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.
Chronic non-infectious prostatitis is detected in men who complain of prolonged pain in the genitals, but the tests do not diagnose bacteria that can cause inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but the following are considered provoking factors:
- 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).
Inactive sexual life, unprotected sexual intercourse and hypothermia are believed to play an important role in the onset of the disease.The symptoms of prostatitis are experienced by 50% of the entire male population on the planet at least once in their lives.
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 defecation.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 all fall 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.
Possible complications
During inflammatory processes in the prostate, neighboring organs also participate in the pathological process.This can lead to various consequences of prostatitis, for example:
- 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.
To prevent the development of these serious complications, at the first symptoms of prostatitis and prostate adenoma, it is advisable to consult a urologist.
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.
The characteristic clinical picture and complaints of patients help to quickly make an accurate diagnosis.The list of mandatory studies when diagnosing prostatitis looks like this:
- Bacteriological urine culture.
- Analysis of prostate secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Ultrasound of the prostate, which allows identifying tumors, cysts, adenomas and also differentiating prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
It is difficult to independently determine the causes of the disease, much less cure them.Therefore, in order to prevent the development of serious complications and not remain infertile in the future, at the first signs of the disease, a man should immediately consult a urologist.
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.
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.