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 old. This disease causes pain in the lower back, perineum or pelvic region, is accompanied by a violation of the normal process of urination and, in severe forms, leads to erectile dysfunction and serious problems in the relationship with the partner.
Approximately a quarter of cases among 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.
Prostate gland (prostate) refers to the male reproductive system. It has the shape of a chestnut, located in front of the rectum, under the bladder and surrounds the urethra (urethra). When the prostate gland becomes inflamed, it compresses the urethra, which further leads to problems with urination. The main function of the prostate is to produce a secretion (fluid) that is part of the sperm and dilutes it, which ensures normal sperm motility.
Prostatitis is very common in the practice of a urologist. It can occur suddenly or gradually, appearing continuously and for a long time (chronic prostatitis). The chronic form of this disease is more common than the acute one. Chronic prostatitis ranks fifth among the twenty leading urological diagnoses.
Since prostatitis is an active focus of infection in the body, it requires mandatory treatment, even if its symptoms do not bother you.
Causes of developing 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, which lead 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.
Very often, the appearance of prostatitis is caused by pyogenic microbes: E. coli, streptococci and staphylococci, mycoplasmas, fungi Candida, Trichomonas, tuberculosis bacillus. They multiply very quickly and destroy prostate tissue, which is manifested by inflammation.
In most cases, the appearance of prostatitis provokes an infection that penetrates the prostate gland through the urethra. It happens that it enters the body through blood or lymph, passes through the bladder or rectum.
Important! Decreased immunity is very dangerous for a patient with chronic prostate, as the prostate gland is quickly inflamed by fatigue, stress, lack of sleep, malnutrition and other negative factors.
With a sedentary lifestyle and lack of a continuous sex life, the blood supply to the pelvic organs deteriorates, which leads to prostate tissue oxygen starvation and overload. A stagnant secretion is an ideal environment for the development of pathogenic microorganisms that cause inflammation.
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 men and the elderly.
congestive prostatitis- inflammation caused by stagnation of secretion. It develops in men with a sedentary lifestyle, who do not have a regular sex life. This form can be quickly replenished by an infection and then the stagnant process is complicated by the bacterial form.
Prostatitis calculosis- stones form in the prostate gland. Chronic untreated 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 are distinguished:
Acute form of prostatitis- this is an inflammation of the prostate gland caused by an infectious agent, characterized by the appearance of edema and purulent foci in the tissue. 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 gland. The chronic form accounts for 10% of all prostatitis cases.
Symptoms of prostatitis
generalsymptoms of prostate inflammationare:
- pain in the lumbar region;
- sensation of discomfort during intestinal motility;
- pain in the perineum or pelvic region;
- disorders in the work of the lower urinary tract.
The acute phase of prostatitis is accompanied by a general intoxication syndrome. This disease is characterized by a sharp manifestation of symptoms with a vivid clinical picture:
- a sharp rise in body temperature, chills, nausea, vomiting and maltreatment;
- pain syndrome and chills in joints and muscles;
- an increase in prostate size 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 may develop. In such a situation, the patient should be urgently hospitalized: with sepsis, treatment of prostatitis should be carried out exclusively in the clinic.
INchronic prostatitis of a bacterial naturesymptoms are usually absent, so treatment begins only when an infection is detected in the urinary system, 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 does not show that chronic pain is caused by pathologies in the prostate gland, then in this case we are dealing withchronic non-bacterial prostatitisor so-calledchronic pelvic pain syndrome. With this disease, a man's quality of life 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 sexual intercourse etc.
Similar symptoms may apply to other urological diseases, so it is impossible to diagnose prostatitis by symptoms alone. For example, urinary disorders and pain are present in prostate adenoma, cystitis, various oncological tumors in the genitourinary organs, etc.
Diagnosis of prostate inflammation
After identifying the first signs of the inflammatory process of the prostate, the patient should immediately contact a doctor - a urologist. The doctor must rule out many diseases that have similar manifestations and determine which type of disease it belongs to.
To confirm that the patient has no other diseases (for example, appendicitis, oncology, inflammatory processes in the bladder and kidneys, prostate adenoma), the doctor must perform the necessary examinations:
- collection of anamnesis (patient question);
- general inspection;
- rectal examination;
- study of prostate gland secretion;
- tests for sexually transmitted infections;
- ultrasound examination of the prostate, scrotum and pelvic organs.
At the meeting, the urologist should explain to the patient the duration of clinical manifestations of the disease, the localization and nature of pain (for example, in the perineum, scrotum, penis and inner thigh), the characteristic changes in sperm (presence of pus and blood).
The doctor diagnoses chronic bacterial prostatitis with a duration of symptoms of at least three months.
The survey will include:
- Digital rectal examination of the gland, to determine the degree of prostate enlargement and its consistency.
- Prostate, urine and / or ejaculate secretion analysis.
- Identification of urogenital infection.
- Urodynamic study.
- Ultrasound examination of the urinary system (kidney, prostate, bladder with determination of residual urine).
- Cultural study of prostate secretion and microscopy of various parts of urine and prostate secretion.
- Androflor is a comprehensive study of 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 only in 5-10% of cases can detect an infection, which eventually leads to prostate.
The patient must undergo a thorough 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 should prescribe treatment.
The main role in the treatment of this disease is assigned to drug therapy:
Antibacterial therapy
In the first stage of therapeutic therapy, it is necessary to eliminate the inflammation. Antibiotics are the main treatment for acute bacterial prostatitis and are recommended for chronic bacterial prostatitis. The doctor chooses an antibacterial drug depending on the bacteria that caused the disease. The patient will need to take oral antibiotics in a course for 4-6 weeks. Chronic or recurrent prostatitis requires more time to resolve. Hospitalization may be required for very severe manifestations, where an intravenous course of antibiotics will be given. Usually, this happens with acute bacterial prostatitis.
Treatment with alpha1-blockers
With difficulty urinating, the doctor prescribes alpha1-blockers, which help facilitate urination and relax the prostate and bladder muscles. Muscle relaxants will relieve pain caused by swelling of the prostate gland, which puts pressure on adjacent muscles. Non-steroidal anti-inflammatory drugs will help relieve the painful syndrome.
Also, the doctor may prescribe ancillary 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 sequence of actions must be observed. Treatment of prostatitis is always complex.
Physiotherapy in the treatment of prostatitis
In the categories of chronic prostatitis, you can also use physiotherapy methods:
- prostate gland massage (prostate);
- laser therapy;
- microwave hyperthermia and thermotherapy;
- electrical stimulation with currents modulated by skin or rectal electrodes;
- acupuncture (acupuncture).
Alternative methods, such as hirudotherapy (treatment with medical caterpillars), are sometimes used to treat prostatitis, but the effectiveness and safety of this method has not been proven.
Stem cell introduction
Cell therapy (stem cell injections) is a promising method for treating prostatitis today, it is in the early stages of development. Regarding the injection of stem cells into the prostate, there can only be hypotheses about its mechanisms and empirical data obtained from specific groups of researchers.
Surgical treatment of prostatitis
Surgical methods are used to treat prostatitis complications (abscess and suffocation of the seminal vesicles).
Treatment of chronic pelvic pain syndrome requires special consideration. Asymptomatic inflammatory prostatitis does not require treatment.
Diet and lifestyle for prostatitis
Prostatitis does not require a special diet, but eating a large amount of vegetables, lean meats 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. ), to replace sugar with natural honey. Proper nutrition with inflammation of the prostate gland will help improve bowel function and reduce the likelihood of recurrence or speed up recovery. The patient should limit himself to drinking coffee, exclude alcohol, drink plenty of fluids and adhere to a healthy lifestyle.
Preventive measures to prevent prostatitis
When a man leads the right path of life: follows the right food, engages in sports, then his chances of developing chronic prostatitis are very small. Rejection of bad habits and casual sex are the prevention of this disease.
Important! There is a primary and secondary prevention to prevent the development of prostatitis in men.
PRIMARY- which aims to prevent the occurrence of the disease. It is about maintaining a balanced diet, regime of physical activity, timely treatment of any infectious diseases of the body and regular protected sexual intercourse, etc.
Medium- aims to prevent recurrence of existing chronic prostatitis and provides regular examination by a urologist and preventive treatment with multivitamins, restorative medicines and sports.