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, urologists most often encounter prostatitis.It can develop unexpectedly (acutely) against the background of the general state of health, or it can last for a long time, with periods of exacerbation and remission, which indicates a chronic course.In addition, the second variant 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 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 gland 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 causes, and the list will include atypical microbes.
Provocative factors for the development of the bacterial variant are:
- unprotected intercourse;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal intercourse;
- sedentary lifestyle;
- inactive sex life;
- diabetes mellitus;
- hypothermia;
- violations of intimate hygiene.
Non-infectious prostatitis in chronic form is found in men who complain of persistent pain in the genitals, but tests do not diagnose bacteria that can cause inflammation.
The exact reason for 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;
- work involving heavy lifting;
- chronic stress;
- congestion in the tissues of the prostate;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
It is believed that an inactive sex life, unprotected intercourse and hypothermia play a major role in the onset of the disease.Symptoms of prostatitis occur in 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 will pass 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 catarrhal prostatitis.It starts with complaints of frequent painful urination.In the lower back and sacrum, as well as in the perineum, there is initially a slight soreness, which quickly increases.
Without treatment, the second stage occurs - acute follicular.At this moment, the pain becomes particularly intense, radiates to the anus and intensifies during defecation.Urination is very difficult, sometimes there is acute retention of urine.The temperature does not exceed 38 degrees and only in rare cases can it be higher.
Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C and more, chills appear.Urinary retention is often observed, sharp, throbbing pain in the perineum appears, 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, gonococcus.But bright manifestations are very rare;more often the disease occurs with slight pain during urination or in the perineum and slight discharge from the urethra.Often these manifestations remain unnoticed even by the patient for a very long time.
Signs of prostatitis in men can appear in different ways, but they are all grouped into three groups - pain, urination disorder, problems with sexual activity.Prostate tissue has no receptors and therefore cannot cause 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 disrupts sleep and normal lifestyle.Pain can radiate to the sacrum, scrotum, lower back, perineum, so self-diagnosis is useless here.
Problems with urination begin at the moment when the prostate increases in volume and begins to press 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, such phenomena are expressed at the very beginning of the disease, in its early stages, then they are compensated by the body, but at a later stage, without adequate 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 and more pronounced, and in an advanced stage, the symptoms of prostatitis are complemented by impotence.
Possible complications
In inflammatory processes in the prostate gland, adjacent organs are also involved in the pathological process.This can cause various consequences of prostatitis, for example:
- vesiculitis;
- posterior urethritis or colliculitis;
- abscess of the gland itself;
- sclerosis or fibrosis of the prostate;
- cysts and stones in the prostate;
- infertility;
- ejaculation disorder;
- erectile dysfunction.
To prevent the development of these serious complications, at the first symptoms of prostatitis and prostate adenoma, you should 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 for consultation with an oncologist.In chronic protracted prostatitis, which is difficult to treat, consultation with an immunologist may be necessary.
The characteristic clinical picture and complaints of the patient help to quickly make an accurate diagnosis.The list of mandatory tests when diagnosing prostatitis looks like this:
- Bacteriological culture of urine.
- Analysis of prostatic secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Ultrasound of the prostate gland, which allows you to identify tumors, cysts, adenomas, as well as distinguish 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 treat them.Therefore, in order to prevent the development of serious complications and to avoid infertility 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 are treated on an outpatient basis.Only in case of severe symptoms of intoxication and suspicion of a purulent process, hospitalization is carried out.
Antibiotics are the drugs of choice to fight inflammation.They are also used in 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 in prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine, confirmed by ultrasound.They help to make urination easier and relax the prostate and bladder muscles.Medicines from the group of NSAIDs help relieve pain.
Treatment of prostatitis is carried out only comprehensively and consistently.In addition to taking medication, the doctor will prescribe a course of prostate massage and physiotherapy is used to improve blood circulation in this organ.Surgical treatment is applied only when abscesses and suppuration of the seminal vesicles occur.
Prognosis and prevention
The acute form without treatment often becomes chronic, which periodically worsens.Complete recovery is not always possible, but if you consult a doctor in time and take all prescribed medications, you can eliminate discomfort, urination problems, and pain.
Self-treatment at home and using traditional methods can often be life-threatening.
To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder promptly, limit the consumption of coffee, spices and alcohol and maintain sexual activity as long as possible.