Causes and symptoms of chronic prostatitis in men.

Chronic inflammation of the prostate occurs in men of any age.In most cases, the catalyst is an infectious factor: Trichomonas, staphylococcus and gonococcus.Bacteria that enter the body cause inflammation of the urethral canal, the prostate gland itself.

The chronic form of prostatitis is usually asymptomatic.The disease itself is determined only after the transition to an acute form.The late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.

Statistics show a constant "rejuvenation" of the disease.More and more patients in their 30s turn to urologists.

Chronic prostatitis: what is it?

The prostate is located below the bladder.The main functions are reduced to protecting the urinary vesica from the entry of seminal fluid, as well as the production of prostatic secretion, a necessary component of male semen.Inflammation of glandular tissue, caused by infection, congestion and other factors, gradually becomes permanent.

Chronic prostatitis leads to degenerative changes.The structure of the tissues is gradually deformed.Often, against the background of inflammation, stones appear in the ducts.Some types of prostatitis cause the development of cancer.

An international classification system has been developed to facilitate differentiation between different prostate diseases.

Chronic prostatitis - causes

It is generally accepted that inflammation of the prostate is caused by two main factors: bacterial and non-bacterial.

The first is associated with the entry of pathogens and infections into the patient's body.Most often, the catalyst is sexually transmitted bacteria.

The second cause of appearance is not associated with an infectious agent.The catalyst for inflammation can be:

• Hypothermia of the body.
• Hormonal imbalances associated with aging and irregular sexual life.
• Bad habits.
• Injury to the pelvic organs.
• Stagnation caused by metabolic disorders and sedentary lifestyle.

After prostatitis is diagnosed, the root cause of chronic prostatitis must be determined.The course of therapy is prescribed depending on the exact cause of the inflammation.Bacterial and non-infectious prostatitis are treated differently.

Urologists mention several additional factors that aggravate the situation and influence the severe course of the disease:

• Sexual abstinence.
• Inferior ejaculation (choice of interrupted sexual relations as a contraceptive method).
• Stress.
• Bad habits: alcohol abuse and smoking.
• Poor nutrition.
• Inflammatory diseases suffered in the past.Often the cause of chronic prostatitis is urethritis and cystitis.

Inflammation is accompanied by destructive changes in the prostate, which allows the disease to be classified into several categories.

Classification of chronic inflammation of the prostate.

Types of prostatitis received their own ICD-10 code: N41.To clarify the diagnosis and differentiate catalyst infection, a separate classification B95-B97 is used.The symptom rating scale divides the disease into several groups and subgroups:

• I - acute inflammation, accompanied by a sharp increase in temperature and fever.
• II - chronic prostatitis, caused by an infectious factor.
• III - class includes a disease in which pelvic pain syndrome begins to manifest itself.It is customary to distinguish two subgroups:
  1. IIIA: there are signs of an inflammatory process.Low-grade fever remains.
  2. IIIB: no inflammation.
• IV - prostatitis in which there are no symptomatic manifestations.Deviations from the norm are detected exclusively by instrumental diagnostic methods.

According to the ICD code:

• N41.1 is diagnosed with chronic prostatitis.
• N41.8 inflammatory diseases of the prostate gland.
• N41.9 an exact diagnosis has not been made.

How does chronic prostatitis manifest?Your symptoms.

The first signs of chronic prostatitis in men appear in an advanced phase of the disease.Early development often has no clinical manifestations.Symptoms, even if present, are temporary, short-lived, and low in intensity.

According to clinical manifestations, three stages of the development of prostatitis are distinguished:

• Initial indirect signs of chronic prostatitis: as already noted, the onset of the disease is not expressed by clearly distinguishable symptoms.The manifestations are subtle or completely absent.Signs to pay attention to: burning sensation during ejaculation, decreased potency, pain when urinating.
• Secondary signs of chronic inflammation of the prostate: at this stage, pathological changes in the structure of tissues occur, the appearance of scar-like formations and a decrease in genitourinary function.The stage is characterized by a sharp deterioration in potency and urination, increased sweating, severe pain in the pelvic area, lumbar spine and scrotum.
• Signs of an advanced disease: the prostate stops functioning normally.Healthy tissues begin to metamorphose.The gland increases in size.Blood and pus appear in the urine, there is a constant feeling of incomplete emptying of the bladder, and night trips to the toilet become more frequent.Erectile function decreases so much that we can speak of total sexual impotence.

In addition to the symptoms specific to each stage of development, there are general signs that appear throughout the entire course of the disease.

pain syndrome

Chronic prostatitis in the last stage of development has pronounced symptoms.The characteristic clinical manifestations are pain of severe intensity that does not disappear on its own and requires the use of analgesics and antispasmodics.

Pain syndrome accompanies the entire period of development of the disease.During the primary signs of prostatitis, discomfort and burning in the urethral canal are of low intensity and are therefore often ignored.The pain is often mistakenly attributed to radiculitis or fatigue.After relieving the pain or taking an antispasmodic, the symptom usually disappears.

Over time, the clinical picture becomes more intense.The pain syndrome manifests itself with greater intensity and persists after taking analgesics.Unpleasant sensations accompany each act of urinating, defecating and ejaculating.

The pain radiates from the spine to the scrotum, sometimes to the extremities, and is accompanied by cramps and numbness.Rashes, itching, and burning tissue in the prostate and genital areas are a normal reaction of the body to internal inflammation.

Temperature increase

Chronic inflammation of the prostate in acute form is accompanied by heat and fever.There is a sharp increase in temperature, reaching 39-40°.The indicators are stable.Body temperature does not decrease even after taking antipyretics.

Slow prostatitis is characterized by a mild fever.Constant indicators of chronic inflammation, between 37-37.2°.

It is strictly prohibited to reduce the temperature and take medications on your own to reduce external manifestations!

dysuria

The first signs of chronic prostatitis appear in various urination disorders.Over time, symptoms become more intense, which helps identify the disease.Manifestations of dysuria:

• Frequent need to go to the bathroom at night.
• Sensation of incomplete emptying of the bladder.
• Hematuria (blood in urine), purulent discharge.
• Pain when urinating.

Clinical signs and the intensity of their manifestation directly affect the diagnosis and require mandatory additional investigations.Symptoms may indicate other inflammatory diseases of the genitourinary system, hyperplasia and oncology.

Disorders of the genital organs.

Chronic prostatitis causes the appearance of scar formations that disrupt blood supply.Lack of nutrients leads to the following manifestations:

• Decreased potency - with chronic prostatitis, sexual disorders are observed.One of the characteristic symptoms is a normal erection, which decreases drastically during sexual intercourse.In the advanced stage, stable power is produced.
• Infertility: after the appearance of scars in the seminal ducts, the viability of sperm decreases.Inflammation changes the structure and composition of the ejaculate.In the advanced stage, the sperm thicken and appear lumpy.
• Pain during sexual intercourse: discharge from the urethral canal is observed.During sexual intercourse, discomfort and painful symptoms are felt, especially during ejaculation.Often, psychosomatic reasons lead to persistent impotence of the patient.

The main symptoms of chronic prostatitis: pain, increased body temperature, dysuria, dysfunction of the genital organs.When making a diagnosis, the intensity and duration of the period since the appearance of clinical signs, as well as related symptoms, are taken into account.

How can you detect chronic inflammation of the prostate?

Prostatitis does not present symptoms that can accurately differentiate the disease.Some disorders of the genitourinary system have similar symptoms.An accurate diagnosis can only be made after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.

Suspecting the presence of disturbances in the functioning of the pelvic organs, the urologist will prescribe a mandatory digital rectal examination.If tissue changes are detected during palpation, various laboratory tests are prescribed.

Laboratory research methods.

Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the catalyst for the development of the disease.When making a diagnosis, additional information will be required from the results of the following laboratory tests:

• Cytological and bacteriological analysis of urine.The PSA level is established.Protein levels increase dramatically with inflammation of glandular tissue.
• Taking a smear from the urethra.
• Microscopy of prostate secretions: according to the results, dysfunctions in the prostate gland are determined.Differentiate cancer from chronic tissue inflammation.It is prohibited to sow prostate secretions during an acute period of the disease, accompanied by elevated body temperature, exacerbation of hemorrhoids or fissures in the anus.
• Testing for STIs (sexually transmitted infections): One of the common catalysts for prostate inflammation is pathogenic microorganisms.Trichomonas, staphylococci and gonococci can cause the disease.Prostatitis develops during the active phase of bacterial proliferation and after the infection has already healed.

Laboratory tests are a mandatory component of the diagnosis of prostatitis and the subsequent choice of the treatment method.

Instrumental detection of the disease.

There are three main methods for testing for prostatitis.Each instrumental diagnostic method provides information about changes in the structure of glandular tissue and has its own indications and contraindications:

• Tomography: MRI is often prescribed to diagnose chronic prostatitis.The study allows you to obtain a layer-by-layer image of the prostate.MRI signs accurately indicate chronic inflammation and also indicate the beginning of tissue degeneration towards malignant formation.MRI technology is absolutely harmless, but has contraindications due to the impossibility of studying patients with pacemakers, metal clips and shunts (left during surgical operations).
• Transrectal TRUS is an informative method that reliably indicates the presence of inflammation.Ultrasound signs of structural changes in the prostate depending on the type of chronic prostatitis include: deviations from the norm in volume and size, structure and the presence of pathological formations.Ultrasound techniques are not prescribed for acute inflammation of the rectum, the presence of cracks in the anus or hemorrhoids.
• Ultrasound: the transabdominal technique has no contraindications.The method is less informative compared to TRUS and MRI.Ultrasound signs make it difficult to determine the abdominal cavity space.Diagnostic results are often controversial and require clarification.The advantage of ultrasound is the simplicity and speed of the study.

The accuracy of the ultrasound image largely depends on the experience of the doctor performing the study.

Differential search for diseases.

After receiving the results of clinical and biochemical studies, symptoms of chronic inflammation of the prostate are evaluated.Common diagnostic standards have been developed that are valid throughout the world.

To facilitate the task of the urologist, the NIH-CPSI symptom index has been invented, prepared in the form of a questionnaire or questionnaire.The doctor fills in the fields of the document and then makes a diagnosis.

There are computer programs based on the NIH-CPSI index.The doctor must complete a questionnaire and the system will independently perform a summary assessment of the symptoms of chronic prostatitis.The effectiveness of the technique has been proven all over the world.

After calculating the results of the questionnaire, when making the diagnosis, an additional assessment of instrumental and clinical studies is taken into account: the presence of ultrasound signs of chronic prostatitis, an elevated level of PSA, identification of an infectious marker using microscopy of secretions.The more data the urologist has, the more accurate the result will be.

What is dangerous about chronic prostatitis?Its consequences.

The consequences of chronic prostatitis in men are disorders in the functioning of the genitourinary system.These include:

• Impotence.
• Acute urinary retention.
• Sterility.

The fibrous changes that accompany advanced disease cause the development of oncology.Normal tissues degenerate into malignant ones.Therefore, preventing functional changes in the prostate gland to prevent the development of cancer is an extremely important task facing the urologist.

When making the diagnosis, the presence of prostatic intraepithelial neoplasia, a harbinger of oncology and fibrous changes, is taken into account.Advanced disease often leads to the need for surgery: prostatectomy.

Diagnosis of prostatitis and differentiation of the disease from related disorders of the pelvic organs is an important task for doctors and patients.Detection of the first symptoms depends entirely on the man himself.If you experience any discomfort when urinating, decreased erection, or persistent mild fever, these are reasons to seek professional medical help immediately.Delay is dangerous!