According to BME, prostatitis is an inflammatory process that occurs in the prostate in men with lesions in the parenchyma and interstitium.Treating prostatitis in men is a long and complex task, most often due to complete ignorance of the disease since its inception.What is prostatitis, what are its causes and first signs, what you need to know about the topic of “diagnosis” and what modern methods of treating prostatitis exist.Everything about prostatitis that men need to know is in this review article.
Ab ovo – from the egg
We are not talking about Horace's satires;In this case, we are interested in everything related to prostatitis, from the beginning to the last “squeal” of treatment.Symptoms of prostatitis occur in men during the period of active sexual activity, from 25 to 45 years.In the thematic video you will be able to study in detail everything related to the fundamentals of the disease, its causes and symptoms, diagnostic and treatment characteristics.
The reasons for the development of prostatitis are extensive.In prostatitis, infectious factors play the greatest role in the development of the disease:
- Acute form.The coccal flora acts as a provoking cause.
- Chronic form.The reasons for its development are more extensive;The main factors for this prostatitis in men are: gonococci, trichomonas, Gr+ and Gr bacteria, Mycobacterium tuberculosis.In rare cases, the diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
It is worth noting that chronic prostatitis, caused by a pathogen that has penetrated the prostate, can subsequently have an abacterial character without the participation of a pathogenic factor.The acute form is often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, a sedentary lifestyle and, as a result, impaired blood and lymphatic circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You can 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 bacterial prostatitis is recorded in 90% of cases.
Table No. 1. Brief characteristics of the pathology
| Categories for prostatitis | Acute infection | The presence of a pathogen in prostate secretion or in the 3rd portion of urine | Level (increase) of leukocytes in urine or secretions |
| 1 cat.Acute bacterial | + | + | + |
| 2 cat.Chronic bacterial | - | + | Uncertain (yes or no) |
| 3h.Chronic pelvic pain syndrome of an inflammatory, non-bacterial nature | - | - | + |
| 3b.Prostatodynia, non-inflammatory pelvic pain syndrome | - | - | - |
| 4 cat.Asymptomatic inflammatory process | - | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more completely;In most cases, the cause of the disease is family bacteria.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as the cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered not fully proven.Symptoms of prostatitis in men with signs of weakened immunity, in particular with HIV, the cause of the disease may be yeast fungi (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 been fully studied, although urologists have thoroughly learned a list of possible pathogenetic (prostatitis-provoking) factors that play an important role in the occurrence of inflammation in the prostate gland without the presence of microorganisms.Thus, the causes of prostatitis, which are non-bacterial in nature, are congestive processes in the pelvis, poor circulation, intraprostatic reflux of urine and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man with prostatitis look like?For a person far from medicine and, especially, who does not understand the problems of urology, the masculine external appearance of an individual does not differ from the multitude of others.And only an experienced specialist, based on the patient's first complaints, will understand where the root of the problem lies and what ways to eliminate it should be taken.
The symptoms of prostatitis are often described in a few sentences, highlighting the most striking moments, and this plays a cruel joke on man.Relying on such imprecise definitions, he ignores really important signs, believing that the disease does not exist, although in fact the clinical picture depends on the nature of morphological changes in the prostate.
The first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in the perineum, radiating to the sacrum, frequent nocturnal urges.
- Follicular prostatitis.Difficulty and frequent urination, sometimes with delay.Pain when urinating, intensifying at the end of the urination process, as well as defecation.Low fever.
- Parenchymal prostatitis.There are symptoms of pronounced dysuria, often acute respiratory distress, pain during natural recovery, general intoxication with a temperature of up to 40 C.
In prostatitis with abscess formation, the symptoms are more pronounced with the possible opening of the abscess into the rectum or the prostatic part of the urethra.With this progress, the symptoms decrease.If the opening of the abscess occurs in the paraprostatic tissue or in the perineal region, visual symptoms may be observed: swelling, redness of the skin with pronounced fluctuation.The man's condition worsens drastically.
Comprehensive treatment of prostatitis cannot be started without a thorough examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is customary to distinguish between acute and chronic prostatitis;in a thematic video on the Internet, you can find out in detail which symptoms are related to one form or another.Let's consider this issue in more detail.
Acute - its typical symptoms are characterized by the manifestation of three stages: catarrhal, follicular and parenchymal.They are described in detail above.
The most interesting in terms of symptoms is the chronic form of prostatitis, as it has many variations in symptoms.In general, effective treatment of prostatitis depends on the prostatitis, or rather, its type.
In the chronicity phase, the following points can be distinguished:
- Chronic prostatitis rarely results from an acute process.
- Primary prostatitis disappears with erased symptoms.
- A characteristic symptom of chronicity is scant secretion from the urethra during defecation.
- The first symptoms, as a rule, are not pronounced;the pathological process itself develops over the years.It is preceded by prostatosis (capillary congestion), which gradually turns into an abacterial form of prostate inflammation.
- Specific pathogenic microflora is not the cause of chronic prostatitis, 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 with prostatitis in the chronic phase?Patient reviews show that most often at first, small pains in the perineum and scanty discharge are felt, which most men simply do not pay attention to.The next stage is the addition of the following symptoms: burning in the urethra, sexual dysfunction, dysuria, general malaise.Frequent failures during sex lead men to depression, become irritable or depressed.
It is important to understand that all these signs do not necessarily appear in each specific case of chronicity, this is what makes diagnosis difficult at an early stage of the disease, in addition, the symptoms tend to change location, which is even more misleading.
Long-term syndromes
What can you expect from chronic prostatitis?If there is no timely diagnosis and treatment, there is nothing good, any specialist will confirm.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 close to it, which inevitably become involved in the inflammatory process.The pain can be of varying intensity - from slightly aching, creating discomfort, to severe, preventing you from falling asleep peacefully.Pain irradiation occurs in all nearby areas (scrotum, sacrum, perineum);Prostatitis pain must be differentiated from similar symptoms of other diseases.
dysuria
Dysuric syndrome always indicates a problem with the urinary system, but what caused it is clarified during the diagnosis.The enlarged prostate inevitably compresses the urethra and the flow of urine is interrupted, followed by the development of a frequent need to go to the bathroom and a feeling of incomplete emptying of the bladder.In advanced prostatitis, compensatory hypertrophy of the muscular layer of the bladder and ureters occurs.At this time, the symptoms of dysuria weaken, but return in an intensified form.
Sex without pleasure
A declining intimate life - these are the first symptoms that men notice and it is they, as reviews show, that force them to see a doctor.Frequent nocturnal erections, dull orgasm, poor erection and rapid ejaculation, pain during the process - this is what worries the stronger sex most.In the 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 initiate sexual intercourse and somehow complete it, leaving aside the characteristic warning signs.For some, even the initial weak reaction of the penis to a charming stimulus becomes a breakdown and the beginning of terrible experiences that turn into prolonged depression.The spectrum of impotence is difficult for patients with prostate problems;specialists and relatives almost always notice that prostatitis worsens the character.
To learn more about the disease, you can study a thematic video where experts explain many of the nuances of the pathology.
What to write in the card
Which record will appear in the patient's medical record and which final diagnosis will be established depends on a series of primary studies, from the patient's arrival at the urologist and his complaints (history) to the last stage of diagnostic measures.What exactly is needed depends on the type of prostatitis, its severity and the patient's consent to specific diagnostic procedures.
In general, the diagnosis consists of:
- History.The doctor will ask in detail about all complaints and symptoms, prerequisites for the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + collection of secretions).
- Prostate ultrasound.
- Spermograms.
- Prostate biopsy (if indicated).
What does the diagnosis provide and is it so important?If you read patient reviews, you can often understand that most men try to avoid many stages of diagnosis, the motivations are very different.The price of this indifference is your own health!It is important to remember that prostatitis can only be cured if it is “detected” in time and the diagnosis is made accurately, determining the form of the disease and its cause.
How to become healthy forever
So, does a man understand that he has prostatitis, what awaits him in the future and is it possible to regain lost health?It is important to understand that it will take 2 times longer to get rid of prostatitis than to develop it.In addition, if the pathological process proceeded practically without the man's attention, then the treatment of prostatitis will take place with his direct participation.Is acute or chronic prostatitis curable?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 will directly depend on what the doctor finally discovers during the examination, the type of disease, the patient's age and physical characteristics.
The treatment regimen is always strictly individual, but may contain the following points:
- Antibacterial therapy.
- Physiotherapeutic methods.
- Phytotherapy.
- Prescription of immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The price for each stage of treatment is different and depends on the total cost of prescribed medications, additional methods and the clinic.Preventive measures after treatment have an important justification – they prevent the disease from returning.Prevention has direct and close contact with treatment;The basic principles of prevention are as important as compliance with all the doctor's requirements during the course of therapy.
Treatment of the acute form
The period of exacerbation requires the use of antibiotics, which are administered in a course.In the presence of chlamydial infection, cephalosporin medications are indicated.
Duration of use is significant;On average, antibiotics are taken for at least 3-4 weeks to prevent the disease from relapsing.Sometimes the doctor continues treatment for a longer period, combining antibiotics with pain relievers to relieve pain.
Antibiotic treatment is carried out taking into account the following rules:
- A bacterial culture is necessary to determine the sensitivity of the microorganisms to the drug.
- Side effects and contraindications of medications are taken into account.
- They take into account the previous course of treatment, when it was carried out, what means were used and the result.
The need for additional treatment methods is determined by the attending physician;it should be remembered that in acute forms of prostatitis, massage is contraindicated, as it provokes the spread of a bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is important to remember that in principle it is impossible to quickly get rid of chronicity, the disease has developed over the years and even doctors in this field cannot destroy it in a few weeks;you don't need to take the word of someone who cured the disease in 2-3 days.Treatment is aimed at stopping the source of infection, restoring immunity in men and prostate function, as well as preventing exacerbations - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks;if the treatment is low, the medication continues.Most often, antibacterial medications are prescribed in combination with other anti-inflammatory medications.In advanced cases, surgical intervention is performed with partial or complete excision of the prostate.
No bacteria or symptoms
A characteristic difference between therapy is the absence of antibiotics;without the presence of pathogenic microflora, they are simply not needed.But sometimes experts prescribe a short course of medication lasting 2 to 4 weeks.
The treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening the patient's immune system.
Diet and lifestyle changes also form the basis of treatment for nonbacterial prostatitis;baths and alpha-blockers are indicated.
Prostatitis without symptoms is difficult to identify;The PSA method is used for diagnosis, followed by a 2-week course of antibiotics as treatment.After that, symptomatic treatment is selected individually.
In general, the treatment of any type of prostatitis is a long-term phenomenon and not always pleasant for the patient.In addition to physical disorders, men suffer psychologically, as their most valuable part of the body is affected - the private part.Reviews of those who cured the disease show that only strict adherence to the doctor's instructions, combined with changes in diet and lifestyle, bears fruit.The price of a frivolous attitude towards treatment is very high - a man not only loses his health, but his whole life, character and relationships with others change.To avoid this, it is necessary to monitor the health of the prostate and eliminate the causes of the development of the disease.