal, dan punggung bawah.

ETIOLOGI
• • • • • Infeksi Imunogen Toxin Trauma Stress

ETIOLOGI
• Bakteri gram negatif : – Enterobacter family : E coli 65% - 80% – E coli 65-80% – Ps. Aeruginosa – Serratia – Klebsiella – Enterobacter aerogenes • Bakteri grsm positif : – Enterococci 5-10% – Staphylococcus saprophyticin – Staphylococcus aureus

PATHOGENESIS

Initiation

Response
Inflammation

Facilitation

Propagation
Immunologic

Outcome

Infection Immunogen Toxin Trauma Stress

Neuroendocrine me chanisms Neurologic “injury”

Neuropathic pain

Neurogenic

(Nickel 2007)

Klassifikasi Prostatitis Sindrome
Traditional
Acute bacterial prostatitis Chronic bacterial prostatitis

National Institutes of Health
Category I Category II Category III Chronic Pelvic Pain Syndrome (CPPS) Category IIIA (Inflammatory CPPS)

Description
Acute infection of the prostate gland Chronic infection of the prostate gland Chronic genitourinary pain in the absence of uropathogenic bacteria localized to the prostate gland employing standard methodology Significant number of white blood cells in expressed prostatic secretions, post-prostatic massage urine sediment (VB3), or semen Insignificant number of white blood cells in expressed prostatic secretions, post-prostatic massage urine sediment (VB3), or semen White blood cells (and.or bacteria) in expressed prostatic secretions, post-prostatic massage urine sediment (VB3), semen, or histologic specimens of prostate gland

Nonbacterial prostatitis Category IIIB (Noninflammatory CPPS)

Prostatodynia

Asymptomatic Inflammatory Prostatitis (AIP)

(Nickel 2007)

Manifestasi Klinis
• Lokal : Nyeri akut Retensi urin akut • Sistemik : Demam Malaise Mual, muntah 5% akan menjadi kronik

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