Chronic inflammation of the prostate gland occurs in men of any age. In most cases, the catalyst is an infectious factor: Trichomonas, staphylococcus and gonococcus. Bacteria that enter the body provoke inflammation of the urethral canal, the prostate itself.
Chronic prostatitis is often asymptomatic. The disease itself is determined only after the transition to an acute form. Late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.
Statistics show the constant "rejuvenation" of the disease. Increasingly, urologists are referred to by patients aged 30 years.
Chronic prostatitis - what is it
The prostate gland is located under the bladder. The main functions are to protect vesica urinaria from ingress, seminal fluid, as well as the production of prostate secretions, an essential component of male semen. Inflammation of the tissues of the gland, provoked by the ingress of infection, congestion and other factors, gradually becomes permanent.
Chronic prostatitis leads to degenerative changes. The tissue structure is gradually deformed. Often, against the background of inflammation, stones appear in the ducts. Some types of prostatitis cause cancer.
An international classification system has been developed to facilitate differentiation between different prostate diseases.
Chronic prostatitis - causes
It is believed that inflammation of the prostate gland is caused by two main factors: bacterial and abacterial.
The first is associated with the ingestion of pathogens and infections into the patient's body. Most often, sexually transmitted bacteria act as a catalyst.
The second cause is not related to the infectious agent. Inflammation can be catalyzed by:
- Hypothermia of the body.
- Hormonal disorders associated with aging, irregular sex life.
- Bad habits.
- Injury to the pelvic organs.
- Congestion caused by metabolic disorders and a sedentary lifestyle.
After diagnosing prostatitis, the root cause of chronic prostatitis is necessarily determined. The course of therapy is prescribed based on what exactly caused the inflammation. Bacterial and non-infectious prostatitis are treated differently.
Urologists name several additional factors that aggravate the situation and affect the severe course of the disease:
- Sexual abstinence.
- Incomplete ejaculation (choice of interrupted sexual intercourse as a method of contraception).
- Bad habits - alcohol abuse and smoking.
- Improper nutrition.
- Past inflammatory diseases. Often urethritis and cystitis act as the cause of chronic prostatitis.
Inflammation is accompanied by destructive changes in the prostate gland, which makes it possible to classify the disease into several categories.
Classification of chronic inflammation of the prostate
Varieties of prostatitis received their ICD-10 code - N41. To clarify the diagnosis and differentiation of catalyst infection, a separate classification B95-B97 is used. The symptom rating scale divides the disease into several groups and subgroups:
- I - acute inflammation, accompanied by a sharp rise in temperature, fever.
- II - chronic prostatitis, provoked by an infectious factor.
- III - this class includes a disease in which pelvic pain syndrome begins to manifest. It is customary to distinguish two subgroups:
- IIIA - there are signs of an inflammatory process. Subfebrile temperature is maintained.
- IIIB - no inflammation.
- IV - prostatitis in which there are no symptomatic manifestations. Deviations from the norm are detected exclusively by instrumental diagnostic methods.
According to the ICD code:
- N41. 1 is diagnosed with chronic prostatitis.
- N41. 8 inflammatory diseases of the prostate gland
- N41. 9 not definitively diagnosed.
How does chronic prostatitis manifest - its symptoms
The first signs of chronic prostatitis in men appear at an advanced stage of the disease. Often, early development has no clinical manifestations. Symptoms, even if present, are temporary, short-term and of low intensity.
According to clinical manifestations, there are three stages of development of prostatitis:
- The initial indirect signs of chronic prostatitis - as already noted, the onset of the disease is not expressed by clearly distinguishable symptoms. Manifestations are subtle or absent. Signs to pay attention to: burning sensation during ejaculation, decreased potency, painful urination.
- Secondary signs of chronic inflammation of the prostate - at this stage, pathological changes in the structure of tissues, the appearance of scar-like formations, and a decrease in genitourinary function occur. The stage is characterized by a sharp deterioration in potency and urination, increased sweating, severe pain in the pelvic area, lumbar spine, scrotum.
- Signs of a neglected disease - the prostate stops functioning normally. Healthy tissues begin to metamorphize. The gland increases in size. Blotches of blood and pus appear in the urine, there is a constant feeling of incomplete emptying of the bladder, and night trips to the toilet become more frequent. Erectile function decreases so much that we can talk about complete impotence.
In addition to the symptoms characteristic of each stage of development, there are general signs that are manifested throughout the course of the disease.
Chronic prostatitis in a late stage of development has pronounced symptoms. Typical clinical manifestations are pain of strong intensity, which do not go away on their own and require the use of analgesics and antispasmodics.
Pain syndrome accompanies the entire period of development of the disease. During the primary signs of prostatitis, discomfort and burning sensation in the urethral canal are of low intensity, therefore they are often ignored. Pain is often falsely attributed to sciatica, fatigue. After taking pain relief or taking an antispasmodic, the symptom usually goes away.
Over time, the clinical picture becomes more and more saturated. The pain syndrome manifests itself more intensely, remains after taking analgesics. Unpleasant sensations accompany every act of urination, defecation and ejaculation.
Pain radiates from the spine to the scrotum, sometimes to the extremities, accompanied by convulsions, numbness. Skin rashes, itching and burning of tissues in the prostate and genital area are a normal reaction of the body to internal inflammation.
Chronic inflammation of the prostate gland in acute form is accompanied by fever and fever. A sharp rise in temperature is observed, reaching 39-40 °. The indicators are stable. Body temperature does not drop even after taking antipyretics.
Sluggish prostatitis is characterized by a subfebrile course. Constant indicators of chronic inflammation, in the range of 37-37. 2 °.
It is strictly forbidden to bring down the temperature and take medications on your own to reduce external manifestations!
The first signs of chronic prostatitis are manifested in various urinary disorders. Over time, the symptoms become more intense, which helps to identify the disease. Dysuria manifestations:
- Frequent urge to go to the toilet at night.
- Feeling of incomplete emptying of the bladder.
- Hematuria (blood in urine), purulent discharge.
- Pain while urinating.
Clinical signs and the intensity of their manifestation directly affect the diagnosis, and require mandatory additional research. Symptoms may indicate other inflammatory diseases of the genitourinary system, hyperplasia, and oncology.
Chronic prostatitis leads to scarring that impairs blood flow. Lack of nutrients leads to the following manifestations:
- Decreased potency - with chronic prostatitis, sexual dysfunction is observed. One of the characteristic symptoms is a normal erection, which sharply decreases during intercourse. In the advanced stage, a steady potency sets in.
- Infertility - after the appearance of scars in the seminal ducts, sperm viability decreases. The inflammation changes the structure and composition of the ejaculate. In the advanced stage, the sperm thickens, lumps appear.
- Pain during intercourse - discharge from the urethral canal is observed. During intercourse, discomfort and painful manifestations are felt, especially during ejaculation. Often, psychosomatic causes lead to persistent impotence of the patient.
The main symptoms in chronic prostatitis: pain, fever, dysuria, dysfunction of the genitals. When making a diagnosis, the intensity and duration of the period from the onset of the onset of clinical signs, as well as related symptoms, are taken into account.
How can chronic prostate inflammation be diagnosed?
Prostatitis has no symptoms that can accurately differentiate the disease. Some disorders of the genitourinary system have similar symptoms. An accurate diagnosis can be made only after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.
Suspecting the presence of abnormalities in the work of the pelvic organs, the urologist will prescribe a mandatory rectal examination. If palpation reveals tissue changes, several laboratory tests are prescribed.
Laboratory research methods
Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the catalyst for the development of the disease. When making a diagnosis, additional information will be required from the results of the following laboratory tests:
- Cytological and bacteriological analysis of urine. The PSA level is set. Protein indicators rise sharply with inflammation of the tissues of the gland.
- Taking a smear from the urethra.
- Microscopy of prostate secretion - according to the results, malfunctions of the prostate gland are determined. Differentiate cancer from chronic tissue inflammation. Sowing the secretion of the prostate is prohibited during the acute period of the disease, accompanied by high body temperature, exacerbation of hemorrhoids, cracks in the anus.
- Tests for STIs (sexually transmitted infections) are one of the most common catalysts for inflammation of the prostate gland - pathogens. Trichomonas, staphylococci and gonococci can all cause disease. Prostatitis develops during the active phase of bacterial reproduction, and after the infection has already been cured.
Laboratory research is a mandatory component of the diagnosis of prostatitis and the subsequent choice of a treatment method.
Instrumental detection of the disease
There are three main methods of research for prostatitis. Each method of instrumental diagnostics provides information about changes in the structure of the tissues of the gland, has its own indications and contraindications:
- Tomography - MRI is often prescribed to diagnose chronic prostatitis. The study allows you to get a layered picture of the prostate. MRI signs accurately indicate chronic inflammation, and also indicate the onset of tissue degeneration into a malignant formation. The magnetic resonance technique is absolutely harmless, but it has contraindications associated with the impossibility of examining patients with pacemakers, metal braces and shunts (left during surgical operations).
- Transrectal TRUS is informative methods that with high reliability indicate the presence of inflammation. Echographic signs of structural changes in the prostate gland by the type of chronic prostatitis include: deviations from the norm in volume and size, structure, and the presence of pathological formations. The ultrasound technique is not prescribed for acute inflammation of the rectum, the presence of cracks in the anus, hemorrhoids.
- Ultrasound - transabdominal technique has no contraindications. The method is less informative compared to TRUS and MRI. Sonographic signs make it difficult to determine the space of the abdominal cavity. Diagnostic results are often controversial and require clarification. The advantage of ultrasound is the simplicity and speed of the study.
The accuracy of the echographic picture largely depends on the experience of the doctor conducting the study.
Differential disease search
After receiving the results of clinical and biochemical studies, the symptoms of chronic inflammation of the prostate gland are evaluated. Common diagnostic standards have been developed that are valid around the world.
To facilitate the urologist's task, the NIH-CPSI symptom index was invented, made in the form of a questionnaire or questionnaire. The doctor fills in the columns of the document, after which he makes a diagnosis.
There are computer programs based on the NIH-CPSI index. The doctor is required to fill out a questionnaire, and the system will independently conduct a summary assessment of symptoms in chronic prostatitis. The effectiveness of the technique has been proven all over the world.
After calculating the results of the questionnaire, when making a diagnosis, the assessment of instrumental and clinical studies is additionally taken into account: the presence of echo signs of chronic prostatitis, an increased PSA level, the identification of an infectious marker by microscopy of the secretion. The more data the urologist has, the more accurate the result will be.
What is the danger of chronic prostatitis - its consequences
The consequences of chronic prostatitis in men are disorders in the work of the genitourinary system. These include:
- Acute urinary retention.
Fibrous changes accompanying an advanced disease become the cause of the development of oncology. Normal tissues are reborn into malignant ones. Therefore, the prevention of functional changes in the prostate gland in order to prevent the development of cancer is an extremely important task facing the urologist.
When making a diagnosis, take into account the presence of prostatic intraepithelial neoplasia - a harbinger of oncology and fibrotic changes. A neglected disease often leads to the need for a surgical operation: prostatectomy.
Diagnosis of prostatitis and differentiation of the disease from adjacent disorders of the pelvic organs is an important task for doctors and the patient. The detection of the first symptoms depends entirely on the man himself. If you experience any unpleasant sensations when urinating, decreased erection, constant low-grade fever are reasons to immediately seek professional medical help. Delay is dangerous!