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Prostatitis in men

Prostatitis is an inflammatory process affecting the prostate tissue.This is one of the most common diseases in the urologist's office.The disease is diagnosed mainly in men aged 25-30, but at an older age the risk of developing the pathology increases significantly.

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

Causes of prostatitis

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

Among the most common causes of bacterial (infectious) prostatitis, gram-negative organisms should be highlighted: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often, the inflammatory process develops against the background of infection with sexually transmitted infections: chlamydia, gonococcus, trichomonas, herpes virus, etc.As a rule, such forms of the disease are diagnosed in men younger than 35 years old.Cases of treatment of pathology on the background of Mycobacterium tuberculosis infection are extremely rare.

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

  • increased pressure in the prostate;
  • autoimmune disorders (destruction of prostate cells by antibodies);
  • pelvic pain syndrome;
  • 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;
  • impotence disorder in men of reproductive age;
  • pain in the perineum when sitting for a long time;
  • frequent and strong need 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 toilet;
  • inability to achieve a quality and lasting erection even with strong excitement.

Signs of acute prostatitis

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

  • Catarrhal.The patient complains of frequent urges, pain during urination, pain in the perineum and sacrum.
  • Follicular.The pain syndrome becomes intense, may 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 up to 38 degrees during a long period (weak degree of temperature) or moderate hyperthermia.
  • Parenchymatous.A person begins to feel general intoxication of the body with chills and a temperature of up to 38-40°C.The pain in the perineum becomes sharp and pulsating.The act of defecation is difficult, and normal emptying of the bladder is impossible, resulting in acute retention of urine (dysuria).

Symptoms of chronic prostatitis

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

  • low temperature (occasionally);
  • slight pain in the perineum;
  • discomfort during urination;
  • scanty discharge from the urogenital canal during defecation.

In general, the clinical picture changes with time, varies in intensity in different patients and can become hidden when trying to self-medicate.Symptoms of the chronic disorder may include a burning sensation in the urethra, pressure in the perineum, dysuria, impaired sexual function, and increased general fatigue.Mental depression, irritability and anxiety appear in the background of potency problems.The fear of impotence leads to the development of a complex, but most men tend to postpone a visit to a urologist due to a sense of shame.

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

In addition to infectious etiology, the cause of the disease is a chronic inflammatory process caused by infection with trichomonas, ureaplasma, chlamydia or gonococcus.Primary infection masks the signs of prostatitis, and its treatment does not eliminate inflammation of the prostate.Often the addition of an accompanying problem goes unnoticed by men.

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

  • Disorder of the urinary system (dysuria).Inflammation increases the volume of the prostate, which leads to compression of the ureter.As its lumen decreases, there is a frequent urge to urinate and a feeling of an incompletely empty bladder.Dysuric disorders in many men occur in the early stages of prostatitis.The compensatory mechanism in this period is manifested in the hypertrophy of the bladder and ureter muscles, which reduces the symptoms of dysuria, but with the development of inflammation they increase again.
  • Pain syndrome.There are no pain receptors in prostate tissue.Pain occurs when the inflammatory process spreads to other pelvic organs and their nerve pathways.Sensations range from mild and painful to very intense, disturbing a night's rest.Increased discomfort occurs with ejaculation, sexual abstinence or excessive sexual activity.The pain spreads to the perineum, sacrum, scrotum and sometimes to the lumbar region.
  • Violation of potency.Lack of treatment in the early stages of prostatitis can lead to dyspotency, when a man experiences frequent night erections, deterioration of orgasm quality and accelerated ejaculation.In different patients, these signs manifest themselves with different intensity.Premature ejaculation occurs due to a decrease in the excitability threshold of the orgasmic center.In this case, the patient feels pain, which leads to the development of pain anticipation syndrome and gradual renunciation of sexual activity.In the absence of comprehensive treatment that addresses the mental factor of the disorder, sexual disorders become worse.Ignoring the need to seek medical help for prostatitis often results in impotence.

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

Complications of prostatitis

Lack of adequate treatment of prostate inflammation leads to accompanying 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 urethra.Therefore, when the prostate enlarges, the urethra is compressed and the normal outflow of urine is disturbed.Taking into account the peculiarities of physiology, if acute or chronic prostatitis is not treated in time, numerous serious pathologies and complications arise.

Related issues:

  • formation of cysts, prostate stones;
  • decrease in the amount of produced male hormones;
  • 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 prostate inflammation that do not undergo timely and comprehensive treatment pose a threat not only to the health, but also to the patient's life (especially oncological pathologies can develop).Therefore, at the first symptoms of prostatitis, you should consult a urologist.Do not forget about regular preventive examinations after the age of 40, when the risk of pathological processes in the prostate greatly increases.

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 of symptoms, history and a general examination.Then the doctor prescribes a series of tests, based on which a diagnosis is made and adequate treatment is selected.As a rule, the exam package includes:

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

To ensure an accurate diagnosis of prostatitis in men and related disorders, you must refrain from urinating 2-3 hours before visiting the urologist.Otherwise, the test results may not be completely accurate, because when the bladder is emptied, the pathogenic microflora is washed away.In accordance with the characteristics of the clinical picture, the method of ultrasound is selected: transrectal or abdominal (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Methods of treatment of prostatitis

The main therapy is antibiotics.The use of modern pharmacological developments gives high 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 secretions for the type of pathogen.If acute prostatitis is diagnosed, oral antibiotic therapy lasts about 4-6 weeks.In case of chronic or recurrent forms of the disease, the treatment will last longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis) hospitalization and intravenous antibiotic therapy is required.

If there is difficulty urinating, the urologist prescribes drugs that alleviate the hypertonicity of the bladder and prostate muscles, which normalizes the outflow of urine and prevents stagnation.Some patients are treated with drugs that reduce sex hormone levels.As a result, there is a decrease in the size of the prostate and, accordingly, a feeling of discomfort during urination, defecation and ejaculation.In severe swelling of the prostate, muscle relaxants help relieve overload of the bladder sphincter and adjacent muscles.Anti-inflammatory non-steroidal drugs effectively fight against pain.Also, chronic prostatitis responds well to auxiliary physiotherapy.Effective methods of such treatment are:

  • instillation of drugs into the urethra;
  • prostate massage;
  • shock wave therapy (SWT);
  • magnetic laser therapy (MLT);
  • electrophoresis;
  • ozonotherapy;
  • intravenous laser irradiation of blood (ILBI);
  • blood ultraviolet radiation (UFOI).

Prostate massage is a frequently used urological technique.The doctor uses the method of digital stimulation of the prostate through the rectum in order to improve the outflow of secretions and restore the patency of the organ's channels.An additional effect is improved blood circulation and accelerated penetration of antibiotics into inflamed tissues.In addition to prostate massage with fingers, 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 on the inflamed area.The procedure helps:

  • activate local blood circulation and the growth of new blood vessels;
  • stimulate their own regenerative abilities;
  • they destroy fibrous foci and calcifications that cause pain and inflammatory processes.

After a course of shockwave therapy, the symptoms of prostatitis are alleviated and a good preventive effect is observed.Expressed results can be achieved only 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 condition and the presence of accompanying pathologies.

Prevention of prostatitis

In order to reduce the risk of recurrence to a minimum, it is necessary to reduce the negative effects on the body.Among the provocative factors are:

  • Smoking.Anatomical characteristics of the position of the prostate lead to constant oxygen starvation, and inhaling tobacco smoke causes vasospasm, which additionally slows down local microcirculation processes.All experienced smokers have the problem of high blood pressure.
  • Deficit of motor activity."Sedentary" work and a sedentary lifestyle lead to congestion in the pelvic organs.
  • Alcohol abuse.Exceeding the daily alcohol limit affects overall health and makes the body more susceptible to various infectious diseases.
  • Stressful conditions.It is necessary to avoid situations that lead to anxiety, irritation and depressive disorders as much as possible.If necessary, consult a specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, which makes the body "open" to colds and inflammation.
  • Fatigue, excessive physical activity.Do not forget about the schedule of work and rest, as well as lifting heavy weights.

Preventive measures will help prevent the development of acute prostatitis and recurrence of chronic prostatitis.For questions regarding the diagnosis and treatment of prostatitis, you can always contact the urology department of our clinic.