Prostatitis in men is an inflammatory process that affects the prostate tissue.The disease is accompanied by pain in the lower back, perineum and pelvis.The main symptoms 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 general health or last for 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 and also combined with prostatic hyperplasia or prostate cancer.
Reasons for development
Inflammation does not occur on its own.The causes of prostatitis can be divided into bacterial and nonbacterial causes.
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 can be many other reasons and the list also includes atypical microbes.
The triggering factors for the development of the bacterial variant are:
- unprotected sexual intercourse;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal sex;
- sedentary lifestyle;
- inactive sex life;
- diabetes mellitus;
- hypothermia;
- Violations of intimate hygiene.
Non-infectious prostatitis in a chronic form is detected in men who complain of persistent pain in the genital area, but tests do not diagnose bacteria that could 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;
- working with heavy lifting;
- chronic stress;
- congestion in prostate tissue;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
It is believed that inactive sex life, unprotected intercourse and hypothermia play an important role in the development of the disease.Symptoms of prostatitis occur in 50% of the entire world's male population at least once in their lives.
Symptoms of acute prostatitis
Acute prostatitis proceeds in several stages, passing from one to another if you do not consult a specialist in a timely manner and stop the development of the disease.
The first stage is called acute catarrhal prostatitis.It begins with complaints of frequent painful urination.Slight pain initially occurs in the lower back, sacrum and perineum, which quickly increases.
Without treatment, the second stage occurs - acute follicular disease.At this moment the pain becomes particularly severe, radiates into the anus and intensifies during bowel movements.Urination is very difficult, sometimes acute urinary retention occurs.The temperature does not exceed 38 degrees and can only be higher in rare cases.
Acute parenchymal prostatitis is manifested by severe intoxication, the temperature reaches 38 ° C and above, and chills appear.Urinary retention is often observed, sharp throbbing pain occurs 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 an independent disease that is primarily chronic and develops over a longer period of time.
Often the chronic course begins as a complication of the inflammatory process, which is caused by various infectious agents - chlamydia, trichomonas, gonococci.But vivid manifestations are very rare;More often, the disease occurs with mild pain when urinating or in the perineal area and slight discharge from the urethra.These symptoms often go unnoticed by the patient for a long time.
Signs of prostatitis in men can appear in different ways, but they are all divided into three groups: pain, urination disorders, problems with sexual activity.Prostate tissue lacks receptors and therefore cannot produce painful sensations.They occur when inflammation begins to spread to the abundantly innervated pelvic organs.Patients' pain can range from barely noticeable discomfort to severe and 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, thereby reducing the lumen of the ureter.There is a frequent urge to urinate, a feeling of incomplete emptying of the bladder.Typically, such phenomena manifest themselves 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 manifest themselves in different ways.Patients complain of worsening erections, accelerated ejaculation and reduced sexual arousal.Over time, sexual dysfunction increases and in advanced stages, impotence is added to the symptoms of prostatitis.
Possible complications
When there are inflammatory processes in the prostate, neighboring organs are also involved in the pathological process.This can have various consequences of prostatitis, for example:
- vesiculitis;
- posterior urethritis or colculitis;
- abscess of the gland itself;
- sclerosis or fibrosis of the prostate;
- prostate cysts and stones;
- Infertility;
- ejaculation disorder;
- erectile dysfunction.
To prevent the development of these serious complications, you should consult a urologist at the first symptoms of prostatitis and prostate adenoma.
diagnosis
Diagnosis and treatment of any form of prostatitis is carried out by a urologist.If a tumor is suspected, the patient can be referred to an oncologist for consultation.For chronic, protracted prostatitis that is difficult to treat, a consultation with an immunologist may be necessary.
The characteristic clinical picture and the patient's complaints help to quickly make an accurate diagnosis.The list of mandatory studies for diagnosing prostatitis is as follows:
- Bacteriological urine culture.
- Analysis of prostate secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Ultrasound of the prostate, which allows you to detect tumors, cysts and adenomas and distinguish prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
It is difficult to independently determine the causes of the disease, let alone cure it.Therefore, in order to prevent the development of serious complications and not to remain infertile in the future, a man should immediately consult a urologist at the first signs of the disease.
Treatment
Patients diagnosed with acute prostatitis without complications are treated on an outpatient basis.Hospitalization is only necessary if there are severe symptoms of poisoning and there is suspicion of a purulent process.
Antibiotics are the drug of choice to combat inflammation.They are also used for chronic bacterial forms.The medicine is selected individually and taken over a period of 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 medicine for prostatitis is alpha1 blockers, which are prescribed if there is residual urine confirmed by ultrasound.They make urination easier and relax the prostate and bladder muscles.Drugs from the NSAID group help relieve pain.
The treatment of prostatitis is only comprehensive and consistent.In addition to taking medications, the doctor will prescribe prostate massage and use physiotherapy to improve blood circulation in this organ.Surgical treatment is only used 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 a timely manner and take all the 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 in a timely manner, limit the consumption of coffee, spices and alcohol, and remain sexually active as long as possible.