According to statistics, one in three working-age men suffers from prostatitis at different periods of life. Constant pain, impotence, infertility - this is not a complete list of the problems that threaten patients in the absence of treatment. Due to the great urgency and danger of the disease, all men should be aware of its initial symptoms and manifestations. In this article, you will learn about all the signs and diagnostic methods that allow you to recognize prostatitis.
The clinical picture in the initial stages of development.
Prostatitis is an inflammatory lesion of the male prostate gland. The following forms of the disease are distinguished: acute and chronic bacterial prostatitis, chronic pelvic pain syndrome, asymptomatic prostatitis. Each form manifests itself in different ways, has characteristic signs and features of the course.
It is difficult to say how the disease will develop in each individual man. The presence of certain signs depends on a number of external and internal factors. For the convenience of characterizing the pathology, it is customary to divide all the symptoms of prostatitis into 3 large groups: those associated with urination disorders, sexual dysfunction, mental problems. The first and most important symptoms of prostatitis (except the asymptomatic form) may be the following signs in a man:
- Pain in the pelvis, back, groin.
- Pain and burning during the act of urination.
- Difficulty urinating.
- Feeling of incomplete emptying of the bladder and false urge to urinate.
Pain in the pelvis, back, groin area, a feeling of incomplete emptying of the bladder, and a false urge to urinate are signs of prostatitis.
The listed symptoms occur due to impaired urinary function, which is due to the anatomical characteristics of the structure and location of the bladder and prostate gland. The signs of prostatitis associated with sexual dysfunction are also significant and pronounced. Men usually present the following complaints:
- Weak erection.
- Rapid onset of ejaculation during intercourse.
- Lack of orgasm or decreased sensitivity.
- Pain in the urethra and rectum when ejaculating.
Problems with urination and difficulties in intimate life due to inflammation of the prostate gland are very disturbing to men. Prostatitis patients are forced to change their way of life, to deny themselves habits, family relationships become more complicated. Obsession with your problem causes increased nervousness, anxiety, decreased libido, which can be called indirect signs of prostatitis, belonging to the third group of the above symptoms (mental disorders).
Prostatitis in men can often be confused with an adenoma or prostate cancer, a pathology of the bladder. All these diseases appear in a similar way, especially in the initial stages. It is very difficult to distinguish between them for an unprepared person, therefore the differential diagnosis is made by analyzing all existing objective symptoms, laboratory and instrumental research data. Since each form of prostatitis has specific signs and characteristics, it is wise to consider them separately.
Characteristics of certain forms of the disease.
Acute prostatitis is an inflammation of the male prostate gland caused by the penetration of an infectious agent into the organ through the blood, lymph, or urethra. The disease begins abruptly and is characterized by the severity of all clinical signs. The main symptoms of acute prostatitis:
- The increase in body temperature to 39-40 degrees.
- Symptoms of general intoxication (headache, weakness, fatigue, decreased performance, etc. ).
- Severe pain in the perineum, sacrum, above the pubic joint of a man.
- Frequent and painful urination.
- Sometimes men have urinary retention.
Temperature 39-40 is a clear sign of inflammation of the prostate gland.
Acute inflammation of the prostate gland ends, as a rule, with the recovery or chronization of the process (the symptoms can bother for several months). But more often this form of prostatitis is primary and is a consequence of the presence of bad habits (alcohol abuse, smoking, etc. ), a sedentary lifestyle, vitamin and mineral deficiency, prolonged sexual abstinence, or arises from anon-aggressive sexually transmitted infection or ingestion of normal microflora agents. The clinical picture of chronic prostatitis appears leaner in relation to the acute form, the symptoms of the disease are inconsistent, which greatly complicates the diagnosis. For the chronic form of prostatitis, the following symptoms are the most typical:
- Increased need to urinate, even at night.
- Pain when urinating, and also when ejaculating.
- Dull aching pain in lower back, pelvis, above chest, etc.
Chronic pelvic pain syndrome (CPPS) in a man combines recurrent pain in the prostate area, temporary disorders of the urinary and reproductive systems. CPPS in medicine is a broader concept, since pathogenetically, the pathology can be based on a tumor or ischemic process, disorders of the nervous system and not just inflammation. The inconsistency of the presence of signs of prostatitis in chronic pelvic pain syndrome significantly complicates the diagnosis, but it is much more difficult to do in the asymptomatic form. In these cases, the main and decisive role is played by data from laboratory and instrumental research methods.
Diagnostic techniques
Based solely on the symptoms of prostatitis, a definitive diagnosis cannot be made. In addition, doctors should collect anamnesis: information about the time of onset of symptoms, their connection with the main and significant events of life, physical and mental shocks, all possible predisposing factors are clarified, etc. A physiological examination is always performed: a digital rectal examination in the position of the knee and elbow of a sick man, lying on his side with his legs bent, or standing with the body bent forward. During this study, you can find characteristic signs of prostatitis (the presence of all is not necessary):
- Enlargement of the male sex gland.
- The shape of the organ is correct or flattened with a depression.
- Seasoned or pasty consistency.
- Smoothness of the edges of the prostate gland.
- Increased pain with pressure.
Further examination of a patient with symptoms of prostatitis is supplemented by laboratory methods. General and biochemical blood tests are prescribed: there are no specific changes in the indicators, only indirect signs that make it possible to judge the presence of an inflammatory process in the body of a man (an increase in the number of leukocytes, acute phase proteins, acceleratedESR). The results of urine tests will be valuable, which will allow to judge the presence of an infectious process in the genital tract, will help to determine the pathogen to start etiological treatment. Also, urologists may prescribe an analysis of prostate discharge, spermogram.
Among the instrumental methods for diagnosing diseases of the prostate, the most informative is TRUS - transrectal ultrasound. In this case, a special sensor is used, which the doctor inserts into the rectum. This causes discomfort to a patient, but is compensated by the information content of this method. With the help of TRUS it is possible to assess the structure of the organ, judge the presence of tissue inflammation, the degree of narrowing of the urinary tract, and exclude the presence of stones. The main echo signs of prostatitis: enlargement of the organ size, edema, fibrosis, changes in sclerotic tissue, heterogeneous and coarse-grained structure.
In addition, patients with symptoms of prostatitis undergo uroflowmetry, a special diagnostic manipulation in which a man's frequency of urination is measured. Based on the data from this study, conclusions can be drawn about the degree of narrowing of the urethra, the activity of the detrusor. Uroflowmetry should not replace TRUS, but rather confirm its findings and signs of existing prostatitis.
The plan for a prostatitis diagnostic test can be expanded if indicated in a man. To clarify the individual points regarding the diagnosis, a cystoscopy, a computed tomography of the pelvis, can be performed. In unclear cases, a biopsy is performed to differentiate them with tumor processes.
What to do when the first symptoms appear.
The biggest and most common mistake many men make when they have signs and symptoms of prostatitis is waiting. Every patient hopes that the unpleasant symptoms are temporary and disappear soon. Untreated prostatitis is dangerous to health, leads to irreversible changes in the body, which are fraught with disturbances of the erection mechanism, infertility, or worse, malignancy of the process (transition to cancer).
To prevent serious complications, every man at the first signs of prostatitis should consult a urologist who will prescribe the treatment. First of all, men receive etiotropic therapy: anti-inflammatory drugs are used, antibiotics are used, and measures are taken to strengthen the immune system. An operation is not necessary in the absence of complications. Men who have had prostatitis in the past are at risk and there is a high probability of recurrence, therefore, after recovery, an important role is given to prevention.