Prostatitis: symptoms, treatment, prevention.

Prostatitis in men is an inflammatory process that involves the prostate tissue.The disease is accompanied by pain that occurs 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, prostatitis is most often encountered by urologists.It can develop unexpectedly (acutely) against the background of general health, or it can last a long time, with periods of exacerbation and remission, indicating a chronic course.In addition, the second variant of the disease is diagnosed much more often.

The disease can be independent or can also be combined with prostate hyperplasia or prostate cancer.

Reasons for development

The inflammation does not appear on its own.The causes of prostatitis can be divided into bacterial and non-bacterial.

The acute infectious variant usually occurs in men under 35 years of age due to damage to the prostate by gram-negative bacteria: Escherichia coli, Proteus, Enterobacter.Inflammation also occurs due to infection with sexually transmitted infections: gonorrhea, chlamydia.In the chronic form, there may be many more reasons and the list will include atypical microbes.

The factors that cause the development of the bacterial variant are:

• unprotected sexual relations;
• AIDS or HIV infection;
• diarrhea or constipation;
• anal intercourse;
• sedentary lifestyle;
• inactive sex life;
• diabetes mellitus;
• hypothermia;
• violations in intimate hygiene.
• emotional disorders;
• autoimmune diseases;
• increased physical activity;
• lack of regular sex life;
• jobs that involve lifting heavy objects;
• chronic stress;
• congestion in the prostate tissues;
• previously confirmed fibrotic changes in the prostate (according to TRUS results).

What are the first signs of prostatitis that you should pay attention to?

The first manifestations of the disease are pain in the lower back and crotch, difficulty urinating.If, when going to the toilet, you notice a weakening of the urine stream, or you feel discomfort or a burning sensation in the urethra, you should consult a urologist as soon as possible.

With the acute onset of the disease, the temperature may rise and general well-being may deteriorate.Such a patient should be treated immediately with antibiotics and anti-inflammatories.

In some cases, the disease may be asymptomatic for a long time, so treatment begins late.

Prostatitis symptoms

Signs of prostatitis in men depend on the form of the disease.In the acute form, the following manifestations are characterized:

• pain in the lumbar area, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficulty defecating;
• thin stream of urine;
• temperature increase;
• shivers;
• deterioration of general health.

The chronic form can occur after the acute phase of the disease or develop as a primary disease.The symptoms of chronic prostatitis in men are mild.The pain is of low intensity, the temperature may increase slightly.The urine stream becomes thin, disorders appear in the intimate area.

In the chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible.The pain may be absent or dull, painful in nature.

Symptoms of acute prostatitis.

Acute prostatitis occurs in several stages, which will progress from one to another if a specialist is not consulted and the development of the disease is stopped in time.

The first stage is called acute catarrhal prostatitis.It begins with complaints of frequent pain when urinating.In the lumbar area and sacrum, as well as in the perineum, a slight pain appears at first that increases rapidly.

Without treatment, the second stage occurs: acute follicular.At this time, the pain becomes especially intense, radiating to the anus and intensifying during bowel movements.It is very difficult to urinate, sometimes there is acute urinary retention.The temperature does not exceed 38 degrees and can only be higher in rare cases.

Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C or higher, and chills appear.Urinary retention is often observed, sharp, stabbing pain appears 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 time.

Often, the chronic course begins as a complication of the inflammatory process caused by various infectious agents: chlamydia, trichomonas, gonococci.But vivid manifestations are very rare;More often, the disease occurs with mild pain during urination or in the perineum and slight discharge from the urethra.Often these manifestations go unnoticed even by the patient for a long time.

Signs of prostatitis in men can occur in different ways, but they are all grouped into three groups: pain, urinary disorders and problems with sexual activity.The prostate tissue lacks receptors and therefore 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, intense pain that disrupts sleep and normal lifestyle.The pain can radiate to the sacrum, scrotum, lower back and perineum, so self-diagnosis is useless here.

Problems with urination begin at the moment when the prostate increases in volume and begins to compress the urethra with a decrease in the lumen of the ureter.There is a frequent urge to urinate, a feeling of incomplete emptying of the bladder.Usually these phenomena are expressed at the beginning of the disease, in its early stages, then they are compensated by the body, but at a later stage, without proper treatment, they appear again.

Potency problems in men can also be expressed in different ways.Patients complain of worsening erection, accelerated ejaculation and decreased sexual arousal.Gradually, sexual dysfunctions become more pronounced, and at an advanced stage, the symptoms of prostatitis are complemented by impotence.

Classification

Experts distinguish several categories of the disease:

• Acute bacterial prostatitis, which is characterized by symptoms of a bacterial infection.The causative agent of the disease in most cases is Escherichia coli.Enterococci and other bacteria are isolated with some frequency;
• Chronic bacterial prostatitis, which is a recurrent form of the disease.The causative agents of the disease are bacteria E. coli, enterococci, etc.Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also be pathogenic;
• Chronic pelvic pain syndrome, in which no infections are detected.There are two types: inflammatory and non-inflammatory.Among the causes of appearance: autoimmune processes, external factors (hypothermia, overheating), poor sex life, low physical activity, rare urination;
• Asymptomatic prostatitis, detected by chance during medical examination.

Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after a thorough diagnosis based on examination data.You should contact a specialist if you have certain symptoms.

Symptoms

The main symptom is dysfunction of the urinary system.You should contact a specialist if you have the following symptoms:

• if you find it difficult to urinate and urine passes intermittently;
• if during bowel movements there is discharge from the urethra;
• with burning sensation in the urethra and perineum;
• if, during bowel movements, discomfort occurs in the bladder and prostate;
• if the urge to urinate intensifies and becomes more frequent;
• if you feel pain in the rectum;
• if there is purulent bloody discharge from the urethra (“floating threads”);
• with frequent increases in body temperature;
• when intimate problems arise (weakening of the erection);
• when erections appear at night for an inexplicable reason;
• if ejaculation during sexual intercourse is too rapid;
• if the sensations during orgasm are “erased”;
• with rapid general fatigue;
• with manifestations of a depressed or unreasonably anxious state, as well as a state of mental depression;
• with frequent depression, manifestations of mental depression in anticipation of complications;
• with general weakening of the body.

One or two symptoms are enough to contact a urologist.Attempts to cure on your own often lead to a worsening of the condition and the disease becoming chronic or severe.In the worst case, not going to the doctor on time can lead to infertility or complete impotence.

If the patient does not consult a doctor in a timely manner or neglects treatment, the following symptoms may appear:

• pain in the perineum;
• pain near the scrotum;
• pain at the base of the root of the penis (painful in nature).

Aching pain indicates stone formation.Doctors call infertility a late sign of a progressive disease.

Signs of prostatitis in acute and chronic forms vary significantly.In particular, in the chronic form, the signs may be mild or not expressed at all.

Acute prostatitis is characterized by pronounced symptoms: general malaise, pain in the groin area.Men need to contact specialists if:

• the need to urinate has become very frequent;
• pain during defecation and urination intensifies in the perineum and radiates to the groin;
• complete emptying of the bladder is impossible;
• the amount of urine produced per day has decreased significantly or urine is not collected;
• elevated temperature, frequent headaches, general weakness.

Acute bacterial prostatitis is characterized by fever and chills, pain in the lumbosacral region (severe), pain manifesting in the perineum and rectum, acute urinary retention, frequent pain in muscles and joints.

Chronic prostatitis is characterized by the following symptoms:

• when urinating, the pain in the perineum intensifies;
• with frequent urges, the bladder is not completely emptied;
• decreased sexual desire;
• Discomfort is felt during sexual relations.

One of the signs of the chronic form is significant disturbances in the emotional background, characterized by insomnia, increased nervousness, bad mood and irritability.

The bacterial form of chronic prostatitis is characterized by problems with ejaculation, which becomes rapid and painful, discomfort in the pubic area, frequent or involuntary urination, and intermittent urine flow.

Chronic pelvic pain syndrome, which, according to medical statistics, is the most common form of prostatitis, is characterized by symptoms similar to the symptoms of bacterial prostatitis in chronic form: frequent urge to urinate, weakening of the urine stream, pain in the penis and testicles, and sexual dysfunction.

Possible complications

• vesiculitis;
• posterior urethritis or coliculitis;
• abscess of the gland itself;
• sclerosis or fibrosis of the prostate;
• prostate cysts and stones;
• sterility;
• ejaculation disorder;
• erectile dysfunction.

Diagnosis

Diagnosis and treatment of any form of prostatitis is carried out by a urologist.If a tumor is suspected, the patient may be referred to an oncologist for consultation.In case of long-term chronic prostatitis, which is difficult to treat, a consultation with an immunologist may be necessary.

1. Bacteriological urine culture.
2. Analysis of prostate secretion for microflora and sensitivity to antibiotics.
3. Rectal examination of the prostate.
4. Ultrasound of the prostate, which allows identifying tumors, cysts, adenomas and also differentiating prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Features of the diagnosis of acute prostatitis.

If the signs of the disease indicate acute prostatitis, the diagnosis is made on the basis of data from instrumental and clinical examinations.Any manipulation that could affect the prostate is contraindicated, as it can cause acute pain or cause the spread of an infection.

Features of the diagnosis of chronic bacterial prostatitis.

The diagnosis in such cases is determined on the basis of the following data: medical examination of the patient, bacteriological and microscopic examination of secretions from the prostate and study of ultrasound data.

Features of the diagnosis of pelvic pain syndrome.

Specialists prescribe diagnostic procedures for symptoms indicating chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory.As a rule, an ultrasound scan is prescribed, as well as the following manipulations:

• examination of prostate secretions;
• molecular biological research;
• bacteriological research.

The choice of technique is determined by the doctor based on the data of the initial examination.

Risk groups

The most likely occurrence and development of prostatitis:

• in men who are obese or lead a sedentary lifestyle;
• in men with sedentary work (office workers, programmers);
• in men whose body is subject to shocks and vibrations (car drivers, including special equipment);
• in men who have suffered from infectious diseases, including diseases of the genitourinary system;
• in sexually hyperactive men and in those who do not have sexual relations regularly;
• in depressed men suffering from mental illness;
• in alcoholics, drug addicts, etc.

Treatment

Patients diagnosed with acute prostatitis without complications receive treatment on an outpatient basis.Only with severe symptoms of poisoning and suspicion of a purulent process is hospitalization carried out.

Antibiotics are the drugs of choice to combat inflammation.They are also used for chronic bacterial forms.The drug is selected individually and taken for 4 to 6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally, in the form of capsules or tablets.

Another medication used for 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 from the NSAID group help relieve pain.

Treatment of prostatitis is carried out only in a comprehensive and consistent manner.In addition to taking medications, the doctor will prescribe a course of 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.

The choice of prostatitis treatment method depends on many factors and is determined individually.When choosing treatment methods, the following is taken into account:

• cause of the disease;
• course of the disease;
• individual characteristics of the body (presence of chronic and concomitant diseases).

For treatment, a specific technique can be selected or a complex prescribed.Specialists in the field of urology, depending on the results of the diagnosis, prescribe:

• Physiotherapeutic procedures: MRI therapy, procedures with laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Pharmacological treatment.
• Diet and psychotherapy.
• Surgical intervention.

When diagnosing bacterial prostatitis, broad-spectrum antibiotics, immunomodulators and multivitamin complexes are prescribed.

When diagnosing non-bacterial prostatitis, physiotherapy and anti-inflammatory drugs are prescribed.

In some cases, specialists may recommend muscle relaxants and hormone therapy, as well as antioxidants to help reduce inflammation and protect cells from free radicals.

Correctly selected complex of drugs for acute bacterial prostatitis:

• restores immunity;
• treats infections (antibiotics);
• treats the prostate (antibacterial medications).

Chronic prostatitis is difficult to treat, therefore an extensive list of medications is used: anti-inflammatory, antispasmodic, absorbent, antibacterial, vibration and finger massage, electrophoresis, EHF and UHF therapy, sinusoidally modulated currents.

Antibiotics and anti-inflammatories, various types of physiotherapy, magnetic and laser therapy, electrical neurostimulation, etc. are used in the diagnosis of pelvic pain syndrome.One of the effective methods is drainage of tissue around the source of inflammation.

The urologist chooses conservative or modern treatment based on the diagnostic data.

tablets

Antibacterial agents and analgesics in the form of tablets can be prescribed for prostatitis.

The course of antibiotic therapy is selected individually based on the result of the analysis of prostate secretions.The microflora that caused the disease must be sensitive to the drug used.It is necessary to fully complete the course of treatment prescribed by the urologist;Otherwise, the cause will not be eliminated, the disease will reappear or become chronic.

Pain relievers for prostatitis help eliminate unpleasant symptoms.For this, non-steroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.

Tablets for male prostatitis, which help treat difficulty urinating, belong to the group of alpha 1 blockers. They relax the smooth muscles and restore the patency of the urethra compressed by the inflamed prostate.

Injections for prostatitis

Antibacterial agents for prostatitis in men are also used in the form of injections.Injectable forms of drugs are prescribed for severe inflammation, as well as in the absence of tableted antibiotics, to which the pathogen is sensitive.Antispasmodics may be injected to quickly restore urination, which is difficult due to urinary tract spasm and prostate compression.

Injectable prostatitis medications work faster than tablet medications, so they are sometimes preferable.

Surgery for prostatitis

The most serious complications are suppuration of the seminal vesicles and abscesses.Medications for the treatment of the disease cannot cope with the disease in such a difficult situation, so surgery is indicated at the first manifestations.

In the absence of timely intervention, the purulent process spreads beyond the organ, so the consequences of prostatitis in a complicated form can be life-threatening.

Prognosis and prevention

The acute form without treatment often becomes chronic, periodically worsening.Complete recovery is not always possible, but if you consult a doctor in a timely manner and take all prescribed medications, you can eliminate discomfort, problems with urination and pain.

Self-treatment at home and the use of traditional methods can often be life-threatening.

To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder on time, limit the consumption of coffee, spices and alcohol, and remain sexually active as long as possible.

Typical signs of prostate cancer.

The prostate is a small organ that only men have.Resembling a sponge in structure, it is located under the bladder and appears to surround the urethra.The growth of the gland begins in adolescence under the influence of male sex hormones;In adulthood, its weight can reach 20 grams.It plays an important role in the male reproductive system, producing secretion, one of the components of sperm.But, unfortunately, mature and elderly men often experience gland hyperplasia or malignant neoplasms of the organ.

How to recognize cancer

As the tumor grows and progresses, prostate cancer symptoms depend on the stage of the process.If the disease is still in the first stage or has even reached the second, then the tumor is localized in the prostate gland, has not grown into neighboring tissues and has not metastasized.

Symptoms of prostate cancer in the early stages are practically absent - this is the insidiousness of the disease.The man has no complaints, feels fine and sees no reason to go to the doctor.This is why this type of tumor is often discovered in an advanced state.An exception may be patients who have previously been diagnosed with benign neoplasms of the prostate, in which case they are periodically observed by a specialized doctor and are tested for a prostate-specific antigen and undergo an ultrasound of the prostate.They have every chance of detecting a tumor at its origin.But it should be noted that detecting prostate cancer is not always easy.Even when a biopsy is performed, the results may be clear, but the oncology is already there.This occurs due to errors in the method;the needle simply does not reach the localized injury site.If prostate pathology is suspected, especially if it is cancer, a fusion biopsy should be performed, which combines the capabilities of ultrasound and MRI in real time, giving the doctor the opportunity to visualize the organ as accurately as possible.

Some symptoms are a consequence of prostate pathology, while others are caused by mechanical compression and blockage of the urethra.

Since the bladder must be emptied regularly, if this process is interrupted, urine can be retained, inflammation can occur, and a bacterial infection can develop.If no measures are taken, the process will spread and this already threatens pyelonephritis and kidney problems.

At stage 4, prostate cancer manifests itself even more clearly.Metastases are most often found in the bones, spine and lymph.Because of this, a person's regional lymph nodes become enlarged, his bones hurt, he suddenly loses weight and becomes weak.

Treating prostate cancer is not an easy task, but it can be done.If the local process is detected in time, a complete cure can be achieved and in more advanced stages life can be prolonged.If you notice the symptoms described above, contact a professional clinic for an examination.

Make an appointment, the clinic's doctors have many years of experience in the treatment of urological diseases and achieve success even in the most difficult cases.