Prostatitis is an inflammatory process associated with inflammation of the prostate gland (prostate) in men. This disease is most common in men over the age of 30. This disease causes pain in the lower back, perineum or pelvic area, 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.
Approximately a quarter of cases among couples suffering from infertility are the causes of the male factor that affect the inability to conceive. Male infertility is a violation of the quality of sperm and their quantitative content in the ejaculate.
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 further leads to problems urinating. The main function of the prostate is to produce secretion (fluid), which is part of the semen and dilutes it, which ensures normal motility of sperm.
Prostatitis is very common in the practice of a urologist. It can appear suddenly or gradually, it can appear permanently 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.
Because prostatitis is an active source of infection in the body, it requires mandatory treatment, even if its symptoms do not bother you.
Causes of prostatitis
The list of causes that provoke 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, 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, tuberculosis bacillus. They multiply very quickly and destroy prostate tissue, which manifests itself with inflammation.
In most cases, the appearance of prostatitis provokes an infection that penetrates the prostate gland through the urethra. It happens that it enters the body through the blood or lymph, passes from the bladder or rectum.
Important! Decreased immunity is very dangerous for a patient with chronic prostatitis, as the prostate gland is quickly inflamed by fatigue, stress, lack of sleep, malnutrition and other adverse factors.
With a sedentary lifestyle and lack of regular sex life, the blood supply to the pelvic organs deteriorates, leading to oxygen starvation of prostate tissue and congestion. Stagnant secretion 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:
By type they are distinguished:
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 regular sex. This form can be quickly supplemented by infection, and then the stagnant process is complicated by the bacterial form.
Calculous prostatitis- stones form in the prostate gland. Untreated chronic prostatitis can cause this complication. This disease affects older men who have not followed the advice of a urologist.
According to the form of the flow, they are distinguished:
Acute form of prostatitis- it is an inflammation of the prostate gland caused by an infectious agent, 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 gland. The chronic form accounts for 10% of all cases of prostatitis.
Symptoms of prostatitis
Totalsymptoms of prostate inflammationare:
- lumbar pain;
- feelings of discomfort during intestinal motility;
- pain in the perineum or pelvic area;
- disorders of the lower urinary tract.
Acute stage of prostatitis is accompanied by a general intoxication syndrome. This disease is characterized by acute symptoms with a bright clinical picture:
- a sharp rise in body temperature, chills, nausea, vomiting and malaise;
- joint and muscle pain and chills syndrome;
- increase in the size of the prostate and the appearance of discomfort in the perineal area;
- frequent urination and urinary retention.
Against 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: in sepsis, the treatment of prostatitis should be carried out exclusively in the clinic.
INchronic prostatitis of bacterial naturesymptoms are usually absent, so treatment begins only when a urinary tract infection is detected, which manifests itself against the background of a complication of the disease. In this case you may notice:
- pain during ejaculation;
- the appearance of blood in the ejaculate;
- the presence of secretions from the urethra;
- erectile dysfunction may develop.
If the examination did not show that the chronic pain was caused by pathologies in the prostate gland, then in this case we are dealingchronic nonbacterial prostatitisor so-calledchronic pelvic pain syndrome. In this disease, the quality of life of men is significantly reduced, as it leads to various disorders of psychological and sexual nature:
- increased fatigue;
- feeling helpless;
- erectile dysfunction;
- painful ejaculation;
- pain after intercourse, etc.
Similar symptoms may apply to other urological diseases, so it is impossible to diagnose prostatitis by symptoms alone. For example, urinary disorders and pain are present in prostate adenoma, cystitis, various oncological tumors in the genitourinary system and others.
Diagnosis of inflammation of the prostate
After identifying the first signs of the inflammatory process of the prostate, the patient should immediately contact a 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 (eg appendicitis, oncology, inflammatory processes in the bladder and kidneys, prostate adenoma), the doctor must conduct the necessary examinations:
- collection of anamnesis (interrogation of the patient);
- overview;
- rectal examination;
- examination of the secretion of the prostate gland;
- analysis for sexually transmitted infections;
- ultrasound examination of the prostate, scrotum and pelvic organs.
At the time of appointment, the urologist should clarify with the patient the duration of the clinical manifestations of the disease, the location and nature of the pain (eg perineum, scrotum, penis and inner thigh), the characteristic changes in semen (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 tests.
- Identification of urogenital infection.
- Urodynamic study.
- Ultrasound examination of the urinary system (kidneys, prostate, bladder with determination of residual urine).
- Cultural examination of prostate secretion and microscopy of various portions 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 identifying the cause of the disease, the doctor will prescribe a course of treatment. It should be remembered that standard methods in only 5-10% of cases can detect an infection that eventually leads to prostatitis.
The patient must undergo a thorough diagnosis, as the success of treatment will depend on the accuracy of the results.
Treatment of prostatitis
When the urologist has diagnosed, determined the cause and form of prostatitis, he must prescribe treatment.
The leading 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 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 bacteria caused the disease. The patient will need to take oral antibiotics for 4-6 weeks. It takes longer to remove chronic or recurrent prostatitis. In very severe cases, hospitalization may be required, which will require an intravenous course of antibiotics. This usually happens with acute bacterial prostatitis.
Treatment with alpha1-blockers
In case of difficulty urinating, the doctor prescribes alpha1-blockers, which help to facilitate urination and relax the muscles of the prostate and bladder. Muscle relaxants will relieve the pain caused by swelling of the prostate gland, which puts pressure on neighboring muscles. Non-steroidal anti-inflammatory drugs will help relieve the disease.
Also, the doctor may prescribe auxiliary drugs: biostimulants, extracts from various plants and insects in the form of rectal suppositories. Unfortunately, the use of drugs alone in the treatment of prostatitis remains insufficient.
In the treatment of this disease, the principles of the sequence of actions must be observed. The treatment of prostatitis is always complex.
Physiotherapy in the treatment of prostatitis
In categories of chronic prostatitis you can additionally use physiotherapeutic methods:
- prostate massage (prostate);
- laser therapy;
- microwave hyperthermia and thermotherapy;
- electrical stimulation with modulated currents with 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 have not been proven.
Introduction of stem cells
Cell therapy (stem cell injections) is a promising method of treating prostatitis today, it is in the early stages of development. Regarding the injection of stem cells into the prostate, there can only be hypotheses about its mechanisms and empirical data obtained from different groups of researchers.
Surgical treatment of prostatitis
Surgical methods are used to treat complications of prostatitis (abscess and suppuration of seminal vesicles).
Treatment of chronic pelvic pain syndrome requires separate consideration. Asymptomatic inflammatory prostatitis does not require treatment.
Diet and lifestyle in prostatitis
Prostatitis does not require a special diet, but eating large amounts of vegetables, lean meats and dairy products will help improve bowel function. You need to enrich your body with enough 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 likelihood of recurrence or speed up recovery. The patient should limit 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, sports, then his chances of developing chronic prostatitis are very small. Giving up bad habits and casual sex are the prevention of this disease.
Important! There are primary and secondary prophylaxis to prevent the development of prostatitis in men.
Basic- aimed at preventing the onset of the disease. It comes down to maintaining a balanced diet, physical activity, timely treatment of all infectious diseases of the body and regular protective sexual intercourse and more.
Second- is aimed at preventing the recurrence of existing chronic prostatitis and provides regular examinations by a urologist and preventive treatment with multivitamins, restorative drugs and sports.