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.
Of all urological diseases, urologists most often encounter prostatitis.It can develop unexpectedly (acutely) against the background of general health, or it can last a long time, with periods of exacerbation and remission, which indicates a chronic course.Moreover, the second variant of the disease is diagnosed much more often.
The disease can be independent and can also be associated 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 can be many more reasons and the list will include atypical microbes.
The factors that cause the development of the bacterial variant are:
- unprotected sexual intercourse;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal intercourse;
- sedentary lifestyle;
- inactive sex life;
- diabetes mellitus;
- hypothermia;
- violations in intimate hygiene.
Chronic noninfectious prostatitis is detected in men who complain of prolonged genital pain, but tests do not diagnose bacteria that may be causing inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but the following factors are considered provoking:
- emotional disorders;
- autoimmune diseases;
- increased physical activity;
- lack of a regular sex life;
- work involving heavy lifting;
- chronic stress;
- congestion in the prostate tissues;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
It is believed that inactive sex life, unprotected sexual intercourse and hypothermia 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 manifests itself in several stages, which will pass from one to another if you do not consult a specialist and do not stop the development of the disease in time.
The first stage is called acute catarrhal prostatitis.It begins with complaints of frequent and painful urination.In the lower back and sacrum, as well as in the perineum, a slight pain initially appears, which rapidly increases.
Without treatment, the second phase occurs: acute follicular.At this time, the pain becomes especially intense, radiating to the anus and intensifies during defecation.Urination is very difficult, sometimes there is acute urinary retention.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 above, and chills appear.Urinary retention, sharp, throbbing pain in the perineum, and difficult defecation are often observed.
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 period.
Often the chronic course begins as a complication of the inflammatory process caused by various infectious agents: chlamydia, trichomonas, gonococcus.But vivid manifestations are very rare;more often the disease manifests itself with mild pain during urination or in the perineum and mild discharge from the urethra.Often these manifestations go unnoticed even by the patient for a long time.
Signs of prostatitis in men can manifest themselves in different ways, but they are all grouped into three groups: pain, urination disorders, problems with sexual activity.The prostate tissue has no 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, 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, such phenomena appear at the beginning of the disease, in its initial stages, then they are compensated by the body, but at a later stage, without adequate treatment, they recur.
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 in an advanced stage, the symptoms of prostatitis are complemented by impotence.
Possible complications
During inflammatory processes in the prostate gland, nearby organs are also involved in the pathological process.This can cause various consequences of prostatitis, for example:
- vesiculitis;
- urethritis or posterior colliculitis;
- 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 prostatic adenoma, it is advisable to consult a urologist.
Diagnostics
Diagnosis and treatment of any form of prostatitis is carried out by a urologist.If cancer is suspected, the patient may be referred for consultation with an oncologist.In case of long-term chronic prostatitis, which is difficult to treat, 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 for the diagnosis of 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, which allows you to identify tumors, cysts, adenomas and also to differentiate 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 sterile 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 with severe symptoms of intoxication and suspicion of a purulent process is hospitalization carried out.
Antibiotics are the drugs of choice to fight inflammation.They are also used for chronic bacterial forms.The medicine is selected individually and taken in a course of 4-6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally, in the form of capsules or tablets.
Another medicine used for prostatitis are alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound.They help make urination easier and relax the prostate and bladder muscles.Medicines from the NSAID group help relieve pain.
Treatment of prostatitis is carried out only comprehensively and consistently.In addition to taking medications, the doctor will prescribe a course of prostate massage, and physiotherapy will be 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, worsening periodically.Full recovery is not always possible, but if you timely consult a doctor and take all prescribed medications, you can eliminate discomfort, problems with urination and pain.
Home self-treatment and the use of 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 stay sexually active for as long as possible.