Chronic inflammation of the prostate occurs in men of any age.In most cases, the catalyst is an infectious factor: trichomonas, staphylococcus and gonococcus.Bacteria that enter the body cause inflammation of the urethral canal, the prostate itself.
The chronic form of prostatitis is often asymptomatic.The disease itself is determined only after transitioning into an acute form.The late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.
Statistics show a constant "rejuvenation" of the disease.More and more patients older than 30 are turning to urologists.
Chronic prostatitis - what is it?
The prostate is located below the bladder.The main functions are reduced to the protection of the vesica urinaria from the entry of seminal fluid, as well as the production of prostate secretions, a necessary component of male semen.Inflammation of the gland tissue, caused by infection, blockage and other factors, gradually becomes permanent.
Chronic prostatitis leads to degenerative changes.The tissue structure is gradually deformed.Stones in the canals often appear against the background of inflammation.Some types of prostatitis cause the development of cancer.
An international classification system has been developed to facilitate the differentiation between different prostate diseases.
Chronic prostatitis - causes
It is generally accepted that inflammation of the prostate is caused by two main factors: bacterial and abacterial.
The first is associated with the entry of pathogens and infections into the patient's body.Most often, the catalyst is sexually transmitted bacteria.
The other cause is not related to an infectious agent.The catalyst of inflammation can be:
- Hypothermia of the body.
- Hormonal imbalance associated with aging and irregular sex life.
- Bad habits.
- Pelvic organ injury.
- Stagnation caused by metabolic disorders and a sedentary lifestyle.
After the diagnosis of prostatitis, it is necessary to determine the underlying cause of chronic prostatitis.The course of therapy is prescribed based on what exactly caused the inflammation.Bacterial and non-infectious prostatitis are treated differently.
Urologists list several additional factors that worsen the situation and affect the severe course of the disease:
- Sexual abstinence.
- Inferior ejaculation (choosing interrupted sexual intercourse as a method of contraception).
- Stress.
- Bad habits – alcohol abuse and smoking.
- Poor nutrition.
- Inflammatory diseases suffered in the past.Often urethritis and cystitis act as the cause of prostatitis in chronic form.
Inflammation is accompanied by destructive changes in the prostate, which allows the classification of the disease into several categories.
Classification of chronic inflammation of the prostate
Types of prostatitis received their own ICD-10 code - N41.To clarify the diagnosis and distinguish catalyst infection, a special classification B95-B97 is used.The symptom rating scale divides the disease into several groups and subgroups:
- I - acute inflammation, followed by a sudden rise in temperature and fever.
- II - chronic prostatitis, caused by an infectious factor.
- III - class includes a disease in which pelvic pain syndrome begins to manifest itself.It is common to distinguish two subgroups:
- IIIA - there are signs of an inflammatory process.A low temperature is maintained.
- IIIB - no inflammation.
- IV - prostatitis with no symptomatic manifestations.Deviations from the norm are detected exclusively by instrumental diagnostic methods.
According to the ICD code:
- N41.1 was diagnosed with chronic prostatitis.
- N41.8 inflammatory diseases of the prostate.
- N41.9 exact diagnosis not established.
How is chronic prostatitis manifested - its symptoms
The first signs of chronic prostatitis in men appear in the advanced stage of the disease.Often, early development has no clinical manifestations.Symptoms, even if present, are temporary, short-lived and of low intensity.
According to the clinical manifestations, there are three stages of the development of prostatitis:
- Initial indirect signs of chronic prostatitis - as already mentioned, the beginning of the disease is not expressed by clearly recognizable symptoms.Manifestations are subtle or non-existent.Signs to pay attention to: burning during ejaculation, reduced potency, painful urination.
- Secondary signs of chronic inflammation of the prostate - in this phase, there are pathological changes in the tissue structure, the appearance of scar formations and a decrease in genitourinary function.The stage is characterized by a sudden worsening of potency and urination, increased sweating, severe pain in the pelvis, lumbar spine and scrotum.
- Signs of advanced disease - the prostate stops functioning normally.Healthy tissues begin to metamorphose.The gland increases in size.Blood and pus appear in the urine, there is a constant feeling of incomplete emptying of the bladder, and trips to the toilet at night are becoming more frequent.Erectile function decreases so much that we can talk about complete sexual impotence.
In addition to the symptoms characteristic of each stage of development, there are also general signs that appear throughout the course of the disease.
Pain syndrome
Chronic prostatitis in the late stage of development has pronounced symptoms.Characteristic clinical manifestations are severe pain that does not go away on its own and requires the use of analgesics and antispasmodics.
The pain syndrome accompanies the entire period of disease development.During the primary signs of prostatitis, discomfort and burning in the urethral canal are of low intensity and therefore often ignored.Pain is often falsely attributed to sciatica or fatigue.After pain relief or taking antispasmodics, the symptom usually disappears.
Over time, the clinical picture becomes more intense.The pain syndrome manifests itself more intensely and remains after taking analgesics.Unpleasant sensations accompany every act of urination, defecation and ejaculation.
The pain spreads from the spine to the scrotum, sometimes to the limbs, and is accompanied by cramps and numbness.Skin rashes, itching and burning tissue in the area of the prostate and genitals are a normal reaction of the body to internal inflammation.
Temperature rise
Chronic prostatitis in acute form is accompanied by heat and temperature.There is a sharp rise in temperature, reaching 39-40°.Indicators are stable.The body temperature does not decrease even after taking antipyretics.
Delayed prostatitis is characterized by a low temperature.Constant indicators of chronic inflammation, within 37-37.2°.
It is strictly forbidden to lower the temperature and to take medicines on your own to reduce external manifestations!
Dysuria
The first signs of chronic prostatitis appear in various urinary disorders.Over time, the symptoms become more intense, which helps to recognize the disease.Manifestations of dysuria:
- Frequent desire to go to the toilet at night.
- Feeling of incomplete emptying of the bladder.
- Hematuria (blood in the urine), purulent discharge.
- Pain during urination.
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.
Disorders of the genital organs
Chronic prostatitis leads to the appearance of scars that hinder blood supply.Lack of nutrients leads to the following manifestations:
- Decreased potency - with chronic prostatitis, sexual disorders are observed.One of the characteristic symptoms is a normal erection, which suddenly decreases during sexual intercourse.In the advanced stage, a stable potency occurs.
- Infertility - after the appearance of scars in the seminal ducts, sperm viability decreases.Inflammation changes the structure and composition of the ejaculate.At an advanced stage, the sperm thickens and lumps appear.
- Pain during sexual intercourse - discharge from the urethral canal is observed.During sexual intercourse, discomfort and painful symptoms are felt, especially during ejaculation.Often psychosomatic reasons lead to permanent impotence of the patient.
The main symptoms of chronic prostatitis: pain, elevated body temperature, dysuria, dysfunction of the genital organs.When establishing a diagnosis, the intensity and duration of the period since the appearance of clinical signs, as well as accompanying symptoms, are taken into account.
How can chronic inflammation of the prostate be detected?
Prostatitis has no symptoms that could accurately distinguish the disease.Some disorders of the genitourinary system have similar symptoms.An accurate diagnosis can only be made after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.
Suspecting the existence of disorders in the work of the pelvic organs, the urologist will prescribe a mandatory rectal examination.If tissue changes are detected by palpation, several laboratory tests are prescribed.
Laboratory research methods
Clinical tests of blood and urine distinguish the presence of an inflammatory process and can often explain the catalyst for the development of the disease.When establishing a diagnosis, additional information from the results of the following laboratory tests will be needed:
- Cytological and bacteriological analysis of urine.PSA level was determined.The protein level rises sharply with inflammation of the glandular tissue.
- Taking a swab from the urethra.
- Microscopy of prostate secretion - based on the results, defects in the prostate are determined.Differentiate cancer from chronic tissue inflammation.It is forbidden to sow prostate secretions in the acute period of the disease, accompanied by high body temperature, worsening of hemorrhoids or fissures in the anus.
- Tests for STIs (sexually transmitted infections) - one of the frequent catalysts of prostate inflammation are pathogenic microorganisms.Trichomonas, staphylococci and gonococci can cause the disease.Prostatitis develops during the active phase of bacterial proliferation, and after the infection has already been cured.
Laboratory tests are a mandatory component of the diagnosis of prostatitis and the subsequent choice of treatment method.
Instrumental disease detection
There are three main methods of testing for prostatitis.Each instrumental diagnostic method provides information about changes in the structure of the gland tissue and has its own indications and contraindications:
- Tomography - MRI is often prescribed to diagnose chronic prostatitis.The study allows you to get a layer-by-layer image of the prostate.MRI signs accurately indicate chronic inflammation, and also indicate the beginning of tissue degeneration into a malignant formation.Magnetic resonance technology is absolutely harmless, but has contraindications due to the impossibility of studying patients with pacemakers, metal staples and shunts (left during surgical operations).
- Transrectal TRUS is an informative method that reliably indicates the presence of inflammation.Sonographic signs of structural changes in the prostate according to the type of chronic prostatitis include: deviations from the norm in volume and size, structure and the presence of pathological formations.Ultrasound techniques are not prescribed for acute inflammation of the rectum, the presence of cracks in the anus or 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 ultrasound image largely depends on the experience of the doctor conducting the study.
Differential search for disease
After receiving the results of clinical and biochemical studies, the symptoms of chronic inflammation of the prostate are evaluated.Common diagnostic standards have been developed that are valid throughout 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 fields in the document and then makes a diagnosis.
There are computer programs based on the NIH-CPSI index.The doctor is asked to fill out a questionnaire, and the system will independently perform a summary assessment of the symptoms of chronic prostatitis.The effectiveness of this technique has been proven all over the world.
After calculating the results of the questionnaire, when establishing the diagnosis, an additional assessment of instrumental and clinical studies is taken into account: the presence of echo signs of chronic prostatitis, elevated PSA level, identification of an infectious marker by microscopy of secretions.The more data the urologist has, the more accurate the result will be.
What is dangerous in chronic prostatitis - its consequences
The consequences of chronic prostatitis in men are disorders in the functioning of the genitourinary system.This includes:
- Impotence.
- Acute retention of urine.
- Infertility.
Fibrous changes accompanying the advanced disease cause the development of oncology.Normal tissues degenerate into malignant ones.Therefore, the prevention of functional changes in the prostate in order to prevent the development of cancer is an extremely important task for the urologist.
When establishing the diagnosis, the presence of prostate intraepithelial neoplasia, signs of oncology and fibrotic changes are taken into account.Advanced disease often leads to the need for surgery: prostatectomy.
Diagnosis of prostatitis and differentiation of the disease from related disorders of the pelvic organs is an important task for doctors and patients.Detecting the first symptoms depends entirely on the person himself.If you experience any discomfort while urinating, reduced erection or persistent low temperature, these are reasons to seek professional medical help immediately.Delay is dangerous!