Prostatitis: symptoms, treatment, prevention.

Prostatitis in men is an inflammatory process involving the prostate tissue. The disease is accompanied by pain that occurs in the lower back, perineum, in the pelvis. The main manifestations are pain in the perineum and dysfunction of the lower urinary tract.

Among all urological diseases, urologists most often come across prostatitis. It can develop unexpectedly (acutely) against the background of general health, or continue for a long time, with periods of exacerbation and remission, indicating 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 prostatic 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 damage to the prostate gland by gram-negative bacteria: Escherichia coli, Proteus, Enterobacter. Also, inflammation occurs due to infection by sexually transmitted infections - gonorrhea, chlamydia. In the chronic form, there can be many more reasons, and the list will include atypical microbes.

The factors that cause the development of the bacterial variant are:

• unprotected sex;
• AIDS or HIV infection;
• diarrhea or constipation;
• anal sexual contact;
• sedentary lifestyle;
• inactive sexual life;
• diabetes;
• hypothermia;
• Violations in intimate hygiene.
• emotional disorders;
• Autoimmune diseases;
• Increased physical activity;
• lack of regular sex life;
• work associated with lifting weights;
• Chronic stress;
• congestion in the tissues of the prostate;
• Previously confirmed fibrotic changes in the prostate (based on TRUS results).

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

The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating. If, going to the toilet, you noticed a weakening of the urine stream, felt discomfort or a burning sensation in the urethra, you should contact a urologist as soon as possible.

With an acute onset of the disease, the temperature may rise, the general well-being worsens. Such a patient should be immediately treated by connecting antibiotics and anti-inflammatory drugs.

In some cases, the disease can be asymptomatic for a long time, so it is started late to treat it.

symptoms of prostatitis

Signs of prostatitis in men depend on the form of the disease. In the acute form, the following manifestations are characteristic:

• pain in the lower back, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficulty passing stool;
• a thin stream of urine;
• temperature increase;
• shaking chills;
• deterioration of general well-being.

The chronic form can occur after the acute phase of the disease or develop as a primary disease. Symptoms of prostatitis in men with a chronic course are mild. The pain is of low intensity, the temperature may rise slightly. The stream of urine thins out, disorders appear in the intimate sphere.

In a chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible. The pain may be absent or have a dull aching character.

Symptoms of acute prostatitis

Acute prostatitis occurs in several stages, which will go from one to another, if you do not contact a specialist and do not stop the development of the disease in time.

The first stage is called acute catarrhal prostatitis. It begins with complaints of frequent and painful urination. In the lower back and sacrum, as well as in the perineum, mild pain appears at first, rapidly increasing.

Without treatment, the second stage occurs - acute follicular. At this time, the pain becomes especially intense, irradiates to the anus and is aggravated during defecation. Urination is very difficult, sometimes there is acute urinary retention. The temperature does not exceed 38 degrees and only in exceptional 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 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 for 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, most often the disease occurs with minor pain when urinating or in the perineum, with a small 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 sexual life. The tissues of the prostate are devoid of receptors, therefore they cannot give painful sensations. They appear when the inflammation begins to move to the pelvic organs, which are richly innervated. Pain in patients can be different - from barely noticeable discomfort to strong and intense, disrupting sleep and the usual way of life. 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 gland increases in volume and begins to squeeze 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 proper treatment, they reappear.

Potency problems in men can also express themselves 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 supplemented by impotence.

Classification

Experts distinguish several categories of the disease:

• acute bacterial prostatitis, which is characterized by symptoms of a bacterial infection. The causative agent of the disease in most cases is Escherichia coli. Somewhat less frequently, enterococci and other bacteria are isolated;
• 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 become pathogens;
• chronic pelvic pain syndrome, in which infections are not detected. There are two types: inflammatory and non-inflammatory. Among the causes: autoimmune processes, external factors (hypothermia, overheating), rare sexual life, low physical activity, rare urination;
• asymptomatic prostatitis, detected by chance during a medical examination.

Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after a full diagnosis based on examination data. You should contact a specialist if you have certain signs.

Symptoms

The main symptom is a violation of the functioning of the urinary system. You should contact a specialist if you have the following symptoms:

• if urination is difficult and urine comes out intermittently;
• if during bowel movements there is discharge from the urethra;
• with a burning sensation in the urethra and perineum;
• if during the bowel movement there are unpleasant sensations in the bladder and prostate;
• if the need to urinate has increased and has become more frequent;
• in case of pain in the rectum;
• if there is purulent bloody discharge from the urethra (floating "threads");
• with a frequent increase in body temperature;
• with the appearance of problems of an intimate nature (weakening of the erection);
• when erections appear at night for an inexplicable reason;
• if ejaculation during intercourse is too fast;
• if the sensations during orgasm are "erased";
• with rapid general fatigue;
• with manifestations of an unreasonably anxious or depressed state, as well as a state of mental depression;
• with frequent depression, manifestations of mental depression in anticipation of complications;
• with a general weakening of the body.

To contact a urologist, one or two symptoms are enough. Attempts to cure themselves, as a rule, lead to a deterioration of the condition, the transition of the disease into a chronic or severe form. In the worst case, an untimely visit to the doctor can lead to infertility or complete impotence.

If the patient did not consult a doctor in a timely manner or neglected treatment, the following symptoms may appear:

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

Aching pains indicate the formation of stones. Doctors call infertility a late sign of a progressive disease.

Signs of prostatitis in acute and chronic forms differ significantly. In particular, in the chronic form, the signs may be mild or not express themselves at all.

Acute prostatitis is characterized by pronounced symptoms: malaise, pain in the groin area. Men need to contact specialists if:

• the desire 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 formed per day has decreased significantly or urine is not collected;
• fever, frequent headaches, general weakness.

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

Chronic prostatitis is characterized by the following symptoms:

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

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

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

Chronic pelvic pain syndrome, which, according to medical statistics, is the most common form of prostatitis, is characterized by signs similar to the symptoms of chronic bacterial prostatitis: frequent urination, weakening of the urine stream, pain in the penis, testicles, sexual dysfunction.

Possible complications

• vesiculitis;
• posterior urethritis or coliculitis;
• abscess of the gland itself;
• sclerosis or fibrosis of the prostate;
• cysts and stones of the prostate;
• sterility;
• ejaculation disorder;
• erectile dysfunction.

Diagnosis

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-term chronic prostatitis, which is difficult to treat, consultation with an immunologist may be necessary.

1. Urine bacteriological culture.
2. Analysis of prostatic secretion for microflora and sensitivity to antibiotics.
3. Rectal examination of the prostate.
4. Ultrasound of the prostate gland, which allows to identify tumors, cysts, adenomas, as well as to differentiate prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Diagnostic characteristics in acute prostatitis.

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

Diagnostic characteristics in chronic bacterial prostatitis.

The diagnosis in such cases is determined on the basis of the following data: examination by the patient's doctor, bacteriological and microscopic examination of discharge from the prostate, study of ultrasound data.

Diagnostic characteristics in pelvic pain syndrome.

Specialists prescribe diagnostic procedures for symptoms indicating chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory. As a rule, ultrasound is prescribed, as well as the following manipulations:

• study of prostatic secretion;
• research in molecular biology;
• bacteriological research.

The choice of technique is determined by the doctor according to the initial examination.

groups at risk

The most likely occurrence and development of prostatitis:

• in men who are obese or who lead a sedentary lifestyle;
• in men with sedentary work (office workers, programmers);
• in men whose body is subjected to shocks and vibrations (car drivers, including special equipment);
• in men who have had infectious diseases, including diseases of the genitourinary system;
• in men who are sexually hyperactive and in those who do not have regular sexual intercourse;
• in men in a state of depression, who suffer from mental illness;
• in alcoholics, drug addicts, etc.

Treatment

Patients with identified acute prostatitis without the development of complications are treated on an outpatient basis. Only with severe symptoms of intoxication and suspicion of a purulent process, hospitalization is carried out.

Antibiotics are the drugs of choice to combat inflammation. They are also used in chronic bacterial form. The drug is selected individually, it is 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 medication used for prostatitis are alpha1 blockers, which are prescribed in the presence of residual urine confirmed by ultrasound. They help 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 medication, the doctor will prescribe a course of 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 for prostatitis depends on many factors and is determined individually. When choosing treatment methods, the following are taken into account:

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

For treatment, a specific technique can be chosen, or a complex can be prescribed. Specialists in the field of urology, based on the results of the diagnosis, prescribe:

• Physiotherapeutic procedures: magnetic resonance therapy, procedures with laser equipment, ultrasound, reflexology, massage, hirudotherapy.
• Medical treatment.
• dietetics and psychotherapy.
• Surgical intervention.

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

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

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

Properly selected complex of drugs for acute bacterial prostatitis:

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

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

When pelvic pain syndrome is diagnosed, antibiotics and anti-inflammatory drugs, various types of physiotherapy, magnetic and laser therapy, electrical nerve stimulation, etc. are used. . One of the effective methods is tissue drainage around the focus of inflammation.

The urologist chooses conservative or modern treatment based on the diagnostic data.

tablets

In the form of tablets for prostatitis, antibacterial and analgesic agents can be prescribed.

The course of antibiotic therapy is selected individually based on the result of the analysis of prostatic discharge. The microflora that caused the disease must be sensitive to the drug used. It is necessary to complete the course of treatment prescribed by the urologist, otherwise the cause will not be eliminated, the disease will recur or become chronic.

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

Prostatitis pills for men, which help treat difficulty urinating, belong to the group of alpha 1 blockers. They relax smooth muscles and restore patency of the urethra that is compressed by the inflamed prostate.

injections for prostatitis

Antibacterial agents for prostatitis in men are also used in the form of injections. Injectable forms of drugs are prescribed for severe inflammation, as well as in the absence of antibiotics in tablet form, to which the pathogen is sensitive. You can make injections of antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of the prostate.

Injectable prostatitis medications work faster than oral medications, which is why they are sometimes preferred.

prostatitis operation

The most formidable complications are suppuration of the seminal vesicles and abscess. Drugs for the treatment of the disease cannot cope with the disease in such a difficult situation, therefore the operation is indicated at the first manifestations.

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

Prognosis and prevention

The acute form without treatment 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 folk methods can often be life-threatening.

To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder in a timely manner, limit the use of coffee, spices and alcohol, and stay sexually active as long as possible.

Typical signs of prostate cancer

The prostate gland is a small organ that only men have. Resembling a sponge in structure, it lies below the bladder and wraps around the urethra. The growth of the gland begins in adolescence under the influence of male sex hormones, in adulthood its weight can reach 20 grams. It plays an important role in the male reproductive system, producing a secret, one of the components of sperm. But unfortunately, in mature and elderly men, glandular hyperplasia or malignant neoplasms of the organ are often found.

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 even reached the second, then the tumor is located in the prostate gland, has not grown into neighboring tissues and has not allowed metastasis.

Symptoms of prostate cancer in the early stages are practically absent - this is the insidiousness of the disease. The man does not complain, he feels fine and sees no reason to go to the doctor. That is why often this type of tumor is already in a state of neglect. An exception may be patients who have previously been diagnosed with benign neoplasms of the prostate gland, in which case they are regularly observed by a specialized doctor and examined for specific prostate antigen, undergo ultrasound of the gland. They have every chance of detecting a tumor at its very beginning. But it's worth noting that detecting prostate cancer isn't always easy. Even with a biopsy, the results may be clear, but the oncology already exists. This is due to method errors, the needle simply does not fall into the place of the localized focus. If pathology of the prostate 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 with the highest possible precision.

Some of the symptoms are a consequence of prostate pathology, while others are caused by mechanical compression and blockage of the urethra.

Since the bladder must be emptied regularly, if this process is disturbed, urine can be retained in it, inflammation can occur, and a bacterial infection can join. If no action is taken, the process will spread, and this already threatens with pyelonephritis and kidney problems.

At stage 4, prostate cancer manifests itself even more clearly. Metastases are most often found in the bones, spine, and lymph. Because of this, the regional lymph nodes of a person increase, the bones ache, he loses weight sharply and becomes weak.

Treating prostate cancer is not an easy task, but it can be done. With timely detection of a local process, a complete cure can be achieved and with more advanced stages, life can be extended. If you notice the symptoms described above, contact a professional clinic for examination.

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