Prostatitis in men is an inflammatory process that involves 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 the general state of 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 may also be associated with prostatic 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 the age of 35 due to damage to the prostate 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.
The factors provoking 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 of intimate hygiene.
- emotional disturbances;
- autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work associated with lifting weights;
- chronic stress;
- congestion in the tissues of the prostate;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
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, while going to the toilet, you noticed a weakening of the urine stream, 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 worsens. Such a patient should be treated immediately by combining antibiotics with anti-inflammatories.
In some cases, the disease can be asymptomatic for a long time, so it is started late to treat 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 defecating;
- a thin stream of urine;
- temperature rise;
- chills;
- deterioration of 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 may rise slightly. The stream of urine becomes thin, troubles 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 pass 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 time, the pains become particularly intense, they radiate towards the anus, and worsen during defecation. Urination is very difficult, sometimes there is acute urinary retention. The temperature does not exceed 38 degrees and only in rare cases can be higher.
Acute parenchymal prostatitis is manifested by severe intoxication, the temperature reaches 38 ° C, and above it, chills appear. Urinary retention is often observed, sharp, stabbing pains in the perineum appear, 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 over a long period.
Often the chronic course begins with a complication of the inflammatory process caused by various infectious agents - chlamydia, Trichomonas, gonococcus. But vivid manifestations are very rare, most often the disease occurs with minor pain during urination or in the perineum, with a 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 occur in different ways, but all of them are combined into three groups - pain syndrome, urination disorder, problems with sex life. Prostate tissues lack receptors, so they cannot give painful sensations. They appear when inflammation begins to move to the pelvic organs, which are richly innervated. Pain in patients can be different - from barely noticeable to strong and intense discomfort, which disrupts 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 when the prostate increases in size and begins to compress 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 are expressed at the very beginning of the disease, in its first stages, then they are compensated by the body, but at a later stage, without adequate treatment, they reappear.
Potency problems in men can also express themselves in different ways. Patients complain of worsening erection, accelerated ejaculation, decreased sexual arousal. Gradually, sexual disorders increase, and at an advanced stage, the symptoms of prostatitis are complemented by impotence.
Classification
Experts distinguish several categories of the disease:
- acute bacterial prostatitis, characterized by symptoms of a bacterial infection. The causative agent of the disease in most cases is Escherichia coli. In a little 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, in which 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 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 experience 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 movements there are unpleasant sensations in the bladder and prostate;
- if the urge to urinate has increased and 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 (weakened erection);
- when erections appear at night for some inexplicable reason;
- if ejaculation during intercourse is too rapid;
- if the sensations during orgasm are "erased";
- 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. Attempts to heal on their own usually 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 total 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 root of the penis (aches).
Aching pains indicate 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 malaise, pain in the groin area. Men should contact specialists if:
- the urge to urinate has become 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 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 retention of urine, frequent pain in the muscles andjoints.
Chronic prostatitis is characterized by the following symptoms:
- during urination, pain in the perineum increases;
- with frequent cravings, the bladder is not completely emptied;
- decreased libido;
- discomfort during sexual intercourse.
One of the signs of the chronic form is a significant disturbance of the emotional background, characterized by insomnia, increased nervousness, whims, irritability.
The bacterial form of chronic prostatitis is characterized by problems with ejaculation, which becomes rapid and painful, pubic discomfort, frequent or involuntary urination and intermittent urination.
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 urination, weakening of the urine 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.
Diagnostic
The urologist deals with the diagnosis and treatment of any form of prostatitis. If a tumor is suspected, the patient may be referred for consultation with an oncologist. In long-lasting, difficult-to-treat chronic prostatitis, consultation with an immunologist may be necessary.
- Bacteriological culture of urine.
- Analysis of prostatic secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Ultrasound of the prostate, which allows to identify tumors, cysts, adenomas, as well as to differentiate prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
Features 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 can affect the prostate is contraindicated, as it can cause sharp pain or cause 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 secretion of the prostate, study of ultrasound data.
Features of the diagnosis of 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, an ultrasound examination is prescribed, as well as the following manipulations:
- study of prostatic secretion;
- molecular biology 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 who lead a sedentary lifestyle;
- in men with sedentary work (office workers, programmers);
- in men whose body is subjected to jolts and vibrations (motorists, 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 have regular 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, 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 of treatment 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 medication, 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, 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, prescribe:
- Physiotherapeutic procedures: magnetic resonance therapy, procedures using laser equipment, ultrasound, reflexology, massages, hirudotherapy.
- Medical treatment.
- dietetics 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, along with antioxidants that help reduce inflammation and protect cells from free radicals.
Properly selected drug complex for acute bacterial prostatitis:
- restores immunity;
- treats infections (antibiotics);
- treats the prostate (antibacterial drugs).
Chronic prostatitis is difficult to treat, which is why a long list of drugs is used: anti-inflammatory, antispasmodic, resorbable, antibacterial, vibration massage and finger massage, electrophoresis, EHF and UHF therapy, sinusoidally 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.
Conservative or modern treatment is selected by the urologist based on diagnostic data.
Tablets
In the form of tablets for prostatitis, antibacterial agents, painkillers can be prescribed.
The course of antibiotic therapy is selected individually depending on the result of the analysis of prostatic secretion. The microflora responsible for the disease must be sensitive to the drug used. It is necessary to complete the 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, nonsteroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.
Prostatitis pills for men, which help treat urination disorders, 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 antibiotic tablets, to which the pathogen is susceptible. You can do injections of 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.
Prostatitis operation
The most formidable complications are suppuration 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.
Forecast and prevention
The acute form without treatment often becomes chronic, which periodically worsens. A full recovery is not always possible, however, with prompt access to a doctor and taking all prescribed medications, discomfort, urination problems and pain can be eliminated.
Self-treatment at home and the use of traditional methods can often be life-threatening.
To prevent prostatitis, it is recommended to avoid hypothermia, to empty the bladder in a timely manner, to limit the consumption of coffee, spices and alcohol, and to remain sexually active as long as possible.
Typical signs of prostate cancer
The prostate is a small organ that only men have. It resembles a sponge in structure, 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 semen. But unfortunately, in mature and elderly men, hyperplasia of the glands 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 at the first stage or has even reached the second, then the tumor is localized in the prostate, has not invaded neighboring tissues and has not allowed metastasis.
Symptoms of prostate cancer in the early stages are practically absent, this is the insidiousness of the disease. The man does not complain, feels well 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 already been diagnosed with benign prostate neoplasms, in which case they are periodically observed by a specialized doctor and tested for a specific prostate antigen, undergo an ultrasound examination of the gland. They have every chance of detecting a tumor at its very beginning. But it should be noted that detecting prostate cancer is not always easy. Even with a biopsy, the results may be clear, but there is already oncology. This is due to errors in the method, the needle simply does not fall in the place of the localized focus. If prostate pathology is suspected, especially if it is cancer, a fusion biopsy should be performed, which combines the capabilities of ultrasound and real-time MRI, giving the physician thepossibility of visualizing the organ as precisely 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 needs to be emptied regularly, if this process is disrupted, urine can be retained in it, inflammation can occur, and bacterial infection can develop. If no action is taken, the process will spread, which already threatens with pyelonephritis and kidney problems.
In stage 4, prostate cancer manifests itself even more clearly. Metastases are most often found in the bones, spine, and lymph. Due to this, the regional lymph nodes of a person increase, the bones hurt, he loses weight sharply and becomes weak.
Treating prostate cancer is not an easy task, but it is doable. With early detection of a local process, complete recovery can be achieved, and with more advanced stages, life can be prolonged. 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 succeed even in the most difficult cases.