Prostatitis in men is an inflammatory process involving prostate tissue.The disease is associated with pain in the lower back, perineum, and pelvis.The main symptoms are perineal pain and lower urinary tract dysfunction.
Of all urological diseases, prostatitis is the one most commonly encountered by urologists.It can develop unexpectedly (acutely) in the context of general health, or it can last for a long time, with periods of exacerbation and remission, indicating a chronic course.Additionally, a second variant of the disease is diagnosed much more frequently.
The disease can exist independently or can be combined with prostatic hyperplasia or prostate cancer.
Development reasons
Inflammation does not occur alone.The causes of prostatitis can be divided into bacterial and non-bacterial causes.
The acute infectious variant usually occurs in men under 35 years of age due to damage to the prostate caused by Gram-negative bacteria (E. coli, Proteus, Enterobacteriaceae).Getting sexually transmitted infections (gonorrhea, chlamydia) can also cause inflammation.In chronic forms, there may be more causes, including atypical microorganisms.
Factors motivating the development of bacterial variants are:
- unprotected sexual intercourse;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal sex;
- sedentary lifestyle;
- Sexual inactivity;
- diabetes;
- low temperature;
- Breach of privacy and hygiene.
Chronic non-infectious prostatitis is found in men who complain of long-term pain in their genitals, but tests cannot diagnose the bacteria that may be causing the inflammation.
The exact causes of this type of prostatitis have not been studied, but the following are considered predisposing factors:
- mood disorders;
- autoimmune diseases;
- Increase physical activity;
- Lack of regular sex life;
- Work involving heavy lifting;
- chronic stress;
- Congestion of prostate tissue;
- Previously confirmed fibrotic changes in the prostate (based on TRUS results).
Sexual inactivity, unprotected intercourse and hypothermia are thought to be the main causes of the disease.50% of men worldwide experience symptoms of prostatitis at least once in their lifetime.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which can move from one stage to another if a specialist is not consulted and the progression of the disease is not promptly prevented.
The first stage is called acute catarrhal prostatitis.It begins with complaints of frequent painful urination.Mild soreness may initially occur in the lower back, sacrum, and perineum, and then the pain may rapidly increase.
If left untreated, a second stage occurs—the acute follicular phase.The pain becomes particularly severe at this time and radiates to the anus, and the pain worsens during defecation.Urinating is difficult and acute urinary retention sometimes occurs.The temperature never goes above 38 degrees, only on rare occasions does it go higher.
Acute parenchymal prostatitis manifests as severe poisoning, body temperature reaching above 38°C, and chills.Urinary retention often occurs, severe pulsating pain in the perineum, and difficulty in defecation.
Symptoms of chronic prostatitis
Sometimes, chronic prostatitis occurs against the background of an acute inflammatory process.It is a separate disease with a primary chronic course that develops over time.
Usually, the chronic course begins with complications of the inflammatory process caused by various infectious agents (Chlamydia, Trichomonas, Neisseria gonorrhoeae).But vivid representations are rare.More commonly, the disease causes mild pain during urination or in the perineum, and light discharge from the urethra.Often, even patients do not notice these manifestations for a long time.
Symptoms of prostatitis in men may appear in different ways, but they all fall into three groups: pain, problems with urination, and problems with sexual activity.Prostate tissue lacks receptors and therefore cannot produce pain sensations.They appear when inflammation begins to spread to the richly innervated pelvic organs.Patients' pain ranges from barely noticeable discomfort to severe pain that disrupts sleep and normal lifestyle.Pain can radiate to the sacrum, scrotum, waist, perineum, so self-diagnosis is useless here.
Urinary problems begin when the prostate increases in size and begins to press on the urethra and the ureteral lumen narrows.Frequent urge to urinate and feeling that the bladder is not completely empty.Usually, such phenomena manifest themselves at the very beginning of the disease, in the early stages, then they are compensated by the body, but in the later stages, without proper treatment, they reappear.
Men's efficacy issues can also be expressed in different ways.Patients complain of worsening erections, accelerated ejaculation, and decreased sexual arousal.Gradually, sexual dysfunction becomes more obvious, and in the late stages, symptoms of prostatitis are accompanied by impotence.
Possible complications
During prostatic inflammation, adjacent organs are also involved in the pathological process.This can lead to various consequences of prostatitis, such as:
- seminal vesiculitis;
- posterior urethritis or colitis;
- Abscess in the gland itself;
- Sclerosis or fibrosis of the prostate;
- Prostatic cysts and stones;
- infertility;
- Ejaculation disorders;
- Erectile dysfunction.
To prevent these serious complications from occurring, you should consult a urologist at the first symptoms of prostatitis and prostate adenoma.
diagnosis
Diagnosis and treatment of any form of prostatitis is performed by a urologist.If a tumor is suspected, the patient may be referred to an oncologist for consultation.If you have chronic, long-term prostatitis that is difficult to treat, you may need to consult an immunologist.
Characteristic clinical manifestations and patient complaints facilitate rapid and accurate diagnosis.The list of mandatory studies when diagnosing prostatitis is as follows:
- Urine bacterial culture.
- Analysis of prostate secretions for microbiota and susceptibility to antibiotics.
- Prostate rectal examination.
- Prostate ultrasound can identify tumors, cysts, adenomas, and differentiate prostatitis from other urological and surgical conditions.
- Sperm test to rule out infertility.
It is difficult to independently determine the causes of diseases, let alone cure them.Therefore, to prevent serious complications and avoid continued infertility in the future, men should consult a urologist immediately at the first sign of disease.
treat
Patients diagnosed with uncomplicated acute prostatitis were treated on an outpatient basis.Hospitalization is only required if severe symptoms of poisoning occur and a purulent process is suspected.
Antibiotics are the drugs of choice for fighting inflammation.They are also used in chronic bacterial forms.The drugs are selected individually and the course of treatment is 4-6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally in the form of capsules or tablets.
Another drug used to treat prostatitis is an alpha-1 blocker, which is prescribed when ultrasound confirms the presence of residual urine.They help make urination easier and relax the muscles of the prostate and bladder.Medications in the NSAID group can help relieve pain.
Prostatitis can only be treated comprehensively and continuously.In addition to taking medications, doctors may prescribe a course of prostate massage and use physical therapy to improve blood circulation to this organ.Surgical treatment is indicated only in cases of seminal vesicle abscess and suppuration.
prognosis and prevention
Untreated acute forms often become chronic and worsen regularly.Full recovery is not always possible, but if you consult your doctor promptly and take all prescribed medications, you can eliminate discomfort, urinary problems, and pain.
Self-treatment at home and traditional methods can often be life-threatening.
To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder promptly, limit the intake of coffee, spices and alcohol, and remain sexually active as much as possible.