According to statistics, every third man of working age suffers from prostatitis at different periods of life. Constant pain, impotence, infertility - this is not a complete list of problems that threaten patients in the absence of treatment. Due to the great urgency and danger of the disease, its symptoms and initial manifestations should be known to every man. In this article, you will learn all the signs and diagnostic methods that allow you to recognize prostatitis.
Clinical picture in the initial stages of development
Prostatitis is an inflammatory lesion of the male prostate. 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 flow characteristics.
It is difficult to say how the disease will develop in any particular man. The presence of certain signs depends on a number of external and internal factors. For the convenience of characterizing the pathology, it is common to divide all the symptoms of prostatitis into 3 major groups: those associated with urination disorders, sexual dysfunction, mental problems. The first and most significant symptoms of prostatitis (other than the asymptomatic form) may be the following signs in men:
- Pain in the pelvis, back, groin.
- Pain and tingling during urination.
- Difficulty urinating.
- Feeling of incomplete bladder emptying and false urge to urinate.
Pain in the pelvis, back, groin, a feeling of incomplete emptying of the bladder and a false urge to urinate are signs of prostatitis.
These symptoms are due to impaired urinary function, which is due to the anatomical characteristics of the structure and position of the bladder and prostate. Signs of prostatitis associated with sexual dysfunction are also significant and pronounced. Men most often make the following complaints:
- Poor erection.
- Rapid onset of ejaculation during intercourse.
- Lack of orgasm or decreased sensitivity.
- Pain in the urethra and rectum during ejaculation.
Problems with urination and difficulties in intimate life due to inflammation of the prostate greatly upset a man. Patients with prostatitis are forced to change their lifestyle, deprive themselves of habits, family relationships become more complicated. Obsession with your problem causes increased nervousness, anxiety, decreased libido, which can be called indirect signs of prostatitis, which belong to the third group of the above symptoms (mental disorders).
Prostatitis in men can often be confused with prostate adenoma or cancer, a pathology of the bladder. All these diseases appear similarly, especially in the initial stages. It is very difficult to distinguish them for an unprepared person, so 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 prudent to consider them separately.
Characteristics of certain forms of the disease
Acute prostatitis is an inflammation of the male prostate, caused by the penetration of an infectious agent into an 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:
- Rise in body temperature to 39-40 degrees.
- Symptoms of general intoxication (headache, weakness, fatigue, decreased work, etc. ).
- Severe pain in the perineum, sacrum, above the pubic bones of a man.
- Frequent, painful urination.
- Sometimes men have urinary retention.
A temperature of 39-40 is a clear sign of prostate inflammation.
Acute inflammation of the prostate ends, as a rule, with recovery or chronicity of the process (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. ), sedentary lifestyle, lack of vitamins and minerals, prolonged sexual abstinence or resulting from non-aggressive sexually transmitted infection or ingestion of normal microflora. The clinical picture of chronic prostatitis seems more sparse compared 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 most typical:
- Increased urge to urinate, including at night.
- Pain during urination and also during ejaculation.
- Dull aching pain in the lower back, pelvis, above the thighs, etc.
Chronic pelvic pain syndrome (CPPS) in men combines recurrent pain in the prostate area, temporary disorders of the urinary and reproductive systems. CPPS is a broader term in medicine, because pathogenetic pathology can be based on a tumor or ischemic process, disorders of the nervous system, and not only on inflammation. The mismatch of the presence of signs of prostatitis in chronic pelvic pain syndrome significantly complicates the diagnosis, but it is much more difficult to do so in an asymptomatic form. In these cases, the main and decisive role is played by the data of laboratory and instrumental research methods.
Diagnostic techniques
A definitive diagnosis cannot be made on the basis of prostatitis symptoms alone. In addition, doctors must collect a medical history: clarify information about the time of onset of symptoms, their connection with the main and most important life events, physical and mental shocks, all possible predisposing factors, etc. A physiological examination is always performed - a digital rectal examination in the knee-elbow position of the patient, lying on the side of the bent legs or standing with the body bent forward. During this study you can find signs characteristic of prostatitis (the presence of all is not necessary):
- Enlargement of the male gonad in size.
- The shape of the organ is correct or flattened by a recess.
- Dressed or doughy consistency.
- Smoothness of prostate borders.
- Increased pressure soreness.
Further examination of the patient with symptoms of prostatitis is supplemented by laboratory methods. General and biochemical blood tests are prescribed - there are no special changes in indicators, but only indirect signs that allow to judge the presence of an inflammatory process in a man's body (increase in the number of leukocytes, acute phase protein, accelerated ESR). 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 determine the pathogen to begin etiological treatment. In addition, urologists may prescribe an analysis of prostate secretion, a spermogram.
Among the instrumental methods for diagnosing prostate disease, the most informative is TRUS - transrectal ultrasound. In this case, a special sensor is used that the doctor inserts into the rectum. This causes discomfort to the sick person, but is compensated by the information content of this method. With the help of TRUS it is possible to assess the structure of organs, to judge the presence of tissue inflammation, the degree of narrowing of the urinary system and to exclude the presence of stones. The main signs of prostatitis reverberation: increase in organ size, edema, fibrosis, changes in sclerotic tissue, coarse-grained and heterogeneous structure.
In addition, patients with symptoms of prostatitis undergo uroflowmetry - a special diagnostic manipulation in which a man's urination rate is measured. Based on the data of this study, conclusions can be drawn about the degree of urethral narrowing, detrusor activity. Uroflowmetry should not replace TRUS, but confirm its findings and signs of existing prostatitis.
The diagnostic examination plan for prostatitis can be extended if it is indicated in men. Cystoscopy and pelvic CT may be performed to clarify certain points regarding the diagnosis. In unclear cases, a biopsy is performed to differentiate with tumor processes.
What to do when the first symptoms appear
It is waiting for the biggest and most common mistake that many men make when they have signs and symptoms of prostatitis. Every patient hopes that the unpleasant symptoms are temporary and will soon disappear. Untreated prostatitis is dangerous to health, it leads to irreversible changes in the body, which are filled with a damaged mechanism of erection, infertility or worse - a malignant process (transition to cancer).
To prevent serious complications, every man at the first signs of prostatitis should consult a urologist who will prescribe treatment. First of all, men are given etiotropic therapy - anti-inflammatory drugs are used, antibiotics are used, measures are taken to strengthen the immune system. There is no need for surgery in the absence of complications. Men who have had prostatitis in the past are at risk, and there is a high probability of recurrence, so after recovery, a big role is given to prevention.