Prostatitis in men is an inflammatory process involving 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 general health, or it can last 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 also be associated with prostate 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 prostate damage 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 reasons and the list will include atypical microbes.
The provoking factors for 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.
Non-infectious prostatitis in the chronic form is detected in men who complain of prolonged pain in the genitals, but tests do not diagnose bacteria that can cause inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but provoking factors are considered:
- emotional disorders;
- autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work involving heavy lifting;
- chronic stress;
- congestion in prostate tissues;
- previously confirmed fibrotic changes in the prostate (according to the results of TRUS).
Inactive sexual life, unprotected sexual intercourse and hypothermia are believed to play an important role in the onset of the disease.The symptoms of prostatitis are experienced by 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 begins with complaints of pain when urinating frequently.In the lumbar region and sacrum, as well as in the perineum, a slight pain initially appears, which quickly increases.
Without treatment, the second stage occurs - acute follicular.At this time, the pain becomes especially intense, radiates to the anus and intensifies during bowel movement.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 or more and chills appear.Urinary retention is often observed, sharp, throbbing pain appears in the perineum, and defecation is difficult.
Chronic prostatitis symptoms
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 time.
Often, the chronic course begins as a complication of the inflammatory process 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 perineum and slight discharge from the urethra.These manifestations often go unnoticed even by the patient for a long time.
Signs of prostatitis in men can occur in different ways, but they are all grouped into three groups - pain, urination disturbance, problems with sexual activity.Prostate tissue lacks receptors and therefore cannot produce painful sensations.They appear when 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.Pain can radiate to the sacrum, scrotum, lower back, perineum, so self-diagnosis is useless here.
Problems with urination begin when the prostate enlarges 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.Normally, such phenomena are expressed at the beginning of the disease, in its initial stages, then 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 excitement.Gradually, sexual dysfunctions become more pronounced and, at an advanced stage, the symptoms of prostatitis are complemented by impotence.
Possible complications
During inflammatory processes in the prostate, neighboring organs are also involved in the pathological process.This can cause various consequences of prostatitis, for example:
- vesiculitis;
- posterior urethritis or coliculitis;
- abscess of the gland itself;
- prostate sclerosis or fibrosis;
- prostate cysts and stones;
- 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 are carried out by a urologist.If a tumor is suspected, the patient may be referred for consultation with an oncologist.In the case of long-lasting chronic prostatitis that is difficult to treat, a 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 studies when diagnosing prostatitis is as follows:
- Urine bacteriological culture.
- Analysis of prostate secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Prostate ultrasound, which allows you to identify tumors, cysts, adenomas, as well as differentiate 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 them.Therefore, in order to prevent the development of serious complications and not remain infertile in the future, at the first signs of the disease, a man should immediately consult a urologist.
Treatment
Patients diagnosed with uncomplicated acute prostatitis 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 medications 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 medication used for prostatitis is alpha1 blockers, which are prescribed in the presence of residual urine confirmed by ultrasound.They help facilitate urination 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 is used to improve blood circulation in this organ.Surgical treatment is used only when abscesses and suppuration of seminal vesicles appear.
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 prescribed medications, you can eliminate discomfort, problems with urination and pain.
Self-treatment at home and the use of traditional methods can often be fatal.
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 for as long as possible.