Prostatitis in men is an inflammatory process involving prostate tissue.The disease is accompanied by pain occurring in the lower back, perineum and pelvis.The main manifestations are perineal pain and lower urinary tract dysfunction.
Among all urological diseases, urologists most often encounter prostatitis.It may develop suddenly (acutely) relative to the general health condition, or it may last for a long time, with periods of exacerbation and remission, which indicates a chronic process.Furthermore, the second variant of the disease is diagnosed much more often.
The disease can be independent or combined with prostate enlargement or prostate cancer.
Reasons for development
Inflammation does not appear on its own.Causes of prostatitis can be divided into bacterial and non-bacterial.
Acute infection usually occurs in men under 35 years old due to prostate damage caused by gram-negative bacteria - Escherichia coli, Proteus, Enterobacter.Inflammation also occurs due to infection with sexually transmitted diseases - gonorrhea, chlamydia.In the chronic form, there may be many other causes and the list will include atypical bacteria.
Factors that stimulate the development of bacterial variants are:
- unprotected sex;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal intercourse;
- sedentary lifestyle;
- inactive sex life;
- diabetes;
- hypothermia;
- violation of intimate hygiene.
Non-infectious prostatitis in the chronic form is detected in men who complain of persistent pain in the genitals, but tests do not diagnose the bacteria that can cause the inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but the following factors are considered provoking factors:
- emotional disorders;
- autoimmune disease;
- increase physical activity;
- lack of regular sex life;
- work that involves lifting heavy objects;
- chronic stress;
- blockage of prostate tissue;
- fibrotic changes were previously confirmed in the prostate (according to TRUS results).
It is believed that an inactive sex life, unprotected sex and hypothermia play a major role in the onset of the disease.50% of men on the planet experience symptoms of prostatitis at least once in their lives.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which will pass from one stage 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 increases.
Without treatment, the second stage will occur - acute follicular cyst.At this time, the pain becomes especially intense, spreading to the anus and gradually increasing when defecating.Urinating is very difficult, sometimes there is acute urinary retention.The temperature does not exceed 38 degrees and only in rare cases can be higher.
Acute parenchymal prostatitis is manifested by severe intoxication, temperature up to 38°C or more and chills.Urinary retention, sharp, stabbing pain in the perineum and difficulty defecating are frequently 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 phase that develops over a long period of time.
Most often, the chronic process begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococcus.But vivid manifestations are rare;Usually the disease occurs with mild pain when urinating or in the perineum and mild discharge from the urethra.Often these manifestations go unnoticed by the patient even for a very long time.
Signs of prostatitis in men can occur in different ways, but they are all grouped into three groups - pain, urinary disorders, problems with sexual activity.Prostate tissue lacks receptors so it cannot produce pain.They appear when inflammation begins to spread to the pelvic organs, which have a lot of nerve innervation.The patient's pain can vary from barely noticeable discomfort to severe and severe pain that disrupts normal sleep and lifestyle.The pain can spread to the sacrum, scrotum, lower back, perineum, so self-diagnosis here is useless.
Urinary problems begin when the prostate increases in volume and begins to compress the urethra, reducing the lumen of the ureters.Frequent need to urinate, feeling like the bladder is not empty.Usually, such phenomena are manifested at the very beginning of the disease, in the early stages, then compensated by the body, but in later stages, if not adequately treated, they appear again.
Potency problems in men can also be expressed in different ways.Patients complain of poorer erections, faster ejaculation, and decreased sexual arousal.Gradually, sexual dysfunction becomes more and more evident. In severe stages, symptoms of prostatitis are combined with impotence.
Complications may occur
During inflammation in the prostate, neighboring organs are also involved in the pathological process.This can cause various consequences of prostatitis, for example:
- vesicular inflammation;
- posterior urethritis or colitis;
- abscess of the gland;
- sclerosis or fibrosis of the prostate;
- prostate cysts and stones;
- infertility;
- ejaculation disorders;
- erectile dysfunction.
To prevent the development of these serious complications, at the first symptoms of prostatitis and prostate adenoma, you should consult a urologist.
Diagnose
Diagnosis and treatment of any form of prostatitis is performed by a urologist.If a tumor is suspected, the patient may be referred to an oncologist for consultation.In cases of long-term, difficult-to-treat chronic prostatitis, consultation with an immunologist may be necessary.
The characteristic clinical picture and patient complaints help to quickly make the correct diagnosis.The list of mandatory studies when diagnosing prostatitis looks like this:
- Urine bacterial culture.
- Analysis of prostatic secretion in terms of microbiota and antibiotic sensitivity.
- Rectal examination of the prostate.
- Ultrasound of the prostate, allows you to identify tumors, cysts, adenomas, and can also distinguish prostatitis from other urological and surgical diseases.
- Sperm analysis to rule out infertility.
It is difficult to independently determine the causes of diseases, let alone cure them.Therefore, to prevent the development of serious complications and avoid infertility in the future, at the first signs of the disease, men should immediately consult a urologist.
Treatment
Patients diagnosed with uncomplicated acute prostatitis were treated as outpatients.Only when there are symptoms of severe poisoning and pus is suspected will hospitalization be performed.
Antibiotics are the drugs of choice to fight inflammation.They are also used for chronic forms of bacteria.Medicines are selected individually and used over a course of 4-6 weeks.In severe cases, antibacterial drugs are administered intravenously, in all other cases - orally, in the form of capsules or tablets.
Another medication used to treat prostatitis is alpha1 blockers, which are prescribed when there is residual urine confirmed by ultrasound.They make urination easier and relax the muscles of the prostate and bladder.Medicines belonging to the NSAID group help relieve pain.
Treatment of prostatitis should only be carried out comprehensively and consistently.In addition to medication, the doctor will prescribe a course of prostate massage and physical therapy to improve blood circulation in this organ.Surgical treatment is used only when abscesses and pus of the seminal vesicles appear.
Prognosis and prevention
The acute form without treatment often becomes chronic, periodically worsening.Complete recovery is not always possible, but if you consult a doctor promptly and take all prescribed medications, you can eliminate discomfort, urination problems and pain.
Self-treatment at home and using traditional methods can often be life-threatening.
To prevent prostatitis, it is recommended to avoid hypothermia, promptly empty the bladder, limit the intake of coffee, spices and alcohol, and maintain sexual activity as long as possible.