Histological Features
In CBP, histological examination reveals a variety of changes in the prostate gland. The primary feature is the presence of inflammatory cells, predominantly
neutrophils, within the prostatic ducts and acini. Chronic inflammation may also lead to the accumulation of
lymphocytes and
plasma cells in the stromal regions of the prostate. Additionally, histological sections may show signs of
fibrosis and glandular atrophy.
Pathogenesis
The pathogenesis of CBP involves the persistent colonization of the prostate by uropathogens, which triggers an ongoing inflammatory response. The bacteria can enter the prostate via the urethra or through the bloodstream. Common pathogens include
Escherichia coli and other Gram-negative bacteria. The immune system's response to these bacteria leads to the infiltration of inflammatory cells and subsequent tissue damage.
Diagnosis
Diagnosis of CBP often involves a combination of clinical evaluation and laboratory tests. Histological examination of prostate tissue obtained via biopsy can provide definitive evidence of chronic inflammation and bacterial infection. Additional diagnostic methods include the
Meares-Stamey test and
prostate-specific antigen (PSA) testing. Imaging studies such as
transrectal ultrasound (TRUS) may also be utilized to assess structural changes in the prostate.
Treatment
Treatment of CBP primarily involves prolonged courses of antibiotics to eradicate the bacterial infection. Commonly used antibiotics include fluoroquinolones and trimethoprim-sulfamethoxazole. However, due to the complex nature of the prostate's anatomy and the presence of biofilms, achieving complete eradication of the bacteria can be challenging. In some cases, adjunct therapies such as anti-inflammatory medications and alpha-blockers may be used to alleviate symptoms. Prognosis and Complications
The prognosis for CBP varies depending on the effectiveness of the treatment and the patient's response. While some individuals achieve complete resolution of symptoms, others may experience recurrent episodes or persistent symptoms. Chronic inflammation of the prostate can lead to complications such as
prostatic abscess, urinary retention, and infertility.
