Prostatitis: symptoms, treatment, prevention

In men, prostatitis is an inflammatory process involving the prostate tissue.The disease is accompanied by pain 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 a general health condition, or it can last for a long time, with periods of exacerbation and remission, which indicates a chronic course.In addition, the second version of the disease is diagnosed much more often.

The disease can be independent and can be combined with prostatic hyperplasia or prostate cancer.

Reasons for development

Inflammation does not occur by itself.The causes of prostatitis can be divided into bacterial and non-bacterial.

The acute infectious version usually occurs in men under the age of 35 due to damage to the prostate gland caused by Gram-negative bacteria - Escherichia coli, Proteus, Enterobacter.Inflammation also occurs due to sexually transmitted infections - gonorrhea, chlamydia.In the chronic form, there may be many more causes, and the list will include atypical microbes.

Factors provoking the development of the bacterial version are the following:

• unprotected sex;
• AIDS or HIV infection;
• diarrhea or constipation;
• anal intercourse;
• sedentary lifestyle;
• inactive sex life;
• diabetes mellitus;
• hypothermia;
• violation of intimate hygiene.
• emotional disturbances;
• autoimmune diseases;
• increased physical activity;
• lack of regular sex life;
• work involving heavy lifting;
• chronic stress;
• congestion in the tissues of the prostate;
• previously proven fibrotic changes in the prostate (according to TRUS results).

What are the first signs of prostatitis to look out for?

The first manifestation of the disease is pain in the lower back and perineum, difficulty urinating.If you notice a weakening of the urine stream when going to the toilet, or if you feel discomfort or burning in the urethra, see a urologist as soon as possible.

With the acute appearance of the disease, the temperature may rise and the general state of health may deteriorate.Such a patient should be treated immediately with antibiotics and anti-inflammatory drugs.

In some cases, the disease can be asymptomatic for a long time, so treatment starts late.

Symptoms of prostatitis

In men, the signs of prostatitis depend on the form of the disease.In acute form, the following manifestations are typical:

• pain in the lower back, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficulty passing stool;
• thin stream of urine;
• rise in temperature;
• chills;
• deterioration of general health.

The chronic form may appear after the acute phase of the disease, or it may develop as a primary disease.Symptoms of chronic prostatitis in men are mild.The pain is of low intensity, the temperature may rise slightly.The stream of urine thins, abnormalities appear in the intimate area.

In the case of a chronic course, prostatitis may worsen with symptoms characteristic of the acute phase.The pain can be absent or dull, aching in nature.

Symptoms of acute prostatitis

Acute prostatitis occurs in several stages, which move 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 chronic prostatitis.It begins with frequent painful urination complaints.In the lower back and sacrum, as well as in the perineum, there is a slight pain at first, which quickly increases.

Without treatment, the second stage occurs - acute follicular.At this moment, the pain becomes particularly strong, radiates to the anus, and intensifies during defecation.Urination is very difficult, sometimes acute urinary retention occurs.The temperature does not exceed 38 degrees and can be higher only in rare cases.

Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C and higher, and chills appear.Urinary retention is often observed, sharp, throbbing pain occurs 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 of time.

The chronic course often begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococcus.But vivid manifestations are very rare;more often, the disease is accompanied by minor pain during urination or in the perineum and a slight discharge from the urethra.Often these manifestations remain unnoticed even by the patient for a very long time.

In men, the signs of prostatitis can appear in different ways, but all of them can be classified into three groups: pain, urinary problems, sexual activity problems.There are no receptors in the prostate tissue, so it cannot produce painful sensations.They appear when the inflammation begins to spread to the pelvic organs, which are abundantly innervated.Patients' pain can range from barely noticeable discomfort to severe and intense pain that interferes with sleep and normal lifestyle.The pain can radiate to the sacrum, the scrotum, the lower back, and the perineum, so self-diagnosis is useless here.

Urinary problems begin at the moment when the volume of the prostate increases and, as the lumen of the ureter decreases, it begins to compress the urethra.Frequent urge to urinate, feeling of incomplete emptying of the bladder.Such phenomena typically appear at the very beginning, in the early stages of the disease, and then the body compensates, but they reappear in the later stages without proper treatment.

Male potency problems can also be expressed in several ways.Patients complain of deterioration of erection, accelerated ejaculation and reduced sexual arousal.Gradually, sexual dysfunctions become more pronounced, and in advanced stages, the symptoms of prostatitis are supplemented by impotence.

Classification

Experts distinguish several categories of the disease:

• Acute bacterial prostatitis characterized by symptoms of bacterial infection.In most cases, the causative agent of the disease is Escherichia coli.Enterococci and other bacteria are isolated somewhat less frequently;
• chronic bacterial prostatitis, which is a recurrent form of the disease.The causative agents of the disease are E. coli bacteria, enterococci, etc.Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also be pathogens;
• chronic pelvic pain syndrome in which infections are not detected.There are two types: inflammatory and non-inflammatory.The causes of its occurrence include: autoimmune processes, external factors (hypothermia, overheating), infrequent sexual life, low physical activity, infrequent urination;
• Asymptomatic inflammation of the prostate, detected by chance during an examination by a doctor.

Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after a thorough diagnosis based on test data.In case of certain symptoms, a specialist should be consulted.

Symptoms

The main symptom is a malfunction of the urinary system.You should consult a specialist if you notice the following symptoms:

• if urination is difficult and the urine comes out intermittently;
• if there is discharge from the urethra during defecation;
• burning sensation in the urethra and perineum;
• if there is discomfort in the bladder and prostate during defecation;
• if the urge to urinate intensifies and becomes more frequent;
• if you feel pain in the rectum;
• if purulent bloody discharge appears from the urethra (floating "threads");
• with a frequent rise in body temperature;
• when intimate problems arise (weakening erection);
• when the erection occurs at night for an unexplained reason;
• if ejaculation during intercourse is too fast;
• if the sensations during orgasm are "erased";
• with rapid general fatigue;
• with an unreasonably anxious or depressed state, as well as manifestations of mental depression;
• with frequent depression, manifestations of mental depression to prevent complications;
• with general weakening of the body.

One or two symptoms are enough to see a urologist.Self-healing attempts usually lead to a worsening of the condition, and the disease becomes chronic or severe.In the worst case, failure to visit a doctor in time can cause infertility or complete impotence.

If the patient does not consult a doctor in time or neglects the treatment, the following symptoms may appear:

• pain in the perineum;
• pain near the scrotum;
• pain at the root of the penis (natural pain).

Aching pain indicates the formation of stones.Doctors call infertility a late sign of a progressive disease.

The signs of prostatitis are significantly different in acute and chronic forms.Especially in the chronic form, the symptoms are mild or not expressed at all.

Acute prostatitis is characterized by pronounced symptoms - general malaise, pain in the groin area.Men should see a specialist if:

• the urge to urinate became very frequent;
• pain during defecation and urination intensifies in the perineum and radiates to the groin;
• complete emptying of the bladder is impossible;
• the amount of urine produced per day is significantly reduced or the urine is not collected;
• increased temperature, frequent headache, general weakness.

Acute bacterial prostatitis is characterized by fever and chills, pain in the lumbosacral region (severe), pain in the perineum and rectum, acute urinary retention, frequent muscle and joint pain.

Chronic prostatitis is characterized by the following symptoms:

• during urination, the pain in the perineum intensifies;
• with frequent urges, the bladder does not empty completely;
• decreased sexual desire;
• discomfort during sexual intercourse.

One of the signs of the chronic form is a significant disturbance of the emotional background, which is characterized by insomnia, increased nervousness, moodiness, and irritability.

The bacterial form of chronic prostatitis is characterized by problems with rapid and painful ejaculation, discomfort in the pubic area, frequent or involuntary urination, and intermittent urination.

Chronic pelvic pain syndrome, which according to medical statistics is the most common form of prostatitis, is characterized by symptoms similar to those of chronic bacterial prostatitis: frequent urge to urinate, weakening of urine flow, pain in the penis and testicles, sexual disorders.

Possible complications

• 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.

Diagnostics

Any form of prostatitis is diagnosed and treated by a urologist.If a tumor is suspected, the patient may be referred to an oncologist for consultation.In the case of chronic, long-lasting, difficult-to-treat prostatitis, an immunologist's consultation may be necessary.

1. Bacteriological culture of urine.
2. Analysis of prostate secretion for microflora and sensitivity to antibiotics.
3. Rectal examination of the prostate.
4. Ultrasound of the prostate gland, which makes it possible to identify tumors, cysts, adenomas, and distinguish prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Characteristics of the diagnosis of acute prostatitis

If the signs of the disease indicate acute prostatitis, the diagnosis is made based on instrumental and clinical examination data.Any manipulation that may affect the prostate is contraindicated, as it may cause severe pain or cause the spread of infection.

Characteristics of the diagnosis of chronic bacterial prostatitis

In such cases, the diagnosis is determined on the basis of the following data: examination of the patient by a doctor, bacteriological and microscopic examination of prostate secretions, study of ultrasound data.

Characteristics of the diagnosis of pelvic pain syndrome

Specialists prescribe diagnostic procedures for symptoms suggestive of chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory.Ultrasound is usually prescribed, as well as the following manipulations:

• examination of prostate secretion;
• molecular biology research;
• bacteriological research.

The choice of technique is determined by the doctor based on the data of the initial examination.

Risk groups

The most likely occurrence and development of prostatitis:

• in obese or sedentary men;
• in men doing sedentary work (office workers, programmers);
• in men whose body is exposed to shock and vibration (car drivers, including those with special equipment);
• in men with infectious diseases, including diseases of the urogenital system;
• in sexually hyperactive men and those who do not have a regular sex life;
• in depressed men with mental illness;
• alcoholics, drug addicts, etc.

Treatment

Patients diagnosed with acute prostatitis without complications are treated on an outpatient basis.Only in case of severe symptoms of poisoning and suspected purulent process, hospitalization is carried out.

Antibiotics are the drugs of choice to fight inflammation.It is also used for chronic bacterial forms.The medicine is selected individually and taken within 4-6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally, in the form of capsules or tablets.

Another drug used to treat prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound.They help facilitate urination and relax the muscles of the prostate and bladder.Medicines belonging to the NSAID group help relieve pain.

Treatment of prostatitis is carried out only comprehensively and consistently.In addition to taking medications, the doctor prescribes 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.

The choice of treatment method for prostatitis depends on many factors and is determined individually.When choosing treatment methods, the following should be taken into account:

• the cause of the disease;
• the course of the disease;
• individual characteristics of the body (presence of chronic and accompanying diseases).

A special technique can be selected for the treatment, or a complex can be prescribed.Depending on the results of the diagnosis, urologists prescribe the following:

• Physiotherapy procedures: magnetic resonance therapy, procedures with laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Drug treatment.
• Diet and psychotherapy.
• Surgical intervention.

When diagnosing bacterial prostatitis, broad-spectrum antibiotics, immunomodulators and multivitamin complexes are prescribed.

When diagnosing non-bacterial prostatitis, physiotherapy and anti-inflammatory drugs are prescribed.

In some cases, specialists may recommend muscle relaxants and hormone therapy, as well as antioxidants to reduce inflammation and protect cells from free radicals.

Correctly selected drug complex for acute bacterial prostatitis:

• restores immunity;
• to treat infections (antibiotics);
• treat the prostate (antibacterial drugs).

Chronic prostatitis is difficult to treat, so a wide list of drugs is used: anti-inflammatory, antispasmodic, absorbent, antibacterial, vibration and finger massage, electrophoresis, EHF and UHF therapy, sinusoidally modulated currents.

When diagnosing pelvic pain syndrome, antibiotics and anti-inflammatory drugs, various physiotherapy, magnetic and laser therapy, electrical neurostimulation, etc. are prescribed.One effective method is tissue drainage around the source of inflammation.

Conservative or modern treatment is selected by the urologist based on the diagnostic data.

Tablets

Antibacterial agents and pain relievers can be prescribed in pill form for prostatitis.

The course of antibiotic therapy is selected individually, depending on the results of the analysis of prostate secretions.The microflora causing the disease must be sensitive to the drug used.The course prescribed by the urologist must be completed completely, otherwise the cause will not be eliminated, the disease will recur or become chronic.

Painkillers for prostatitis help to get rid of unpleasant symptoms.For this purpose, non-steroidal anti-inflammatory drugs are used, which not only eliminate pain, but also reduce inflammation.

The group of alpha-1 blockers includes anti-prostatitis pills for men, which help treat urinary disorders.They relax the smooth muscles and restore the patency of the urethra compressed by the inflamed prostate.

Injections for prostatitis

In men, antibacterial agents against prostatitis are also used in the form of injections.In case of severe inflammation, and in the absence of antibiotics in tablet form, injectable drugs are prescribed, to which the pathogen is sensitive.You can inject antispasmodics to quickly restore urination, which is difficult due to urinary tract spasm and compression of the prostate.

Injectable prostatitis drugs work faster than pills, so they are sometimes more beneficial.

Prostatitis surgery

The most serious complications are enlargement of the seminal vesicles and abscess.Medicines for the treatment of the disease are not able to cope with the disease in such a difficult situation, therefore surgery is required in case of the first manifestations.

In the absence of timely intervention, the purulent process spreads beyond the organ, so the consequences of complicated prostatitis can be life-threatening.

Prognosis and prevention

The acute form without treatment often becomes chronic, which periodically worsens.A complete recovery is not always possible, but if you see a doctor in time and take all the prescribed medicines, you can eliminate discomfort, urination problems and pain.

Self-treatment at home and the use of traditional methods can often be life-threatening.

In order to prevent prostatitis, it is recommended to avoid hypothermia, to empty the bladder in time, to limit the consumption of coffee, spices and alcohol, and to remain sexually active as long as possible.

Typical symptoms of prostate cancer

The prostate is a small organ that only men have.It is sponge-like in structure, located below the bladder and appears to surround the urethra.Growth of the gland begins in adolescence under the influence of male sex hormones;by adult age, its weight can reach 20 grams.It plays an important role in the male reproductive system, producing a secretion that is one of the components of sperm.But unfortunately, mature and elderly men often experience hyperplasia of the gland or malignant tumors of the organ.

How to recognize cancer

As the tumor grows and progresses, the symptoms of prostate cancer depend on the stage of the process.If the disease is still in the first stage or has reached the second stage, then the tumor is localized in the prostate gland, has not grown into neighboring tissues and has not metastasized.

Prostate cancer symptoms are practically absent in the early stages, this is the insidious nature of the disease.The man has no complaints, feels well and sees no reason to see a doctor.This is why this type of tumor is often discovered at an advanced stage.Exceptions may be patients who have previously been diagnosed with a benign prostate tumor, in which case they are regularly monitored by a specialist and tested for specific prostate antigen and undergo an ultrasound examination of the prostate.They have every chance to nip the tumor in the bud.But it is worth noting that detecting prostate cancer is not always easy.Even when taking a biopsy, the results may be clear, but the oncology is already there.This is due to errors in the method;the needle simply does not reach the site of the localized lesion.If prostate pathology is suspected, especially if it is cancer, a fusion biopsy should be performed, which combines the capabilities of ultrasound and MRI in real time, giving the doctor the opportunity to visualize the organ as accurately as possible.

Some symptoms are the result of prostate pathology, while others are caused by mechanical compression and obstruction of the urethra.

Since the bladder must be emptied regularly, if this process is interrupted, urine may remain in it, inflammation may occur, and a bacterial infection may develop.If measures are not taken, the process will spread further and it threatens pyelonephritis and kidney problems.

In stage 4, prostate cancer manifests itself even more clearly.Metastases are most often found in the bones, spine and lymphatic tissues.Because of this, the person's regional lymph nodes become enlarged, his bones ache, he suddenly loses weight and becomes weak.

Treating prostate cancer is not an easy task, but it can be solved.If the local process is detected in time, a full recovery can be achieved, and life can be extended in more advanced stages.If you notice the symptoms described above, contact a qualified clinic for examination.

Make an appointment, the clinic's doctors have many years of experience in the treatment of urological diseases, and they achieve success even in the most difficult cases.