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Asymptomatic inflammatory prostatitis
Last reviewed: 05.07.2025
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Asymptomatic inflammatory prostatitis (NIH Category IV) is a histologically confirmed, clinically latent bacterial or abacterial inflammation of the prostate gland that is detected during examination for other diseases.
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Causes of asymptomatic inflammatory prostatitis
The presumed causes of asymptomatic inflammation of the prostate gland are bacterial pathogens, which may or may not be detectable using modern diagnostic methods.
Pathologically, this form of the disease reveals lymphohistiocytic infiltration of the prostate tissue and its ducts in combination with foci of sclerosis.
Symptoms of asymptomatic inflammatory prostatitis
Clinically, this form of the disease is completely latent. Patients with asymptomatic inflammatory prostatitis do not present complaints. There may be an anamnestic indication of an increase in total PSA (reason for performing a prostate biopsy).
Palpation of the prostate gland can help to identify enlargement, tenderness, asymmetry and heterogeneity of the organ.
Treatment of asymptomatic inflammatory prostatitis
The goal of treatment is to normalize total PSA when it increases. In other cases, treatment is not required.
Indications for hospitalization
Treatment of asymptomatic inflammatory prostatitis is carried out on an outpatient basis.
Non-drug treatment
During treatment, it is advisable to lead an active lifestyle, exclude immunosuppressive effects (hypothermia, insolation). It is necessary to have regular (at least 3 times a week) and protected sexual activity, adhere to a diet aimed at eliminating alcohol, carbonated drinks, spicy, pickled, salty and bitter foods.
Drug treatment
Taking into account the data on the possible infectious nature of the disease, antibacterial therapy is carried out with fluoroquinolones (ofloxacin, levofloxacin, moxifloxacin), tetracyclines (doxycycline) or sulfonamides (sulfamethoxazole/trimethoprim). The duration of taking antibacterial drugs is 4-6 weeks. The criterion for effective treatment with an increase in total PSA is its normalization within 3 months after the end of therapy. If pathological changes in the SPS and PM 3 are detected in the 4-glass sample, it is necessary to normalize the indicators.
Diagnostics
Laboratory tests for the diagnosis of asymptomatic inflammatory prostatitis are not mandatory due to the presence of a primary histological diagnosis. When performing a 4-glass test, it is possible or not to detect an increase in the number of leukocytes and bacteria in the SPG and PM 3.
Instrumental methods
TRUS may not be performed due to the absence of changes typical for this form of the disease. The ultrasound picture does not differ significantly from that of chronic bacterial prostatitis (non-uniform echostructure of the prostate with areas of increased echo density),
Differential diagnostics
Differential diagnostics are not performed due to the presence of histological examination results of prostate tissue.
Example of diagnosis formulation
- Asymptomatic inflammatory prostatitis.
Prevention
Prevention of asymptomatic inflammatory prostatitis has not been developed.