Prostatitis: symptoms, treatment, prevention

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

Among all urological diseases, urologists most often meet with prostatitis. It can develop suddenly (acute) against the background of general health, or continue for a long time, with periods of exacerbation and remission, which indicates a chronic course. Moreover, 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 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 old due to damage to the prostate gland by gram-negative bacteria - Escherichia coli, Proteus, Enterobacter. Also, inflammation occurs due to infection with sexually transmitted infections - gonorrhea, chlamydia. In the chronic form, there may be many more reasons, and the list will include atypical microbes.

Provocative 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;
• 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 prostate tissue;
• previously confirmed fibrotic changes in the prostate (according to TRUS results).

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

The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating. If, when you go to the toilet, you have noticed a weakening of the flow of urine, you have felt discomfort or a burning sensation in the urethra, you should contact a urologist as soon as possible.

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

In some cases, the disease can be asymptomatic for a long time, so its treatment is started 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 the lower back, sacrum, perineum;
• frequent or difficult urination;
• acute retention of urine;
• difficulty in defecation;
• a thin stream of urine;
• Increase in temperature;
• chills;
• deterioration of general well-being.

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

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

Symptoms of acute prostatitis

Acute prostatitis occurs in several stages, which will move from one to another, if you do not contact 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 first appears, which quickly increases.

Without treatment, the second stage occurs - acute follicular. At this moment, the pains become particularly strong, they radiate to the anus and are aggravated during defecation. Urination is very difficult, sometimes there is an acute retention of urine. The temperature does not exceed 38 degrees and only in rare cases can it be higher.

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

Symptoms of chronic prostatitis

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

Often, the chronic course begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococcus. But vivid manifestations are very rare, more often the disease appears with small pains during urination or in the perineum, with small discharge from the urethra. Often these manifestations go unnoticed even by the patient for a very long time.

Signs of prostatitis in men can appear in different ways, but all of them are combined in three groups - pain syndrome, urination disorder, problems with sex life. Prostate tissue has no receptors, so it cannot give painful sensations. They appear when the inflammation begins to move to the pelvic organs, which are highly innervated. Pain in patients can be different - from barely noticeable discomfort to strong and intense, which disrupt sleep and the usual way of life. Pain can radiate to the sacrum, scrotum, lower back, 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 a frequent need to urinate, a feeling of incomplete emptying of the bladder. Usually, such phenomena are expressed at the beginning of the disease, in its early stages, then they are compensated by the organism, but at a later stage, without adequate treatment, they reappear.

Problems with potency in men can also be expressed in different ways. Patients complain of worsening erection, accelerated ejaculation, decreased sexual arousal. Gradually, sexual disorders become more pronounced and at an advanced stage the symptoms of prostatitis are complemented by impotence.

Distribution

Experts distinguish several categories of the disease:

• acute bacterial prostatitis, which is characterized by symptoms of a bacterial infection. The causative agent of the disease in most cases is Escherichia coli. Somewhat less frequently, enterococci and other bacteria are isolated;
• chronic bacterial prostatitis, which is a recurrent form of the disease. The causes of the disease are E. coli bacteria, enterococci, etc. Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also become pathogenic;
• chronic pelvic pain syndrome, in which infections are not detected. There are two types: inflammatory and non-inflammatory. Among the causes: autoimmune processes, external factors (hypothermia, overheating), infrequent sexual life, low physical activity, infrequent urination;
• asymptomatic prostatitis, discovered incidentally during a medical examination.

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

Symptoms

The main symptom is a violation of the functioning of the urinary system. You should contact a specialist if you have the following symptoms:

• if urination is difficult and urine passes intermittently;
• if there is leakage from the urethra during bowel movements;
• with a burning sensation in the urethra and perineum;
• if there are unpleasant sensations in the bladder and prostate during bowel movements;
• if the urge to urinate has increased and become more frequent;
• in case of pain in the rectum;
• if there is bloody purulent discharge from the urethra ("floating" threads);
• with a frequent increase in body temperature;
• with the appearance of problems of an intimate nature (weakening of erection);
• when erections appear at night for an unexplained reason;
• if ejaculation during sexual intercourse is too fast;
• if sensations during orgasm are "hidden";
• with rapid general fatigue;
• with manifestations of an irrational state of anxiety or depression, 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.

One or two symptoms are enough to contact a urologist. Attempts to heal yourself, as a rule, lead to a worsening of the condition, the transition of the disease to a chronic or severe form. In the worst case, an untimely visit to the doctor can cause infertility or complete impotence.

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

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

Painful pain indicates the formation of stones. Doctors call infertility a late sign of a progressive disease.

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

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

• the urge to urinate became 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 formed per day is significantly reduced or the urine does not accumulate;
• fever, frequent headaches, general weakness.

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

Chronic prostatitis is characterized by the following symptoms:

• during urination, the pain in the perineum increases;
• with frequent urges, the bladder does not empty completely;
• decreased sexual desire;
• discomfort during sexual intercourse.

One of the signs of the chronic form is a significant disturbance of the emotional background, characterized by insomnia, increased irritability, capriciousness, 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 interruption of the flow of urine.

Chronic pelvic pain syndrome, which, according to medical statistics, is the most common form of prostatitis, is characterized by signs similar to the symptoms of chronic bacterial prostatitis: frequent urge to urinate, weakening of urine flow, 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;
• prostate cysts and stones;
• infertility;
• ejaculation disorder;
• erectile dysfunction.

Diagnosing

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. In long-term chronic prostatitis, which is difficult to treat, consultation with an immunologist may be required.

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

Characteristics of diagnosis in acute prostatitis

If the signs of the disease indicate acute prostatitis, the diagnosis is made on the basis of instrumental and clinical examination data. Any manipulation that may affect the prostate is contraindicated, as it may 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 these data: examination by the patient's doctor, bacteriological and microscopic examination of prostate secretion, study of ultrasound data.

Features of diagnosis in pelvic pain syndrome

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

• study of prostate secretion;
• molecular biological research;
• bacteriological research.

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

Groups at risk

The most likely appearance and development of prostatitis:

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

Treatment

Patients with acute prostatitis identified without the development of complications are treated on an outpatient basis. Only with severe symptoms of intoxication and 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, 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 for prostatitis is alpha-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound. They help facilitate urination, relax the prostate and bladder muscles. NSAIDs help relieve pain.

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

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

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

For treatment, a specific technique can be chosen or a complex can be prescribed. Specialists in the field of urology, depending on the results of the diagnosis, describe:

• Physiotherapy procedures: magnetic resonance therapy, procedures using laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Medical treatment.
• diet and psychotherapy.
• Surgical intervention.

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, experts may recommend muscle relaxants and hormone therapy, as well as antioxidants that 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 a wide list of medications is used: anti-inflammatory, antispasmodic, absorbent, antibacterial, vibration massage and finger massage, electrophoresis, EHF and UHF therapy, sinusoidally modulated currents.

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

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

tablets

In the form of tablets for prostate, antibacterial agents, pain relievers can be prescribed.

The course of antibiotic therapy is selected individually depending on the result of the prostate secretion analysis. 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 help to get rid of unpleasant symptoms. For this, non-steroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.

Prostatitis pills for men, which help treat impaired urination, belong to the group of alpha 1-blockers. They relax the smooth muscles and restore the patency of the urethra squeezed 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 for severe inflammation, as well as in the absence of tablet forms of antibiotics, to which the pathogen is sensitive. You can make injections with antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of their prostate.

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

Surgery for prostate

The most feared complications are suffocation of the seminal vesicles and abscess. Medicines for the treatment of the disease are not able to cope with the disease in such a difficult situation, therefore, an operation 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.

Prediction and prevention

The acute form without treatment often becomes chronic, which periodically worsens. Complete recovery is not always possible, however, with timely access to the doctor and taking all prescribed drugs, discomfort, problems with urination and pain can be eliminated.

Self-medication 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 at the right time, limit the use of coffee, spices and alcohol and stay sexually active as long as possible.

Typical signs of prostate cancer

The prostate gland is a small organ that only men have. Its structure resembles a sponge, it is located under the bladder and wraps around the urethra. 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, producing a secret, one of the components of sperm. But unfortunately, mature and elderly men are often diagnosed with 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 gland, has not grown in the neighboring tissues and has not allowed metastases.

Symptoms of prostate cancer in the early stages are practically absent, this is the secret of the disease. The man does not make any complaints, feels well and sees no reason to go to the doctor. This is why this type of tumor is often already found in a neglected state. Exceptions can be made by patients who have previously been diagnosed with benign neoplasia of the prostate gland, in which case they are periodically observed by a specialist doctor and tested for a specific antigen of the prostate, undergo an ultrasound of the gland. They have every chance to detect a tumor in its early stages. But it is worth noting that detecting prostate cancer is not always easy. Even with a biopsy, the results can be clear, but there is already oncology. This is due to errors in the method, the needle simply does not fall on the place of localized focus. If a pathology of the prostate 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 accurately as possible. possible.

Some of the 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 disturbed, urine can be retained in it, inflammation can occur and a bacterial infection can join. If measures are not taken, the process will spread and this already threatens with pyelonephritis and kidney problems.

In stage 4, prostate cancer appears even more clearly. Metastases are most often found in the bones, spine and lymph. Because of this, a person's regional lymph nodes grow, bones hurt, he loses weight sharply and becomes weak.

Treating prostate cancer is not an easy task, but it can be done. With a timely detection of a local process, a complete cure can be achieved, and with more advanced stages, life can be extended. If you notice the symptoms described above, contact a professional clinic for examination.

Leave the 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.