What does Prof. Alessandro Natali?

These are the uro-andrological clinical fields in which Prof. A. Natali practices his profession both from the medical and surgical point of view




The prostate for man is a very important gland, located in the male perineum, below the bladder and in front of the rectum. It is crossed by the urethra that allows the urine and sperm to come out. We urologists in describing the prostate comparing it to a chestnut, because this is normally its shape and size. Inside it there are also two structures, the seminal vesicles, which produce, together with the prostate itself, at least 80% of the liquid that comes out with the ejaculation.

This particular anatomical position, in contact with the outside through the urethra, and with the rectum, from which is separated by a thin layer of mucosa, means that this gland can be infected by germs that can come from the outside through the urethra or from the inside through the lymphatic vessels that drain beyond the prostate even sigma and rectum, and can be inflamed by incorrect behavioral factors related to the lifestyle.

In fact anxiety, stress, smoking, alcohol ,coffee, use of drugs, unregulated sexual activity, especially if episodic, sedentary life, driving vehicles-cars, motorbikes, mopeds, bicycles-, continuously for many hours, incorrect feeding without fibers , irregular bowel, are all elements that mixed together contribute in a decisive way to inflame this gland and to give even in the absence of a specific infectious agent, a very varied symptoms that can also influence the social life of the man with prostatitis, with disorders in minction and in sexual life.

The real incidence of prostatitis is difficult to estimate, it is believed that at least one third of the male population suffers every year, but these are certainly underestimated percentages. Also because, due to the multiplicity of factors involved, theoretically speaking, a man can meet this pathology at any age, even if the peak incidence is between 20 and 50 years.

Recent American research has highlighted how prostatitis represents the first reason in the world because an urological examination is required. From the clinical point of view, acute, subacute and chronic prostatitis can be distinguished.

The latter, due to the tendency to recur often and willingly, represent the largest share. While from an etiological point of view, we distinguish the bacterial prostatitis from the abacterial if in the biological liquids we are going to examine, essentially sperm and urine, bacteria are present or not.

How is Prostatitis presented from a clinical point of view?

The symptoms of prostatitis can be the most varied, both in the urological field: increase in urinating frequency, burning to urinate, sense of incomplete emptyng after urinating, heaviness in the perineal, suprapubic and testicular level, and in the sexual field: burning ejaculation, difficulty ejaculations or tendency to premature ejaculation. All these disorders are certainly bothersome and limiting for the patient's relationship life.

How is Prostatitis diagnosed?

The diagnosis is based on a careful and detailed assessment of the patient's life, with questions regarding his daily behavior: nutrition, type of life, sexual and intestinal activity, alcohol and coffee intake, use of drugs.

Then in addition to the evaluation of the prostate by digitorectal exploration it is essential to perform urine and sperm culture and possibly urethral swab, to exclude or confirm the presence of both common germs, or those related to sexually transmitted diseases (Chlamydia Trachomatis , Ureaplasma Urealyticum and Mycoplasma).

In the most striking forms with urinary symptomatology, the execution of a transrectal prostatic ultrasound may be useful to clarify the degree of the prostate inflammation.

How is a Prostatitis treated?

To treate a prostatitis it is necessary to be very clear with the patients, explaining that the resolution of the problem inevitably passes from the removal and / or reduction of the negative behavioral factors mentioned above. If these incorrect behaviors are not radically changed, the prostatitis may tend to become chronic and the symptoms periodically and cyclically may reappear, despite the prepared medical therapies.

We can use antibiotics aimed to eliminate any germs detected and anti-inflammatory drugs aimed to reduce pain and urinary symptoms.


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