Prostatitis: symptoms, treatment, prevention

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.
• 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).

What are the first signs of prostatitis that you should pay attention to?

The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating.If while going to the toilet you notice a weakening of the stream of urine or feel discomfort or burning in the urethra, you should contact a urologist as soon as possible.

With the acute onset of the disease, the temperature may rise and general health may deteriorate.Such a patient should be immediately treated with antibiotics and anti-inflammatory drugs.

In some cases, the disease can be asymptomatic for a long time, so treatment starts late.

Symptoms of prostatitis

Signs of prostatitis in men depend on the form of the disease.In the acute form, the following manifestations are characteristic:

• pain in the lower back, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficult defecation;
• thin stream of urine;
• increase in temperature;
• chills;
• deterioration of general health.

The chronic form can occur after the acute phase of the disease or develop as a primary disease.Symptoms of chronic prostatitis in men are mild.The pain is of low intensity, the temperature may rise slightly.The stream of urine becomes thin, disorders appear in the intimate area.

With a chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible.Pain may be absent or dull, aching in nature.

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 point, the pain becomes particularly intense, radiates to the anus and intensifies during a bowel movement.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 all of them are 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 reappear.

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.

Classification

Experts distinguish several categories of the disease:

• Acute bacterial prostatitis, which is characterized by symptoms of a bacterial infection.The causative agent of the disease in most cases is Escherichia coli.A little less often, enterococci and other bacteria are isolated;
• chronic bacterial prostatitis, which is a recurrent form of the disease.The causative agents of the disease are bacteria E. coli, enterococci, etc.Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also be pathogens;
• chronic pelvic pain syndrome in which no infections are detected.There are two types: inflammatory and non-inflammatory.Among the causes of occurrence: autoimmune processes, external factors (hypothermia, overheating), infrequent sexual life, low physical activity, infrequent urination;
• Asymptomatic prostatitis discovered incidentally during a medical examination.

Only a qualified specialist can accurately determine the type of prostatitis and determine the course of treatment after a thorough diagnosis based on the research data.You should contact a specialist if you have certain symptoms.

Symptoms

The main symptom is dysfunction of the excretory system.You should contact a specialist if you have the following symptoms:

• if urination is difficult and urine is released intermittently;
• if there is a discharge from the urethra during bowel movements;
• with a burning sensation in the urethra and perineum;
• if discomfort occurs in the bladder and prostate during a bowel movement;
• if the urge to urinate becomes stronger and more frequent;
• if you experience rectal pain;
• if there is purulent bloody discharge from the urethra (floating "threads");
• with frequent increase in body temperature;
• when intimate problems arise (weakened erection);
• when the erection occurs at night for an unexplained reason;
• if ejaculation during intercourse is too fast;
• if sensations during orgasm are "deleted";
• with rapid general fatigue;
• with manifestations of an unreasonable anxious or depressive state, as well as a state of mental depression;
• with frequent depression, manifestations of mental depression in anticipation of complications;
• with general weakening of the body.

One or two symptoms are enough to contact a urologist.Attempts to treat yourself usually lead to a worsening of the condition and a chronic or severe course of the disease.In the worst case, the lack of a timely visit to the doctor can cause infertility or complete impotence.

If the patient does not consult a doctor in time or neglects treatment, the following symptoms may appear:

• pain in the perineum;
• pain near scrotum;
• pain at the base of the root of the penis (painful nature).

Pain indicates the formation of stones.Doctors call infertility a late sign of a progressive disease.

Signs of prostatitis in acute and chronic form differ significantly.In particular, in the chronic form, the signs may be mild or not expressed at all.

Acute prostatitis is characterized by pronounced symptoms - general malaise, pain in the groin area.Men should contact specialists if:

• the urge to urinate has become very frequent;
• pain during defecation and urination intensifies in the perineum and radiates to the groin;
• complete emptying of the bladder is impossible;
• the amount of urine produced per day has decreased significantly or urine is not collected;
• fever, frequent headaches, general weakness.

Acute bacterial prostatitis is characterized by high fever and chills, pain in the lumbosacral region (acute), pain manifesting in the perineum and rectum, acute urinary retention, frequent muscle and joint pain.

Chronic prostatitis is characterized by the following symptoms:

• during urination, the pain in the perineum intensifies;
• with frequent urges, the bladder does not empty completely;
• decreased sexual desire;
• discomfort is felt during intercourse.

One of the signs of the chronic form is significant disturbances in the emotional background, characterized by insomnia, increased nervousness, mood and irritability.

The bacterial form of chronic prostatitis is characterized by problems with ejaculation that becomes rapid and painful, discomfort in the pubic area, frequent or involuntary urination, and an irregular stream of urine.

Chronic pelvic pain syndrome, which according to medical statistics is the most common form of prostatitis, is characterized by symptoms similar to the symptoms of chronic bacterial prostatitis: frequent urges to urinate, weakening of the stream of urine, pain in the penis and testicles, sexual dysfunction.

Possible complications

• 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.

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.

1. Bacteriological culture of urine.
2. Analysis of prostatic secretion for microflora and sensitivity to antibiotics.
3. Rectal examination of the prostate.
4. Ultrasound of the prostate gland, which allows you to identify tumors, cysts, adenomas, as well as distinguish prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Features of diagnosis of acute prostatitis

If the signs of the disease indicate acute prostatitis, the diagnosis is made based on data from instrumental and clinical studies.Any manipulations that can affect the prostate are contraindicated, as they can cause acute pain or provoke the spread of infection.

Features of diagnosis of chronic bacterial prostatitis

The diagnosis in such cases is determined on the basis of the following data: examination by a doctor of the patient, bacteriological and microscopic examination of prostate secretions, examination of ultrasound data.

Diagnostic features of pelvic pain syndrome

Specialists prescribe diagnostic procedures for symptoms indicating chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory.As a rule, ultrasound is prescribed, as well as the following manipulations:

• examination of prostate secretion;
• molecular biological research;
• bacteriological examination.

The choice of technique is determined by the doctor based on the data from the initial examination.

Risk groups

The most likely appearance and development of prostatitis:

• in men who suffer from obesity or lead a sedentary lifestyle;
• in men with sedentary jobs (office workers, programmers);
• in men whose body is subject to shaking and vibration (drivers of cars, including special equipment);
• in men who have had infectious diseases, including diseases of the genitourinary system;
• in men who are sexually hyperactive and in those who do not have regular sex;
• in depressed men suffering from mental illness;
• in alcoholics, drug addicts, etc.

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 for 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.

The choice of treatment method for prostatitis depends on many factors and is determined individually.When choosing treatment methods, take into account:

• cause of the disease;
• course of the disease;
• individual characteristics of the body (presence of chronic and concomitant diseases).

For treatment, a specific technique can be chosen or a complex prescribed.Specialists in the field of urology, depending on the results of the diagnosis, prescribe:

• Physiotherapy procedures: magnetic resonance therapy, procedures with laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Drug treatment.
• Diet and psychotherapy.
• Surgical intervention.

When diagnosing bacterial prostatitis, broad-spectrum antibiotics, immunomodulators and multivitamin complexes are prescribed.

When diagnosing non-bacterial prostatitis, physiotherapy and anti-inflammatory drugs are prescribed.

In some cases, specialists may recommend muscle relaxants and hormone therapy, as well as antioxidants, to help reduce inflammation and protect cells from free radicals.

Correctly selected complex of drugs for acute bacterial prostatitis:

• restores immunity;
• treat infections (antibiotics);
• treat the prostate (antibacterial drugs).

Chronic prostatitis is difficult to treat, so an extensive list of drugs is used: anti-inflammatory, antispasmodic, absorbent, antibacterial, vibration and finger massage, electrophoresis, EHF and UHF therapy, sinusoidally modulated currents.

When diagnosing pelvic pain syndrome, antibiotics and anti-inflammatory drugs, various types of physiotherapy, magnetic and laser therapy, electrical neurostimulation, etc. are used.One of the effective methods is tissue drainage around the focus of inflammation.

Conservative or modern treatment is chosen by a urologist based on diagnostic data.

Tablets

In the form of tablets for prostatitis, antibacterial agents and pain relievers can be prescribed.

The course of antibiotic therapy is selected individually depending on the result of the prostate secretion analysis.The microflora that caused the disease must be sensitive to the drug used.It is necessary to completely complete the course of treatment prescribed by the urologist, otherwise the cause will not be eliminated, the disease will recur or become chronic.

Pain relievers for prostatitis help to get rid of unpleasant symptoms.For this purpose, non-steroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.

Prostatitis tablets for men, which help to treat impaired urination, belong to the group of alpha-1-blockers.They relax the smooth muscles and restore the patency of the urethra, pressed by the inflamed prostate.

Injections for prostatitis

Antibacterial agents for prostatitis in men are also used in the form of injections.Injectable forms of drugs are prescribed for severe inflammation, as well as in the absence of tablet forms of antibiotics to which the pathogen is sensitive.You can inject antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of the prostate.

Injectable prostatitis drugs work faster than tablets, so they are sometimes preferable.

Surgery for prostatitis

The most serious complications are suppuration of the seminal vesicles and abscess.Medicines for the treatment of the disease are not able to cope with the disease in such a difficult situation, which is why surgery is indicated at the first manifestations.

In the absence of timely intervention, the purulent process spreads outside the organ, so the consequences of prostatitis in a complicated form can be life-threatening.

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.

Characteristic signs of prostate cancer

The prostate gland is a small organ that only men have.Its structure resembles a mushroom, it is located under the bladder and seems to surround the urethra.Growth of the gland begins in adolescence under the influence of male sex hormones;by adulthood, its weight can reach 20 grams.It plays an important role in the male reproductive system by producing secretion, one of the components of sperm.But unfortunately, mature and elderly men often experience hyperplasia of the gland or malignant neoplasms of the organ.

How to recognize cancer

As the tumor grows and progresses, the symptoms of prostate cancer depend on the stage of the process.If the disease is still in the first stage or has even reached the second, then the tumor is localized in the prostate gland, has not grown into neighboring tissues and has not metastasized.

Symptoms of prostate cancer in the early stages are practically absent, this is the insidiousness of the disease.The man has no complaints, feels well and sees no reason to visit a doctor.That is why this type of tumor is often found in an advanced state.An exception can be made by patients who have previously been diagnosed with benign neoplasms of the prostate gland, in which case they are periodically monitored by a specialist doctor and tested for specific prostate antigen and undergo an ultrasound scan of the prostate.They have every chance of finding a tumor in its very germ.But it is worth noting that detecting prostate cancer is not always easy.Even with a biopsy, the results may be clear, but the oncology is already there.This happens due to errors in the method;the needle just doesn't reach the site of the localized lesion.If prostate pathology is suspected, especially if it is cancer, a fusion biopsy should be performed, which combines the capabilities of ultrasound and MRI in real time, giving the doctor the opportunity to visualize the organ as accurately as possible.

Some symptoms are a consequence of prostate pathology, while others are caused by mechanical compression and obstruction of the urethra.

Since the bladder must be emptied regularly, if this process is disturbed, urine can be retained in it, inflammation can occur and a bacterial infection can develop.If no measures are taken, the process will spread, and this already threatens with pyelonephritis and kidney problems.

At stage 4, prostate cancer is even more obvious.Most often, metastases are found in the bones, spine and lymph.Because of this, a person's regional lymph nodes increase, his bones ache, he suddenly loses weight and becomes weaker.

Treating prostate cancer is not an easy task, but it can be done.With timely detection of the local process, a complete cure can be achieved, and in the more advanced stages, life can be extended.If you notice the symptoms described above, contact a professional clinic for an examination.

Make an appointment, the clinic's doctors have many years of experience in the treatment of urological diseases and achieve success even in the most difficult cases.