According to the BME, prostatitis is an inflammatory process that occurs in the prostate gland in men with damage to the parenchyma and interstitium.Treatment of prostatitis in men is a long and complex undertaking, most often due to the complete ignorance of the disease in its beginnings.What is prostatitis, what are its causes and first signs, what you need to know about the topic of "diagnosis" and what modern methods of prostatitis treatment exist.Everything men need to know about prostatitis is in this review article.
Ab ovo – from the egg
We are not talking about Horace's satires;in this case, we are interested in everything related to prostatitis, from the beginning to the last "jump" of treatment.Symptoms of prostatitis appear in men during the period of active sexual activity, from 25 to 45 years old.In the thematic video, you can study in detail everything related to the basics of the disease, its causes and symptoms, features of diagnosis and treatment.
The reasons for the development of prostatitis are wide.In prostate, infectious factors play the biggest role in the development of the disease:
- Acute form.The bone flora acts as a provocative factor.
- Chronic form.The reasons for its development are wider;The main factors of such prostatitis in men are: gonococci, trichomonas, Gr+ and Gr bacteria, mycobacterium tuberculosis.In rare cases, the diagnosis reveals mycoplasma, viruses, fungi, chlamydia, etc.
It is worth noting that chronic prostatitis, caused by a pathogen that has penetrated the prostate gland, can then have a bacterial character without the participation of a pathogenic factor.The acute form is often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, physical inactivity and as a result damage to blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You can often hear about only one type of prostatitis - infectious, but according to the WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is recorded in 90% of cases.
Table no.1. Brief features of the pathology
| Categories for prostatitis | Acute infection | The presence of a pathogen in the secretion of the prostate or in the third part of the urine | Level (increase) of leukocytes in urine or secretions |
| 1 cat.Acute bacterial | + | + | + |
| 2 cats.Chronic bacterial | - | + | Uncertain (yes or no) |
| 3 a.Chronic pelvic pain syndrome of an inflammatory, non-bacterial nature | - | - | + |
| 3 b.Prostatodynia, non-inflammatory pelvic pain syndrome | - | - | - |
| 4 cats.Asymptomatic inflammatory process | - | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more fully;in most cases, the cause of the disease is family bacteria.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as a cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered not fully proven.Symptoms of prostatitis in men with signs of weakened immunity, especially with HIV, the cause of the disease can be yeast fungi (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, especially often causing its abscess form.
The causes of the bacterial form of prostatitis have not been fully studied, although urologists have fully learned a list of possible pathogenetic factors (provocative of prostatitis) that play an important role in the appearance of inflammation in the prostate without the presence of microorganisms.Thus, the causes of prostatitis, which is non-bacterial in nature, are congestive processes in the pelvis, poor circulation, intraprostatic reflux of urine and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man with prostatitis look like?For a person away from medicine, and especially not understanding the problems of urology, the male appearance of an individual does not differ from the crowd of others.And only an experienced specialist, based on the first complaints of the patient, will understand where the root of the problem is and what ways to eliminate it will have to be taken.
Symptoms of prostatitis are often described in a few phrases, highlighting the most surprising moments, and this plays a cruel joke on a man.Relying on such incorrect definitions, he ignores really important signals, believing that the disease does not exist, although in fact the clinical framework depends on the nature of the morphological changes in the prostate.
The first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in perineum, radiating to sacrum, frequent nocturnal urges.
- Follicular prostatitis.Difficulty and frequent urination, sometimes delayed.Pain during urination, which intensifies at the end of the urination process, as well as defecation.Low-grade fever.
- Parenchymal prostatitis.There are symptoms of pronounced dysuria, often acute respiratory disturbances, pain during natural recovery, general intoxication with temperature up to 40 C.
With prostatitis with abscess formation, the symptoms are more vivid with the possible opening of the abscess in the rectum or in the prostatic part of the urethra.With such a discovery, the symptoms disappear.If the opening of the abscess occurs in the paraprostatic tissue or in the perineal area, visual symptoms can be observed: swelling, redness of the skin with pronounced fluctuations.The man's condition worsens significantly.
Comprehensive treatment of prostatitis cannot be started without a complete examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is customary to distinguish between acute and chronic prostatitis;in a thematic video on the Internet, you can find out in detail which symptoms are associated with one form or another.Let's consider this issue in more detail.
Acute - its typical symptoms are characterized by the manifestation of three phases: catarrhal, follicular and parenchymal.They are described in detail above.
More interesting in terms of symptoms is the chronic form of prostatitis, as there are many variations in symptoms.In general, the effective treatment of prostatitis depends on the prostatitis, or rather on its type.
In the chronization phase, the following points can be distinguished:
- Chronic prostatitis rarely results from an acute process.
- Primary prostatitis passes with erased symptoms.
- A characteristic symptom of chronicity is scanty discharge from the urethra during defecation.
- The first symptoms, as a rule, are not pronounced;the pathological process itself develops over the years.It is preceded by prostatosis (compressed in capillaries), which gradually turns into a bacterial form of inflammation of the prostate gland.
- Specific pathogenic microflora is not the cause of chronic prostatitis, but the chronic process itself is a complication of the inflammatory process due to the effects of ureaplasma, trichomonas, chlamydia and gonococci.
How does a man with prostatitis in the chronic phase feel?Reviews from patients show that most often, at first, they feel small pains in the perineum and few discharges, which most men simply do not pay attention to.The next stage is the addition of the following symptoms: burning in the urethra, sexual dysfunction, dysuria, general malaise.Frequent mistakes during sex lead men to depression, they become nervous or depressed.
It is important to understand that all these signs do not necessarily appear in every particular case of chronicity, this is what complicates the diagnosis at an early stage of the disease, in addition, the symptoms tend to change places, which is even more misleading.
Long-term syndromes
What can you expect from chronic prostatitis?If there is no timely diagnosis and treatment, there is nothing good, any specialist will confirm this.This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself does not hurt, but many nerve endings pass through it and are nearby, which are inevitably involved in the inflammatory process.The pain can be of different intensity - from mild pain, which creates discomfort, to strong, preventing you from falling asleep peacefully.Pain radiation occurs in all nearby areas (scrotum, sacrum, perineum);pain from prostatitis should be differentiated from similar symptoms of other diseases.
dysuria
Dysuric syndrome always indicates a problem in the urinary system, but what caused this is clarified during diagnosis.The increased volume of the prostate inevitably compresses the urethra and the flow of urine is disrupted, followed by the development of a frequent urge to go to the toilet and a feeling of incomplete emptying of the bladder.With advanced prostatitis, there is compensatory hypertrophy of the muscular layer of the bladder and ureters.At this time, dysuria symptoms weaken, but return again in an intensified form.
Sex without pleasure
An intimate life that is declining - these are the first symptoms that men notice and it is they, as the reviews show, that force them to go to the doctor.Frequent erections at night, orgasms in the form of obliteration, weak erection and rapid ejaculation, pain during it - this is what worries the stronger sex the most.In the advanced stage of chronicity, nothing good can be expected from prostatitis;erectile dysfunction often develops.
The rate of sexual dysfunction in men is not the same;some initiate sexual intercourse and somehow end it, ignoring the characteristic warning signs.For some, even the initial weak response of the penis to a sympathetic stimulus becomes a collapse and the beginning of terrible experiences that turn into prolonged depression.The spectrum of impotence is difficult for patients with problems with the prostate gland;specialists and relatives almost always notice that prostatitis worsens the character.
To learn more about the disease, you can study a thematic video where experts explain many of the nuances of the pathology.
What to write on the card
What note will appear in the patient's medical record and what final diagnosis will be made depends on a number of primary studies, starting from the patient's visit to the urologist and his complaints (history) to the last stage of diagnostic measures.What exactly is required depends on the type of prostatitis, its severity and the patient's consent to specific diagnostic procedures.
In general, the diagnosis consists of:
- History.The doctor will ask in detail about all complaints and symptoms, prerequisites for the disease, etc.
- Urine analysis.
- Prostate massage (digital rectal examination + collection of secretions).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does diagnostics provide and is it so important?If you read patient reviews, you can often understand that most men try to avoid many stages of diagnosis, the motivations are very different.The price of such indifference is your health!It is important to remember that prostatitis is curable only if it is "caught" in time and the diagnosis is made accurately, determining the form of the disease and its cause.
How to get healthy forever
So, a man understands that he has prostatitis, what awaits him in the future and is it possible to regain lost health?It is important to understand that it will take 2 times longer to get rid of prostatitis than it took to develop.In addition, if the pathological process has continued practically without the attention of the man, then the treatment of prostatitis will be done with his direct participation.Is acute or chronic prostatitis curable?Yes, if you follow all the doctor's recommendations, in advanced cases of the chronic form, treatment can achieve lasting remission.
The stages of prostatitis treatment will depend directly on what the doctor finally discovered during the examination, on the type of disease, the patient's age and physical characteristics.
The treatment regimen is always strictly individual, but the following points may be present in it:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Prescription of immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The price of each stage of treatment is different and depends on the total cost of prescribed drugs, additional methods and the clinic.Preventive measures after treatment have an important reason - they prevent the recurrence of the disease.Prevention has direct and close contact with treatment;the basics of prevention are as important as complying with all the doctor's requirements during the course of therapy.
Treatment of the acute form
The period of deterioration requires taking antibiotics, which are taken in a course.In the presence of chlamydial infection, cephalosporin drugs are indicated.
The duration of the course of use is important;on average, antibiotics are taken for at least 3-4 weeks to prevent the disease from returning.Sometimes the doctor continues the treatment for a longer period, combining antibiotics with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- A bacterial culture is required to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of drugs are taken into account.
- They take into account the previous course of treatment, when it took place, what tools were used and the result.
The need for additional treatment methods is determined by the attending physician;it should be remembered that in acute forms of prostatitis, massage is contraindicated, as it provokes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is important to remember that it is impossible to get rid of chronicity quickly in principle, the disease has developed over the years and even doctors in their field cannot destroy it in two weeks;you do not need to take the word of those who cured the disease in 2-3 days.Treatment is aimed at stopping the source of infection, restoring immunity in men and the functioning of the prostate gland, as well as preventing irritations - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks;if the treatment is low, the treatment is continued.Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete removal of the prostate gland is offered.
No bacteria or symptoms
A characteristic difference between the therapy is the absence of antibiotics;without the presence of pathogenic microflora, they are simply not needed.But sometimes experts prescribe a short course of drugs of 2-4 weeks.
The treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy by strengthening the patient's immune system.
Diet and lifestyle changes also form the basis of non-bacterial prostatitis treatment;baths and alpha-blockers are indicated.
Asymptomatic prostatitis is difficult to identify;The PSA method is used for diagnosis, followed by a 2-week course of antibiotics as treatment.After that, symptomatic treatment is selected individually.
In general, the treatment of any type of prostatitis is a long-term phenomenon and not always pleasant for the patient.In addition to physical discomfort, a man suffers psychologically, because his most valuable part of the body - the private part - is affected.Reviews from those who have cured the disease show that only strict adherence to the doctor's instructions, along with diet and lifestyle changes, bears fruit.The price of a frivolous attitude to treatment is very high - a man loses not only his health, but changes his whole life, character and relationships with others.To prevent this, it is necessary to monitor the health of the prostate gland and eliminate the causes of the development of the disease.