Prostatitis in men is an inflammatory process that involves 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 meet with prostatitis. It can develop unexpectedly (acutely) against the background of general health, or proceed for a long time, with periods of exacerbation and remission, which indicates a chronic course. Moreover, 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 with sexually transmitted infections - gonorrhea, chlamydia. In the chronic form, there can be many more 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;
- diabetes;
- hypothermia;
- violations in intimate hygiene.
Non-infectious prostatitis in a chronic form is detected in men complaining of prolonged pain in the genital organs, but the tests do not diagnose bacteria that could cause inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but the provoking factors are:
- emotional disorders;
- autoimmune diseases;
- increased physical activity;
- lack of regular sexual life;
- work associated with lifting weights;
- chronic stress;
- congestion in the tissues of the prostate;
- previously confirmed fibrotic changes in the prostate (according to the results of TRUS).
It is believed that inactive sex life, unprotected sex, hypothermia play an important role in the appearance of the disease. Symptoms of prostatitis at least once in a lifetime experience 50% of the entire male population of the planet.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which will move 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 begins with complaints of frequent painful urination. In the lower back and sacrum, as well as in the perineum, a slight soreness appears at first, which quickly increases.
Without treatment, the second stage occurs - acute follicular. At this moment, the pains become especially intense, they radiate to the anus, and intensify during defecation. Urination is very difficult, sometimes there is an acute urinary retention. The temperature does not exceed 38 degrees and only in rare cases can 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 in the perineum appear, 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 over a long period of 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 minor pain during urination or in the perineum, with small discharge from the urethra. Often these manifestations go unnoticed even by the patient for a very 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 prostate tissues are devoid of receptors, therefore, they cannot give painful sensations. They appear when 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, which disrupt sleep and habitual lifestyle. 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 are 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 adequate 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 supplemented by impotence.
Possible Complications
In inflammatory processes in the prostate gland, neighboring organs are also involved in the pathological process. This can cause various consequences of prostatitis, for example:
- vesiculitis;
- posterior urethritis or colliculitis;
- abscess of the gland itself;
- sclerosis or fibrosis of the prostate;
- cysts and stones of the prostate;
- infertility;
- 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.
Diagnostics
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 chronic long-term prostatitis, which is difficult to treat, consultation with an immunologist may be required.
The characteristic clinical picture and patient complaints help to quickly make an accurate diagnosis. The list of mandatory studies in the diagnosis of prostatitis looks like this:
- Bacteriological culture of urine.
- Analysis of prostate secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Ultrasound of the prostate gland, which allows to identify tumors, cysts, adenomas, as well as to differentiate 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 prevent 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.
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 fight inflammation. They are also used in chronic bacterial form. The medicine 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 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.
Forecast 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 drugs, discomfort, problems with urination 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 remain sexually active as long as possible.