TY  - CHAP
T1  - Defining Prostatitis in a global perspective – a narrative viewpoint
T2  - Urogenital Infections and Inflammations. Living Handbook
AU  - Grabe, Magnus J
ED  - Naber, Kurt G.
ED  - Bjerklund Johansen, Truls Erik
AD  - Magnus J Grabe, Lund University, Department of Translational Medicine, Malmö, Schweden, E-mail: magnus.grabe@gmail.com
N2  - The prostate, due to its anatomical position in a narrow space below the urinary bladder and wrapping the proximal urethra, is exposed to the mixed urinary and genital secretory flows. A reflux of urine into the prostatic ducts and the prostatic glandular fluid secreted the same way result in a prostate-urine flow loop bringing into the gland microorganisms from the urogenital microbiome and other components that eventually trigger the immune response. Inflammation of the prostatic tissue – etymologically the meaning of prostatitis – can start in the mature gland at any time and the risk increases with age. Acute inflammation causes tissue damage that eventually may turn into a chronic inflammation under sustained exposure or in combination with other traumatic events or risk factors. Inflammatory infiltration is reported in over three quarter of all benign prostatic hyperplasia (BPH) samples, in at least half of all prostate cancer (PCa) samples, and is obligate in bacterial prostatitis. It is expected but not always proven in chronic non-bacterial prostatitis. Inflammatory infiltration of various grade is incidentally found in men over 60 years in 30–100% of prostate biopsy or surgical samples independently of the perception of symptoms or not. The number of benign prostatic hyperplasia/enlargement (BPH/E) reported worldwide exceeds 112 million (probably grossly underestimated), prostate cancer over 1.5 million with high mortality rate, and the number of urogenital infectious (UGI) events is incalculably huge. The associated use and overuse of antimicrobial agents contribute to the increasing number of public health threatening multi-resistant microorganisms. It is essential to distinguish between a silent (asymptomatic) intra-prostatic chronic inflammation and the symptomatic prostatitis syndrome, both labelled prostatitis. The hypothesis of a life-long progressive stimulation of the prostatic gland’s immune system sustaining a chronic inflammation that interacts with the other disease related risk factor in the niche-specific environments of the different anatomical zones is discussed. The end-result is a disability of global health significance affecting hundreds of millions of men worldwide. 
PY  - 2026
DA  - 2026/10/30
DO  - 10.5680/lhuii000076
ET  - 2026 Oct 30
LA  - en
L1  - https://books.publisso.de/de/system/getFile/81490
L1  - https://books.publisso.de/de/system/getFile/79102
UR  - https://dx.doi.org/10.5680/lhuii000076
L2  - https://dx.doi.org/10.5680/lhuii000076
PB  - German Medical Science GMS Publishing House
CY  - Berlin
ER  -