Chronic prostatitis occurs in men of all ages.In most cases, the catalyst is an infectious factor: Trichomonas, staphylococci and gonococci.Bacteria enter the body causing inflammation of the urethra and prostate.
The chronic form of prostatitis is often asymptomatic.The disease itself is identified only after turning into an acute form.Late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often overlooked.
Statistics show the continuous "rejuvenation" of this disease.More and more patients in their 30s are seeing urologists.
Chronic prostatitis - what is it?
The prostate is located below the bladder.The main functions are reduced to protecting the bladder from semen penetration, as well as producing prostatic secretions, a necessary component of male semen.Adenomatitis, caused by infection, obstruction, and other factors, gradually becomes permanent.
Chronic prostatitis leads to degenerative changes.The structure of tissues gradually deforms.Often, against the background of inflammation, stones appear in the ducts.Some types of prostatitis cause the development of cancer.
An international classification system has been developed to facilitate distinction between different prostate diseases.
Chronic prostatitis - causes
It is generally accepted that prostatitis is caused by two main factors: bacteria and bacteria.
The first involves the penetration of pathogens and infections into the patient's body.Usually, the catalyst is sexually transmitted bacteria.
The second cause occurs unrelated to the infectious agent.Inflammatory catalysts can be:
- Hypothermia of the body.
- Hormonal imbalance related to aging and irregular sex life.
- Bad habit.
- Damage to pelvic organs.
- Stagnation due to metabolic disorders and sedentary lifestyle.
After diagnosing prostatitis, the root cause of chronic prostatitis must be determined.The treatment course is prescribed based on the exact cause of the inflammation.Bacterial and noninfectious prostatitis are treated differently.
Urologists name a number of additional factors that worsen the situation and affect the serious course of the disease:
- Abstain from sex.
- Poor ejaculation (choose interrupted sexual intercourse as a method of contraception).
- Emphasize.
- Bad habits - alcohol abuse and smoking.
- Poor nutrition.
- Inflammatory diseases suffered in the past.Often urethritis and cystitis act as causes of prostatitis in chronic form.
Inflammation is accompanied by destructive changes in the prostate, allowing the disease to be classified into several types.
Classification of chronic prostatitis
Types of prostatitis receive their own ICD-10 code - N41.To clarify the diagnosis and differentiate catalytic infections, the 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, provoked by an infectious factor.
- III - class includes a disease in which pelvic pain syndrome begins to manifest.People often distinguish two subgroups:
- IIIA - there are signs of an inflammatory process.Mild fever is maintained.
- IIIB - no inflammation.
- IV - prostatitis in which there are no symptomatic manifestations.Deviations from the norm are detected only by instrumental diagnostic methods.
According to ICD code:
- N41.1 was diagnosed with chronic prostatitis.
- Prostatitis N41.8.
- N41.9 exact diagnosis has not been made.
How does chronic prostatitis manifest itself - its symptoms
The first signs of chronic prostatitis in men appear in severe stages of the disease.Usually, early development has no clinical manifestations.Symptoms, even when present, are temporary, short-term, and low-intensity.
According to clinical manifestations, three stages of development of prostatitis are distinguished:
- Initial indirect signs of chronic prostatitis - as already noted, the onset of the disease is not manifested by clearly distinguishable symptoms.The manifestations are very subtle or completely absent.Signs you should pay attention to: burning sensation during ejaculation, decreased potency, painful urination.
- Secondary signs of chronic prostatitis - at this stage, pathological changes occur in the structure of tissues, the appearance of scars and deterioration of sexual function.This stage is characterized by a marked decline in fertility and urination, profuse sweating, and severe pain in the pelvic region, lumbar spine, and scrotum.
- Signs of progressive disease - the prostate stops working normally.Healthy tissues begin to degenerate.The gland increases in size.Blood and pus appear in the urine, there is a constant feeling that the bladder is not completely emptied, and trips to the toilet at night become more frequent.Erectile function is reduced to the point where we can speak of complete sexual impotence.
In addition to the typical symptoms of each stage of development, there are also general signs that appear throughout the entire course of the disease.
Pain syndrome
Chronic prostatitis in the late stages of development has obvious symptoms.The typical clinical manifestation is severe pain that does not go away on its own and requires the use of pain relievers and antispasmodics.
Pain syndrome accompanies the entire period of development of the disease.During the initial signs of prostatitis, the discomfort and burning sensation in the urethral canal is low-grade and therefore often overlooked.Pain is often mistaken for radiculitis or fatigue.After pain relief or antispasmodic medication, this symptom usually disappears.
Over time, the clinical picture becomes more intense.Pain syndrome manifests itself more strongly and persists after taking painkillers.Discomfort accompanies each act of urination, defecation, and ejaculation.
The pain spreads from the spine to the scrotum, sometimes to the limbs, accompanied by cramps and numbness.Rashes on the skin, itching and burning of tissues in the prostate and genital area are normal body reactions to internal inflammation.
Temperature increases
Chronic prostatitis in its acute form is accompanied by heat and fever.The temperature increased sharply, reaching 39-40°.Indicators are stable.Body temperature does not decrease even after taking antipyretics.
Indolent prostatitis is characterized by low-grade fever.Continuous indices of chronic inflammation, range 37-37.2°.
It is strictly forbidden to lower the temperature yourself and arbitrarily use drugs to reduce external manifestations!
Difficulty urinating
The first signs of chronic prostatitis appear in many different forms of urinary disorders.Over time, symptoms become more intense, helping to identify the disease.Symptoms of dysuria:
- Frequent urge to go to the toilet at night.
- Feeling of incomplete bladder emptying.
- Hematuria (blood in urine), pus discharge.
- Pain when urinating.
Clinical signs and the intensity of their manifestations directly affect the diagnosis and require mandatory additional studies.Symptoms may indicate other inflammatory diseases of the genitourinary system, hyperplasia and cancer.
Genitourinary disorders
Chronic prostatitis leads to the appearance of scars that impair blood supply.Nutrient deficiency leads to the following manifestations:
- Reduced potency - with chronic prostatitis, sexual dysfunction is observed.One of the characteristic symptoms is a normal erection, which decreases sharply during sexual intercourse.In the advanced stages, a stable effect occurs.
- Infertility - after the appearance of scarring in the vas deferens, the viability of sperm decreases.Inflammation changes the structure and composition of semen.In the late stages, sperm thickens and tumors appear.
- Pain during sexual intercourse - observed discharge from the urethral canal.During sex, you will feel uncomfortable and have painful symptoms, especially during ejaculation.Usually psychological causes lead to prolonged impotence in the patient.
The main symptoms of chronic prostatitis: pain, increased body temperature, difficulty urinating, sexual organ dysfunction.When making the diagnosis, the intensity and duration of the period from the appearance of clinical signs as well as associated symptoms are taken into account.
How can chronic prostatitis be detected?
Asymptomatic prostatitis 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 instrumental methods of detecting the disease.
When a disorder in the functioning of the pelvic organs is suspected, the urologist will prescribe a mandatory rectal examination.If tissue changes are detected on palpation, several laboratory tests will be ordered.
Research methods in the laboratory
Clinical blood and urine tests help distinguish the presence of an inflammatory process and can often explain the cause of the development of the disease.When making a diagnosis, additional information will be required from the results of the following tests:
- Cytological and bacteriological analysis of urine.PSA levels are established.Protein concentrations increase sharply when glandular tissue becomes inflamed.
- Take a smear from the urethra.
- Microscopy of prostatic secretions - based on the results, identify malfunctions in the prostate.Distinguishing cancer from chronic tissue inflammation.Sowing prostatic secretions is prohibited in the acute stage of the disease, accompanied by high body temperature, exacerbation of hemorrhoids or cracks in the anus.
- STI (sexually transmitted infection) testing - one of the common catalysts for prostatitis is pathogenic microorganisms.Trichomonas, staphylococci, and gonococci can all cause disease.Prostatitis develops during the active phase of bacterial growth and after the infection has been cured.
Laboratory tests are a mandatory component in the diagnosis of prostatitis and the selection of subsequent treatment.
Disease detection tools
There are three main methods for testing for prostatitis.Each instrumental diagnostic method provides information about changes in the structure of the glandular tissue and has its own indications and contraindications:
- CT scan - MRI is often indicated to diagnose chronic prostatitis.The study allows you to get layer-by-layer images of the prostate.MRI signs accurately show chronic inflammation, and also show the beginning of tissue degeneration into a malignant mass.Magnetic resonance technology is completely harmless but has contraindications because it cannot be studied in patients using pacemakers, metal pins and shunts (left during surgery).
- Transrectal TRUS is an informative method that reliably indicates the presence of inflammation.Ultrasound signs of changes in the structure of the prostate according to the type of chronic prostatitis include: deviations from the norm in volume and size, structure and the presence of pathological formations.Ultrasound techniques are not indicated for acute proctitis, the presence of anal fissures, or hemorrhoids.
- Transabdominal ultrasound technique has no contraindications.This method is less informative than TRUS and MRI.Ultrasound findings make it difficult to define abdominal space.Diagnostic results are often controversial and require clarification.The advantage of ultrasound is the simplicity and speed of the study.
The accuracy of ultrasound imaging largely depends on the experience of the doctor performing the study.
Look for differences in disease
After receiving the results of clinical and biochemical studies, the symptoms of chronic inflammation of the prostate will be evaluated.Common diagnostic criteria have been developed and are valid worldwide.
To facilitate the work of urologists, the NIH-CPSI symptom index was invented, implemented in the form of a questionnaire or questionnaire.The doctor fills in the fields in the document and then provides a diagnosis.
There are computer programs based on the NIH-CPSI index.The doctor is asked to fill out a questionnaire, and the system independently conducts a summary assessment of the symptoms of chronic prostatitis.The effectiveness of this technique has been proven worldwide.
After calculating the results of the questionnaire, when making a diagnosis, additional assessment of instrumental and clinical studies should be taken into account: the presence of echogenic signs of chronic prostatitis, increased PSA level, microscopic identification of signs of infection of secretions.The more data a urologist has, the more accurate the results will be.
How dangerous is chronic prostatitis - its consequences
The consequence of chronic prostatitis in men is dysfunction of the reproductive system.These include:
- Impotent.
- Acute urinary retention.
- Infertility.
The fibrous changes that accompany progressive disease cause the development of cancer.Normal tissues degenerate into malignant tissues.Therefore, preventing changes in prostate function to prevent the development of cancer is an extremely important task facing urologists.
At diagnosis, the presence of prostatic intraepithelial neoplasia, a precursor to cancer and fibrotic changes, is taken into account.Progressive disease often leads to surgery: prostatectomy.
Diagnosing prostatitis and distinguishing the disease from related disorders of the pelvic organs is an important task for doctors and patients.Detecting the first symptoms depends entirely on the patient himself.If you experience discomfort when urinating, a decreased ability to have an erection, or a persistent low-grade fever, these are reasons you should seek professional medical help immediately.Delay is dangerous!