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Prostatitis in men

Prostatitis is an inflammatory process that affects the tissue of the prostate gland.This is one of the most common diseases in the practice of a urologist.The disease is diagnosed mainly in men between 25 and 30 years old, but at older ages the risk of developing pathology increases significantly.

The form distinguishes between acute and chronic prostatitis.In the latter case, the inflammation is characterized by a prolonged course with periodic relapses.This condition is much more common compared to the acute one.

Causes of prostatitis

Many prostate diseases, for example benign hyperplasia or oncopathologies, are problems of the older age group.However, prostatitis does not fall into this category.Its symptoms usually appear in men between 30 and 50 years old.Most often, the cause is an infectious lesion due to the penetration of pathogenic flora from the urogenital canal or glands of the genitourinary system.This is explained by the proximity of the urethra and anus.

Among the most common causative agents of bacterial (infectious) prostatitis, it is worth highlighting gram-negative organisms: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often, the inflammatory process develops against the background of STI infection: chlamydia, gonococci, trichomonas, herpes viruses, etc.As a rule, these forms of the disease are diagnosed in men under 35 years of age.Cases of pathology treatment against the background of Mycobacterium tuberculosis infection are extremely rare.

There are also non-bacterial types of prostatitis.Among its main reasons:

  • increased pressure in the prostate gland;
  • autoimmune disorders (destruction of prostate cells by antibodies);
  • muscle pain syndrome in the pelvic area;
  • psychoemotional disorders;
  • motor activity deficit;
  • excessive physical stress.

Primary signs of prostatitis

a man with signs of prostatitis

The disease is accompanied by a complex of disorders that affect the functioning of the entire urinary system.Among the main symptoms:

  • uncontrolled urination;
  • discomfort, pain when emptying the bladder;
  • potency disorder in men of reproductive age;
  • pain in the perineum when sitting for a long time;
  • frequent and strong urge to urinate;
  • difficulty emptying the bladder;
  • decreased libido and erection problems;
  • reproductive dysfunction (infertility);
  • feeling of incomplete emptying of the bladder after going to the bathroom;
  • inability to achieve a high-quality and long-lasting erection even with strong arousal.

Signs of acute prostatitis

The symptoms of the disease in acute form and the general clinical picture differ depending on the stage of the pathological process:

  • Catarrhal.The patient complains of frequent urge, pain when urinating, pain in the perineum and sacrum.
  • Follicular.The pain syndrome becomes intense, can radiate to the anus and intensify during defecation.Urine is released in a thin stream.In some cases there is a delay.There is an increase in body temperature of up to 38 degrees for a long period (mild fever) or moderate hyperthermia.
  • Parenchymatous.The man begins to experience general intoxication of the body with chills and a temperature of up to 38-40°C.The pain in the perineum becomes sharp and stabbing.The act of defecation is difficult and normal emptying of the bladder is impossible, causing acute urinary retention (dysuria).

Symptoms of chronic prostatitis.

The chronic form of inflammation of the prostate may be a consequence of the absence or late treatment of the acute stage.However, in many men it develops immediately and is characterized by "fuzzy" symptoms.Among the main signs are:

  • mild fever (occasionally);
  • mild pain in the perineum;
  • discomfort when urinating;
  • Scant secretion from the urogenital canal during defecation.

In general, the clinical picture changes over time, differs in intensity in different patients and can be hidden when self-medication is attempted.Symptoms of a chronic disorder may include a burning sensation in the urethra, pressure in the perineum, dysuria, impaired sexual function, and increased general fatigue.Against the background of potency problems, mental depression, irritability and anxiety arise.The fear of impotence leads to the development of complexes, but most men tend to postpone visiting the urologist out of a feeling of shame.

Primary chronic prostatitis develops over a long period.Stagnation of blood in the capillaries (prostatosis) provokes the initial stage of non-bacterial inflammation, which leads to the onset of the disease.

Of infectious etiology, the cause of the disease is a chronic inflammatory process due to an infection with trichomonas, ureaplasma, chlamydia or gonococci.The primary infection masks the signs of prostatitis and its treatment does not eliminate the inflammation of the prostate.Often, men go unnoticed when a concomitant problem appears.

Let's consider in detail the three main symptoms of chronic prostatitis:

  • Urinary disorder (dysuria).Inflammation increases the volume of the prostate, causing compression of the ureter.As its light decreases, a frequent need to urinate and a feeling of a bladder that is not completely empty appears.Dysuric disorders in many men occur in the early stages of prostatitis.The compensatory mechanism during this period is manifested in hypertrophy of the muscles of the bladder and ureters, which reduces the symptoms of dysuria, but with the development of inflammation they increase again.
  • Pain syndrome.There are no pain receptors in the prostate tissue.Pain occurs when the inflammatory process spreads to other pelvic organs and their nerve pathways.The sensations range from mild and painful to very intense, which interfere with a night's rest.Greater discomfort occurs with ejaculation, sexual abstinence, or excessive sexual activity.The pain radiates to the perineum, sacrum, scrotum and sometimes to the lower back.
  • Power violation.Lack of treatment in the early stages of prostatitis can lead to dyspotency, when a man experiences frequent nocturnal erections, deterioration in orgasm quality, and accelerated ejaculation.In different patients, these signs manifest themselves with different intensity.Premature ejaculation occurs due to a decrease in the threshold of excitability of the orgasmic center.In this case, the patient experiences pain, which leads to the development of pain anticipation syndrome and a gradual renunciation of sexual activity.In the absence of comprehensive treatment that addresses the mental factor of the disorder, sexual disorders become increasingly worse.Ignoring the need to seek medical help for prostatitis often ends in impotence.

The degree of sexual dysfunction varies depending on individual factors.Some men are so afraid of erectile dysfunction that their problems arise more from suggestion than from objective physiological factors.In particular, psychogenic dyspotence is observed precisely with increased anxiety and obsessional complexes.The mere thought of possible male health disorders is difficult for these patients to bear.This greatly affects your character and communication with others.Irritability, hypochondria, bad mood and depression appear.

Complications of prostatitis

The lack of adequate treatment for prostate inflammation leads to concomitant diseases.The fact is that the prostate is closely related to other organs of the male genitourinary system.It is located around the neck of the bladder and the urinary canal.Therefore, when the prostate enlarges, the urethra becomes compressed and the normal flow of urine is disturbed.Taking into account the peculiarities of physiology, if acute or chronic prostatitis is not treated in a timely manner, a number of serious pathologies and complications arise.

Related issues:

  • formation of cysts, prostate stones;
  • decreased amount of male hormones produced;
  • decreased sexual desire (libido);
  • erectile dysfunction (erectile dysfunction);
  • infertility (in 40% of patients with chronic prostatitis);
  • prostate adenoma (benign tumor);
  • prostate cancer.

Some consequences of inflammation of the prostate, which does not receive timely and complete treatment, pose a threat not only to health, but also to the patient's life (in particular, oncological pathologies may develop).Therefore, at the first symptoms of prostatitis, it is advisable to consult a urologist.It should also be remembered about periodic preventive examinations after the age of 40, when the risk of pathological processes in the prostate increases sharply.

Diagnosis of prostatitis

Many urological problems have similar symptoms, so the specialist works with each clinical case separately and uses all available diagnostic tools.A consultation with a urologist always begins with a survey about symptoms, medical history and general examination.The doctor then prescribes a series of tests, based on the results of which a diagnosis is made and the appropriate treatment is selected.As a rule, the exam package includes:

  • digital rectal examination of the prostate to determine the size, structure of the prostate and the level of compression of the urethra;
  • Ultrasound of the urinary system (prostate, bladder, kidneys);
  • laboratory tests of urine, prostate secretion, ejaculation;
  • testing for urogenital infections;
  • urodynamic study.

To ensure an accurate diagnosis of prostatitis in men and related disorders, you should refrain from urinating for 2 to 3 hours before visiting a urologist.Otherwise, the test results may not be entirely correct, since when the bladder is emptied, pathogenic microflora is eliminated.According to the characteristics of the clinical picture, the method of performing ultrasound is selected: transrectal or abdominal (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Treatment methods for prostatitis

The main therapy is antibiotics.The use of modern pharmacological developments gives good results, although it is impossible to completely eliminate the risk of relapse.The doctor prescribes an antibacterial drug after culture of urine and/or prostate secretion depending on the type of pathogen.If acute prostatitis is diagnosed, oral antibiotic therapy lasts 4 to 6 weeks.In chronic or recurrent forms of the disease, treatment will take longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis), hospitalization and treatment with intravenous antibiotics are required.

If there is difficulty urinating, the urologist prescribes medications that relieve hypertonicity of the muscles of the bladder and prostate, which normalizes the outflow of urine and prevents stagnation.Some patients are treated with medications that reduce sex hormone levels.As a result, there is a decrease in the size of the prostate and, consequently, a feeling of discomfort when urinating, defecating and ejaculating.In case of severe inflammation of the prostate, muscle relaxants help relieve excessive tension of the bladder sphincter and adjacent muscles.Non-steroidal anti-inflammatory drugs effectively combat pain.In addition, chronic prostatitis responds well to auxiliary physiotherapy.The effective methods of such treatment are:

  • instillation of medications into the urethra;
  • prostate massage;
  • shock wave therapy (SWT);
  • magnetic laser therapy (MLT);
  • electrophoresis;
  • ozone therapy;
  • intravenous laser blood irradiation (ILBI);
  • Ultraviolet blood irradiation (UFO).

Prostate massage is a frequently used urological technique.The doctor uses the method of digital stimulation of the prostate through the rectum to improve the outflow of secretions and restore the patency of the organ's ducts.An additional effect is the improvement of blood circulation and accelerated penetration of antibiotics into inflamed tissues.In addition to finger massage of the prostate, hardware methods are also possible.Shock wave therapy shows good results in the treatment of prostatitis.The basis of this medical technology is short-term exposure to low-frequency sound waves in the inflamed area.The procedure helps:

  • activate local blood circulation and the growth of new vessels;
  • stimulate the body's own regenerative capabilities;
  • Destroy fibrous foci and calcifications that cause pain and inflammatory processes.

After a course of shock wave therapy, the symptoms of prostatitis are relieved and a good preventive effect is observed.Pronounced results can only be achieved with an integrated approach to the problem.In addition, the patient's responsible attitude towards medical prescriptions is important.

For their part, the clinic's urologists ensure the preparation of an individual treatment regimen, taking into account the cause, form, stage of the disease, general well-being and the presence of concomitant pathologies.

Prostatitis prevention

To minimize the risk of relapse, it is necessary to reduce the negative effects on the body.Among the provoking factors are:

  • Smoke.The anatomical features of the location of the prostate cause a constant lack of oxygen, and inhalation of tobacco smoke causes vasospasm, which further slows down local microcirculation processes.All experienced smokers have the problem of high blood pressure.
  • Motor activity deficit."Sedentary" work and a sedentary lifestyle cause congestion in the pelvic organs.
  • Alcohol abuse.Exceeding the daily alcohol limit affects overall health and makes the body more vulnerable to various infectious diseases.
  • Stressful conditions.It is necessary to avoid situations that cause anxiety, irritation and depressive disorders as much as possible.If necessary, you should contact a specialized specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, making the body "open" to colds and inflammation.
  • Fatigue, excessive physical activity.You should not forget about the work and rest schedule, as well as lifting heavy weights.

Preventive measures will help prevent the development of acute prostatitis and relapses of chronic prostatitis.If you have questions about the diagnosis and treatment of prostate inflammation, you can always contact the urology department of our clinic.