Prostatitis is an inflammatory process associated with inflammation of the prostate (prostate) in men. This disease most often occurs in men older than 30 years. This disease causes pain in the lower back, perineum or pelvic region, is accompanied by a violation of the normal process of urination, and in severe forms leads to erectile dysfunction and serious problems in the relationship with a partner.
About a quarter of cases among couples who suffer from infertility are the causes of the male factor that affects the impossibility of conception. Male infertility is a violation of the quality of sperm and their quantitative content in the ejaculate.
The prostate (prostate) refers to the male reproductive system. It is chestnut-shaped, located in front of the rectum, below the bladder and surrounds the urethra. When the prostate becomes inflamed, it compresses the urethra, which further leads to urination problems. The main function of the prostate is to produce a secretion (fluid) that is part of the semen and dilutes it, which ensures normal sperm motility.
Prostatitis is very common in the urologist's office. It can occur suddenly or gradually, occurring constantly and for a long time (chronic prostatitis). The chronic form of this disease is more common than the acute one. 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.
Reasons for the development of prostatitis
The list of causes that cause inflammation of the prostate 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 exert himself regularly;
- sedentary lifestyle and irregular sex life, which lead to stagnation of secrecy;
- urinary retention - swollen bladder increases pressure on the prostate;
- frequent hypothermia (or overheating);
- pelvic injuries;
- hormonal disorders that weaken the immune system.
Very often the appearance of prostatitis is caused by pyogenic microbes: E. coli, streptococci and staphylococci, mycoplasmas, fungi Candida, Trichomonas, tubercle bacillus. They multiply very quickly and destroy the prostate tissue, which is manifested by inflammation.
In most cases, the appearance of prostatitis causes an infection that penetrates the prostate through the urethra. It happens that it enters the body through the blood or lymph, passes from the bladder or rectum.
Bitan! Decreased immunity is very dangerous for a patient with chronic prostatitis, because the prostate quickly becomes inflamed due to fatigue, stress, lack of sleep, malnutrition and other adverse factors.
A sedentary lifestyle and the absence of a constant sexual life worsens blood flow to the pelvic organs, which leads to oxygen starvation of prostate tissue and congestion. The rising secret is 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:
They differ in type:
Bacterial prostatitis- Inflammation caused by infection. Bacterial prostatitis occurs in both young and older men.
congestive prostatitis- inflammation caused by stagnation of secretions. It develops in men with a sedentary lifestyle who do not have a regular sex life. This form can be quickly supplemented by infection, and then the stagnant process is complicated by the bacterial form.
Calculous prostatitis- Prostate stones form. Untreated chronic prostatitis can cause this complication. This disease affects older men who have not followed the advice of a urologist.
According to the shape of the flow, they differ:
Acute form of prostatitis- this is an inflammation of the prostate 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 form of prostatitischaracterized by persistent or recurrent urogenital symptoms caused by a bacterial infection of the prostate. The chronic form accounts for 10% of all cases of prostatitis.
Symptoms of prostatitis
Generalsymptoms of prostate inflammationare:
- pain in the lumbar region;
- feeling uncomfortable during intestinal motility;
- pain in the perineum or pelvic region;
- lower urinary tract disorders.
The acute stage of prostatitis is accompanied by general intoxication syndrome. This disease is characterized by a sharp manifestation of symptoms with a vivid clinical picture:
- sudden rise in body temperature, chills, nausea, vomiting and malaise;
- pain and chills syndrome in joints and muscles;
- increase in prostate size and the appearance of discomfort in the perineal area;
- frequent urination and urinary retention.
In the background of individual inflammatory processes may develop purulent-septic disease that affects the blood. In such a situation, the patient must be urgently hospitalized: with sepsis, the treatment of prostatitis should be carried out exclusively in the clinic.
Atchronic prostatitis of bacterial naturesymptoms are usually absent, so treatment begins only when an infection is detected in the urinary system, which manifests itself against the background of complications of the disease. In this case you may notice:
- pain during ejaculation;
- the appearance of blood in the ejaculate;
- the presence of urethral discharge;
- erectile dysfunction may develop.
If the examination did not show that the chronic pain was caused by pathologies in the prostate, then in this case it ischronic nonbacterial prostatitisor so-calledchronic pelvic pain syndrome. With this disease, the quality of life of men is significantly reduced, because it leads to various disorders of psychological and sexual nature:
- increased fatigue;
- feeling helpless;
- erectile dysfunction;
- painful ejaculation;
- pain after intercourse, etc.
Similar symptoms can apply to other urological diseases, so it is impossible to diagnose prostatitis by symptoms alone. For example, urination disorders and pain are present in prostate adenoma, cystitis, various oncological tumors in the genitourinary organs, etc.
Diagnosis of prostate inflammation
After determining the first signs of the inflammatory process of the prostate, the patient should immediately contact a doctor - urologist. The doctor must rule out many diseases that have similar manifestations, and determine what type of disease it belongs to.
To confirm that the patient has no other diseases (for example, appendicitis, oncology, inflammatory processes in the bladder and kidneys, prostate adenoma), the doctor must perform the necessary examinations:
- history taking (patient examination);
- general inspection;
- rectal examination;
- study of prostate secretion;
- analysis for sexually transmitted infections;
- ultrasound examination of the prostate, scrotum and pelvic organs.
During the examination, the urologist should clarify with the patient the duration 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).
The doctor diagnoses chronic bacterial prostatitis with symptoms lasting at least three months.
The survey will include:
- Digital rectal examination of the gland, to determine the degree of enlargement of the prostate and its consistency.
- Prostate, urine and / or ejaculate secretion analyzes.
- Identification of urogenital infection.
- Urodynamic study.
- Ultrasound examination of the urinary system (kidneys, prostate, urinary bladder with determination of residual urine).
- Cultural study of prostate secretion and microscopy of different parts of urine and prostate secretion.
- Androflor is a comprehensive study of the microbiocenosis of the urogenital tract in men by PCR, which will determine the qualitative and quantitative composition of the microflora.
After determining the cause of the disease, the doctor will recommend a course of treatment. It must be borne in mind that standard methods can detect infection in only 5-10% of cases, which ultimately leads to prostatitis.
The patient must definitely undergo a thorough diagnosis, because the success of the treatment will depend on the accuracy of the results.
Treatment of prostatitis
When a urologist diagnoses, determines the cause and form of prostatitis, he must prescribe treatment.
The leading role in the treatment of this disease is attributed to drug therapy:
Antibacterial therapy
In the first phase of therapeutic therapy, it is necessary to eliminate the inflammation. Antibiotics are the main treatment for acute bacterial prostatitis and are recommended for chronic bacterial prostatitis. The doctor chooses an antibacterial drug depending on which bacterium caused the disease. The patient will have to take oral antibiotics for 4-6 weeks. Chronic or recurrent prostatitis takes longer to resolve. Hospitalization may be required for very severe manifestations, where an intravenous course of antibiotics will be given. This usually happens with acute bacterial prostatitis.
Treatment with alpha1-blockers
In case of difficult urination, the doctor prescribes alpha1-blockers, which facilitate urination and relax the muscles of the prostate and bladder. Muscle relaxants will relieve the pain caused by the swelling of the prostate, which puts pressure on the neighboring muscles. Nonsteroidal anti-inflammatory drugs will help alleviate the pain syndrome.
Also, the doctor may prescribe auxiliary 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 principles of the order of actions must be respected. The treatment of prostatitis is always complex.
Physiotherapy in the treatment of prostatitis
In the categories of chronic prostatitis, you can additionally use physiotherapeutic methods:
- prostate massage (prostate);
- laser therapy;
- microwave hyperthermia and thermotherapy;
- electrical stimulation with modulated currents by 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 this method has not been proven.
Introduction of stem cells
Cell therapy (stem cell injections) is today a promising method for treating prostatitis, which is in the early stages of development. As for the injection of stem cells into the prostate, one can only have hypotheses about its mechanisms and empirical data obtained by individual groups of researchers.
Surgical treatment of prostatitis
Surgical methods are used to treat complications of prostatitis (abscess and fertilization of seminal vesicles).
Treatment of chronic pelvic pain syndrome requires separate consideration. Asymptomatic 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 bowel function. It is necessary to enrich your body with a sufficient amount of fiber, food rich in vitamin E (wheat germ, corn oil, etc. ), replace sugar with natural honey. Proper nutrition with prostatitis will help improve bowel function and reduce the likelihood of recurrence or speed recovery. The patient should limit his coffee intake, exclude alcohol, drink plenty of fluids and adhere to a healthy lifestyle.
Preventive measures to prevent prostatitis
When a man leads a proper lifestyle: follows a proper diet, does sports, then his chances of developing chronic prostatitis are very small. Rejecting bad habits and casual sex are the prevention of this disease.
Bitan! There is primary and secondary prevention to prevent the development of prostatitis in men.
Primarily- in order to prevent the occurrence of the disease. It comes down to maintaining a balanced diet, physical activity regime, timely treatment of any infectious diseases of the body and regular protected sexual intercourse, etc.
Secondary- aims to prevent recurrence of existing chronic prostatitis and envisages regular examinations by urologists and preventive treatment with multivitamins, restorative drugs and sports.