Prostatitis: symptoms, treatment, prevention

Prostatitis in men is an inflammatory process involving 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.

Among all urological diseases, urologists most often encounter prostatitis.It can develop unexpectedly (acute) against the background of general health, or it can last a long time, with periods of exacerbation and remission, which indicates a chronic course.In addition, the second variant of the disease is diagnosed much more often.

The disease can be independent and can also be associated with prostate 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 prostate damage 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 may 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 in intimate hygiene.
• 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 the results of TRUS).

What are the early signs of prostatitis that you need to pay attention to?

The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating.If, when going to the bathroom, you notice a weakening of the stream of urine, or feel discomfort or a burning sensation in the urethra, contact a urologist as soon as possible.

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

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

Prostatitis symptoms

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

In the chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible.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 stop the development of the disease in time.

The first stage is called acute catarrhal prostatitis.It begins with complaints of pain when urinating frequently.In the lumbar region and sacrum, as well as in the perineum, a slight pain initially appears, which quickly increases.

Without treatment, the second stage occurs - acute follicular.At this time, the pain becomes especially intense, radiates 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 or more and chills appear.Urinary retention is often observed, sharp, throbbing pain appears in the perineum, and defecation is difficult.

Chronic prostatitis symptoms

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 time.

Often, the chronic course begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococci.But vivid manifestations are very rare;More often, the disease occurs with mild pain when urinating or in the perineum and slight discharge from the urethra.These manifestations often go unnoticed even by the patient for a long time.

Signs of prostatitis in men can occur in different ways, but they are all grouped into three groups - pain, urination disturbance, problems with sexual activity.Prostate tissue lacks receptors and therefore cannot produce painful sensations.They appear when inflammation begins to spread to the pelvic organs, which are abundantly innervated.Patients' pain can range from barely noticeable discomfort to intense, severe 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 when the prostate enlarges 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.Normally, such phenomena are expressed 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 reappear.

Potency problems in men can also be expressed in different ways.Patients complain of worsening erection, accelerated ejaculation and decreased sexual excitement.Gradually, sexual dysfunctions become more pronounced and, at 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 bacterial infection.The causative agent of the disease in most cases is Escherichia coli.Enterococci and other bacteria are isolated 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 pathogens;
• chronic pelvic pain syndrome, in which infections are not detected.There are two types: inflammatory and non-inflammatory.Among the causes of occurrence: autoimmune processes, external factors (hypothermia, overheating), rare sex life, low physical activity, rare urination;
• Asymptomatic prostatitis, detected by chance during a medical examination.

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

Symptoms

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

• if urination is difficult and urine passes intermittently;
• if during evacuation there is secretion from the urethra;
• with a burning sensation in the urethra and perineum;
• if discomfort occurs in the bladder and prostate during evacuation;
• if the urge to urinate intensifies and becomes more frequent;
• if you feel pain in the rectum;
• if there is purulent bloody discharge from the urethra (“floating threads”);
• with frequent increases in body temperature;
• when intimate problems arise (weakening of the erection);
• when erections appear at night for an unexplained reason;
• if ejaculation during sexual intercourse is very rapid;
• if the sensations during orgasm are “erased”;
• with rapid general fatigue;
• with manifestations of an excessively 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.

All it takes to contact a urologist is one or two symptoms.Attempts to cure it on your own often lead to the condition worsening and the disease becoming chronic or severe.In the worst case scenario, not seeing a 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 (painful in nature).

Severe pain indicates the formation of stones.Doctors consider infertility 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 even expressed.

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

• the urge to urinate became very frequent;
• pain when evacuating and urinating intensifies in the perineum and radiates to the groin;
• complete emptying of the bladder is impossible;
• the amount of urine produced per day has significantly decreased or urine is not collected at all;
• 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 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;
• discomfort is felt during sexual intercourse.

One of the signs of the chronic form are significant disturbances in the emotional context, characterized by insomnia, increased nervousness, bad mood 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 flow of urine.

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 the chronic form: frequent urge to urinate, weakening of the urinary stream, pain in the penis and testicles and sexual dysfunction.

Possible complications

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

Diagnosis

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

1. Urine bacteriological culture.
2. Analysis of prostate secretion for microflora and sensitivity to antibiotics.
3. Rectal examination of the prostate.
4. Prostate ultrasound, which allows you to identify tumors, cysts, adenomas, as well as differentiate prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Features of diagnosing acute prostatitis

If the signs of the disease indicate acute prostatitis, the diagnosis is made on the basis of instrumental and clinical examination data.Any manipulations that may impact the prostate are contraindicated, as they may cause acute pain or cause the spread of infections.

Features of diagnosing chronic bacterial prostatitis

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

Features of diagnosing pelvic pain syndrome

Specialists prescribe diagnostic procedures for symptoms indicative of chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory.As a rule, an ultrasound is prescribed, as well as the following manipulations:

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

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

Groups of risk

The most likely occurrence and development of prostatitis:

• in obese men or men with a sedentary lifestyle;
• in men with sedentary work (office workers, programmers);
• in men whose body is subject to tremors and vibrations (car drivers, 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 illness;
• in alcoholics, drug addicts, etc.

Treatment

Patients diagnosed with uncomplicated acute prostatitis 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 medications of choice to combat inflammation.They are also used for chronic bacterial forms.The medicine is selected individually and taken over a period of 4 to 6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally, in the form of capsules or tablets.

Another medication used for prostatitis is 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 is used to improve blood circulation in this organ.Surgical treatment is used only when abscesses and suppuration of seminal vesicles appear.

The choice of prostatitis treatment method 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 organism (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 diagnostic results, prescribe:

• Physiotherapeutic procedures: magnetic resonance imaging, procedures with laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Drug treatment.
• Diet and psychotherapy.
• Surgical intervention.

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, experts 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 medicines for acute bacterial prostatitis:

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

Chronic prostatitis is difficult to treat, which is why an extensive list of medications 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 to drain the tissues around the source of inflammation.

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

Pills

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

The course of antibiotic therapy is selected individually, depending on the results of the analysis of prostate secretions.The microflora that caused the disease must be sensitive to the medicine used.It is necessary to completely complete the treatment prescribed by the urologist, otherwise the cause will not be eliminated, the disease will recur or become chronic.

Painkillers for prostatitis help eliminate unpleasant symptoms.For this purpose, non-steroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.

Prostatitis tablets for men, which help treat urination problems, belong to the group of alpha 1 blockers. They relax smooth muscles and restore the 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 medicines are prescribed for severe inflammation, as well as in the absence of tablet antibiotics, to which the pathogen is sensitive.You can inject antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of the prostate gland.

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

Surgery for prostatitis

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

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

Prognosis and prevention

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

Self-treatment at home and the use of traditional methods can often be fatal.

To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder in a timely manner, limit the consumption of coffee, spices and alcohol and remain sexually active for as long as possible.

Typical signs of prostate cancer

The prostate 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.Gland growth 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 have glandular hyperplasia or malignant neoplasms of the organ.

How to recognize cancer

As the tumor grows and progresses, prostate cancer symptoms depend on the stage of the process.If the disease is still in the first stage or has already reached the second, the tumor is located in the prostate, has not grown into neighboring 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 fine and sees no reason to see a doctor.This is why this type of tumor is often discovered at an advanced stage.An exception may be patients who have already been diagnosed with benign prostate neoplasms, in which case they are seen periodically by a specialized doctor and tested for a specific prostate antigen and undergo a prostate ultrasound.They have every chance of detecting a tumor at its source.But it is worth mentioning that it is not always easy to detect prostate cancer.Even with a biopsy, the result may be clear, but the oncology is already there.This occurs due to errors in the method;the needle simply does not reach the location of the localized injury.If prostate pathology is suspected, especially if cancer is present, a fusion biopsy should be performed, which combines the capabilities of ultrasound and MRI in real time, 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.

Because the bladder must be emptied regularly, if this process is interrupted, urine may become trapped in the bladder, inflammation may occur, and a bacterial infection may develop.If no measures are taken, the process will spread, and this already threatens pyelonephritis and kidney problems.

In 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 enlarge, their bones hurt, they suddenly lose weight and become 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 cure 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 clinic's doctors have many years of experience in treating urological diseases and are successful even in the most difficult cases.