Prostatitis in men is an inflammatory process involving prostate tissue.The disease is accompanied by pain in the lower back, perineum and pelvis.The main manifestations are pain in the perineum and dysfunction of the lower urinary tract.
Of all urological diseases, prostatitis is most often encountered by urologists.It can develop unexpectedly (acutely) against the background of general health or it can last 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 can be independent, or it can be combined with prostate hyperplasia or prostate cancer.
Reasons for development
Inflammation does not occur by itself.The causes of prostatitis can be divided into bacterial and non-bacterial.
The acute infectious variant most often occurs in men younger than 35 years old due to damage to the prostate by gram-negative bacteria - Escherichia coli, Proteus, Enterobacter.Inflammation also 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 sexual intercourse;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal intercourse;
- sedentary lifestyle;
- inactive sex life;
- diabetes mellitus;
- hypothermia;
- violations of intimate hygiene.
Non-infectious prostatitis in the chronic form is detected in men who complain of long-term pain in the genitals, but the tests do not diagnose the bacteria that could cause the inflammation.
The exact cause of the development of this type of prostatitis has not been studied, but the following factors are considered provocative:
- emotional disorders;
- autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work involving heavy lifting;
- chronic stress;
- congestion in prostate tissues;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
It is believed that an inactive sex life, unprotected sexual relations and hypothermia play a major role in the development of the disease.Symptoms of prostatitis are experienced by 50% of the entire male population of the planet at least once in their life.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which will pass from one to another if you do not consult 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, there is a slight pain at first, which quickly increases.
Without treatment, the second stage occurs - acute follicular.At this moment, the pain becomes particularly intense, radiates to the anus, and intensifies during defecation.Urination is very difficult, sometimes there is acute retention of urine.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 more, and chills appear.Urinary retention is often observed, sharp, throbbing pain in the perineum appears, and 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, and mild discharge from the urethra.Often these manifestations remain unnoticed even by the patient for a very long time.
Signs of prostatitis in men can appear in different ways, but they are all grouped into three groups - pain, urination disorder, problems with sexual activity.Prostate tissue lacks receptors and therefore cannot cause painful sensations.They appear when the inflammation starts to spread to the pelvic organs, which are richly innervated.Pain in patients can vary from barely noticeable discomfort to severe and intense pain that disrupts sleep and normal 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 compress 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 the early stages, then they are compensated by the body, but in 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 and reduced sexual arousal.Gradually, sexual dysfunctions become more and more pronounced, and in the advanced stage the symptoms of prostatitis are supplemented by impotence.
Possible complications
During inflammatory processes in the prostate, 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;
- prostate cysts and stones;
- infertility;
- ejaculation disorder;
- erectile dysfunction.
To prevent the development of these serious complications, at the first symptoms of prostatitis and prostate adenoma, you should consult a urologist.
Diagnostics
Diagnosis and treatment of any form of prostatitis is carried out by a urologist.If a tumor is suspected, the patient can be referred to an oncologist.In the case of long-term chronic prostatitis, which is difficult to treat, a consultation with an immunologist may be necessary.
The characteristic clinical picture and complaints of patients help to quickly make an accurate diagnosis.The list of mandatory studies when diagnosing 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, which allows you to identify tumors, cysts, adenomas, and also distinguish prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
It is difficult to independently determine the causes of diseases, and even less to cure them.Therefore, in order to prevent the development of serious complications and not remain infertile in the future, at the first signs of the disease, a man should immediately contact a urologist.
Treatment
Patients diagnosed with acute prostatitis without complications are treated on an outpatient basis.Only with severe symptoms of intoxication and suspicion of a purulent process is hospitalization carried out.
Antibiotics are the drugs of choice to fight inflammation.They are also used for chronic bacterial forms.The drug is selected individually and taken within 4-6 weeks.In severe cases, antibacterial agents are given 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 facilitate urination and relax the prostate and bladder muscles.Medicines from the NSAID group 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.
Prognosis and prevention
The acute form without treatment often becomes chronic, which occasionally worsens.Complete recovery is not always possible, but if you see a doctor in time and take all the prescribed medications, you can eliminate discomfort, urination problems, and pain.
Self-medication at home and the use of traditional methods can often be life-threatening.
To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder in time, limit the consumption of coffee, spices and alcohol, and remain sexually active as long as possible.