Prostatitis in men is an inflammatory process that involves the tissue of the prostate. The disease is accompanied by pain that occurs in the lumbar region, perineum, in the pelvis. The main manifestations are perineal pain and lower urinary tract dysfunction.
Among all urological diseases, urologists often find themselves with prostatitis. It may develop unexpectedly (acutely) in the context of general health or continue 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 is independent, and can also be combined with an enlarged prostate or prostate cancer.
reasons for development
Inflammation does not appear alone. 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 damage to the prostate by gram-negative bacteria - Escherichia coli, Proteus, Enterobacter. Also, inflammation 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 provoking factors for the development of the bacterial variant are:
- unprotected sex;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal sexual contact;
- sedentary lifestyle;
- inactive sex life;
- violations in intimate hygiene.
Chronic non-infectious prostatitis is detected in men who complain of prolonged pain in the genitals, but tests do not diagnose bacteria that can cause inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but the triggering factors are:
- emotional disturbances;
- autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work associated with lifting weights;
- chronic stress;
- congestion in prostate tissues;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
It is believed that inactive sex life, unprotected sex, hypothermia play an important role in the onset of the disease. Symptoms of prostatitis at least once in a lifetime affect 50% of the entire male population on the planet.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which will pass from one to another, if you do not contact a specialist and stop the development of the disease in time.
The first stage is called acute catarrhal prostatitis. It starts with complaints of frequent painful urination. In the lower back and sacrum, as well as in the perineum, a slight pain initially appears, which rapidly increases.
Without treatment, the second stage occurs - acute follicular. At this time, the pains become especially intense, radiate to the anus and are aggravated during defecation. Urination is very difficult, sometimes there is acute urinary retention. The temperature does not exceed 38 degrees and only in rare cases can it be higher.
Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C and above, chills appear. Urinary retention is often observed, sharp, throbbing pains appear in the perineum, the act of defecating 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 time.
Often, the chronic course 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 occurs with little pain during urination or in the perineum, with little discharge from the urethra. Often these manifestations go unnoticed even by the patient for a long time.
Signs of prostatitis in men can occur in different ways, but they are all combined into three groups - pain syndrome, urination disorder, problems with sex life. Prostate tissues are devoid of receptors, therefore, they cannot give painful sensations. They appear when inflammation starts to move to the pelvic organs, which are richly innervated. Pain in patients can be different - from almost imperceptible to strong and intense discomfort, which interrupts sleep and the usual lifestyle. The pain can radiate to the sacrum, scrotum, lower back, perineum, so self-diagnosis is useless here.
Problems with urination begin at the moment when the prostate increases in volume and begins to squeeze the urethra with a decrease in the lumen of the ureter. There is frequent urge to urinate, feeling of incomplete emptying of the bladder. Usually, such phenomena are expressed at the beginning of the disease, in its early stages, then they are compensated by the body, but at a later stage, without proper treatment, they reappear.
Problems with potency in men can also be expressed in different ways. Patients complain of worsening erection, accelerated ejaculation, decreased sexual arousal. Gradually, sexual disorders become more pronounced, and at an advanced stage, the symptoms of prostatitis are complemented by impotence.
In inflammatory processes in the prostate, neighboring organs are also involved in the pathological process. This can cause various consequences of prostatitis, for example:
- posterior urethritis or colculitis;
- abscess of the gland itself;
- sclerosis or fibrosis of the prostate;
- prostate cysts and stones;
- ejaculation disorder;
- erectile dysfunction.
To prevent the development of these serious complications, at the first symptoms of prostatitis and prostate adenoma, you should contact a urologist.
The urologist deals with the diagnosis and therapy of any form of prostatitis. If a tumor is suspected, the patient may be referred for a consultation with an oncologist. In long-standing chronic prostatitis that is difficult to treat, consultation with an immunologist may be necessary.
The characteristic clinical picture and the patient's complaints help to make a quick and accurate diagnosis. The list of mandatory studies in diagnosing prostatitis looks like this:
- Bacteriological culture of urine.
- Analysis of prostate secretion for microflora and antibiotic sensitivity.
- Rectal examination of the prostate.
- Ultrasonography of the prostate, which allows identifying tumors, cysts, adenomas, as well as differentiating prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
It is difficult to independently determine the causes of the disease, and even more so, to cure them. Therefore, in order to avoid the development of serious complications and in the future not to remain infertile, at the first signs of the disease, a man should immediately contact a urologist.
Patients with identified acute prostatitis without the development of complications are treated on an outpatient basis. Only with severe symptoms of intoxication and suspected purulent process, hospitalization is carried out.
Antibiotics are the drugs of choice to fight inflammation. They are also used in the chronic bacterial form. The drug is selected individually, taken as a course for 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 for prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound. They help to facilitate urination, relax the muscles of the prostate and bladder. NSAIDs help relieve pain.
Treatment of prostatitis is carried out only comprehensively and consistently. In addition to taking the medication, the doctor will prescribe a course of prostate massage and physical therapy is used to improve blood circulation in this organ. Surgical treatment is used only when abscesses and suppuration of the seminal vesicles appear.
prediction and prevention
The untreated acute form often becomes chronic, which periodically worsens. Full recovery is not always possible, however, with timely access to a doctor and taking all prescribed medications, discomfort, urination problems, and pain can be eliminated.
Self-treatment at home and the use of popular methods can often be fatal.
To prevent prostatitis, it is recommended to avoid hypothermia, empty your bladder in a timely manner, limit the use of coffee, spices and alcohol, and remain sexually active as long as possible.