Prostatitis in men is an inflammatory process that affects 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 face prostatitis.It can develop unexpectedly (acutely) against the background of general 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 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 caused 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 will include atypical microbes.
The factors provoking the development of the bacterial variant are:
- unprotected sex;
- 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 chronic form is detected in men who complain of prolonged pain in the genitals, but tests cannot diagnose bacteria that can cause inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but the provoking factors are as follows:
- emotional disorders;
- autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work involving heavy lifting;
- chronic stress;
- congestion of prostate tissues;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
An inactive sex life, unprotected sex and hypothermia are believed to play a major role in the onset of the disease.Symptoms of prostatitis are experienced by 50% of the entire male population on the planet at least once in their life.
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 frequent painful urination.In the lower back and sacrum, as well as in the perineum, a slight pain appears at first, which quickly worsens.
Without treatment, the second stage occurs - acute follicular.At this time, the pain becomes particularly intense, radiates 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 can only be higher in rare cases.
Acute parenchymal prostatitis is expressed by severe intoxication, the temperature reaches 38°C and above and chills appear.Urinary retention is often observed, sharp, shooting pain appears 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 a separate disease in which there is a primary chronic course that develops over a long period.
Often, the chronic course begins with a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococci.But strong demonstrations are very rare;most often the disease is manifested by minor pain during urination or in the perineum and slight discharge from the urethra.Often, these manifestations go unnoticed for a very long time, even for the patient.
Signs of prostatitis in men can appear in different ways, but they are all grouped into three groups: pain, urination disorders, 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.
Urination problems 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.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 appear again.
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 supplemented by impotence.
Possible complications
During inflammatory processes in the prostate, neighboring organs are also involved in the pathological process.This can lead to various consequences of prostatitis, for example:
- vesiculitis;
- posterior urethritis or colliculitis;
- 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, at the first symptoms of prostatitis and prostate adenoma, you should consult a urologist.
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 to an oncologist.In the case of long-term chronic prostatitis, which is difficult to treat, a consultation with an immunologist may be necessary.
The characteristic clinical picture and patient complaints help to quickly make an accurate diagnosis.The list of mandatory studies to diagnose prostatitis looks like this:
- Bacteriological culture of urine.
- Analysis of prostate secretion for microflora and antibiotic sensitivity.
- Prostate rectal exam.
- 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, let alone cure them.Therefore, in order to avoid the development of serious complications and not to remain infertile 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 in case of severe symptoms of poisoning and suspicion of a purulent process is hospitalization carried out.
Antibiotics are the drugs of choice to combat inflammation.They are also used for chronic bacterial forms.The medication is selected individually and taken over a period 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 medication used for prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound.They help to facilitate urination and relax the muscles of the prostate and bladder.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 prostate massage, and physiotherapy is 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 and worsens periodically.Full 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-medication 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 on time, limit the consumption of coffee, spices and alcohol, and remain sexually active as long as possible.