Causes and symptoms of chronic prostatitis in men

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

The chronic form of prostatitis is often asymptomatic.The disease itself is determined only after the transition to an acute form.A 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.More and more patients aged 30 are turning to urologists.

Chronic prostatitis: what is it?

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

Chronic prostatitis leads to degenerative changes.The structure of the tissues gradually becomes deformed.Often, against the background of inflammation, stones appear in the ducts.Some types of prostatitis cause cancer to develop.

An international classification system has been developed to facilitate differentiation between different prostate diseases.

Chronic prostatitis - causes

It is generally accepted that prostate inflammation is caused by two main factors: bacterial and abacterial.

The first is associated with the entry of pathogens and infections into the patient's body.Most often, the catalyst is a sexually transmitted bacteria.

The second cause of occurrence is not associated with an infectious agent.The catalyst for inflammation can be:

• Hypothermia of the body.
• Hormonal imbalances associated with aging and an irregular sex life.
• Bad habits.
• Injury to the pelvic organs.
• Stagnation caused by metabolic disorders and a sedentary lifestyle.

After diagnosing prostatitis, the root cause of chronic prostatitis must be determined.The course of treatment is prescribed depending on the exact cause of the inflammation.Bacterial and non-infectious prostatitis are treated differently.

Urologists name several additional factors that aggravate the situation and influence the severe course of the disease:

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

Inflammation is accompanied by destructive changes in the prostate, which makes it possible to classify the disease into several categories.

Classification of chronic inflammation of the prostate

Varieties of prostatitis received their own ICD-10 code - N41.To clarify the diagnosis and differentiate infection from the catalyst, a separate classification B95-B97 is used.The symptom assessment 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.
• Class III 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.A mild fever is maintained.
  2. IIIB - no inflammation.
• IV - prostatitis in which there are no symptomatic manifestations.Deviations from the norm are detected exclusively by instrumental diagnostic methods.

According to the CIM code:

• N41.1 is diagnosed with chronic prostatitis.
• N41.8 inflammatory diseases of the prostate.
• N41.9, an exact diagnosis has not been made.

How does chronic prostatitis manifest - its symptoms

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

Depending on the clinical manifestations, three stages of development of prostatitis are distinguished:

• First indirect signs of chronic prostatitis - as already noted, the onset of the disease is not expressed by clearly distinguishable symptoms.Manifestations are subtle or completely absent.Signs you should pay attention to: burning sensation during ejaculation, decreased potency, painful urination.
• Secondary signs of chronic inflammation of the prostate - at this stage, pathological changes occur in the structure of tissues, the appearance of scar-like formations and a decrease in genitourinary function.The stage is characterized by a sharp deterioration in power and urination, increased sweating, severe pain in the pelvic region, lumbar spine and scrotum.
• Signs of advanced disease - the prostate stops functioning normally.Healthy tissues begin to metamorphose.The gland increases in size.Blood and pus appear in the urine, there is a constant feeling of incomplete emptying of the bladder, and nightly trips to the toilet become more frequent.Erectile function decreases so much that we can speak of total 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 an advanced stage of development has pronounced symptoms.Characteristic clinical manifestations are pain of severe intensity that does not disappear on its own and requires the use of analgesics and antispasmodics.

Pain syndrome accompanies the entire period of development of the disease.At the first signs of prostatitis, the discomfort and burning in the urethral canal are of low intensity and are therefore often ignored.The pain is often incorrectly 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 painkillers.Unpleasant sensations accompany every act of urination, defecation and ejaculation.

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

Increase in temperature

Chronic inflammation of the prostate in acute form is accompanied by heat and fever.There is a sharp increase in temperature, reaching 39-40°.The indicators are stable.Body temperature does not decrease even after taking antipyretics.

Slow prostatitis is characterized by a low-grade fever.Constant indicators of chronic inflammation, between 37 and 37.2°.

Lowering the temperature and taking medications yourself to reduce external manifestations is strictly prohibited!

Dysuria

The first signs of chronic prostatitis appear in various urination disorders.Over time, symptoms become more intense, which helps identify 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.
• Pain during urination.

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

Genital disorders

Chronic prostatitis leads to the appearance of scar formations that impair blood supply.Lack of nutrients leads to the following manifestations:

• Decreased potency - with chronic prostatitis, sexual disorders are observed.One of the characteristic symptoms is a normal erection, which sharply decreases during sexual intercourse.In the late stage, stable power appears.
• Infertility - after the appearance of scars in the seminal ducts, the viability of spermatozoa decreases.Inflammation changes the structure and composition of the ejaculate.In the advanced stage, the sperm thicken and lumps appear.
• Pain during sexual intercourse - discharge from the urethral canal is observed.During sexual relations, discomfort and painful symptoms are felt, especially during ejaculation.Psychosomatic reasons often lead to persistent impotence of the patient.

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

How to detect chronic inflammation of the prostate?

Prostatitis does not present any symptoms that can accurately differentiate the disease.Some disorders of the genitourinary system have similar symptoms.An accurate diagnosis can be made only after a comprehensive examination of the patient, including laboratory tests and methods of instrumental detection of the disease.

Having suspected the presence of disorders in the functioning of the pelvic organs, the urologist will prescribe a mandatory rectal examination.If tissue changes are detected on palpation, several laboratory tests are prescribed.

Laboratory research methods

Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the catalyst for the development of the disease.When making a diagnosis, additional information will be required from the following laboratory test results:

• Cytological and bacteriological analysis of urine.The PSA level is established.Protein levels increase sharply with inflammation of the glandular tissue.
• Take a smear from the urethra.
• Microscopy of prostate secretions - based on the results, prostate dysfunctions are determined.Differentiate cancer from chronic tissue inflammation.It is forbidden to sow prostatic secretions during an acute period of the disease, accompanied by high body temperature, exacerbation of hemorrhoids or fissures of the anus.
• Tests for STIs (sexually transmitted infections) - pathogenic microorganisms are one of the common catalysts of prostate inflammation.Trichomonads, staphylococci, and gonococci can all cause the disease.Prostatitis develops during the active phase of bacterial proliferation and after the infection has healed.

Laboratory tests are an obligatory element of the diagnosis of prostatitis and the subsequent choice of treatment method.

Instrumental detection of disease

There are three main methods of 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 provides 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.Magnetic resonance technology is absolutely harmless, but has contraindications due to the impossibility of studying patients with pacemakers, metal clips and shunts (left during surgical operations).
• Transrectal TRUS is an informative method that reliably indicates the presence of inflammation.Ultrasound signs of structural changes in the prostate gland depending on the type of chronic prostatitis include: deviations from the norm in terms of volume and size, structure and the presence of pathological formations.Ultrasound techniques are not prescribed in cases of acute inflammation of the rectum, the presence of fissures in the anus or hemorrhoids.
• Ultrasound - the transabdominal technique has no contraindications.The method is less informative than TRUS and MRI.Ultrasound signs make it difficult to determine the abdominal cavity space.Diagnostic results are often controversial and require clarification.The advantage of ultrasound is the simplicity and speed of the study.

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

Differential disease testing

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 and are valid worldwide.

To facilitate the task of the urologist, the NIH-CPSI symptom index was invented, carried out in the form of a questionnaire or questionnaire.The doctor fills in the fields of the document then makes a diagnosis.

There are computer programs based on the NIH-CPSI index.The doctor must fill out a questionnaire and the system will independently make a summary assessment of the symptoms of chronic prostatitis.The effectiveness of the technique has been proven all over the world.

After calculating the results of the questionnaire, when establishing the diagnosis, an additional assessment of instrumental and clinical studies is taken into account: presence of echo-signs of chronic prostatitis, increased PSA level, identification of an infectious marker by microscopy of secretions.The more data the urologist has, the more precise the result will be.

What is dangerous in chronic prostatitis - its consequences

The consequences of chronic prostatitis in men are disorders in the functioning of the genitourinary system.These include:

• Impotence.
• Acute urinary retention.
• Infertility.

Fibrous changes that accompany advanced disease provoke the development of oncology.Normal tissue degenerates into malignant tissue.Therefore, preventing functional changes in the prostate in order to prevent the development of cancer is an extremely important task for the urologist.

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

Diagnosis of prostatitis and differentiation of the disease from associated disorders of the pelvic organs is an important task for doctors and patients.Detection of the first symptoms depends entirely on the man himself.If you experience discomfort during urination, decreased erection or a mild and persistent fever, these are reasons why you should immediately consult a professional doctor.Delay is dangerous!