Prostatitis is an inflammatory process associated with inflammation of the prostate gland (prostate) in men. Most often the disease occurs in men over 30 years of age. The disease causes pain in the lower back, perineum or pelvic area, accompanied by a violation of the normal process of urination and, in severe form, leads to erectile dysfunction and serious problems in relationships with partners.
About a quarter of cases among couples experiencing infertility are the cause of male factors influencing the impossibility of fertilization. Male infertility is a violation of the quality of spermatozoa and its quantitative content in ejaculation.
The prostate gland (prostate) refers to the male reproductive system. It is shaped like a chestnut, located in front of the rectum, below the bladder and surrounds the urethra (urethra). When the prostate gland becomes inflamed, it compresses the urethra, which in turn leads to urinary problems. The main function of the prostate is to produce the secretion (fluid) that is part of semen and dilute it, which ensures normal sperm movement.
Prostatitis is very common in the practice of urologists. It can occur suddenly or gradually, appear continuously and for a long time (chronic prostatitis). The chronic form of the disease is more common than the acute form. Chronic prostatitis ranks fifth among the twenty major urological diagnoses.
Since prostatitis is an active focus of infection in the body, it requires mandatory treatment, even if the symptoms do not bother you.
Causes of the development of prostatitis
The list of causes that trigger inflammation of the prostate gland is very diverse:
- diseases of the genitourinary system (cystitis, urethritis, pyelonephritis);
- sexually transmitted infections (trichomoniasis, gonorrhea);
- infections associated with pneumonia, influenza, tonsillitis, furunculosis;
- chronic constipation, forcing a man to strain regularly;
- sedentary lifestyle and irregular sex life, leading to secret stagnation;
- urinary retention - a swollen bladder increases the pressure on the prostate;
- frequent hypothermia (or overheating);
- injuries in the pelvic area;
- hormonal disorders that weaken the immune system.
Often, the appearance of prostatitis is caused by pyogenic microbes: E. coli, streptococci and staphylococci, mycoplasmas, Candida fungi, Trichomonas, tubercle bacillus. They multiply rapidly and destroy prostate tissue, which is indicated by inflammation.
In most cases, the occurrence of prostatitis gives rise to an infection that penetrates into the prostate gland through the urethra. It happens that it enters the body through blood or lymph, passing through the bladder or rectum.
Important! Decreased immunity is especially dangerous for patients with chronic prostatitis, because the prostate gland quickly becomes inflamed with fatigue, stress, lack of sleep, malnutrition and other adverse factors.
With an inactive lifestyle and the constant absence of sexual life, the blood supply to the pelvic organs worsens, leading to oxygen starvation of prostate tissue and congestion. Stagnant secretions are an ideal environment for the development of pathogenic microorganisms that cause inflammation.
Types and forms of prostatitis
Prostatitis, depending on the cause of the disease, is classified into types and forms:
By type, they are distinguished:
Bacterial prostatitis- Inflammation caused by infection. Bacterial prostatitis occurs in young and old men.
congestive prostatitis- inflammation caused by stagnation of secretions. It develops in men with sedentary lifestyles who do not have a normal sex life. This form can be added quickly by infection, and then the stagnant process becomes complicated by the bacterial form.
Prostatitis calculus- stones form in the prostate gland. Untreated chronic prostatitis can cause these complications. The disease affects older men who do not follow the advice of a urologist.
According to the form of flow, they are distinguished:
Acute forms of prostatitis- this is an inflammation of the prostate gland caused by an infectious agent, which is characterized by the appearance of edema and purulent foci in the tissues. 30-58% of men of reproductive age (30-50 years) face such a diagnosis.
Chronic forms of prostatitischaracterized by persistent or recurrent urogenital symptoms caused by a bacterial infection of the prostate gland. The chronic form occupies 10% of all cases of prostatitis.
Symptoms of prostatitis
Generalsymptoms of prostate inflammationis:
- pain in the lumbar region;
- sensation of discomfort during intestinal motility;
- pain in the perineum or pelvis;
- disturbances in the work of the lower urinary tract.
The acute stage of prostatitis is accompanied by general intoxication syndrome. The disease is characterized by acute symptomatic manifestations with a clear clinical picture:
- sudden increase in body temperature, chills, nausea, vomiting and malaise;
- pain and chills syndrome in joints and muscles;
- an increase in the size of the prostate and the occurrence of discomfort in the perineum area;
- frequent urination and urinary retention.
Against the background of individual inflammatory processes, purulent-septic diseases can develop that affect the blood. In such cases, the patient must be immediately hospitalized: with sepsis, treatment of prostatitis should be carried out exclusively in the clinic.
Onchronic bacterial prostatitissymptoms are usually absent, so treatment begins only when an infection in the urinary system is detected, which manifests itself on the background of complications of the disease. In this case, you can observe:
- pain during ejaculation;
- appearance of blood in ejaculation;
- the presence of discharge from the urethra;
- Erectile dysfunction may develop.
If the examination does not show that chronic pain is caused by pathology in the prostate gland, then in this case we are dealing withchronic non -bacterial prostatitisor so -calledchronic pelvic pain syndrome. With this disease, a man's quality of life is significantly reduced, as it leads to various disorders of a psychological and sexual nature:
- increased fatigue;
- feelings of helplessness;
- erectile dysfunction;
- painful ejaculation;
- pain after intercourse, etc.
The same symptoms may occur for other urological diseases, so it is impossible to diagnose prostatitis with symptoms alone. For example, urinary disorders and pain are found in prostate adenomas, cystitis, various oncological tumors in the genitourinary organs, etc.
Diagnosis of prostate inflammation
After identifying the first signs of the inflammatory process of the prostate, the patient should immediately contact a doctor - urologist. The doctor must exclude many diseases that have similar manifestations, and determine the type of disease.
To confirm that the patient does not have other diseases (for example, appendicitis, oncology, inflammatory processes in the bladder and kidneys, prostate adenoma), the doctor must conduct the necessary examinations:
- collection of anamnesis (questioning patients);
- general inspection;
- rectal examination;
- secretory study of the prostate gland;
- analysis for sexually transmitted infections;
- ultrasound examination of the prostate, scrotum and pelvic organs.
During the appointment, the urologist should explain with the patient the period of clinical manifestations of the disease, localization and nature of pain (for example, in the perineum, scrotum, penis and inner thighs), characteristic changes in sperm (presence of pus and blood).
Doctors prescribe a diagnosis of chronic bacterial prostatitis with a symptomatic duration of at least three months.
The survey will include:
- Digital rectal examination of the gland, to determine the degree of prostate enlargement and its consistency.
- Analysis of prostate secretion, urine and / or ejaculation.
- Identification of urogenital infections.
- Urodynamic studies.
- Ultrasound examination of the urinary system (kidneys, prostate, bladder with determination of residual urine).
- Cultural study of prostate secretion and microscopy of various parts of urine and prostate secretion.
- Androflor is a comprehensive study of urogenital tract microbiocenosis in men by PCR, which will determine the qualitative and quantitative composition of the microflora.
After identifying the cause of the disease, the doctor will recommend a course of treatment. Keep in mind that the standard method only in 5-10% of cases can detect infection, which eventually leads to prostatitis.
The patient must definitely undergo a thorough diagnosis, as the success of treatment will depend on the accuracy of the results.
Treatment of prostatitis
Once the urologist has made a diagnosis, determined the cause and form of prostatitis, he must prescribe treatment.
The main role in the treatment of this disease is given to drug therapy:
Antibacterial therapy
In the first stage of therapeutic therapy, it is necessary to eliminate inflammation. Antibiotics are the primary treatment for acute bacterial prostatitis and are recommended for chronic bacterial prostatitis. Doctors choose antibacterial drugs depending on the bacteria that cause the disease. Patients should take oral antibiotics in a course of 4-6 weeks. Chronic or recurrent prostatitis takes longer to resolve. Hospitalization may be required for very severe manifestations, in which case a course of intravenous antibiotics will be given. Typically, this occurs with acute bacterial prostatitis.
Treatment with alpha1-blockers
With difficulty urinating, doctors prescribe alpha1 blockers, which help facilitate urination and relax the muscles of the prostate and bladder. Muscle relaxation will relieve pain caused by swelling of the prostate gland, which puts pressure on adjacent muscles. Non-steroidal anti-inflammatory drugs will help relieve the painful syndrome.
Also, the doctor may prescribe additional drugs: biostimulants, extracts of various plants and insects in the form of rectal suppositories. Unfortunately, the use of drugs alone in the treatment of prostatitis is still insufficient.
In the treatment of this disease, the principle of sequence of actions must be observed. The treatment of prostatitis is always complicated.
Physiotherapy in the treatment of prostatitis
In the category of chronic prostatitis, you can also use physiotherapy methods:
- massage of the prostate gland (prostate);
- laser therapy;
- microwave hyperthermia and thermotherapy;
- electrical stimulation with a modulated current with the skin or rectal electrodes;
- acupuncture (acupuncture).
Alternative methods, such as hirudotherapy (treatment with medical leeches), are sometimes used to treat prostatitis, but the effectiveness and safety of these methods have not been proven.
Stem cell identification
Cellular therapy (stem cell injection) is a promising method for the treatment of prostatitis today, it is in the early stages of development. With respect to the injection of stem cells into the prostate, one can only have hypotheses about the mechanism and empirical data obtained by a group of individual researchers.
Surgical treatment of prostatitis
Surgical methods are used to treat complications of prostatitis (abscesses and pus of the seminal vesicles).
Treatment of chronic pelvic pain syndrome requires separate consideration. Symptomatic inflammatory prostatitis does not require treatment.
Diet and lifestyle for prostatitis
Prostatitis does not require a special diet, but eating large amounts of vegetables, lean meats and dairy products will help improve intestinal function. It is necessary to enrich your body with a sufficient amount of fiber, foods rich in vitamin E (wheat germ, corn oil, etc. ), replace sugar with natural honey. Proper nutrition with inflammation of the prostate gland will help improve bowel function and reduce the chances of relapse or speed recovery. Patients should limit themselves in consuming coffee, exclude alcohol, drink plenty of fluids and adhere to a healthy lifestyle.
Preventive measures to prevent prostatitis
When a man leads a proper lifestyle: he follows a proper diet, goes in for sports, then his chances of developing chronic prostatitis are very small. Rejection of bad habits and casual sex is the prevention of this disease.
Important! There are primary and secondary prevention to prevent the development of prostatitis in men.
main- aims to prevent the occurrence of disease. It depends on maintaining a balanced diet, physical activity regimen, timely treatment for any infectious diseases of the body and regular protected sexual intercourse, etc.
Intermediate- aims to prevent recurrence of pre -existing chronic prostatitis and provides regular checkups by urologists and preventive treatment with multivitamins, restorative medications, and sports.