Prostatitis: symptoms, treatment, prevention

Prostatitis in men is an inflammatory process that involves the prostate tissue. The disease is accompanied by pain that occurs in the lower back, perineum, 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 last for a long time, with periods of exacerbation and remission, which indicates a chronic course. In addition, the second variant of the disease is diagnosed much more often.

The disease is independent and can be combined 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 35 years of age due to damage to the prostate gland 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 causes, and the list will include atypical microbes.

The provoking factors for the development of the bacterial variant are:

• unprotected sex;
• AIDS or HIV infection;
• diarrhea or constipation;
• anal sex;
• sedentary way of life;
• inactive sex life;
• diabetes;
• hypothermia;
• violations of intimate hygiene.
• emotional disorders;
• autoimmune diseases;
• increased physical activity;
• lack of regular sex life;
• work related to 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 have noticed a weakening of the stream of urine, you feel discomfort or a burning sensation in the urethra, you should contact a urologist as soon as possible.

At the acute onset of the disease, the temperature may rise, the general well-being deteriorates. Such a patient should be immediately treated by combining antibiotics, anti-inflammatory drugs.

In some cases, the disease can be asymptomatic for a long time, so treatment starts late.

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;
• difficult defecation;
• thin stream of urine;
• rise in temperature;
• chills;
• deterioration of general well-being.

The chronic form can appear 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, disorders appear in the intimate sphere.

With a chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible. Pain may be absent or dull, aching in nature.

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 starts with complaints of frequent painful urination. In the lower back and sacrum, as well as in the perineum, there is initially a slight soreness, which quickly increases.

Without treatment, the second stage occurs - acute follicular. At this moment, the pains become particularly intense, radiate to the anus and intensify during defecation. Urination is very difficult, sometimes there is acute retention of urine. The temperature does not exceed 38 degrees and only in rare cases can it be higher.

Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C and more, chills appear. Urinary retention is often observed, sharp, throbbing pains appear in the perineum, 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 time.

Often, the chronic course begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococcus. But bright manifestations are very rare, more often the disease occurs with slight pain during urination or in the perineum, with a small discharge from the urethra. Often these manifestations remain unnoticed even by the patient for a very long time.

Signs of prostatitis in men can appear in different ways, but they are all united in three groups - pain syndrome, urination disorder, problems with sex life. The tissues of the prostate are devoid of receptors, therefore they cannot cause painful sensations. They appear when the inflammation begins to move to the pelvic organs, which are richly innervated. Pain in patients can be different - from barely noticeable discomfort to strong and intense, 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 at the moment when the prostate increases in volume and begins to press 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 early stages, then they are compensated by the body, but at a later stage, without adequate treatment, they appear again.

Potency problems in men can also be expressed in different ways. Patients complain of worsening erection, accelerated ejaculation, decreased sexual arousal. Gradually, sexual disorders become more pronounced, and in an advanced stage, the symptoms of prostatitis are supplemented by impotence.

Classification

Experts distinguish several categories of the disease:

• acute bacterial prostatitis, which is characterized by symptoms of a bacterial infection. The causative agent of the disease in most cases is Escherichia coli. A little less often, enterococci and other bacteria are isolated;
• chronic bacterial prostatitis, which is a recurrent form of the disease. The causative agents of the disease are bacteria E. coli, enterococci, etc. Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also become pathogens;
• chronic pelvic pain syndrome in which no infections are detected. There are two types: inflammatory and non-inflammatory. Among the reasons: autoimmune processes, external factors (hypothermia, overheating), infrequent sexual life, low physical activity, infrequent urination;
• asymptomatic prostatitis discovered incidentally during a medical examination.

Only a qualified specialist can accurately determine the type of prostatitis and determine the course of treatment after a thorough diagnosis based on the research data. You should contact a specialist if you have certain signs.

Symptoms

The main symptom is a malfunction of the excretory system. You should contact a specialist if you have the following symptoms:

• if urination is difficult and urine is released intermittently;
• if there is a discharge from the urethra during bowel movements;
• with a burning sensation in the urethra and perineum;
• if during a bowel movement there are unpleasant sensations in the bladder and prostate;
• if the urge to urinate increases and becomes more frequent;
• with pain in the rectum;
• if there are purulent bloody discharges from the urethra (floating "threads");
• with a frequent increase in body temperature;
• with the appearance of problems of an intimate nature (weakening of an erection);
• when the erection occurs at night for an unexplained reason;
• if ejaculation during intercourse is too fast;
• if sensations during orgasm are "deleted";
• with rapid general fatigue;
• with manifestations of an unreasonable anxious or depressive state, as well as a state of mental depression;
• with frequent depression, manifestations of mental depression in anticipation of complications;
• with general weakening of the body.

One or two symptoms are enough to contact a urologist. Attempts to self-medicate, as a rule, lead to a worsening of the condition, the transition of the disease into a chronic or severe form. In the worst case, an untimely visit to the doctor can cause infertility or complete impotence.

If the patient did not consult a doctor in time or neglected the treatment, the following symptoms may appear:

• pain in the perineum;
• pain near scrotum;
• pain at the base of the root of the penis (pain).

Aching pains indicate the formation of stones. Doctors call infertility a late sign of a progressive disease.

Signs of prostatitis in acute and chronic form 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 became 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 is significantly reduced or urine is not collected;
• fever, frequent headaches, general weakness.

Acute bacterial prostatitis is characterized by high fever and chills, pain in the lumbosacral region (severe), pain in the perineum and rectum, acute urinary retention, frequent muscle and joint pain.

Chronic prostatitis is characterized by the following symptoms:

• during urination, the pain in the perineum increases;
• with frequent urges, the bladder is not completely emptied;
• decreased sexual desire;
• discomfort during intercourse.

One of the signs of the chronic form is a significant disturbance of the emotional background, characterized by insomnia, increased nervousness, capriciousness, irritability.

The bacterial form of chronic prostatitis is characterized by problems with ejaculation that becomes rapid and painful, discomfort in the pubic area, frequent or involuntary urination and interruption of the stream of urine.

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 urges to urinate, weakening of the stream of urine, 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;
• cysts and stones in the prostate;
• infertility;
• ejaculation disorder;
• erectile dysfunction.

Diagnosis

The urologist deals with diagnosis and treatment of any form of prostatitis. If a tumor is suspected, the patient may be referred for consultation with an oncologist. In chronic protracted prostatitis, which is difficult to treat, consultation with an immunologist may be necessary.

1. Bacteriological culture of urine.
2. Analysis of prostatic secretion for microflora and sensitivity to antibiotics.
3. Rectal examination of the prostate.
4. Ultrasound of the prostate gland, which allows to identify tumors, cysts, adenomas, as well as to differentiate prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Features of diagnosis in acute prostatitis

If the signs of the disease indicate acute prostatitis, the diagnosis is made based on data from instrumental and clinical studies. Any manipulations that can affect the prostate are contraindicated, as they can cause acute pain or provoke 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 a doctor of the patient, bacteriological and microscopic examination of prostate secretion, examination of ultrasound data.

Features of diagnosis in pelvic pain syndrome

Specialists prescribe diagnostic procedures for symptoms that indicate chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory. As a rule, ultrasound is prescribed, as well as the following manipulations:

• examination of prostate secretion;
• molecular biological research;
• bacteriological examination.

The choice of technique is determined by the doctor according to the initial examination.

Risk groups

The most likely appearance and development of prostatitis:

• in men who suffer from obesity or lead a sedentary lifestyle;
• in men with sedentary jobs (office workers, programmers);
• in men whose body is subject to shaking and vibration (drivers of cars, 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 depressed men suffering from mental illness;
• in alcoholics, drug addicts, etc.

Treatment

Patients with identified acute prostatitis without development of complications are treated on an outpatient basis. Only in case of 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 medicine is selected individually, it is taken in a course of 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 in prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine, confirmed by ultrasound. They help facilitate urination, relax the prostate and bladder muscles. 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 applied only when abscesses and suppuration of the seminal vesicles occur.

The choice of treatment for prostatitis depends on many factors and is determined individually. When choosing treatment methods, take into account:

• the cause of the disease;
• the course of the disease;
• individual characteristics of the body (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:

• Physiotherapy procedures: magnetic resonance therapy, procedures with laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Medical treatment.
• diet and psychotherapy.
• Surgical intervention.

When diagnosing bacterial prostatitis, broad-spectrum antibiotics, immunomodulators and multivitamin complexes are prescribed.

When diagnosing non-bacterial prostatitis, physiotherapy and anti-inflammatory drugs are prescribed.

In some cases, experts may recommend muscle relaxants and hormone therapy, as well as antioxidants, which help reduce inflammation and protect cells from free radicals.

Correctly selected complex of drugs for acute bacterial prostatitis:

• restores immunity;
• treat infections (antibiotics);
• treat the prostate (antibacterial drugs).

Chronic prostatitis is difficult to treat, so an extensive 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 the drainage of the tissues around the focus of inflammation.

Conservative or modern treatment is chosen by a urologist based on diagnostic data.

Tablets

In the form of tablets for prostatitis, antibacterial agents, pain relievers can be prescribed.

The course of antibiotic therapy is selected individually depending on the result of the prostate secretion analysis. The microflora that caused the disease must be sensitive to the drug used. It is necessary to complete the course of treatment prescribed by the urologist, otherwise the cause will not be eliminated, the disease will recur or become chronic.

Painkillers for prostatitis help to get rid of unpleasant symptoms. For this, non-steroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.

Prostatitis pills for men, which help to treat impaired urination, belong to the group of alpha-1-blockers. They relax the smooth muscles and restore the patency of the urethra, pressed 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 tablet forms of antibiotics to which the pathogen is sensitive. You can make injections with antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of their prostate.

Injectable prostatitis drugs work faster than oral drugs, so they are sometimes preferred.

Surgery for prostatitis

The worst 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, which is why surgery is indicated at the first manifestations.

In the absence of timely intervention, the purulent process spreads outside the organ, so the consequences of prostatitis in a complicated form can be life-threatening.

Prognosis and prevention

The acute form without treatment often becomes chronic, which periodically worsens. Full recovery is not always possible, but with timely access to a doctor and taking all prescribed medications, discomfort, urination problems and pain can be eliminated.

Self-medication at home and the use of folk methods can often be life-threatening.

To prevent prostatitis, it is recommended to avoid hypothermia, empty the bladder promptly, limit the use of coffee, spices and alcohol and maintain sexual activity as long as possible.

Characteristic signs of prostate cancer

The prostate gland is a small organ that only men have. Its structure resembles a mushroom, it is located under the bladder and envelops the urethra. The growth of the gland begins in adolescence under the influence of male sex hormones, and in adulthood its weight can reach 20 grams. It plays an important role in the male reproductive system by producing secretion, one of the components of sperm. But unfortunately, in mature and elderly men, hyperplasia of the gland 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 in the first stage or has even reached the second stage, then the tumor is localized in the prostate gland, has not grown into neighboring tissues and has not metastasized.

Symptoms of prostate cancer in the early stages are practically absent, this is the insidiousness of the disease. The man has no complaints, feels well and sees no reason to go to the doctor. That is why this type of tumor is often detected already in a neglected state. Exceptions may be patients who have previously been diagnosed with benign neoplasms of the prostate gland, in which case they are periodically monitored by a specialist doctor and examined for specific prostate antigen, undergo ultrasound of the gland. They have every chance of finding a tumor at its very beginning. But it is worth noting 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 the errors of the method, the needle simply does not fall into 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 MRI in real time, giving the doctor the opportunity to visualize the organ as precisely as possible.

Some of the symptoms are a consequence of prostate pathology, while others are caused by mechanical compression and obstruction of the urethra.

Since the bladder must be emptied regularly, if this process is disturbed, urine can be retained in it, inflammation can occur and a bacterial infection can join. If no measures are taken, the process will spread, and this already threatens with pyelonephritis and kidney problems.

At stage 4, prostate cancer is even more obvious. Most often, metastases are found in the bones, spine and lymph. Because of this, a person's regional lymph nodes increase, bones ache, he suddenly loses weight and becomes emaciated.

Treating prostate cancer is not an easy task, but it can be done. With timely detection of a local process, a complete cure can be achieved, and in more advanced stages, life can be extended. If you notice the symptoms described above, contact a professional clinic for an examination.

Make an appointment, the clinic's doctors have many years of experience in the treatment of urological diseases and achieve success even in the most difficult cases.