Prostatitis: symptoms, treatment, prevention

Prostatitis in men is an inflammatory process that involves the prostate tissue.The disease is accompanied by pain that occurs 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, urologists most often encounter prostatitis.It can develop unexpectedly (acutely) against the background of general health, or it can last 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 and can also be associated 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.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 factors that cause 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 in intimate hygiene.
• emotional disorders;
• autoimmune diseases;
• increased physical activity;
• lack of a regular sex life;
• work involving heavy lifting;
• chronic stress;
• congestion in the prostate tissues;
• previously confirmed fibrotic changes in the prostate (according to 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, when going to the toilet, you notice a weakening of the flow of urine, or you feel discomfort or a burning sensation in the urethra, you should contact a urologist as soon as possible.

With the acute onset of the disease, the temperature may rise and general health may worsen.Such a patient should be treated immediately with antibiotics and anti-inflammatory drugs.

In some cases, the disease can remain asymptomatic for a long time, so treatment starts late.

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 defecating;
• thin stream of urine;
• increase in temperature;
• chills;
• deterioration of general health.

The chronic form can occur after the acute phase of the disease or develop as a primary disease.Symptoms of chronic prostatitis in men are mild.The pain is of low intensity, the temperature may increase slightly.The flow of urine becomes thin, disorders appear in the intimate area.

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

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 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, a slight pain initially appears, which rapidly increases.

Without treatment, the second phase occurs: acute follicular.At this time, the pain becomes especially intense, radiating to the anus and intensifies during bowel movements.Urination is very difficult, sometimes there is acute urinary retention.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 above, and chills appear.Urinary retention, sharp, throbbing pain in the perineum, and difficult defecation are often observed.

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.

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 manifests itself with mild pain during urination or in the perineum and mild discharge from the urethra.Often these manifestations go unnoticed even by the patient for a long time.

Signs of prostatitis in men can manifest themselves in different ways, but they are all grouped into three groups: pain, urination disorders, problems with sexual activity.The prostate tissue has no receptors and therefore cannot produce painful sensations.They appear when the inflammation begins to spread to the pelvic organs, which are abundantly innervated.Patients' pain can range from barely noticeable discomfort to severe, intense pain that disrupts sleep and normal lifestyle.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 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 appear at the beginning of the disease, in its initial stages, then they are compensated by the body, but at a later stage, without adequate treatment, they recur.

Potency problems in men can also be expressed in different ways.Patients complain of worsening erection, accelerated ejaculation and decreased sexual arousal.Gradually, sexual dysfunctions become more pronounced, and in an advanced stage, the symptoms of prostatitis are complemented by impotence.

Classification

Experts distinguish several categories of the disease:

• Acute bacterial prostatitis, characterized by symptoms of a bacterial infection.The causative agent of the disease in most cases is Escherichia coli.Enterococci and other bacteria are isolated somewhat less frequently;
• 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 be pathogenic agents;
• chronic pelvic pain syndrome, in which infections go undetected.There are two types: inflammatory and non-inflammatory.Among the causes of the onset: autoimmune processes, external factors (hypothermia, overheating), rare sexual life, low physical activity, rare urination;
• Asymptomatic prostatitis, detected by chance during examination by a doctor.

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

Symptoms

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

• if urination is difficult and urine passes intermittently;
• if discharge from the urethra occurs during bowel movements;
• with a burning sensation in the urethra and perineum;
• if you experience bladder and prostate discomfort during bowel movements;
• if the urge to urinate intensifies and becomes more frequent;
• if you feel pain in the rectum;
• if there is a purulent bloody discharge from the urethra ("floating threads");
• with frequent increases in body temperature;
• when intimate problems arise (weakened erection);
• when erections appear at night for an inexplicable reason;
• if ejaculation during sexual intercourse is too rapid;
• whether sensations during orgasm are “erased”;
• with rapid general tiredness;
• with manifestations of an unreasonably anxious or depressive state, as well as a state of mental depression;
• with frequent depression, manifestations of mental depression in anticipation of complications;
• with general weakening of the body.

One or two symptoms are enough to contact a urologist.Attempts to heal on their own usually lead to a worsening of the condition and the disease becomes chronic or severe.In the worst case, failure to visit the doctor in a timely manner can cause infertility or complete impotence.

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

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

Aching pain indicates stone formation.Doctors define infertility as a late sign of a progressive disease.

Signs of prostatitis in acute and chronic forms vary significantly.In particular, in the chronic form, the signs may be mild or not expressed.

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

• the urge to urinate has become 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 produced per day has decreased significantly or urine is not collected;
• high temperature, frequent headaches, general weakness.

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

Chronic prostatitis is characterized by the following symptoms:

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

One of the signs of the chronic form is significant disturbances of the emotional background, characterized by insomnia, increased nervousness, mood swings 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 flow.

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

Possible complications

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

Diagnostics

Diagnosis and treatment of any form of prostatitis is carried out by a urologist.If cancer is suspected, the patient may be referred for consultation with an oncologist.In case of long-term chronic prostatitis, which is difficult to treat, consultation with an immunologist may be necessary.

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

Features of the diagnosis for acute prostatitis

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

Features of the diagnosis of chronic bacterial prostatitis

The diagnosis in these cases is determined on the basis of the following data: examination by a doctor of the patient, bacteriological and microscopic examination of prostatic secretions, study of ultrasound data.

Features of diagnosis for 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, an ultrasound and the following manipulations are prescribed:

• examination of prostate secretions;
• molecular biological research;
• bacteriological research.

The choice of technique is determined by the doctor based on the data of the initial examination.

Groups at risk

The most likely occurrence and development of prostatitis:

• in obese men or those who lead a sedentary lifestyle;
• in men with sedentary jobs (clerks, programmers);
• in men whose body is subject to shocks and vibrations (motorists, including special equipment);
• in men who have had infectious diseases, including diseases of the genitourinary system;
• in sexually hyperactive men and those who do not have sex regularly;
• in depressed men suffering from mental illnesses;
• in alcoholics, drug addicts, etc.

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 medicine is selected individually and taken in a course of 4-6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally, in the form of capsules or tablets.

Another medicine used for prostatitis are alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound.They help 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 medications, the doctor will prescribe a course of prostate massage, and physiotherapy will be 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 method for prostatitis depends on many factors and is determined individually.When choosing treatment methods, the following are taken into account:

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

For treatment, you can select a specific technique or prescribe a complex.Specialists in the field of urology, depending on the results of the diagnosis, prescribe:

• Physiotherapy procedures: magnetic resonance therapy, procedures using laser equipment, ultrasound, foot reflexology, massage, hirudotherapy.
• Pharmacological treatment.
• Diet and psychotherapy.
• Surgery.

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

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

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

Correctly selected complex of drugs for acute bacterial prostatitis:

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

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

When diagnosing pelvic pain syndrome, antibiotics and anti-inflammatory drugs, various types of physiotherapy, magnetic and laser therapy, electrical neurostimulation, etc. are used.One of the effective methods is drainage of the tissues around the source of inflammation.

Conservative or modern treatment is chosen by the urologist based on diagnostic data.

Tablets

Antibacterial agents and painkillers can be prescribed in the form of tablets for prostatitis.

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

Painkillers for prostatitis help get rid of unpleasant symptoms.For this purpose, nonsteroidal anti-inflammatory drugs are used that not only eliminate pain, but also relieve inflammation.

Tablets for male prostatitis, which help treat impaired urination, belong to the group of alpha 1-blockers.They relax the smooth muscles and restore patency of the urethra 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 antibiotic tablets, to which the pathogen is sensitive.Antispasmodics can be injected to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of the prostate.

Injectable drugs for prostatitis work faster than tablet drugs, so they are sometimes preferable.

Surgery for prostatitis

The most serious complications are suppuration of the seminal vesicles and abscess.Drugs for the treatment of the disease are not able to cope with the disease in such a difficult situation, therefore at the first manifestations surgery is indicated.

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

Prognosis and prevention

The acute form without treatment often becomes chronic, worsening periodically.Full recovery is not always possible, but if you timely consult a doctor and take all prescribed medications, you can eliminate discomfort, problems with urination and pain.

Home self-treatment and the use of traditional methods can often be life-threatening.

To prevent prostatitis it is recommended to avoid hypothermia, empty the bladder promptly, limit the consumption of coffee, spices and alcohol and stay sexually active for as long as possible.

Typical signs of prostate cancer

The prostate gland is a small organ that only men have.It resembles a sponge in its structure, is located under the bladder and appears to surround 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 secretion, one of the components of sperm.But unfortunately, mature and elderly men often experience hyperplasia of the glands or malignant neoplasms of the organ.

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 has even reached the second stage, the tumor is localized in the prostate gland, has not developed into nearby tissues and has not metastasized.

Symptoms of prostate cancer in the early stages are practically absent, this is the insidiousness of the disease.The man has no complaints, feels well and sees no reason to consult a doctor.This is why this type of tumor is often discovered in an advanced state.An exception may be patients who have previously been diagnosed with benign tumors of the prostate, in which case they are periodically observed by a specialized doctor and are tested for a specific prostate antigen and undergo an ultrasound of the prostate.They have every chance of detecting a tumor in the bud.But it's worth noting that spotting prostate cancer isn't always easy.Even when taking a biopsy, the results may be clear, but the oncology is already there.This occurs due to errors in the method;the needle simply does not reach the site of the localized lesion.If prostate pathology is suspected, especially if it is cancer, it is necessary to perform a fusion biopsy, which combines the capabilities of ultrasound and real-time MRI, giving the doctor the opportunity to visualize the organ as accurately as possible.

Some 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 interrupted, urine can be retained in it, inflammation can occur, and a bacterial infection can develop.If no measures are taken, the process will spread, and this already threatens 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, a person's regional lymph nodes swell, his bones hurt, he suddenly loses weight and becomes weaker.

Treating prostate cancer is not an easy task, but it can be done.If the local process is detected in a timely manner, complete recovery can be achieved, and in more advanced stages, life can be prolonged.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.