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Prostatitis in men

Prostatitis is an inflammatory process that affects the tissue of the prostate gland.This is one of the most common diseases in the practice of a urologist.The disease is mainly diagnosed in men aged 25-30, but the risk of developing the pathology increases significantly at an older age.

The form distinguishes between acute and chronic prostatitis.In the latter case, inflammation is characterized by a long course with periodic relapses.This condition is more common than acute.

Causes of prostatitis

Many diseases of the prostate gland, for example, benign hyperplasia or oncopathologies, are problems of the older age group.But prostatitis does not belong to this category.Its symptoms usually appear in men between the ages of 30 and 50.Most often, the cause is an infectious lesion due to the penetration of pathogenic flora from the genitourinary tract or glands of the genitourinary system.This is explained by the proximity of the urethra and anus.

Gram-negative organisms are among the most common causative agents of bacterial (infectious) prostatitis: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often, the inflammatory process develops against the background of infection with STIs: chlamydia, gonococci, trichomonas, herpes virus, etc. As a rule, such forms of the disease are diagnosed in men under 35 years of age.Cases of treatment of pathology against the background of infection by Mycobacterium tuberculosis are extremely rare.

There are also non-bacterial types of prostatitis.Among their main reasons:

  • increased pressure in the prostate gland;
  • autoimmune disorders (destruction of prostate cells by antibodies);
  • muscle pain syndrome in the pelvic region;
  • psycho-emotional disorders;
  • lack of motor activity;
  • excessive physical stress.

Early signs of prostatitis

a man with symptoms of prostatitis

The disease is accompanied by a complex of disorders that affect the work of the entire urinary system.Among the main symptoms:

  • uncontrolled urination;
  • discomfort, pain when emptying the bladder;
  • impotence in men of reproductive age;
  • pain in the perineum when sitting for a long time;
  • frequent and strong urge to urinate;
  • difficulty emptying the bladder;
  • decreased libido and erectile problems;
  • reproductive dysfunction (infertility);
  • a feeling of incomplete emptying of the bladder after going to the toilet;
  • not being able to achieve a high-quality and lasting erection even with strong arousal.

Symptoms of acute prostatitis

In acute form, the symptoms of the disease and the general clinical picture differ depending on the stage of the pathological process:

  • catarrhalThe patient often complains of urges, pain when urinating, pain in the perineum and sacrum.
  • Follicular.The pain syndrome intensifies, can radiate to the anus, and intensifies during defecation.Urine is released in a thin stream.In some cases there is a delay.For a long time, there is an increase in body temperature up to 38 degrees (low-grade fever) or moderate hyperthermia.
  • Parenchymatous.The man begins to experience general intoxication of the body with chills and a temperature of up to 38-40 ° C.The pain in the perineum is sharp and throbbing.The act of defecation is difficult and normal emptying of the bladder is impossible, resulting in acute urinary retention (dysuria).

Symptoms of chronic prostatitis

The chronic form of inflammation of the prostate can be the result of the absence of an acute stage or not being treated in time.But in many men, it develops immediately and is characterized by "blurred" symptoms.Among the main symptoms:

  • low-grade fever (sometimes);
  • slight pain in the perineum;
  • discomfort while urinating;
  • a small amount of discharge from the urinary tract during defecation.

In general, the clinical picture changes over time, differs in intensity in different patients, and can be hidden when trying to self-treat.Symptoms of a chronic disorder may include a burning sensation in the urethra, pressure in the perineum, dysuria, sexual dysfunction, and increased general fatigue.Against the background of potency problems, mental depression, irritability and anxiety arise.The fear of impotence leads to the development of complexes, but most men tend to postpone a visit to the urologist due to a sense of shame.

Primary chronic prostatitis develops over a long period of time.Blood stagnation in the capillaries (prostatosis) provokes the initial stage of non-bacterial inflammation, which leads to the onset of the disease.

The cause of the disease with an infectious etiology is a chronic inflammatory process due to infection with trichomonas, ureaplasma, chlamydia or gonococcus.The primary infection masks the symptoms of prostatitis, and its treatment does not eliminate inflammation of the prostate.The addition of an accompanying problem is often overlooked by a man.

Let's take a closer look at the three main symptoms of chronic prostatitis:

  • Disturbance of urination (dysuria).Inflammation increases the volume of the prostate gland, which causes compression of the ureter.As its lumen decreases, there is a frequent urge to urinate and a feeling of an incompletely empty bladder.In many men, dysuric disorders occur in the early stages of prostatitis.During this period, the compensatory mechanism manifests itself in the hypertrophy of the muscles of the bladder and ureters, which reduces the symptoms of dysuria, but they increase again with the development of inflammation.
  • Pain syndrome.There are no pain receptors in prostate tissue.Pain occurs when the inflammatory process spreads to other pelvic organs and their nerve pathways.Sensations range from mild and painful to severe enough to interfere with nighttime rest.Increased anxiety occurs with ejaculation, lack of intercourse, or excessive sexual activity.The pain spreads to the perineum, sacrum, scrotum and sometimes the lower back.
  • Violation of potency.Lack of treatment in the early stages of prostatitis can lead to dyspotency when a man experiences frequent nocturnal erections, deterioration of orgasm quality, and accelerated ejaculation.These symptoms manifest themselves with different intensity in different patients.Premature ejaculation occurs due to a decrease in the excitation threshold of the orgasm center.In this case, the patient feels pain, which leads to the development of pain expectation syndrome and gradual refusal of sexual activity.Without comprehensive treatment that addresses the mental factor of the disorder, sexual disorders tend to get worse.Ignoring the need to see a doctor for prostatitis often ends in impotence.

The degree of sexual dysfunction varies depending on individual factors.Some men are so afraid of erectile dysfunction that their problems arise not from objective physiological factors, but from suggestions.In particular, an increase in psychogenic dyspotency is clearly observed with anxiety and obsessive complexes.It is difficult for such patients to think about possible disorders of male health.This greatly affects their character and communication with others.Irritability, hypochondria, irritability and depression appear.

Complications of prostatitis

Lack of adequate treatment for inflammation of the prostate causes accompanying diseases.The fact is that the prostate gland is closely related to other organs of the male genitourinary system.It is located around the neck of the bladder and urethra.Therefore, when the prostate enlarges, the urethra is compressed and the normal output of urine is disturbed.Taking into account the characteristics of physiology, if acute or chronic prostatitis is not treated in time, a number of serious pathologies and complications arise.

Related problems:

  • formation of cysts, prostate stones;
  • decrease in the amount of male hormones produced;
  • decrease in sexual desire (libido);
  • erectile dysfunction (erectile dysfunction);
  • infertility (in 40% of patients with chronic prostatitis);
  • prostate adenoma (benign tumor);
  • prostate cancer.

Some consequences of inflammation of the prostate gland, which does not receive timely and comprehensive treatment, pose a threat not only to the patient's health, but also to his life (especially oncological pathologies may develop).Therefore, you should consult a urologist at the first signs of prostatitis.You should also remember about regular preventive examinations after 40 years, when the risk of pathological processes in the prostate gland is greatly increased.

Diagnosis of prostatitis

Many urological problems have similar symptoms, so the specialist works with each clinical case separately and uses all available diagnostic tools.A consultation with a urologist always begins with a question about symptoms, medical history and a general examination.Then the doctor prescribes a series of tests, based on their results, a diagnosis is made and adequate treatment is selected.As a rule, the examination package includes the following:

  • rectal digital examination of the prostate to determine the size, structure and level of compression of the urethra;
  • Ultrasound of the urinary system (prostate, bladder, kidneys);
  • laboratory tests of urine, prostate secretion, ejaculation;
  • test for urogenital infections;
  • urodynamic study.

To ensure an accurate diagnosis of prostatitis and related disorders in men, it is necessary not to urinate for 2-3 hours before visiting a urologist.Otherwise, the test results may not be completely accurate, because the pathogenic microflora is washed away when the bladder is emptied.According to the characteristics of the clinical picture, the ultrasound method is chosen: transrectal or abdominal (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Methods of treatment of prostatitis

The main therapy is antibiotics.The use of modern pharmacological developments gives high results, although it is impossible to completely eliminate the risk of relapse.After the culture of urine and/or prostate secretion for the type of pathogen, the doctor prescribes an antibacterial drug.If acute prostatitis is diagnosed, oral antibiotic therapy takes about 4-6 weeks.In chronic or recurring forms of the disease, treatment will take longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis), hospitalization and a course of intravenous antibiotics are required.

If there is difficulty in urinating, the urologist prescribes drugs that eliminate the hypertonicity of the muscles of the bladder and prostate gland, normalize the output of urine and prevent stagnation.Some patients are treated with drugs that reduce the level of sex hormones.As a result, the size of the prostate decreases and, accordingly, there is a feeling of discomfort during urination, defecation and ejaculation.With severe swelling of the prostate gland, muscle relaxants help to relieve excessive tension of the bladder sphincter and adjacent muscles.Anti-inflammatory non-steroidal drugs effectively combat pain.Also, chronic prostatitis responds well to adjuvant physiotherapy.Effective methods of such treatment are:

  • instillation of drugs into the urethra;
  • prostate massage;
  • shock wave therapy (SWT);
  • magnetic laser therapy (MLT);
  • electrophoresis;
  • ozone therapy;
  • intravenous laser blood irradiation (ILBI);
  • ultraviolet blood radiation (UFOI).

Prostate massage is a commonly used urological method.The doctor uses digital stimulation of the prostate gland through the rectum to increase secretion flow and restore the patency of the organ's ducts.The additional effect improves blood circulation and accelerates the penetration of antibiotics into inflamed tissues.In addition to finger massage of the prostate, hardware methods are also possible.Shock wave therapy gives good results in the treatment of prostatitis.The basis of this medical technology is the short-term impact of low-frequency sound waves on the inflamed area.The procedure helps:

  • activate local blood circulation and the growth of new vessels;
  • stimulate the body's own regenerative abilities;
  • destroy fibrous foci and calcifications that provoke pain and inflammatory processes.

After a course of shock wave therapy, symptoms of prostatitis are eliminated and a good preventive effect is observed.Certain results can be achieved only with an integrated approach to the problem.In addition, the patient's responsible attitude to medical prescriptions is important.

In turn, the clinic's urologists ensure the development of an individual treatment regimen, taking into account the cause, form, stage, general well-being and the presence of accompanying pathologies.

Prevention of prostatitis

To minimize the risk of relapse, it is necessary to reduce the negative effects on the body.Among the provoking factors:

  • Smoking.The anatomical features of the location of the prostate gland lead to constant oxygen starvation, and inhalation of tobacco smoke causes vasospasm, which further slows down local microcirculation processes.All experienced smokers have problems with high blood pressure.
  • Lack of motor activity."Sedentary" work and a sedentary lifestyle cause congestion in the pelvic organs.
  • Alcohol abuse.Exceeding the daily limit of alcohol affects general health and makes the body more susceptible to various infectious diseases.
  • Stressful conditions.Situations that cause anxiety, irritation, and depressive disorders should be avoided as much as possible.If necessary, you should contact a specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, which makes the body "open" to colds and inflammation.
  • Fatigue, excessive physical activity.You should not forget the schedule of work and rest, as well as heavy lifting.

Preventive measures will help prevent the development of acute prostatitis and relapses of chronic prostatitis.For questions about the diagnosis and treatment of inflammation of the prostate gland, you can contact the urology department of our clinic.