Prostatitis in men is an inflammatory process involving the prostate tissue. The disease is accompanied by pain that occurs in the lower back, perineum, pelvis. The main manifestations are perineal pain and lower urinary tract dysfunction.
Among all urological diseases, urologists most often encounter prostatitis. It can develop unexpectedly (acutely) against the background of general health or proceed for a long time, with periods of exacerbation and remission, which indicate a chronic course. Also, the second variant of the disease is diagnosed much more often.
The disease is independent and can also be combined with prostatic hyperplasia or prostate cancer.
Reasons for development
Inflammation does not appear by itself. The causes of prostatitis can be divided into bacterial and non-bacterial.
The acute infectious variant usually occurs in men under the age of 35 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, the causes can be much more, 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 disturbances;
- Autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work associated with weight lifting;
- 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 watch out for?
The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating. If, going to the toilet, you notice a weakening of urine flow, feel 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, general well-being worsens. 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 it is late to start treating it.
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 urinary retention;
- difficulty defecation;
- a thin stream of urine;
- Temperature increase;
- chills;
- deterioration of general well-being.
The chronic form can occur after the acute stage 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 may rise slightly. The urine stream becomes thinner, disturbances 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 appears at first, which quickly increases.
Without treatment, the second stage occurs - acute follicular. At this time the pains become particularly intense, radiate to the anus and worsen during defecation. Urination is very difficult, sometimes there is acute urinary retention. The temperature does not exceed 38 degrees and can only be higher in rare cases.
Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C and above, chills appear. Urinary retention is often observed, sharp shooting 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 separate 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 manifests itself with a slight pain when urinating or in the perineum, with a small discharge from the urethra. Often these manifestations go unnoticed even by the patient for a long time.
Signs of prostatitis in men can manifest themselves in different ways, but they are all combined into three groups: pain syndrome, urination disorders, problems with sex life. The prostate tissues lack receptors, so they cannot give painful sensations. They appear when the inflammation begins to move to the pelvic organs, which are richly innervated. Pain in patients can be different: from barely noticeable discomfort to strong and intense, disrupting sleep and the usual way of life. The 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 enlarges and begins to squeeze the urethra with a decrease in the lumen of the ureter. There are frequent urges to urinate, a feeling of incomplete emptying of the bladder. Usually, such phenomena manifest themselves at the very beginning of the disease, in its initial stages, then they are compensated for by the body, but at a later stage, without proper treatment, they reappear.
Potency problems 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 in an advanced stage, the symptoms of prostatitis are supplemented by impotence.
Classification
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. Slightly less often enterococci and other bacteria are isolated;
- chronic bacterial prostatitis, which is a recurring form of the disease. The causative agents of the disease are E. coli bacteria, enterococci, etc. Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also become pathogens;
- chronic pelvic pain syndrome, where infections go undetected. There are two types: inflammatory and non-inflammatory. Among the causes: autoimmune processes, external factors (hypothermia, overheating), rare sex life, low physical activity, rare urination;
- asymptomatic prostatitis, detected by chance during a medical examination.
Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after a thorough diagnosis based on the examination data. You should contact a specialist if you have certain signs.
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 during bowel movements there is discharge from the urethra;
- with a burning sensation in the urethra and perineum;
- if during bowel movement there are unpleasant sensations in the bladder and prostate;
- if the urge to urinate has increased and has become more frequent;
- in case of pain in the rectum;
- if there are 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);
- when erections appear at night for an unexplained reason;
- if ejaculation during intercourse is too fast;
- if the sensations during orgasm are "erased";
- with rapid general fatigue;
- with manifestations of an unreasonably anxious or depressive 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. Attempts to heal on their own, as a rule, lead to a deterioration 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 lead to infertility or complete impotence.
If the patient did not consult a doctor in a timely manner or neglected treatment, the following symptoms may appear:
- pain in the perineum;
- pain near the scrotum;
- pain at the base of the shaft of the penis (aching).
Aching pains indicate stone formation. 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 manifest at all.
Acute prostatitis is characterized by pronounced symptoms: general malaise, pain in the groin area. Men need to 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 produced per day has significantly decreased 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 muscle and joint pain.
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 sexual desire;
- discomfort during intercourse.
One of the signs of the chronic form is a significant disturbance of the emotional background, which is characterized by insomnia, increased nervousness, 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 intermittent urinary flow.
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 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;
- prostate cysts and stones;
- infertility;
- ejaculation disorder;
- erectile dysfunction.
Diagnostics
The urologist deals with the diagnosis and treatment 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 necessary.
- Bacteriological culture of urine.
- Analysis of prostatic secretion for microflora and sensitivity to antibiotics.
- Rectal exam of the prostate.
- Ultrasound of the prostate gland, which allows you to identify tumors, cysts, adenomas, as well as to differentiate prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
Features of the diagnosis in acute prostatitis
If the signs of the disease indicate acute prostatitis, the diagnosis is made on the basis of the data of instrumental and clinical examination. Any manipulations that may affect the prostate are contraindicated, as they can cause acute pain or provoke the spread of infection.
Features of the diagnosis in chronic bacterial prostatitis
The diagnosis in such cases is determined on the basis of the following data: doctor's examination of the patient, bacteriological and microscopic examination of the secretion of the prostate, study 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 type of disease: inflammatory or non-inflammatory. As a rule, ultrasound and the following manipulations are prescribed:
- study of prostatic secretion;
- molecular biological research;
- bacteriological research.
The choice of technique is determined by the doctor based on the initial examination.
Risk groups
The most likely occurrence and development of prostatitis:
- in men who are obese or lead a sedentary lifestyle;
- in men with sedentary work (office workers, programmers);
- in men whose body is prone to shocks and vibrations (motorists, including special equipment);
- in men who have had infectious diseases, including diseases of the genitourinary system;
- in sexually hyperactive men and in those who do not regularly have sex;
- in men in a state of depression, suffering from mental illness;
- in alcoholics, drug addicts, etc.
Treatment
Patients with identified acute prostatitis without the development of complications are treated on an outpatient basis. Only with severe symptoms of intoxication and suspicion of a purulent process is hospitalization carried out.
Antibiotics are the drugs of choice to fight inflammation. They are also used in chronic bacterial form. The medicine 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 alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound. They help 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 medications, the doctor will prescribe a course of prostate massage, and physiotherapy is used to improve blood circulation in this organ. Surgical treatment is used only when abscesses and suppuration of the seminal vesicles appear.
The choice of treatment for prostatitis depends on many factors and is determined individually. When choosing treatment methods, the following are 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, you can choose a specific technique or prescribe a complex. Specialists in the field of urology, depending on the results of the diagnosis, prescribe:
- Physiotherapeutic procedures: magnetic resonance therapy, procedures with laser equipment, ultrasound, reflexology, massage, hirudotherapy.
- Medical treatment.
- Diet and psychotherapy.
- Surgery.
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 that help reduce inflammation and protect cells from free radicals.
Correctly selected complex of drugs for acute bacterial prostatitis:
- restores immunity;
- cures infections (antibiotics);
- treats the prostate (antibacterial drugs).
Chronic prostatitis is difficult to treat, so a large list of drugs is used: anti-inflammatory, antispasmodic, absorbable, antibacterial, vibration massage and finger massage, electrophoresis, EHF and UHF therapy, modulated sinusoidal 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.
Conservative or modern treatment is chosen by the urologist based on diagnostic data.
Tablets
In the form of tablets for prostatitis, antibacterial agents, pain relievers 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 help 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 smooth muscles and restore patency to 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 antibiotic tablets, to which the pathogen is sensitive. You can make injections of antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and squeezing of their prostate.
Injectable prostatitis drugs work faster than oral drugs, so they are sometimes preferred.
Operation for prostatitis
The most formidable complications are suppuration of the 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, 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.
Forecasting and prevention
The acute form without treatment often becomes chronic, which periodically worsens. Full recovery is not always possible, however, with timely access to a doctor and taking all prescribed medications, discomfort, problems with urination and pain can be eliminated.
Self-treatment at home and the use of folk methods can often be life-threatening.
To prevent prostatitis, it is recommended to avoid hypothermia, timely empty the bladder, limit the use of coffee, spices and alcohol and remain sexually active as long as possible.
Typical signs of prostate cancer
The prostate gland is a small organ that only men have. Resembling a sponge in its 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, producing a secret, one of the components of sperm. But unfortunately, hyperplasia of the gland or malignant neoplasms of the organ are often found in mature and elderly men.
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 into neighboring tissues and has not allowed metastases.
Symptoms of prostate cancer in the early stages are practically absent, this is the insidiousness of the disease. The man doesn't complain, feels fine and sees no reason to go to the doctor. That is why often this type of tumor is already in a neglected state. An exception may be patients who have previously been diagnosed with benign neoplasms of the prostate gland, in which case they are periodically observed by a specialized doctor and tested for a specific prostate antigen, undergo ultrasound of the gland. They have every chance to detect a tumor early. But it's worth noting that detecting prostate cancer isn't always easy. Even with a biopsy, the results can be clear, but there is already oncology. This is due to method errors, the needle simply does not fall into the localized focus point. If prostate disease is suspected, especially if it is cancer, a fusion biopsy should be done, which combines the capabilities of real-time ultrasound and MRI, giving the doctor an opportunity to visualize the organ in the as accurately as 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 no measures are taken, the process will spread, and this already threatens with pyelonephritis and kidney problems.
At stage 4, prostate cancer manifests itself even more clearly. Metastases are most often found in the bones, spine and lymph. Because of this, a person's regional lymph nodes increase, his bones ache, he loses weight sharply and becomes weak.
Treating prostate cancer is not an easy task, but it can be done. With timely detection of a local process, a complete cure can be achieved, and with more advanced stages, it is possible to prolong life. If you notice the symptoms described above, contact a professional clinic for an examination.
Make an appointment, the doctors of the clinic have many years of experience in the treatment of urological diseases and achieve success even in the most difficult cases.