Prostatitis - types, symptoms and treatment

what is prostatitis

Prostatitis is an inflammatory process associated with inflammation of the prostate gland (prostate) in men. Most often, this disease occurs in men over 30 years of age. This ailment causes pain in the lower back, perineum or pelvic region, is accompanied by a violation of the normal urination process, and in severe forms leads to erectile dysfunction and serious problems in relationships with a partner.

Approximately a quarter of the cases between couples suffering 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.

How is a normal prostate

The prostate gland (prostate) refers to the male reproductive system. It is chestnut-shaped, located in front of the rectum, below the bladder, and surrounds the urethra (urethra). When the prostate gland swells, it compresses the urethra, causing even more problems with urination. The main function of the prostate is to produce a secret (fluid) that is part of the semen and dilutes it, which ensures normal sperm motility.

Prostatitis is very common in the practice of a urologist. 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.

Since prostatitis is an active source 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 gland is very diverse:

  • diseases of the genitourinary system (cystitis, urethritis, pyelonephritis);
  • sexually transmitted infections (trichomoniasis, gonorrhea);
  • infections associated with pneumonia, influenza, tonsillitis, furunculosis;
  • chronic constipation, forcing a man to strain regularly;
  • sedentary lifestyle and irregular sex life, leading to stagnation of secrecy;
  • urinary retention: a swollen bladder increases pressure on the prostate;
  • frequent hypothermia (or overheating);
  • injuries in the pelvic area;
  • Hormonal disorders that weaken the immune system.

Most often, the appearance of prostatitis is caused by pyogenic microbes: E. coli, streptococci and staphylococci, mycoplasmas, Candida fungi, Trichomonas, tubercle bacillus. They multiply very quickly and destroy prostate tissue, which is manifested by inflammation.

In most cases, the appearance of prostatitis causes an infection that enters the prostate through the urethra. It happens that it enters the body through blood or lymph, passes from the bladder or rectum.

Important! A decrease in immunity is very dangerous for a patient with chronic prostatitis, since the prostate rapidly swells with fatigue, stress, lack of sleep, malnutrition and other adverse factors.

With a sedentary lifestyle and the absence of a constant sex life, the blood supply to the pelvic organs worsens, which leads to a lack of oxygen in the prostate tissues and congestion. A stagnant secret is an ideal environment for the development of pathogenic microorganisms that cause inflammation.

comparison of normal and diseased prostate

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 elderly men.

congestive prostatitis- inflammation caused by stagnation of the secretion. It develops in men with a sedentary lifestyle who do not have a regular sex life. This form can quickly be supplemented by an infection, and then the stagnant process is complicated by the bacterial form.

Calculous prostatitis- Stones form in the prostate gland. 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- this 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 such a 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

Generalsymptoms of prostate inflammationare:

  • pain in the lumbar region;
  • sensations of discomfort during intestinal motility;
  • pain in the perineum or pelvic region;
  • disorders in the work of the lower urinary tract.

The acute stage 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 increase in body temperature, chills, nausea, vomiting and general malaise;
  • pain syndrome and chills in the joints and muscles;
  • increase in the size of the prostate and the appearance of discomfort in the perineal area;
  • 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 must be urgently hospitalized: with sepsis, treatment of prostatitis should be carried out exclusively in the clinic.

Achronic prostatitis of a bacterial naturesymptoms are usually absent, so 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 observe:

  • pain during ejaculation;
  • the appearance of blood in the ejaculate;
  • the presence of discharge from the urethra;
  • erectile dysfunction may develop.

If the examination did not show that chronic pain is caused by pathologies in the prostate gland, then 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 diseases, making it impossible to diagnose prostatitis based on symptoms alone. For example, pain and urination disorders are present in prostate adenoma, cystitis, various oncological tumors in the genitourinary organs, etc.

Diagnosis of inflammation of the prostate.

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 which 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 conduct the necessary tests:

  • collection of anamnesis (interrogation of the patient);
  • General inspection;
  • Rectal exam;
  • study of the secret of the prostate gland;
  • testing for sexually transmitted infections;
  • ultrasound of prostate, scrotum and pelvic organs.

At the appointment, 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), the characteristic changes in 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 survey will include:

  1. Digital rectal exam of the gland, to determine the degree of enlargement of the prostate and its consistency.
  2. Analysis of prostatic secretion, urine and/or ejaculate.
  3. Identification of urogenital infection.
  4. Urodynamic study.
  5. Ultrasound examination of the urinary system (kidneys, prostate, bladder with determination of residual urine).
  6. Prostatic secretion culture study and microscopy of several portions of urine and prostatic secretion.
  7. 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 disease, the doctor will recommend a course of treatment. It should be remembered that standard methods are only able to detect an infection in 5-10% of cases, which ultimately leads to prostatitis.

The patient should definitely undergo a full diagnosis, because the success of the treatment will depend on the accuracy of the results.

Treatment of prostatitis

When a urologist has made a diagnosis, determined the cause and form of prostatitis, he must prescribe treatment.

The main role in the treatment of this disease is assigned to drug therapy:

antibacterial therapy

At the first stage 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 based on the bacteria that caused the disease. The patient will need to take oral antibiotics in a course of 4 to 6 weeks. Chronic or recurrent prostatitis takes longer to resolve. Hospitalization may be required for very severe manifestations, where an intravenous course of antibiotics will be administered. 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 will relieve the pain caused by the inflammation of the prostate, which puts pressure on the surrounding muscles. Nonsteroidal anti-inflammatory drugs will help relieve pain syndrome.

Also, the doctor may 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:

  • massage of the prostate (prostate);
  • laser therapy;
  • hyperthermia and microwave thermotherapy;
  • electrical stimulation with modulated currents with cutaneous or rectal electrodes;
  • acupuncture (acupuncture).

Alternative methods, such as hirudotherapy (treatment with medical leeches), are sometimes used to treat prostatitis, but the efficacy and safety of this method have not been proven.

introduction of stem cells

Cell therapy (stem cell injections) is a promising method for the treatment of prostatitis today, it is in the early stages of development. Regarding the injection of stem cells into the prostate, only hypotheses can be had about its mechanisms and empirical data obtained by individual groups of researchers.

Surgical treatment of prostatitis

Surgical methods are used to treat complications of prostatitis (abscess and suppuration of seminal vesicles).

The treatment of chronic pelvic pain syndrome requires a separate consideration. Asymptomatic inflammatory prostatitis does not require treatment.

Diet and lifestyle for prostatitis.

Prostatitis does not require a special diet, but eating plenty 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 inflammation of the prostate gland will help improve bowel function and reduce the likelihood of relapse or speed up recovery. The patient should limit himself to coffee, exclude alcohol, drink plenty of fluids and follow a healthy lifestyle.

Preventive measures to prevent prostatitis.

When a man leads the correct lifestyle: he follows proper nutrition, plays sports, then his chances of developing chronic prostatitis are very small. The rejection of bad habits and casual sex are the prevention of this disease.

Important! There is primary and secondary prevention to prevent the development of prostatitis in men.

Primary- intended to prevent the onset of the disease. It is about maintaining a balanced diet, a regimen of physical activity, timely treatment of any infectious disease of the body, and regular protected sexual intercourse, etc.

Secondary- is aimed at preventing the recurrence of existing chronic prostatitis and provides for regular examination by a urologist and preventive treatment with multivitamins, restorative drugs and sports.