Prostatitis is an inflammatory process associated with inflammation of the prostate (prostate) in men. Most often, this disease occurs in men over 30 years old. This disease causes pain in the lower back, perineum or pelvis, is accompanied by a violation of the normal process of urination and, in severe forms, leads to erectile dysfunction and serious problems in relationships with the partner.
Approximately a quarter of the cases among couples who suffer from infertility are precisely the causes of the male factor that affect 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 shaped like a chestnut, located in front of the rectum, under the bladder and surrounds the urethra (urethra). When the prostate becomes inflamed, it compresses the urethra, which leads to problems with urination. The main function of the prostate is to produce a secret (liquid) that is part of the semen and dilutes it, which ensures normal sperm motility.
Prostatitis is very common in a urologist's practice. It can occur suddenly or gradually, appear constantly and for a long time (chronic prostatitis). The chronic form of this disease is more common than the acute form. Chronic prostatitis ranks fifth among the top twenty urologic diagnoses.
As prostatitis is an active focus of infection in the body, it requires mandatory treatment, even if its symptoms do not bother you.
Reasons for the development of prostatitis
The list of causes that provoke inflammation of the prostate is very diverse:
- diseases of the genitourinary system (cystitis, urethritis, pyelonephritis);
- sexually transmitted infections (trichomoniasis, gonorrhea);
- infections associated with pneumonia, flu, tonsillitis, furunculosis;
- chronic constipation, forcing a man to exert himself regularly;
- sedentary lifestyle and irregular sex life, which lead to the stagnation of secrecy;
- urinary retention - a swollen bladder increases pressure on the prostate;
- frequent hypothermia (or overheating);
- lesions in the pelvic region;
- 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, tuberculosis bacillus. They multiply very quickly and destroy prostate tissue, which is manifested by inflammation.
In most cases, the occurrence 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 through the bladder or rectum.
Important! A decrease in immunity is very dangerous for a patient with chronic prostatitis as the prostate quickly becomes inflamed with fatigue, stress, lack of sleep, malnutrition and other adverse factors.
With a sedentary lifestyle and the absence of a steady sex life, the blood supply to the pelvic organs worsens, which leads to lack of oxygen to the prostate tissues and congestion. A stagnant 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:
By type, they are distinguished:
bacterial prostatitis- Inflammation caused by infection. Bacterial prostatitis occurs in both young and old men.
congestive prostatitis- inflammation caused by stagnation of secretion. It develops in men with a sedentary lifestyle who do not have a regular sex life. This form can be quickly supplemented by an infection and then the stagnation process is complicated by the bacterial form.
calculous prostatitis- stones form in the prostate. 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 flow, they are distinguished:
Acute form of prostatitis- it is an inflammation of the prostate 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 this diagnosis.
Chronic form of prostatitischaracterized by persistent or recurrent urogenital symptoms caused by a bacterial infection in the prostate. The chronic form occupies 10% of all cases of prostatitis.
symptoms of prostatitis
Generallyprostate inflammation symptomsthey are:
- pain in the lower back;
- sensations of discomfort during intestinal motility;
- pain in the perineum or pelvic region;
- disorders in the work of the lower urinary tract.
The acute phase of prostatitis is accompanied by a general intoxication syndrome. This disease is characterized by an acute manifestation of symptoms with a vivid clinical picture:
- a sharp rise in body temperature, chills, nausea, vomiting, and malaise;
- pain syndrome and chills in the joints and muscles;
- increase in prostate size and occurrence of discomfort in the perineal region;
- frequent urination and urinary retention.
Against the background of individual inflammatory processes, a purulent septic disease that affects the blood can develop. In such a situation, the patient should be urgently hospitalized: with sepsis, the treatment of prostatitis should be carried out exclusively in the clinic.
At thechronic prostatitis of a bacterial naturesymptoms are usually absent, therefore, treatment begins only when an infection in the urinary system is detected, which manifests itself against the background of a complication of the disease. In this case, you can see:
- pain during ejaculation;
- the appearance of blood in the ejaculate;
- the presence of discharge from the urethra;
- erectile dysfunction can develop.
If the examination did not show that the chronic pain is caused by pathologies in the prostate, in this case we are dealing withchronic nonbacterial prostatitisor the callchronic pelvic pain syndrome. With this disease, the quality of life of a man is significantly reduced, as it leads to various disorders of a psychological and sexual nature:
- increased fatigue;
- a feeling of helplessness;
- erectile dysfunction;
- painful ejaculation;
- pain after intercourse, etc.
Similar symptoms can apply to other urological conditions, 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 Organs genitourinary organs, etc.
Diagnosis of prostate inflammation
Having identified the first signs of the inflammatory process of the prostate, the patient should immediately contact a doctor - a urologist. The doctor must exclude many diseases that have similar manifestations and determine to what type of disease it belongs.
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 carry out the necessary tests:
- anamnesis collection (patient questioning);
- general inspection;
- rectal examination;
- study of the secret of the prostate;
- analysis of sexually transmitted infections;
- ultrasound examination of the prostate, scrotum and pelvic organs.
At the consultation, the urologist should clarify with the patient the duration of the clinical manifestations of the disease, the location and nature of the pain (for example, in the perineum, scrotum, penis and inner thigh), characteristic changes in the sperm (presence of pus and blood).
The doctor establishes the diagnosis of chronic bacterial prostatitis with a duration of symptoms of at least three months.
The search will include:
- Digital rectal examination of the gland, to determine the degree of prostate enlargement and its consistency.
- Analysis of prostatic secretion, urine and/or ejaculation.
- Identification of urogenital infection.
- Urodynamic study.
- Ultrasound examination of the urinary system (kidneys, prostate, bladder with determination of residual urine).
- Cultural study of prostatic secretion and microscopy of various portions of urine and prostatic 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 condition, the doctor will recommend a course of treatment. It should be remembered that standard methods can only detect an infection in 5-10% of cases, which leads to prostatitis.
The patient should definitely undergo a thorough diagnosis, as the success of the treatment will depend on the accuracy of the results.
treatment of prostatitis
When a urologist makes a diagnosis, determines the cause and form of prostatitis, he must prescribe treatment.
The main role in the treatment of this disease is attributed to drug therapy:
In the first phase of therapeutic therapy, it is necessary to eliminate 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 illness. The patient will have to take oral antibiotics in a course of 4-6 weeks. Chronic or recurrent prostatitis takes longer to resolve. Hospitalization may be necessary for very severe manifestations where an intravenous course of antibiotics will be given. This usually happens with acute bacterial prostatitis.
Treatment with alpha1-blockers
With difficulty urinating, the doctor prescribes alpha1-blockers, which help to facilitate urination and relax the muscles of the prostate and bladder. Muscle relaxants relieve pain caused by the swelling of the prostate, which puts pressure on adjacent muscles. Non-steroidal anti-inflammatory drugs will help relieve the pain syndrome.
In addition, the doctor can 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 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 the categories of chronic prostatitis, you can also use physiotherapy methods:
- prostate massage (prostate);
- laser therapy;
- hyperthermia and microwave 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 has not been proven.
Introduction of stem cells
Cell therapy (stem cell injections) is a promising method for treating prostatitis today as it is in the early stages of development. As far as the injection of stem cells into the prostate is concerned, 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 the complications of prostatitis (abscess and suppuration of the seminal vesicles).
The 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 a lot of vegetables, lean meat, and dairy products will help improve bowel 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 prostate inflammation will help improve bowel function and reduce the likelihood of relapse or speed recovery. The patient needs to limit himself to drinking coffee, excluding alcohol, drinking plenty of fluids and adhering to a healthy lifestyle.
Preventive measures to prevent prostatitis
When a man leads the right life: he follows proper nutrition, plays sports, then his chances of developing chronic prostatitis are very small. Refusal of bad habits and casual sex are the prevention of this disease.
Important! There are primary and secondary prevention to prevent the development of prostatitis in men.
Primary- aimed at preventing the occurrence of the disease. It all boils down to maintaining a balanced diet, physical activity regimen, timely treatment of any infectious diseases of the body, and regular protected sex, etc.
Secondary- aims to prevent the recurrence of existing chronic prostatitis and provides for regular examination by a urologist and preventive treatment with multivitamins, restorative drugs and sports.