Prostatitis: symptoms, treatment, prevention

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

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

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

reasons for development

Inflammation does not occur by itself. 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 damage to the prostate 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 more reasons and the list will include atypical microbes.

The provoking factors for the development of the bacterial variant are:

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

What are the first signs of prostatitis to look out for?

The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating. If you notice a weakening of the urine stream when going to the toilet, an uncomfortable or burning sensation in the urethra, you should see a urologist as soon as possible.

With an acute onset of the disease, the temperature can rise, general well-being worsens. Such a patient should be treated immediately by connecting antibiotics and anti-inflammatory drugs.

In some cases, the disease can be asymptomatic for a long time, so treatment is started late.

Symptoms of prostate inflammation

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

• pain in the lower back, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficulty passing stool;
• a thin stream of urine;
• temperature rise;
• Chills;
• deterioration in general well-being.

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

With a chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible. The pain may be absent or have a dull, aching character.

Symptoms of acute prostatitis

Acute prostatitis occurs in several stages, moving from one to another, if you do not contact a specialist and do not 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, there is initially a slight pain that quickly intensifies.

Without treatment, the second stage occurs - acute follicles. At this moment, the pain becomes particularly intense, radiating to the anus and worsening during defecation. Urination is very difficult, sometimes there is acute urinary retention. The temperature does not exceed 38 degrees and can be higher only in rare cases.

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

Symptoms of chronic prostatitis

Sometimes chronic prostatitis occurs against the background of an acute inflammatory process. This is a disease in its own right, in which there is a primarily chronic course that develops over a long period of time.

Often the chronic course begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococci. However, vivid manifestations are very rare, more often the disease occurs with mild pain during urination or in the perineum, with small discharge from the urethra. These manifestations often go unnoticed by the patient for a long time.

Signs of prostatitis in men can appear in different ways, but they are all combined into three groups - pain syndrome, urination disorders, problems with sex life. The tissues of the prostate are devoid of receptors, so they cannot cause painful sensations. They occur when inflammation spreads to the richly innervated pelvic organs. Pain in patients can be different - from barely noticeable discomfort to severe and intense pain that interferes with sleep and the usual lifestyle. Pain can radiate to the sacrum, scrotum, lower back, and perineum, so self-diagnosis is useless here.

Problems with urination begin at the moment when the prostate increases in volume and begins to squeeze the urethra with a decrease in the lumen of the ureter. There is 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 the body compensates for them, but at a later stage, without proper treatment, they reappear.

Potency problems in men can also manifest themselves in different ways. Patients complain of worsening erection, accelerated ejaculation, decreased sexual arousal. Gradually, sexual disorders become more pronounced, and in the advanced stages, the symptoms of prostatitis are complemented by impotence.

classification

Experts distinguish several categories of the disease:

• acute bacterial prostatitis, characterized by symptoms of bacterial infection. The causative agent of the disease in most cases is Escherichia coli. Enterococci and other bacteria are isolated somewhat less frequently;
• chronic bacterial prostatitis, which is a recurrent form of the disease. The causative agents of the disease are E. coli bacteria, enterococci, etc. Trichomonads, fungi, chlamydia, viruses, mycoplasma can also become pathogens;
• chronic pelvic pain syndrome in which no infections are detected. There are two types: inflammatory and non-inflammatory. The causes include: autoimmune processes, external factors (hyperthermia, overheating), infrequent sex life, low physical activity, infrequent urination;
• asymptomatic prostatitis, accidentally detected during a medical examination.

Only a qualified specialist doctor can accurately name the type of prostatitis and determine the course of treatment after a thorough diagnosis based on examination data. If there are certain signs, you should contact a specialist.

symptoms

The main symptom is a violation of the functioning of the urinary system. If you have the following symptoms, you should consult a specialist:

• if urination is difficult and urine is intermittent;
• if there is discharge from the urethra during defecation;
• with a burning sensation in the urethra and perineum;
• when there are unpleasant sensations in the bladder and prostate during bowel movements;
• if the urge to urinate has increased and is becoming more frequent;
• for pain in the rectum;
• with purulent, bloody discharge from the urethra (floating "threads");
• with a frequent increase in body temperature;
• with the appearance of problems of an intimate nature (weakening of the erection);
• if erections occur at night for no apparent reason;
• if ejaculation occurs too quickly during intercourse;
• when the sensations are "erased" during orgasm;
• with rapid general fatigue;
• with manifestations of an unreasonably anxious or depressed state, as well as a state of mental depression;
• with frequent depression, manifestations of mental depression in anticipation of complications;
• with a general weakening of the body.

To contact a urologist, one or two symptoms are enough. As a rule, attempts at self-healing lead to a worsening of the condition, the transition of the disease to a chronic or severe form. In the worst case, a late visit to the doctor can lead to infertility or complete impotence.

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

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

Aching pains indicate the formation of stones. Doctors describe infertility as a late sign of a progressive disease.

Signs of prostatitis in acute and chronic forms differ significantly. In the chronic form in particular, the signs can be mild or not pronounced at all.

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

• urging to urinate became very frequent;
• Pain during defecation and urination amplifies in the perineum and radiates to the groin;
• complete emptying of the bladder is impossible;
• the amount of urine formed per day has decreased significantly or urine is not collected;
• Fever, frequent headaches, general weakness.

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

Chronic prostatitis is characterized by the following symptoms:

• when urinating, pain in the perineum increases;
• with frequent urges, the bladder is not completely emptied;
• decreased sex drive;
• Discomfort during sexual intercourse.

One of the signs of the chronic form is a significant disruption in the emotional background, characterized by insomnia, increased nervousness, moodiness, irritability.

The bacterial form of chronic prostatitis is characterized by problems with ejaculation, which becomes rapid and painful, discomfort in the pubic area, frequent or involuntary urination, and interruptions in the stream of urine.

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

Possible complications

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

diagnosis

The urologist deals with the diagnosis and therapy of any form of prostatitis. If a tumor is suspected, the patient may be referred for a consultation with an oncologist. With chronic, long-lasting, difficult to treat prostatitis, consultation with an immunologist may be necessary.

1. Bacteriological urine culture.
2. Analysis of prostate secretion for microflora and sensitivity to antibiotics.
3. Rectal examination of the prostate.
4. Ultrasound of the prostate, which allows identifying tumors, cysts and adenomas, as well as distinguishing prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Features of the diagnosis in acute prostatitis

If the signs of the disease indicate acute prostatitis, then the diagnosis is made using instrumental and clinical examination data. All manipulations that can affect the prostate are contraindicated, since they can cause acute pain or provoke the spread of infection.

Features of diagnosis in chronic bacterial prostatitis

The diagnosis in such cases is determined on the basis of the following data: examination by the patient's doctor, bacteriological and microscopic examination of the prostate secretion, examination of ultrasound data.

Features of the diagnosis in pelvic pain syndrome

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

• Examination of prostate secretion;
• molecular biology research;
• Bacteriological Research.

The choice of technique is determined by the doctor after the initial examination.

risk groups

The most likely occurrence and development of prostatitis:

• in men who are obese or lead a sedentary lifestyle;
• in sedentary men (office workers, programmers);
• in men whose body is exposed to shock and vibration (motorists, including special equipment);
• in men with infectious diseases, including diseases of the genitourinary system;
• in men who are sexually hyperactive and in those who do not have regular sex;
• in men in a state of depression suffering from mental illness;
• alcoholics, drug addicts, etc.

treatment

Patients with proven acute prostatitis without the occurrence of complications are treated on an outpatient basis. Only if there are severe symptoms of intoxication and there is a suspicion of a purulent process, hospitalization is carried out.

Antibiotics are the drugs of choice to fight inflammation. They are also used in chronic bacterial form. The drug is selected individually and taken as a course for 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 in prostatitis are alpha1 blockers, which are prescribed in the presence of residual urine confirmed by ultrasound. They facilitate urination, relax the muscles of the prostate and bladder. NSAIDs help relieve pain.

Treatment of prostatitis is carried out only comprehensively and consistently. In addition to taking medication, the doctor prescribes a prostate massage, and physiotherapy is used to improve blood flow to this organ. Surgical treatment is used only when abscesses and suppuration of the seminal vesicles occur.

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

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

For treatment, a specific technique can be chosen or a complex can be prescribed. Depending on the result of the diagnosis, specialists in the field of urology prescribe:

• Physiotherapeutic procedures: magnetic resonance therapy, procedures using laser devices, ultrasound, reflexology, massage, hirudotherapy.
• Medical treatment.
• nutrition and psychotherapy.
• Surgical intervention.

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

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

In some cases, experts may recommend muscle relaxants and hormone therapy, as well as antioxidants, which help reduce inflammation and protect cells from free radicals.

Properly selected complex of drugs for acute bacterial prostatitis:

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

Chronic prostatitis is difficult to treat, so an extensive list of drugs is used: anti-inflammatory, antispasmodic, absorbable, antibacterial, vibration massage and finger massage, electrophoresis, EHF and UHF therapy, sinusoidal modulated currents.

When diagnosing pelvic pain syndrome, antibiotics and anti-inflammatory drugs, various types of physiotherapy, magnetic and laser therapy, electrical nerve stimulation, etc. are used. One of the effective methods is tissue drainage around the focus of inflammation.

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

tablets

In the form of tablets for prostatitis, antibacterial agents and painkillers can be prescribed.

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

Painkillers for prostatitis will help get rid of unpleasant symptoms. For this, nonsteroidal anti-inflammatory drugs are used, which not only eliminate pain, but also reduce inflammation.

Male prostatitis pills that help treat urinary disorders belong to the group of alpha-1 blockers. They relax the smooth muscles and restore the patency 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 severe inflammation, as well as in the absence of tablet forms of antibiotics, to which the pathogen is sensitive. You can inject antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of the prostate.

Injectable prostatitis medications work faster than oral medications, so they are sometimes preferred.

Operation for prostatitis

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

Without 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, which periodically worsens. Full recovery is not always possible, however, discomfort, problems with urination and pain can be eliminated if you consult a doctor in time and take all prescribed medications.

Self-treatment at home and the use of folk 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 for as long as possible.

Typical signs of prostate cancer

The prostate is a small organ that only men have. Resembling a sponge in structure, it is located under the bladder and envelops the urethra. The growth of the gland begins in adolescence under the influence of male sex hormones, in adulthood its weight can reach 20 grams. It plays an important role in the male reproductive system and produces a secret, one of the components of sperm. But, unfortunately, in mature and elderly men, glandular hyperplasia or malignant neoplasms of the organ are often found.

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, the tumor is localized in the prostate, has not grown into adjacent tissues and has not allowed metastases.

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 go to the doctor. That is why this type of tumor is often found already in a neglected state. An exception may be patients who have previously been diagnosed with benign prostate neoplasms. In this case, they are regularly observed by a specialized doctor and tested for a specific prostate antigen and undergo an ultrasound of the gland. You have every chance of detecting a tumor in its infancy. However, it is worth noting that detecting prostate cancer is not always easy. Even with a biopsy, the results can be unequivocal, but there is already oncology. This is due to the flaws in the method, the needle simply does not fall in the place of the localized focus. If there is a suspicion of pathology of the prostate, especially cancer, a fusion biopsy should be performed, which combines the possibilities of ultrasound and MRI in real time, giving the doctor the opportunity to visualize the organ as accurately as possible.

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

Because the bladder needs to be emptied regularly, disruption to this process can lead to urinary retention, inflammation, and bacterial infection. If no action is taken, the process will spread, and this already threatens with pelvic inflammatory disease and kidney problems.

In stage 4, prostate cancer manifests itself even more clearly. Metastases are most commonly found in the bones, spine, and lymph. Because of this, a person's regional lymph nodes increase, bones ache, he loses a lot of weight and weakens.

Treating prostate cancer is no easy task, but it can be done. With timely detection of a local process, complete healing 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 achieve success even in the most difficult cases.