Prostatitis is an inflammatory process associated with inflammation of the prostate gland (prostate) in males. Most often this disease occurs in men older than 30 years. This ailment causes pain in the lower back, perineum or pelvic region, is accompanied by a violation of the normal process of urination and, in severe forms, leads to erectile dysfunction and serious problems in relations with a partner.
Approximately a quarter of cases among couples suffering from infertility are precisely the causes of the male factor that affect the impossibility of conception. Male infertility is a violation of the quality of spermatozoa and their quantitative content in the ejaculate.
The prostate gland (prostate) refers to the male reproductive system. It is shaped like a chestnut, located in front of the rectum, under the bladder and surrounds the urethra (urethra). When the prostate gland becomes inflamed, it compresses the urethra, which further leads to problems with urination. The main function of the prostate is to produce a secret (fluid) that is part of the semen and dilutes it, which ensures normal sperm motility.
Prostatitis is very common in the practice of a urologist. It can occur suddenly or gradually, appear constantly and for a long time (chronic prostatitis). The chronic form of this disease is more common than the acute form. Chronic prostatitis ranks fifth among the twenty major urological diagnoses.
Since prostatitis is an active focus of infection in the body, it requires mandatory treatment, even if its symptoms do not bother you.
Reasons for the development of prostatitis
The list of causes that provoke inflammation of the prostate gland is very diverse:
- diseases of the genitourinary system (cystitis, urethritis, pyelonephritis);
- sexually transmitted infections (trichomoniasis, gonorrhea);
- infections associated with pneumonia, influenza, tonsillitis, furunculosis;
- chronic constipation, forcing a man to strain regularly;
- sedentary lifestyle and irregular sex life, which lead to stagnation of the secret;
- urinary retention - a swollen bladder increases pressure on the prostate;
- frequent hypothermia (or overheating);
- injuries in the pelvic area;
- hormonal disorders that weaken the immune system.
Very often, the appearance of prostatitis is caused by pyogenic microbes: E. coli, streptococci and staphylococci, mycoplasmas, Candida fungi, Trichomonas, tubercle bacillus. They multiply very quickly and destroy prostate tissue, which is manifested by inflammation.
In most cases, the occurrence of prostatitis is provoked by an infection penetrating into the prostate gland through the urethra. It happens that it enters the body through the blood or lymph, passes from the bladder or rectum.
Important! A decrease in immunity is very dangerous for a patient with chronic prostatitis, since the prostate gland quickly becomes inflamed with fatigue, stress, lack of sleep, malnutrition and other adverse factors.
With a sedentary lifestyle and the absence of a constant sexual life, the blood supply to the pelvic organs worsens, which leads to oxygen starvation of prostate tissues and congestion. A stagnant secret is an ideal environment for the development of pathogenic microorganisms that cause inflammation.
Types and forms of prostatitis
Prostatitis, depending on the cause of the disease, is classified into types and forms:
By type, they are distinguished:
Bacterial prostatitis- Inflammation caused by infection. Bacterial prostatitis occurs in both young and elderly men.
congestive prostatitis- inflammation caused by stagnation of the secretion. It develops in men with a sedentary lifestyle who do not have a regular sex life. This form can quickly be supplemented by an infection, and then the stagnant process is complicated by the bacterial form.
Calculous prostatitis- stones form in the prostate gland. Untreated chronic prostatitis can cause this complication. This disease affects older men who have not followed the advice of a urologist.
According to the form of flow, they are distinguished:
Acute form of prostatitis- this is an inflammation of the prostate gland caused by an infectious agent, characterized by the appearance of edema and purulent foci in the tissues. 30-58% of men of reproductive age (30-50 years) face such a diagnosis.
Chronic form of prostatitischaracterized by persistent or recurring urogenital symptoms caused by a bacterial infection in the prostate gland. The chronic form occupies 10% of all cases of prostatitis.
Symptoms of prostatitis
Generalsymptoms of inflammation of the prostateare:
- pain in the lumbar region;
- sensations of discomfort during intestinal motility;
- pain in the perineum or pelvic region;
- disorders in the work of the lower urinary tract.
The acute stage of prostatitis is accompanied by a general intoxication syndrome. This disease is characterized by a sharp manifestation of symptoms with a vivid clinical picture:
- a sharp increase in body temperature, chills, nausea, vomiting and malaise;
- pain syndrome and chills in the joints and muscles;
- an increase in the size of the prostate and the occurrence of discomfort in the perineal area;
- frequent urination and urinary retention.
Against the background of individual inflammatory processes, a purulent-septic disease can develop that affects the blood. In such a situation, the patient must be urgently hospitalized: with sepsis, treatment of prostatitis should be carried out exclusively in the clinic.
Atchronic prostatitis of a bacterial naturesymptoms are usually absent, so treatment begins only when an infection in the urinary system is detected, which manifests itself against the background of a complication of the disease. In this case, you may observe:
- pain during ejaculation;
- the appearance of blood in the ejaculate;
- the presence of discharge from the urethra;
- erectile dysfunction may develop.
If the examination did not show that chronic pain is caused by pathologies in the prostate gland, then in this case we are dealing withchronic non-bacterial prostatitisor the so-calledchronic pelvic pain syndrome. With this disease, the quality of life of a man is significantly reduced, as it leads to various disorders of a psychological and sexual nature:
- increased fatigue;
- a feeling of helplessness;
- erectile dysfunction;
- painful ejaculation;
- pain after intercourse, etc.
Similar symptoms may apply to other urological diseases, so it is impossible to diagnose prostatitis by symptoms alone. For example, urination disorders and pain are present in prostate adenoma, cystitis, various oncological tumors in the genitourinary organs, etc.
Diagnosis of inflammation of the prostate
Having identified the first signs of the inflammatory process of the prostate, the patient should immediately contact a doctor - a urologist. The doctor must exclude many diseases that have similar manifestations, and determine which type of disease it belongs to.
To confirm that the patient does not have other diseases (for example, appendicitis, oncology, inflammatory processes in the bladder and kidneys, prostate adenoma), the doctor must conduct the necessary examinations:
- collection of anamnesis (questioning of the patient);
- general inspection;
- rectal examination;
- study of the secret of the prostate gland;
- analysis for sexually transmitted infections;
- ultrasound examination of the prostate, scrotum and pelvic organs.
At the appointment, the urologist should clarify with the patient the duration of the clinical manifestations of the disease, the localization and nature of pain (for example, in the perineum, scrotum, penis and inner thigh), characteristic changes in sperm (presence of pus and blood).
The doctor establishes the diagnosis of chronic bacterial prostatitis with a duration of symptoms of at least three months.
The survey will include:
- Digital rectal examination of the gland, to determine the degree of prostate enlargement and its consistency.
- Analyzes of prostate secretion, urine and / or ejaculate.
- Identification of urogenital infection.
- Urodynamic study.
- Ultrasound examination of the urinary system (kidneys, prostate, bladder with determination of residual urine).
- Cultural study of prostate secretion and microscopy of various portions of urine and prostate secretion.
- Androflor is a comprehensive study of the microbiocenosis of the urogenital tract in men by PCR, which will determine the qualitative and quantitative composition of the microflora.
After identifying the cause of the disease, the doctor will recommend a course of treatment. It must be remembered that standard methods only in 5-10% of cases can detect an infection, which ultimately leads to prostatitis.
The patient must definitely undergo a thorough diagnosis, because the success of the treatment will depend on the accuracy of the results.
Treatment of prostatitis
When a urologist has made a diagnosis, determined the cause and form of prostatitis, he must prescribe treatment.
The leading role in the treatment of this disease is assigned to drug therapy:
At the first stage of therapeutic therapy, it is necessary to eliminate inflammation. Antibiotics are the main treatment for acute bacterial prostatitis and are recommended for chronic bacterial prostatitis. The doctor chooses an antibacterial drug depending on which bacteria caused the disease. The patient will have to take oral antibiotics in a course for 4-6 weeks. Chronic or recurrent prostatitis takes longer to resolve. Hospitalization may be required for very severe manifestations, where an intravenous course of antibiotics will be given. Usually, this happens with acute bacterial prostatitis.
Treatment with alpha1-blockers
With difficulty urinating, the doctor prescribes alpha1-blockers, which help facilitate urination and relax the muscles of the prostate and bladder. Muscle relaxants will relieve the pain caused by swelling of the prostate gland, which puts pressure on adjacent muscles. Non-steroidal anti-inflammatory drugs will help relieve the painful syndrome.
Also, the doctor may prescribe auxiliary preparations: biostimulants, extracts of various plants and insects in the form of rectal suppositories. Unfortunately, the use of drugs alone in the treatment of prostatitis remains insufficient.
In the treatment of this disease, the principles of the sequence of actions must be observed. Treatment of prostatitis is always complex.
Physiotherapy in the treatment of prostatitis
In chronic prostatitis categories, you can additionally use physiotherapy methods:
- massage of the prostate gland (prostate);
- laser therapy;
- microwave hyperthermia and thermotherapy;
- electrical stimulation with modulated currents with skin or rectal electrodes;
- acupuncture (acupuncture).
Alternative methods, such as hirudotherapy (treatment with medical leeches), are sometimes used to treat prostatitis, but the effectiveness and safety of this method has not been proven.
Introduction of stem cells
Cellular therapy (stem cell injections) is a promising method for the treatment of prostatitis today, it is in the early stages of development. With regard to the injection of stem cells into the prostate, one can only have hypotheses about its mechanisms and empirical data obtained by individual groups of researchers.
Surgical treatment of prostatitis
Surgical methods are used to treat complications of prostatitis (abscess and suppuration of seminal vesicles).
Treatment of chronic pelvic pain syndrome requires separate consideration. Asymptomatic inflammatory prostatitis does not require treatment.
Diet and lifestyle for prostatitis
Prostatitis does not require a special diet, but eating a large amount of vegetables, lean meat and dairy products will help improve bowel function. It is necessary to enrich your body with a sufficient amount of fiber, foods rich in vitamin E (wheat germ, corn oil, etc. ), replace sugar with natural honey. Proper nutrition with inflammation of the prostate gland will help improve bowel function and reduce the likelihood of relapse or speed up recovery. The patient needs to limit himself in taking coffee, exclude alcohol, drink plenty of fluids and adhere to a healthy lifestyle.
Preventive measures to prevent prostatitis
When a man leads the right way of life: he follows proper nutrition, goes in for sports, then his chances of developing chronic prostatitis are very small. Refusal of bad habits and casual sex are the prevention of this disease.
Important! There is primary and secondary prevention to prevent the development of prostatitis in men.
Primary- aimed at preventing the occurrence of the disease. It comes down to maintaining a balanced diet, physical activity regimen, timely treatment of any infectious diseases of the body and regular protected sexual intercourse, etc.
Secondary- is aimed at preventing the recurrence of existing chronic prostatitis and provides for regular examination by a urologist and preventive treatment with multivitamins, restorative drugs, and sports.