Every second man of reproductive age (up to fifty years old) is prone to such a delicate disease as acute prostatitis, in which, under the influence of certain factors, the prostate (prostate gland) becomes inflamed, causing various forms of disorders of the sexuality. functions, fertility and psycho-emotional states. He is attentive to what his body says about him and does not neglect timely treatment.
What is acute prostatitis?
If a man feels discomfort and even pain when urinating, he should immediately consult a doctor, because acute prostatitis is a disease of infectious etiology that causes inflammation of the prostate gland, followed by the formation of edema of the glandular tissue, the formation of purulent foci. in that. If you do not pay attention to the signs of acute inflammation of the prostate, the pathological process can transform into a chronic form that is difficult to treat, and there is very little time to reflect - the transformation occurs in a matter of days.
However, more serious complications than the transition from it to a chronic form are possible. There is a risk of sepsis - a general infection of the blood and an ascending infection of the urinary tract with the development of pyelonephritis and cystitis. In these cases, the patient is urgently hospitalized, the condition may be critical. Although sepsis as a complication is rare, it can occur in patients with immunosuppressive conditions: intoxication, fever, severe symptoms, weakness. Therefore, blood cultures are needed to detect microorganisms.
Symptoms of acute prostatitis
Every man needs to know and remember the symptoms of acute prostatitis. The general signs of the disease are manifested:
- Sharp pain when urinating.
- bodily intoxication.
- Disorders of urination (intermittent stream, weak, forced).
- Frequent urge to go to the bathroom at night.
These are external symptoms of prostatitis, but with a deeper study, leukocytes, traces of mucus and pus are found in the urine in the secretory fluid of the prostate gland. On palpation, a dense and enlarged organ is felt, pressure will be painful. Further development of the inflammatory process is characterized by heaviness and pain in the perineum, radiating to the penis, sacrum and rectum. As a result, the patient finds it difficult to empty the bladder and defecate due to severe pain. Body temperature can rise up to 38°C.
Causes of acute prostatitis
Since this disease is bacterial inflammatory in nature, the following infectious agents are the causes of acute prostatitis:
- Gram-negative - Klebsiella, E. coli, Proteus.
- Gram-positive: enterococci, staphylococci, streptococci.
- Urogenital: trichomoniasis, chlamydia, ureaplasmosis, gonorrhea, candidiasis, mycoplasmosis.
Microbial microflora penetrates the glandular tissue of the prostate, as a rule, transcanalicularly (through the urethra and excretory ducts of the prostate gland). In cystitis, the infection migrates to the prostate from the bladder. Other possible pathways for bacterial penetration are opened during endourethral manipulations (catheter placement, urethral dilation, cystoscopy, urethroscopy). Pathogenic microorganisms migrate to the prostate from distant pathogenic foci in caries, sinusitis, tonsillitis, cholecystitis, pyoderma, bronchitis.
There is a high probability of infection of the intestines with proctitis, hemorrhoidal fissures, colitis. Non-infectious factors that can cause an attack of prostatitis are congestive (congestive) venous phenomena in the pelvic area and poor drainage of the acini of the gland. Engorgement can be caused by irregular or, conversely, excessive sexual activity, interruption of sexual intercourse, a sedentary lifestyle, frequent constipation, frequent alcohol intoxication, varicose veins of the small pelvis, hypothermia.
Forms of acute prostatitis.
The clinical development of this disease is considered in three stages, which in turn are forms of acute pancreatitis. This is:
- The first stage is the catarrhal form.
- The second stage is the follicular form.
- The third stage is the parenchymal form.
Acute prostatitis in men begins with a catarrhal inflammation, which is characterized by the expansion of the acini, the appearance of edema of the glandular tissue and, as a result, an increase in the size of the organ. The excretory ducts of the prostate glands, flowing into the posterior urethra, actively participate in the inflammatory process. The lobes and ducts of the prostate gland become inflamed, their contractility is impaired, they become narrow and obstructed, this can hinder the secretion of the prostate gland.
At the catarrhal stage, the pathological process stops in the mucous layers and does not go deep. In the process of progression, the disease spreads to the entire prostate gland. Follicular acute bacterial prostatitis develops. At the analysis in urine pus is revealed. The tissues of the gland change destructively, the swelling continues to increase. The follicular form is still amenable to relatively easy treatment.
In addition, a parenchymal form of the disease develops, the result of which may be a prostate abscess, that is, chronic prostatitis. Therefore, symptoms such as:
- An increase in body temperature to 39 ° C and above.
- Manifestations of intoxication: weakness, chills, thirst, lack of appetite.
- Frequent urges to go to the bathroom for small needs are accompanied by sharp, stabbing pains.
- Inability to empty the bladder.
- Flatulence.
- tenesmus
- Constipation.
- Discharge of mucus from the anus.
Diagnosis of acute prostatitis
At the first suspicion of inflammation of the prostate, go to the doctor. Correct and complete diagnosis of acute prostatitis is very important for prompt and successful treatment. The doctor will first analyze the history, clarify when the sensations of pain in the perineum appear, whether they increase or decrease during ejaculation, urination and defecation. Make sure that the doctor must study the patient's medical history: what diseases were transferred, whether there were sexually transmitted infections.
The urologist will palpate the external genital organs for developmental pathologies, visible signs of prostatitis, and rectal examination - palpation of the prostate gland through the anus. To create a complete clinical picture, it will be necessary to undergo the following examinations:
- Urinalysis to determine the level of leukocytes and the presence of purulent threads.
- Blood test.
- Culture smear: The contents and scraping of the urethra are taken to determine the growth of bacteria and their sensitivity to antibiotics.
- Determination of urine velocity (uroflowmetry).
- Ultrasound of the prostate to detect diffuse changes in the gland and its abscess formation.
- A blood test for the presence of pathogens of diseases such as syphilis, gonorrhea, mycoplasmosis, chlamydia.
- Diagnosis by PCR.
Treatment of acute prostatitis
After a complete diagnosis, they begin the treatment of acute prostatitis. It is based on antibiotic therapy, the purpose of which is to suppress infectious pathogens. Also, conservative treatment of prostatitis includes the use of:
- Anti-inflammatory medications.
- Means that improve blood circulation.
- Analgesics and antispasmodics.
- Drugs that support metabolic processes in the prostate.
- Multivitamins.
- Phytotherapeutic agents.
- Immunomodulators.
Advanced forms of inflammation of the prostate with the appearance of purulent foci require surgical intervention. Transurethral (through the wall of the urethra) or transrectal (through the wall of the anus) drainage of abscessed areas is performed. Surgery may be necessary in case of pathological urinary retention. A puncture epicystostomy is performed - an incision is made in the abdominal cavity, into which a tube is inserted to divert urine.
drugs
Treatment of acute prostatitis in men with drugs (tablets, injections) is the basis of successful therapy. With well-prescribed antibiotic therapy, the infection can be overcome within a few days. However, it is recommended to continue treatment for four weeks to achieve complete eradication of pathogenic microflora. The drugs used in the disease are:
- Etiotropics (antibiotics) - destroying pathogens.
- Pathogenetic (NSAID) - eliminates congestion in the prostate.
- Symptomatic (analgesics, antipyretics) - relieves pain, muscle spasms of the organ and other symptoms.
To treat inflammation of the prostate, the doctor may prescribe a complex of drugs, which will include:
- Injections - contribute to the penetration of the drug into the tissues of the body in a short time.
- Candles (rectal) - analgesic, antibacterial effect.
- Instillations: administration of the drug to the prostate through the opening of the urethra.
- Microclysters with herbal decoctions.
- Antibacterial drugs with a wide spectrum of action, if a specific causative agent of the disease is not identified.
Antibiotics for acute prostatitis
The main causative agents of prostatitis are pathogenic bacteria that cause inflammation in the tissues of the prostate gland. Therefore, antibiotics for acute prostatitis are the basis of treatment and are prescribed only after testing the sensitivity of the microflora. Antimicrobials used for inflammation are divided into the following groups:
- Fluoroquinolones.
- penicillins.
- Cephalosporins.
- macrolides.
- tetracyclines.
- aminoglycosides.
Prevention of acute prostatitis
In order for a man to be always healthy, full of strength, prevention of acute prostatitis is important, which includes:
- Regular sexual life with a regular partner, excluding casual relationships.
- Use of condoms.
- Stop smoking, drugs, alcohol.
- Proper nutrition.
- personal hygiene.
- Annual preventive examinations at the urologist.
- Take vitamins and zinc preparations.
It is important to completely cure diseases of the genitourinary organs (urethritis, cystitis, pyelonephritis, balanoposthitis). Untreated diseases can provoke the development of an inflammatory process in the prostate gland. Among other things, we must not forget to increase physical activity. In the cold season, hypothermia should be avoided. Prostate massage is very useful for men's health. However, if the disease has already made itself felt, massage is contraindicated and even impossible due to the pain of the organ.