Prostatitis is inflammation of the prostate (seminal) gland. Of all diseases of the genitourinary system in men, prostatitis occurs most often. Depending on the course, acute or chronic prostatitis is distinguished, the symptoms and treatment, respectively, depend on the form of the disease. According to various statistics, up to 45% of European males face this disease.
Signs of prostatitis in men
Signs of prostatitis in men are often considered violations of the process of urination, disturbances in the intimate sphere, painful sensations. The risk group is represented by men between the ages of 30 and 50, but the disease manifests itself at an early age. Diagnostics is carried out by a urologist, andrologist. The clinical picture allows you to determine the disease, an ultrasound examination is also performed, a bacteriological culture of urine is required, as well as secretion of the prostate. Prostatitis can cause the appearance of abscesses in the prostate gland, inflammatory processes in the upper parts of the genitourinary system, testes and epididymis, which can cause serious damage to health and affect reproductive function.
An infection that causes prostatitis can enter the gland from the organs of the genitourinary system or from remote foci in case of various inflammatory diseases (tonsillitis, flu, furunculosis, etc. ). The presence of an infection in the body does not always lead to disease; experts identify some factors that increase the risk of disease.
Etiology of prostatitis
Infections that cause prostatitis are often caused by Staphylococcus aureus, enterococci, enterobacteria, Proteus, Klebsiella, Pseudomonas aeruginosa and Escherichia coli. They often work together. But the vast majority of microorganisms belong to the conditionally pathogenic microflora, that is, they do not cause inflammation on their own.
Complications of prostatitis
Complications caused by acute prostatitis. If the patient does not seek medical attention for acute prostatitis, an abscess of the prostate gland sometimes develops. This is manifested by chills, severe hyperthermia. Pain in the perineal region becomes strong, sharp, urination becomes much more difficult, defecation becomes impossible. In addition, the process of urination significantly complicates edema of the prostate. Occasionally, there are cases when the abscess opens on its own. In this case, the pus can pass through the urethra (found in the urine) or through the rectum (out of the stool). But often the abscess must be surgically opened. It is important to identify an abscess in a timely manner, since its rupture can lead to sepsis or peritonitis, there are cases of death.
Characteristic complications of chronic prostatitis. Chronic prostatitis has many periods with persistent remission, when inflammation has virtually no effect on well-being. It is during such periods when the patient does not feel pain and discomfort that he refuses to treat prostatitis. This can lead to the development of serious complications. First of all, cystitis and pyelonephritis develop. Most often there are inflammatory processes in the testicles, epididymis, seminal vesicles. In turn, they can cause the extinction of reproductive function. As a consequence of chronic prostatitis, calcareous prostatitis sometimes occurs, characterized by the presence of stones in the prostate and excretory ducts. They are formed from the secretion of the prostate, lime salts, phosphates.
Prevention of prostatitis
As a prophylaxis of prostatitis, men are advised to minimize and, if possible, eliminate factors that increase the likelihood of developing the disease. When working sedentary, it is necessary to take regular breaks which should be used for physical activity (warm up, walking). It is necessary to establish good nutrition in compliance with the regime. In case of constipation, intensify defecation by taking laxatives.
As for sexual life, experts recommend adhering to the golden mean, since prolonged sexual abstinence and excessive male activity in this area are equally dangerous. It is also necessary to seek help in time if a urological disease or sexually transmitted infection is suspected.
To avoid relapses, patients with a chronic form should regularly undergo preventive examinations with an andrologist and a urologist.
Causes of prostatitis
Various circumstances associated with single or permanent adverse effects, lifestyle, nature of professional activity can significantly affect the predisposition to the disease.
The risk is increased by any prostate congestion and infectious diseases. Severe hypothermia, both as an isolated case and on an ongoing basis (associated with professional activity), sometimes causes inflammation. A man's activity level is of great importance. Sedentary work, a lifestyle that does not involve sports, walking, leads to the congestion that causes prostatitis in men. In addition, such factors include frequent constipation, the lack of an established rhythm of sexual life (a prolonged absence of sexual intercourse and excessive activity are equally dangerous, and incomplete ejaculation is also dangerous). Various chronic diseases or foci of infection (cholecystitis, tonsillitis, caries and many others), venereal (trichomoniasis, gonorrhea, chlamydiasis), various diseases of the urinary tract increase the likelihood of the disease.
Lifestyle disorders, manifested in constant stress, lack of a normal sleep and wake regime, improper diet, too intense loads in athletes - all this reduces the body's defenses and, in combination with other factors, leads to prostatitis. The constant ingestion of harmful substances into the body due to smoking, alcohol abuse - increases and contributes to the onset of the disease.
Some experts note the relationship of prostatitis in men with permanent injuries to the perineum (vibrations, tremors), which are often observed in drivers, motorcyclists, cyclists. Although these effects often only aggravate the existing disease.
Symptoms of prostatitis
Symptoms of acute prostatitis vary depending on the stage of the disease:
- Catarrhal prostatitis (acute). There is pain in the perineum, in the sacrum. Urination becomes more frequent, the process can be accompanied by pain.
- Follicular prostatitis (acute). Painful sensations intensify, especially acutely manifested during intestinal emptying, as they are given in the anus. The urination process is impaired, urine comes out in a thin stream or is held in the bladder. There may be a slight increase in temperature.
- Parenchymal prostatitis (acute). Hyperthermia, sometimes the temperature reaches 40 degrees, intoxication of the body. Urination is delayed, defecation is difficult. The pain becomes sharp, throbbing.
Sometimes acute prostatitis flows into a chronic form, but most often chronic prostatitis develops mainly, while there are no pronounced symptoms. Sometimes the patient may notice a slight hyperthermia, non-intense painful sensations appear in the perineum, especially during urination, defecation. A clear sign of prostatitis is a slight discharge from the urethra that occurs during bowel movements.
Primary chronic prostatitis does not manifest itself overnight. A long-term process usually begins with blood pooling in the capillaries and eventually results in inflammation.
Often it develops as a result of a neglected inflammatory process caused by gonococci, Trichomonas, chlamydia and ureaplasma. This inflammatory process hides the minor symptoms of prostatitis. As a result, the patient is unaware of the development of the disease.
Chronic prostatitis can be identified by the frequent feeling of fatigue, burning sensation in the perineum, urethra and urinary disorders that occur. Intimate disorders associated with erectile dysfunction often cause depression. But in patients, the symptoms manifest themselves in different ways, some signs of prostatitis in men may not be observed at all.
Medical science defines the following chronic prostatitis syndromes:
- pain syndrome;
- urination disorders;
- violations in the genital area.
Pain syndrome.Although prostate tissue does not possess pain receptors, patients can experience pain with prostatitis. This is due to the fact that the nerve pathways, of which there are many in the small pelvis, are almost always involved in the inflammatory process. The sensations differ in different patients. The pain can be mild, aching, or it can cause significant discomfort. It can also intensify or decrease slightly during active intercourse, ejaculation. The pain sometimes radiates to the lumbar region (this symptom is characteristic of many diseases), to the scrotum, perineum or sacrum.
Problems with urination (dysuric disorders).With prostatitis, the internal space of the ureter decreases due to compression. The more the prostate gland increases in size, the more the ureter is compressed. Therefore, from the early stages, the patient begins to notice an increase in the urge to urinate, there is a feeling that the bladder is not completely empty. In the process of compensatory hypertrophy of the muscles of the ureters and bladder, disorders become less noticeable, but recur over time.
Problems in the intimate sphere.At the very beginning of the development of the disease, sexual dysfunctions can manifest themselves in different ways. Some patients complain of a weakened orgasm, others have a worsening of the erection or often have nocturnal erections. Ejaculation is faster. Pain during ejaculation causes some patients to refrain from sexual intercourse. With the development of an inflammatory disease, ailments become more noticeable, until the appearance of impotence.
Research has shown that this syndrome is highly dependent on psychological factors. Potency disorders due to the inflammatory process do not occur in all patients. But usually patients, upon becoming aware of the presence of prostatitis, fall into a state of panic and expect impotence. The stronger the feeling of anxiety and the degree of suggestibility in the patient, the more often despotence develops in chronic prostatitis. The disease has psychological complications, manifested in an obsession with the disease and its consequences, severe anxiety, excessive irritability. This is due to the painful reaction to the possible consequences of chronic prostatitis.
Diagnosis of the disease helps to create a specific clinical picture. In addition to interviewing the patient, studying anamnesis, rectal palpation is in the first place, the secret of the prostate gland is taken for analysis.
Ultrasound examination allows you to determine the presence of structural changes in the gland (cysts, tumors, prostate adenomas) and confirm the diagnosis. To study the reproductive function, a spermogram is performed.
Various urodynamic studies make it possible to determine the degree and nature of disorders of the urinary process. To exclude the presence of tumors and prostate adenoma, a control of the level of PSA (prostate specific antigen) is prescribed, the high concentration of which indicates the presence of a tumor.
Treatment of prostatitis
Acute prostatitis therapy.If there are no complications in the acute form, prostatitis in men can be treated on an outpatient basis under the supervision of an andrologist or urologist. If there are signs of an abscess, general intoxication is observed, they resort to the treatment of prostatitis in a hospital. A patient with an acute form is prescribed a course of antibiotics. Before this, the sensitivity of the infectious agent is checked. Drugs are often used that can penetrate deep into the prostate tissue (for example, ciprofloxacin). If an abscess occurs, it is surgically opened through the urethra or rectum. Physiotherapy for the acute form of the disease can be prescribed only after eliminating the acute symptoms. In these cases, prostate massage, electrophoresis, microwave and UHF therapy are performed. If there is prolonged urinary retention, they resort to bladder catheterization.
Often, acute prostatitis flows into a chronic form, this is also observed in those patients who received timely treatment.
Therapeutic measures for chronic prostatitis
Treatment for chronic prostatitis does not always provide the opportunity to completely get rid of the disease. But with a properly organized process, it is almost always possible to remove the symptoms, to achieve the effect of a stable remission for a long time.
With chronic prostatitis, complex therapy is performed. First of all, the patient takes antibacterial drugs for one or two months. In addition to the main course of antibiotic therapy, physiotherapy and prostate massage are prescribed. In addition, the patient is helped to adapt the lifestyle in order to increase the body's defenses and minimize the factors that cause inflammation.
Taking antibacterial drugs for chronic prostatitis.The doctor separately selects the drug, the period of admission, the required dose. The course is usually quite long. Before prescribing a drug, a study is carried out on the sensitivity of microflora by sowing prostatic secretions, urine.
Prostate massage in the treatment of the disease.This measure is showing good results. The gland receives a complex effect. First of all it becomes possible to remove from the body the inflammatory secret that has accumulated in the prostate (it is released during the massage). Improving blood circulation through these manipulations allows you to fight all types of stagnation, and also contributes to the good penetration of antibiotics into the gland tissue.
Physiotherapy in the treatment of inflammation.Physiotherapy for chronic prostatitis is aimed at activating blood circulation. For this purpose, the patient is exposed to a laser, ultrasound and magnetic vibrations are used. In some cases, these procedures are replaced with warm medicinal enemas, which are regularly given to the patient. Recommend sitz baths, mud baths, mineral waters.
Immunocorrection in the treatment of chronic prostatitis.Decreased immunity adversely affects health. This factor is one of the fundamental factors in the development of the disease and its exacerbation. Long-term courses of taking antibiotics, which are mandatory for persistent prostatitis, also reduce the body's defenses. Therefore, the patient is advised to consult an immunologist to choose a strategy for conducting immunocorrection.
Correction of the usual way of life in the treatment of the disease.Maintaining a healthy lifestyle is not only the most effective prevention of prostatitis, but also a necessary therapeutic measure. Therefore, the patient, together with the specialist, analyzes the habits that become harmful factors. It is necessary to build a daily regimen with a sufficient sleep period, to ensure the presence of regular moderate physical activity. Nutrition is important.