In men, prostatitis is an inflammatory process involving the prostate tissue.The disease is accompanied by pain in the lower back, perineum and pelvis.The main manifestations are pain in the perineum and dysfunction of the lower urinary tract.
Among all urological diseases, urologists most often encounter prostatitis.It can develop unexpectedly (acutely) against the background of a general health condition, or it can last for a long time, with periods of exacerbation and remission, which indicates a chronic course.In addition, the second version of the disease is diagnosed much more often.
The disease can be independent and can be combined with prostatic hyperplasia or prostate cancer.
Reasons for development
Inflammation does not occur by itself.The causes of prostatitis can be divided into bacterial and non-bacterial.
The acute infectious version usually occurs in men under the age of 35 due to damage to the prostate gland caused by Gram-negative bacteria - Escherichia coli, Proteus, Enterobacter.Inflammation also occurs due to sexually transmitted infections - gonorrhea, chlamydia.In the chronic form, there may be many more causes, and the list will include atypical microbes.
Factors provoking the development of the bacterial version are the following:
- unprotected sex;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal intercourse;
- sedentary lifestyle;
- inactive sex life;
- diabetes mellitus;
- hypothermia;
- violation of intimate hygiene.
Non-infectious, chronic prostatitis is seen in men who complain of prolonged pain in the genitals, but tests do not diagnose the bacteria causing the inflammation.
The exact cause of the development of this type of prostatitis has not been investigated, but the following are considered provoking factors:
- emotional disturbances;
- autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work involving heavy lifting;
- chronic stress;
- congestion in the tissues of the prostate;
- previously proven fibrotic changes in the prostate (according to TRUS results).
It is believed that an inactive sex life, unprotected sex and hypothermia play a major role in the development of the disease.Symptoms of prostatitis are experienced by 50% of the entire male population of the planet at least once in their lives.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which move from one to another, if you do not consult a specialist and stop the development of the disease in time.
The first stage is called acute chronic prostatitis.It begins with frequent painful urination complaints.In the lower back and sacrum, as well as in the perineum, there is a slight pain at first, which quickly increases.
Without treatment, the second stage occurs - acute follicular.At this moment, the pain becomes particularly strong, radiates to the anus, and intensifies during defecation.Urination is very difficult, sometimes acute urinary retention occurs.The temperature does not exceed 38 degrees and can be higher only in rare cases.
Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C and higher, and chills appear.Urinary retention is often observed, sharp, throbbing pain occurs in the perineum, and defecation is difficult.
Symptoms of chronic prostatitis
Sometimes chronic prostatitis occurs against the background of an acute inflammatory process.This is a separate disease in which there is a primary chronic course that develops over a long period of time.
The chronic course often begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococcus.But vivid manifestations are very rare;more often, the disease is accompanied by minor pain during urination or in the perineum and a slight discharge from the urethra.Often these manifestations remain unnoticed even by the patient for a very long time.
In men, the signs of prostatitis can appear in different ways, but they can all be classified into three groups: pain, urinary disorders, and sexual activity problems.There are no receptors in the prostate tissue, so it cannot produce painful sensations.They appear when the inflammation begins to spread to the pelvic organs, which are abundantly innervated.Patients' pain can range from barely noticeable discomfort to severe and intense pain that interferes with sleep and normal lifestyle.The pain can radiate to the sacrum, the scrotum, the lower back, and the perineum, so self-diagnosis is useless here.
Urinary problems begin at the moment when the volume of the prostate increases and, as the lumen of the ureter decreases, it begins to compress the urethra.Frequent urge to urinate, feeling of incomplete emptying of the bladder.Typically, such phenomena appear at the very beginning, in the early stages of the disease, and then the body compensates, but at a later stage, they appear again without proper treatment.
Male potency problems can also be expressed in several ways.Patients complain of deterioration of erection, accelerated ejaculation and reduced sexual arousal.Gradually, sexual dysfunctions become more pronounced, and in advanced stages, the symptoms of prostatitis are complemented by impotence.
Possible complications
During inflammatory processes of the prostate, neighboring organs also participate in the pathological process.This can cause various consequences of prostatitis, such as:
- vesiculitis;
- posterior urethritis or colliculitis;
- abscess of the gland itself;
- sclerosis or fibrosis of the prostate;
- prostate cysts and stones;
- infertility;
- ejaculation disorder;
- erectile dysfunction.
In order to prevent the development of these serious complications, a urologist should be consulted at the first symptoms of prostatitis and prostate adenoma.
Diagnostics
Any form of prostatitis is diagnosed and treated by a urologist.If a tumor is suspected, the patient may be referred to an oncologist for consultation.In the case of chronic, long-lasting, difficult-to-treat prostatitis, an immunologist's consultation may be necessary.
The typical clinical picture and the patient's complaints help to establish a quick and accurate diagnosis.The list of mandatory tests for the diagnosis of prostatitis looks like this:
- Bacteriological culture of urine.
- Analysis of prostate secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Ultrasound of the prostate gland, which makes it possible to identify tumors, cysts, adenomas, and distinguish prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
It is difficult to independently determine the causes of the disease, let alone cure them.Therefore, in order to prevent the development of serious complications and not remain infertile in the future, a man should immediately consult a urologist at the first signs of the disease.
Treatment
Patients diagnosed with acute prostatitis without complications are treated on an outpatient basis.Only in case of severe poisoning symptoms and suspicion of a purulent process, hospitalization is carried out.
Antibiotics are the drugs of choice to fight inflammation.It is also used for chronic bacterial forms.The medicine is selected individually and taken within 4-6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally, in the form of capsules or tablets.
Another drug used to treat prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound.They help facilitate urination and relax the muscles of the prostate and bladder.Medicines belonging to the NSAID group help relieve pain.
Treatment of prostatitis is carried out only comprehensively and consistently.In addition to taking medications, the doctor prescribes prostate massage, and physiotherapy is used to improve blood circulation in this organ.Surgical treatment is used only when abscesses and suppuration of the seminal vesicles appear.
Prognosis and prevention
The acute form without treatment often becomes chronic, which periodically worsens.A complete recovery is not always possible, but if you see a doctor in time and take all the prescribed medicines, you can eliminate discomfort, urination problems and pain.
Self-treatment at home and the use of traditional methods can often be life-threatening.
In order to prevent prostatitis, it is recommended to avoid hypothermia, to empty the bladder in time, to limit the consumption of coffee, spices and alcohol, and to remain sexually active as long as possible.