Causes and symptoms of chronic prostatitis in men

Chronic inflammation of the prostate occurs in men of all ages.In most cases, the trigger is an infectious factor: Trichomonas, staphylococci and gonococci.Bacteria entering the body trigger inflammation of the urethral canal, the prostate gland itself.

The chronic form of prostatitis is often asymptomatic.The disease itself is detected 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.Patients over the age of 30 are increasingly turning to urologists.

Chronic prostatitis – what is it?

The prostate is located under the bladder.The main functions are limited to protecting the vesica urinaria from the penetration of seminal fluid and producing prostatic secretion, a necessary component of male seminal fluid.Inflammation of the glandular tissue caused by infection, congestion and other factors gradually becomes permanent.

Chronic prostatitis leads to degenerative changes.The structure of the tissue gradually deforms.Against the background of inflammation, stones often appear in the ducts.Some types of prostatitis cause the development of cancer.

To make it easier to distinguish between different prostate diseases, an international classification system has been developed.

Chronic prostatitis – causes

It is generally accepted that inflammation of the prostate is caused primarily by two factors: bacterial and nonbacterial.

The first is associated with the penetration of pathogens and infections into the patient's body.The most common cause is sexually transmitted bacteria.

The second cause of occurrence is not associated with an infectious agent.Inflammation can be triggered by:

• hypothermia of the body.
• Hormonal imbalances related to age and irregular sex life.
• Bad habits.
• Injury to the pelvic organs.
• Stagnation due to metabolic disorders and lack of exercise.

After prostatitis is diagnosed, the cause of chronic prostatitis must be determined.The course of therapy depends on what exactly caused the inflammation.Bacterial and non-infectious prostatitis are treated differently.

Urologists name several other factors that aggravate the situation and influence the serious course of the disease:

• Sexual abstinence.
• Inferior ejaculation (choosing interrupted sexual intercourse as a contraceptive method).
• Stress.
• Bad habits – alcohol abuse and smoking.
• Poor diet.
• Inflammatory diseases suffered in the past.Urethritis and cystitis are often the cause of prostatitis in a chronic form.

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

Classification of chronic inflammation of the prostate

Different types of prostatitis received their own ICD-10 code – N41.To clarify the diagnosis and differentiate the infection of the catalyst, 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.Mild fever persists.
  2. IIIB – no inflammation.
• IV - prostatitis, in which there are no symptomatic manifestations.Deviations from the norm are determined exclusively through instrumental diagnostic procedures.

According to the ICD code:

• N41.1 is diagnosed with chronic prostatitis.
• N41.8 Inflammatory diseases of the prostate.
• N41.9 An exact diagnosis was not made.

How does chronic prostatitis manifest itself – its symptoms

The first signs of chronic prostatitis in men appear at an advanced stage of the disease.Often early development does not show clinical manifestations.Symptoms, although present, are transient, short-term and of low intensity.

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

• First indirect signs of chronic prostatitis – as already mentioned, the onset of the disease is not manifested by clearly distinguishable symptoms.The manifestations are subtle or absent.Signs to look out for: burning during ejaculation, reduced potency, pain when urinating.
• Secondary signs of chronic inflammation of the prostate – at this stage, pathological changes in the structure of tissues, the appearance of scar-like formations and a decrease in urogenital function occur.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 advanced disease – the prostate no longer functions normally.Healthy tissue begins to transform.The gland increases in size.Blood and pus appear in the urine, there is a constant feeling of incomplete bladder emptying, and nighttime trips to the toilet become more frequent.Erectile function decreases so much that we can speak of complete sexual impotence.

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

Pain syndrome

Chronic prostatitis in the late stages of development has pronounced symptoms.Characteristic clinical manifestations are pain of severe intensity that does not go away on its own and requires the use of analgesics and antispasmodics.

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

Over time, the clinical picture becomes more intense.The pain syndrome manifests itself more intensely and persists after taking analgesics.Unpleasant sensations accompany every act of urination, defecation and ejaculation.

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

Temperature rise

Chronic inflammation of the prostate is accompanied in acute form by heat and fever.The temperature rises sharply and reaches 39-40°.The indicators are stable.Body temperature does not decrease even after taking antipyretics.

Sluggish prostatitis is characterized by a mild fever.Constant signs of chronic inflammation, in the range of 37-37.2°.

Lowering the temperature and taking medications alone to relieve external phenomena is strictly prohibited!

Dysuria

The first signs of chronic prostatitis appear with various urination disorders.Over time, symptoms worsen, making it easier to recognize the disease.Manifestations of dysuria:

• Frequent urge to go to the toilet at night.
• Feeling of incomplete emptying of the bladder.
• Hematuria (blood in the urine), purulent discharge.
• Painful urination.

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

Diseases of the sexual organs

Chronic prostatitis causes scarring that affects the blood supply.A lack of nutrients leads to the following manifestations:

• Reduced potency – sexual disorders are observed in chronic prostatitis.One of the characteristic symptoms is a normal erection, which decreases sharply during sexual intercourse.In the advanced stage, a stable potency is achieved.
• Infertility – after the appearance of scars in the seminiferous ducts, sperm viability decreases.Inflammation changes the structure and composition of the ejaculate.In the advanced stages, the sperm thickens and lumps form.
• Pain during sexual intercourse – discharge from the urethral canal is observed.Discomfort and painful symptoms are felt during sexual intercourse, especially during ejaculation.Psychosomatic reasons often lead to persistent impotence in the patient.

The main symptoms of chronic prostatitis: pain, increased body temperature, dysuria, dysfunction of the sexual organs.When making a diagnosis, the intensity and duration of the period from the onset of clinical symptoms as well as the associated symptoms are taken into account.

How can chronic inflammation of the prostate be recognized?

Prostatitis has no symptoms that allow the disease to be accurately distinguished.Some diseases of the genitourinary system have similar symptoms.An accurate diagnosis can be made only after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.

If dysfunction of the pelvic organs is suspected, the urologist will order a mandatory rectal examination.If tissue changes are detected during palpation, several laboratory tests are required.

Laboratory research methods

Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the trigger for the development of the disease.To make a diagnosis, additional information from the results of the following laboratory tests is required:

• Cytological and bacteriological analysis of urine.The PSA value is determined.When the glandular tissue becomes inflamed, the protein level rises sharply.
• Take a swab from the urethra.
• Microscopy of the prostate secretion - the results are used to determine prostate malfunctions.Distinguish cancer from chronic tissue inflammation.Sowing prostatic secretions is prohibited during an acute phase of the disease, which is accompanied by high body temperature, exacerbation of hemorrhoids or cracks in the anus.
• Tests for STIs (sexually transmitted infections) – one of the most common triggers of prostate inflammation are pathogenic microorganisms.Trichomonas, staphylococci and gonococci can cause the disease.Prostatitis develops during the active phase of bacterial reproduction and after the infection has already healed.

Laboratory tests are an obligatory part of diagnosing prostatitis and the subsequent choice of 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 into a malignant formation.The magnetic resonance technique is absolutely harmless, but it has contraindications, since it cannot examine patients with pacemakers, metal clamps and shunts (left behind during surgical procedures).
• Transrectal TRUS is a meaningful method that reliably indicates the presence of inflammation.Sonographic 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, cracks in the anus or hemorrhoids.
• Ultrasound – transabdominal technique has no contraindications.The method is less informative compared to TRUS and MRI.Sonographic signs make it difficult to determine the abdominal cavity.Diagnostic results are often controversial and require clarification.The advantage of ultrasound is the simplicity and speed of the examination.

The accuracy of the echographic image largely depends on the experience of the doctor conducting the study.

Differential search for diseases

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

To facilitate the work of the urologist, the NIH-CPSI symptom index was invented, which is drawn up in the form of a questionnaire or questionnaire.The doctor fills in the fields in the document and then makes a diagnosis.

There are computer programs based on the NIH CPSI index.The doctor must fill out a questionnaire and the system independently carries out a summary assessment of the symptoms of chronic prostatitis.The effectiveness of the technology has been proven worldwide.

After calculating the results of the questionnaire, when making a diagnosis, an additional assessment of instrumental and clinical studies is taken into account: the presence of echo signs of chronic prostatitis, an increased PSA value, the identification of an infectious marker by secretion microscopy.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 dysfunction of the genitourinary system.This includes:

• Impotence.
• Acute urinary retention.
• Infertility.

Fiber changes accompanying advanced disease cause the development of oncology.Normal tissue degenerates into malignant.Therefore, an extremely important task of the urologist is to prevent functional changes in the prostate in order to prevent the development of cancer.

When making a diagnosis, the presence of intraepithelial neoplasia of the prostate, a harbinger of oncology and fibrous changes, is taken into account.Advanced disease often requires surgery: prostatectomy.

Diagnosing prostatitis and differentiating the disease from related diseases of the pelvic organs is an important task for doctors and patients.Recognizing the first symptoms depends entirely on the man himself.If you experience difficulty urinating, decreased erection, or persistent low-grade fever, these are reasons to seek professional medical help immediately.Delay is dangerous!