According to the BME, prostatitis is an inflammatory process that occurs in the prostate gland in men with damage to the parenchyma and interstitium.Treatment of prostatitis in men is a long and complex undertaking, most often due to complete ignorance at the beginning of the disease.What is prostatitis, what are its causes and first signs, what you need to know about the topic of "diagnosis" and what modern methods exist for treating prostatitis.This review article has everything men need to know about prostatitis.
Ab ovo - from the egg
We are not talking about Horace's satires;in this case, I am interested in everything related to prostatitis, from the beginning of treatment to the last "squeal".The symptoms of prostatitis in men appear during the period of active sexual activity, between the ages of 25 and 45.In the thematic video, you can study in detail everything related to the basics, causes and symptoms of the disease, features of diagnosis and treatment.
The causes of prostatitis are extensive.In prostatitis, infectious factors play the biggest role in the development of the disease:
- Acute form.Coconut flora acts as a provoking factor.
- Chronic form.The reasons for its formation are more extensive;In men, the primary factors of such prostatitis are: gonococci, trichomonas, Gr+ and Gr- bacteria, mycobacterium tuberculosis.In rare cases, the diagnosis includes mycoplasmas, viruses, fungi, chlamydia, etc.
It is noteworthy that chronic prostatitis, which is caused by a pathogen that has penetrated the prostate gland, can later be abacterial without the involvement of a pathogenic factor.The acute form is often triggered by external causes: hypothermia, trauma to the urethra or damage to the bladder due to endoscopic examinations or various manipulations, physical inactivity and, as a result, disturbance of blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You often hear about only one type of prostatitis - infectious, but according to the WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is registered in 90% of cases.
Table No. 1 Brief characteristics of the pathology
| Categories of prostatitis | Acute infection | The presence of a pathogen in the secretion of the prostate or in the 3rd part of the urine | The level (elevation) of leukocytes in the urine or sputum |
| 1 cat.Acute bacterial | + | + | + |
| 2 cat.Chronic bacterial | — | + | Not sure (yes or no) |
| 3 a.Inflammatory chronic pelvic pain syndrome, not bacterial | — | — | + |
| 3 b.Prostatodynia, non-inflammatory pelvic pain syndrome | — | — | — |
| 4 cat.Asymptomatic inflammatory process | — | Not sure (yes or no) | Not sure (yes or no) |
The etiology of bacterial prostatitis has been studied more thoroughly in acute and chronic manifestations;in most cases, the cause of the disease is bacteria belonging to the family.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as the root cause of prostatitis (ureplasma, chlamydia, mycoplasma) cannot currently be considered fully proven.Symptoms of prostatitis in men with signs of weakened immunity, especially in HIV infection, can be caused by yeast (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played a significant role in the development of prostatitis, especially often causing its abscess form.
The causes of the abacterial form of prostatitis have not yet been fully investigated, although urologists have thoroughly familiarized themselves with the list of possible pathogenetic (provocative prostatitis) factors that play an important role in the occurrence of prostatitis without the presence of microorganisms.Thus, the causes of non-bacterial prostatitis are stagnant processes in the pelvis, poor circulation, intraprostatic urine reflux and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man with prostatitis look like?For a person who is far from medicine and especially does not understand the problems of urology, the external male appearance of one individual does not differ from the mass of others.And only an experienced specialist, based on the patient's first complaints, will understand where the root of the problem is and what methods should be used to eliminate it.
The symptoms of prostatitis are often described in a few sentences, highlighting the most obvious moments, and this plays a cruel joke on a person.Relying on such imprecise definitions, you ignore the really important signs, believing that the disease does not exist, when in fact the clinical picture depends on the nature of the morphological changes of the prostate.
The very first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in perineum radiating to sacrum, frequent nocturnal urge.
- Follicular prostatitis.Difficulty and frequent urination, sometimes delayed.Pain during urination, intensifies at the end of the urination process, as well as during defecation.Low-grade fever.
- Parenchymal prostatitis.There are pronounced symptoms of dysuria, often acute difficulty breathing, pain during natural healing, general intoxication up to 40 C.
In prostatitis with abscess formation, the symptoms are more intense if the abscess opens into the rectum or the prostatic part of the urethra.With such a breakthrough, the symptoms are alleviated.If the opening of the abscess occurs in the paraprostatic tissue or in the perineal area, visual symptoms are observed: swelling, redness, with pronounced fluctuation.The man's condition is rapidly deteriorating.
Comprehensive treatment of prostatitis cannot begin without a thorough examination of the man, analysis of the diagnosis and symptoms, which can directly indicate the type of the disease.
In general, it is customary to distinguish between acute and chronic prostatitis;in the thematic video on the Internet, you can find out in detail which symptoms are associated with one or another form.Let's consider this question in more detail.
Acute - its typical symptoms are characterized by the manifestation of three stages: catarrhal, follicular and parenchymal.These are described in detail above.
In terms of symptoms, the chronic form of prostatitis is the most interesting, as it shows a wide variety of symptoms.In general, the effective treatment of prostatitis depends on the prostatitis, or rather its type.
In the stage of becoming chronic, the following points can be distinguished:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis passes with the disappearance of symptoms.
- A characteristic symptom of chronicity is a slight discharge from the urethra during defecation.
- The first symptoms are usually not pronounced;the pathological process itself develops over the years.It is preceded by prostatosis (congestion of the capillaries), which gradually turns into an abacterial form of inflammation of the prostate gland.
- Chronic prostatitis is not caused by specific pathogenic microflora, but the chronic process itself is a complication of the inflammatory process due to the effects of ureaplasma, trichomonas, chlamydia and gonococci.
How does a man feel in the chronic stage of prostatitis?Reviews of patients show that most often at first they feel a minor pain in the perineum and a slight discharge, which most men simply do not pay attention to.The next stage is the addition of the following symptoms: burning sensation in the urethra, sexual dysfunction, dysuria, general malaise.Frequent misfires during sex lead men to depression, they become irritable or depressed.
It is important to understand that all these signs do not necessarily appear in each chronic case, this is what complicates the diagnosis in the early stages of the disease, in addition, the symptoms tend to change places, which is even more misleading.
Long-term syndromes
What can you expect from chronic prostatitis?If there is no timely diagnosis and treatment, then nothing is good, any specialist will confirm this.This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself does not hurt, but many nerve endings pass through it and are nearby, which inevitably take part in the inflammatory process.The pain can be of different intensity - from mildly aching, causing discomfort to severe, preventing peaceful sleep.Irradiation of pain occurs in all nearby areas (scrotum, sacrum, perineum);Pain caused by prostatitis should be distinguished from similar symptoms of other diseases.
Dysuria
Dysuria syndrome always indicates a problem with the urinary tract, but the diagnosis reveals what caused it.The increased volume of the prostate inevitably compresses the urethra and the flow of urine is disturbed, followed by the frequent urge to go to the toilet and the feeling of incomplete emptying of the bladder.In advanced prostatitis, there is compensatory hypertrophy of the muscle layer of the bladder and ureters.Then the symptoms of dysuria weaken, but return again in an increased form.
Sex without pleasure
Declining intimate life - these are the first symptoms that men notice, and, according to opinions, it is precisely these that force them to consult a doctor.Frequent erections at night, erased orgasms, bad erections and rapid ejaculation, pain during them - this worries the stronger sex the most.In an advanced stage of chronicity, nothing good can be expected from prostatitis;erectile dysfunction often develops.
The degree of sexual dysfunction in men is not the same;some start having sex and somehow end it, ignoring the typical warning signs.For some, even the initial weak response of the penis to a charming stimulus turns into a breakdown and the beginning of terrible experiences that turn into long-term depression.The specter of impotence is difficult for patients with prostate problems;professionals and relatives almost always notice that prostatitis worsens the character.
If you want to learn more about the disease, you can study a thematic video in which experts explain the many nuances of the pathology.
What should we write on the card?
What entry appears in the patient's medical record and what final diagnosis is made depends on a series of primary examinations, starting from the patient's arrival at the urologist and complaints (history) to the very last stage of diagnostic measures.What exactly is needed depends on the type and severity of the prostatitis and the patient's consent to specific diagnostic procedures.
In general, the diagnosis consists of:
- History.The doctor asks in detail about all complaints and symptoms, the prerequisites of the disease, etc.
- Urine test.
- Prostate massage (digital rectal examination + discharge).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does it provide and how important is the diagnosis?If you read the opinions of patients, you can often understand that most men try to avoid many stages of diagnosis, the motivations are very different.The price of such indifference is your own health!It is important to remember that prostatitis can only be cured if it is "caught" in time and the diagnosis is made accurately, determining the form and cause of the disease.
How to be healthy forever
So, a man understands that he has prostatitis, what awaits him in the future, and is it possible to regain lost health?It is important to understand that getting rid of prostatitis takes twice as long as its development.In addition, if the pathological process took place practically without the attention of the man, then the treatment of prostatitis is carried out with his direct participation.Can acute or chronic prostatitis be cured?Yes, if you follow all the doctor's recommendations, in advanced cases of the chronic form, treatment can achieve stable remission.
The stages of prostatitis treatment directly depend on what the doctor finally found during the examination, the type of disease, the patient's age and physical characteristics.
The treatment regimen is always strictly individual, but it may include the following points:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Prescribing immune correctors.
- Urological massage.
- Therapeutic gymnastics.
The price of each stage of treatment is different and depends on the total cost of prescribed drugs, additional methods and the clinic.There is an important reason for preventive measures after treatment - they prevent the disease from returning.Prevention is directly and closely related to treatment;the basics of prevention are as important as following all the doctor's requirements during therapy.
Treatment of acute form
The period of exacerbation requires taking antibiotics, which are taken in one course.In the presence of chlamydia infection, cephalosporin drugs are indicated.
The duration of use is significant;on average, they take antibiotics for at least 3-4 weeks to prevent relapse.Sometimes the doctor continues the treatment for a longer period of time, combining antibiotics with painkillers to relieve pain.
Antibiotic treatment is carried out in accordance with the following rules:
- Bacterial culture is required to determine the sensitivity of microorganisms to drugs.
- Side effects and contraindications of medications are taken into account.
- They take into account the previous treatment process, its time, the tools used and the result.
The need for additional treatment methods is determined by the attending physician;It should be remembered that massage is contraindicated in acute forms of prostatitis, as it provokes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is important to remember that, in principle, you cannot get rid of chronicity quickly, the disease has developed over the years, and even doctors in their field cannot destroy it in a few weeks;there is no need to take our word for it for those who cured the disease in 2-3 days.The goal of treatment is to stop the source of infection, restore men's immunity and prostate function, and prevent exacerbations - this takes time.
The course of antibiotic therapy lasts 4-12 weeks;if treatment is low, medication is continued.Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete excision of the prostate is provided.
No bacteria or symptoms
The characteristic difference between the therapy is the absence of antibiotics;without the presence of pathogenic microflora, they are simply not needed.But sometimes experts prescribe a short 2-4 week course of medication.
The treatment of abacterial prostatitis is based on the use of physiotherapy methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy by strengthening the patient's immune system.
The treatment of non-bacterial prostatitis is also based on diet and lifestyle changes;baths and alpha-blockers are recommended.
Asymptomatic prostatitis is difficult to identify;the PSA method is used for diagnosis, followed by a 2-week course of antibiotics.After that, symptomatic treatment is selected individually.
In general, the treatment of any type of prostatitis is a long-term phenomenon and is not always pleasant for the patient.In addition to physical discomfort, a person also suffers mentally, because the most valuable part of the body - the intimate part - is affected.The opinions of those who have cured the disease show that only strict adherence to the doctor's instructions, combined with diet and lifestyle changes, will bear fruit.The price of a frivolous attitude to treatment is very high - a person not only loses his health, but his whole life, character and relationship with others change.In order to prevent this, the health of the prostate gland should be monitored and the causes of the disease should be eliminated.