Prostatitis: symptoms, treatment, prevention

Prostatitis in men is an inflammatory process that affects prostate tissue.The disease is accompanied by pain that occurs in the lower back, perineum and pelvis.The main manifestations are pain in the perineum and dysfunction of the lower urinary tract.

Among all urological diseases, urologists most often face prostatitis.It can develop unexpectedly (acutely) against the background of general health, or it can last for a long time, with periods of exacerbation and remission, which indicates a chronic course.In addition, the second variant of the disease is diagnosed much more often.

The disease can be independent and can also be associated with prostate hyperplasia or prostate cancer.

Reasons for development

Inflammation does not appear on its own.The causes of prostatitis can be divided into bacterial and non-bacterial.

The acute infectious variant usually occurs in men under 35 years of age due to prostate damage caused by Gram-negative bacteria - Escherichia coli, Proteus, Enterobacter.Inflammation also occurs due to infection with sexually transmitted infections - gonorrhea, chlamydia.In the chronic form, there can be many other reasons and the list will include atypical microbes.

The factors provoking the development of the bacterial variant are:

• unprotected sex;
• AIDS or HIV infection;
• diarrhea or constipation;
• anal sex;
• sedentary lifestyle;
• inactive sex life;
• diabetes mellitus;
• hypothermia;
• violations of intimate hygiene.
• emotional disorders;
• autoimmune diseases;
• increased physical activity;
• lack of regular sex life;
• work involving heavy lifting;
• chronic stress;
• congestion of prostate tissues;
• previously confirmed fibrotic changes in the prostate (according to TRUS results).

What are the first signs of prostatitis that you should pay attention to?

The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating.If, when going to the toilet, you notice a weakening of the urinary stream, or feel discomfort or a burning sensation in the urethra, you should contact a urologist as quickly as possible.

With the acute onset of the disease, the temperature may rise and the general state of health may deteriorate.Such a patient should be treated immediately with antibiotics and anti-inflammatories.

In some cases, the disease may remain asymptomatic for a long time, so treatment begins late.

Symptoms of prostatitis

Signs of prostatitis in men depend on the form of the disease.In the acute form, the following manifestations are characteristic:

• pain in lower back, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficulty defecating;
• thin stream of urine;
• increase in temperature;
• chills;
• deterioration of general health.

The chronic form can occur after the acute phase of the disease or develop as a primary disease.The symptoms of chronic prostatitis in men are mild.The pain is of low intensity, the temperature may increase slightly.The stream of urine becomes thinner, disorders appear in the intimate area.

During the chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible.The pain may be absent or dull, aching in nature.

Symptoms of acute prostatitis

Acute prostatitis occurs in several stages, which will pass from one to another if you do not consult a specialist and stop the development of the disease in time.

The first stage is called acute catarrhal prostatitis.It begins with complaints of frequent painful urination.In the lower back and sacrum, as well as in the perineum, a slight pain appears at first, which quickly worsens.

Without treatment, the second stage occurs - acute follicular.At this time, the pain becomes particularly intense, radiates to the anus and intensifies during bowel movements.Urination is very difficult, sometimes there is acute urinary retention.The temperature does not exceed 38 degrees and can only be higher in rare cases.

Acute parenchymal prostatitis is expressed by severe intoxication, the temperature reaches 38°C and above and chills appear.Urinary retention is often observed, sharp, shooting pain appears in the perineum, and defecation is difficult.

Symptoms of chronic prostatitis

Sometimes chronic prostatitis occurs against the background of an acute inflammatory process.This is a separate disease in which there is a primary chronic course that develops over a long period.

Often, the chronic course begins with a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococci.But strong demonstrations are very rare;most often the disease is manifested by minor pain during urination or in the perineum and slight discharge from the urethra.Often, these manifestations go unnoticed for a very long time, even for the patient.

Signs of prostatitis in men can appear in different ways, but they are all grouped into three groups: pain, urination disorders, problems with sexual activity.Prostate tissue lacks receptors and therefore cannot produce painful sensations.They appear when inflammation begins to spread to the pelvic organs, which are abundantly innervated.Patients' pain can range from barely noticeable discomfort to severe, intense pain that disrupts sleep and normal lifestyle.Pain can radiate to the sacrum, scrotum, lower back, perineum, so self-diagnosis is useless here.

Urination problems begin when the prostate enlarges and begins to compress the urethra with a decrease in the lumen of the ureter.There is a frequent urge to urinate, a feeling of incomplete emptying of the bladder.Usually, such phenomena are expressed at the very beginning of the disease, in its early stages, then they are compensated by the body, but at a later stage, without adequate treatment, they appear again.

Potency problems in men can also be expressed in different ways.Patients complain of worsening erection, accelerated ejaculation and decreased sexual arousal.Gradually, sexual dysfunctions become more pronounced, and in an advanced stage, the symptoms of prostatitis are supplemented by impotence.

Ranking

Experts distinguish several categories of diseases:

• Acute bacterial prostatitis, characterized by symptoms of a bacterial infection.The causative agent of the disease in most cases is Escherichia coli.Enterococci and other bacteria are isolated a little less frequently;
• Chronic bacterial prostatitis, which is a relapsing form of the disease.The causative agents of the disease are E. coli bacteria, enterococci, etc.Trichomonads, fungi, chlamydia, viruses, mycoplasmas can also be pathogens;
• chronic pelvic pain syndrome, in which infections go undetected.There are two types: inflammatory and non-inflammatory.Among the causes of occurrence: autoimmune processes, external factors (hypothermia, overheating), rare sex life, low physical activity, rare urination;
• Asymptomatic prostatitis, detected incidentally during examination by a doctor.

Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after a thorough diagnosis based on examination data.You should contact a specialist if you have certain symptoms.

Symptoms

The main symptom is a dysfunction of the urinary system.You should contact a specialist if you experience the following symptoms:

• if urination is difficult and urine passes intermittently;
• if during bowel movements there is discharge from the urethra;
• with a burning sensation in the urethra and perineum;
• if, during bowel movements, discomfort appears in the bladder and prostate;
• if the urge to urinate intensifies and becomes more frequent;
• if you feel pain in the rectum;
• if there is purulent and bloody discharge from the urethra (floating threads);
• with frequent increases in body temperature;
• when intimate problems arise (weakening of the erection);
• when erections appear at night for an unexplained reason;
• if ejaculation during sexual intercourse is too rapid;
• if the sensations during orgasm are “erased”;
• with rapid general fatigue;
• with manifestations of an unreasonably anxious or depressive state, as well as a state of mental depression;
• in case of frequent depression, manifestations of mental depression in anticipation of complications;
• with general weakening of the body.

To contact a urologist, one or two symptoms are enough.Attempts to cure yourself usually lead to worsening of the condition and chronic or serious illness.In the worst case, not seeing a doctor in time can cause infertility or complete impotence.

If the patient does not consult a doctor in time or neglects treatment, the following symptoms may appear:

• pain in the perineum;
• pain near the scrotum;
• pain at the base of the root of the penis (natural pain).

Aching pain indicates stone formation.Doctors consider infertility a late sign of a progressive disease.

Signs of prostatitis in acute and chronic form vary significantly.Particularly in the chronic form, the signs may be mild or unexpressed.

Acute prostatitis is characterized by pronounced symptoms - general malaise, pain in the groin.Men should contact specialists if:

• the urge to urinate has become very frequent;
• pain during defecation and urination intensifies in the perineum and radiates to the groin;
• complete emptying of the bladder is impossible;
• the amount of urine produced per day has decreased significantly or urine is not collected;
• high temperature, frequent headaches, general weakness.

Acute bacterial prostatitis is characterized by fever and chills, pain in the lumbosacral region (severe), pain manifested in the perineum and rectum, acute urinary retention, frequent pain in the muscles and joints.

Chronic prostatitis is characterized by the following symptoms:

• during urination, pain in the perineum intensifies;
• with frequent urges, the bladder does not empty completely;
• decreased libido;
• discomfort is felt during sexual intercourse.

One of the signs of the chronic form is significant disturbances in the emotional background, characterized by insomnia, increased nervousness, mood swings and irritability.

The bacterial form of chronic prostatitis is characterized by problems with ejaculation, which become rapid and painful, discomfort in the pubic region, frequent or involuntary urination and intermittent urine flow.

Chronic pelvic pain syndrome, which, according to medical statistics, is the most common form of prostatitis, is characterized by symptoms similar to bacterial prostatitis in chronic form: frequent urge to urinate, weakening of the urinary stream, pain in the penis and testicles and sexual dysfunction.

Possible complications

• vesiculitis;
• posterior urethritis or colliculitis;
• abscess of the gland itself;
• sclerosis or fibrosis of the prostate;
• prostate cysts and stones;
• infertility;
• ejaculation disorder;
• erectile dysfunction.

Diagnosis

Diagnosis and treatment of any form of prostatitis is carried out by a urologist.If a tumor is suspected, the patient can be referred for consultation to an oncologist.In the case of long-term chronic prostatitis, which is difficult to treat, a consultation with an immunologist may be necessary.

1. Bacteriological culture of urine.
2. Analysis of prostate secretion for microflora and antibiotic sensitivity.
3. Prostate rectal exam.
4. Ultrasound of the prostate, which allows you to identify tumors, cysts, adenomas, and also to differentiate prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Features of the diagnosis of acute prostatitis

If the signs of the disease indicate acute prostatitis, the diagnosis is made based on the data of instrumental and clinical examination.All manipulations that can have an impact on the prostate are contraindicated, as they can cause sharp pain or cause the spread of infection.

Features of the diagnosis of chronic bacterial prostatitis

The diagnosis in such cases is determined based on the following data: examination by a doctor of the patient, bacteriological and microscopic examination of prostatic secretions, study of ultrasound data.

Features of the diagnosis of pelvic pain syndrome

Specialists prescribe procedures for diagnosing symptoms indicating chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory.As a rule, an ultrasound scan is prescribed, as well as the following manipulations:

• examination of prostate secretions;
• molecular biology research;
• bacteriological research.

The choice of technique is determined by the doctor based on the data of the initial examination.

Risk groups

The most likely occurrence and development of prostatitis:

• in men who are obese or lead a sedentary lifestyle;
• in men with sedentary work (office workers, programmers);
• in men whose body is subjected to shocks and vibrations (drivers of cars, including special equipment);
• in men who have had infectious diseases, including diseases of the genitourinary system;
• in sexually hyperactive men and those who do not have sex regularly;
• in depressed men with mental illness;
• in alcoholics, drug addicts, etc.

Treatment

Patients diagnosed with acute prostatitis without complications are treated on an outpatient basis.Only in case of severe symptoms of poisoning and suspicion of a purulent process is hospitalization carried out.

Antibiotics are the drugs of choice to combat inflammation.They are also used for chronic bacterial forms.The medication is selected individually and taken over a period of 4-6 weeks.In severe cases, antibacterial agents are administered intravenously, in all other cases - orally, in the form of capsules or tablets.

Another medication used for prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound.They help to facilitate urination and relax the muscles of the prostate and bladder.Medicines from the NSAID group help relieve pain.

Treatment of prostatitis is carried out only comprehensively and consistently.In addition to taking medications, the doctor will prescribe prostate massage, and physiotherapy is used to improve blood circulation in this organ.Surgical treatment is used only when abscesses and suppuration of the seminal vesicles appear.

The choice of method of treating prostatitis depends on many factors and is determined individually.When choosing treatment methods, the following are taken into account:

• cause of illness;
• progression of the disease;
• individual characteristics of the body (presence of chronic and concomitant diseases).

For treatment, a specific technique can be selected or a complex can be prescribed.Specialists in the field of urology, depending on the diagnostic results, prescribe:

• Physiotherapeutic procedures: magnetic resonance therapy, procedures using laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Drug treatment.
• Diet and psychotherapy.
• Surgery.

When diagnosing bacterial prostatitis, broad-spectrum antibiotics, immunomodulators and multivitamin complexes are prescribed.

When diagnosing non-bacterial prostatitis, physiotherapy and anti-inflammatory drugs are prescribed.

In some cases, specialists may recommend muscle relaxers and hormone therapy, as well as antioxidants to help reduce inflammation and protect cells from free radicals.

Complex of correctly selected drugs for acute bacterial prostatitis:

• restores immunity;
• treats infections (antibiotics);
• treats the prostate (antibacterial drugs).

Chronic prostatitis is difficult to treat, therefore a long list of drugs is used: anti-inflammatories, antispasmodics, absorbents, antibacterials, vibration and finger massage, electrophoresis, EHF and UHF therapy, sinusoidally modulated currents.

When diagnosing pelvic pain syndrome, antibiotics and anti-inflammatories are used, various types of physiotherapy, magnetic and laser therapy, electrical neurostimulation, etc.One of the effective methods is to drain the tissues around the source of inflammation.

Conservative or modern treatment is chosen by the urologist based on diagnostic data.

Tablets

Antibacterial agents and pain relievers can be prescribed in tablet form for prostatitis.

The course of antibiotic therapy is chosen individually depending on the result of the analysis of prostate secretions.The microflora causing the disease must be sensitive to the drug used.It is necessary to completely complete the treatment prescribed by the urologist, otherwise the cause will not be eliminated, the disease will recur or become chronic.

Pain relievers for prostatitis help eliminate unpleasant symptoms.For this purpose, nonsteroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.

Prostatitis tablets for men, which help treat urination disorders, belong to the group of alpha-1 blockers.They relax smooth muscles and restore the permeability of the urethra compressed by the inflamed prostate.

Injections for prostatitis

Antibacterial agents for prostatitis in men are also used in the form of injections.Injectable forms of drugs are prescribed in case of severe inflammation, as well as in the absence of antibiotic tablets, to which the pathogen is sensitive.You can inject antispasmodics to quickly restore urination, which is difficult due to urinary tract spasms and prostate compression.

Injectable prostatitis medications work more quickly than tablet medications, so they are sometimes preferable.

Prostatitis surgery

The most serious complications are suppuration of the seminal vesicles and abscesses.Medicines for the treatment of the disease are not able to cope with the disease in such a difficult situation, therefore surgery is indicated at the first manifestations.

In the absence of timely intervention, the purulent process spreads beyond the organ, so the consequences of prostatitis in a complicated form can be life-threatening.

Prognosis and prevention

The acute form without treatment often becomes chronic and worsens periodically.Full recovery is not always possible, but if you consult a doctor in a timely manner and take all prescribed medications, you can eliminate discomfort, problems with urination and pain.

Self-medication at home and the use of traditional methods can often be life-threatening.

To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder on time, limit the consumption of coffee, spices and alcohol, and remain sexually active as long as possible.

Typical signs of prostate cancer

The prostate is a small organ that only men have.Its structure resembles a sponge, it is located under the bladder and seems to surround the urethra.The growth of the gland begins in adolescence under the influence of male sex hormones;as an adult, its weight can reach 20 grams.It plays an important role in the male reproductive system, producing secretion, one of the components of sperm.But unfortunately, middle-aged and elderly men often suffer from hyperplasia of the glands or malignant neoplasms of the organ.

How to recognize cancer

As the tumor grows and progresses, the symptoms of prostate cancer depend on the stage of the process.If the disease is still in the first stage or has even reached the second, then the tumor is localized in the prostate, has not grown into neighboring tissues and has not metastasized.

Symptoms of prostate cancer in the early stages are practically absent, this is the insidious nature of the disease.The man does not complain, feels good and sees no reason to consult a doctor.This is why this type of tumor is often discovered in an advanced state.An exception may be patients who have already been diagnosed with benign prostate neoplasms, in which case they are periodically observed by a specialist doctor and are tested for a specific prostate antigen and undergo an ultrasound scan of the prostate.They have every chance of detecting a tumor in its bud itself.But you should know that detecting prostate cancer is not always easy.Even with a biopsy, the results may be clear, but the oncology is already there.This happens due to errors in the method;the needle simply does not reach the site of the localized lesion.If prostate pathology is suspected, especially if it is cancer, a fusion biopsy should be performed, which combines the capabilities of ultrasound and MRI in real time, giving the doctor the opportunity to visualize the organ as precisely as possible.

Some symptoms are a consequence of prostate pathology, while others are caused by mechanical compression and blockage of the urethra.

Since the bladder must be emptied regularly, if this process is disrupted, urine may be retained there, inflammation may occur, and a bacterial infection may develop.If no measures are taken, the process will spread, which already threatens pyelonephritis and kidney problems.

At stage 4, prostate cancer manifests itself even more clearly.Metastases are most often found in the bones, spine and lymph.Because of this, a person's regional lymph nodes become enlarged, their bones hurt, they suddenly lose weight and become weak.

Treating prostate cancer is not an easy task, but it can be done.If the local process is detected in time, complete recovery can be achieved, and in more advanced stages life can be prolonged.If you notice the symptoms described above, contact a professional clinic for examination.

Make an appointment, the clinic's doctors have many years of experience in the treatment of urological diseases and are successful even in the most difficult cases.