According to BME, prostatitis is an inflammatory process occurring in the prostate gland in men with damage to the parenchyma and interstitium.The treatment of prostatitis in men is a long and complicated undertaking, which is most often due to the complete ignorance of the disease at its very beginning.What is prostatitis, what are the causes and the first signs, what you need to know about the topic "diagnosis" and what modern methods of treatment of prostatitis exist.Everything men need to know about prostatitis is in this overview article.
Ab ovo – from the egg
We are not speaking of Horace's satires;in this case, we are interested in everything related to prostatitis, from the very beginning to the last "squeak" of treatment.Symptoms of prostatitis appear in men during the period of active sexual activity, from 25 to 45 years.In the thematic video, you can study in detail everything related to the basics of the disease, its causes and symptoms, features of diagnosis and treatment.
There are many reasons for the development of prostatitis.In prostatitis, infectious factors play the biggest role in the development of the disease:
- Sharp shape.The coccus flora act as provoking causes.
- Chronic form.The reasons for its development are more extensive;the main factors of such prostatitis in men are: gonococci, trichomonads, Gr+ and Gr- bacteria, mycobacteria tuberculosis.In rare cases, diagnostics reveal mycoplasmas, viruses, fungi, chlamydia, etc.
It should be noted that chronic prostatitis caused by a pathogen that has penetrated the prostate gland may subsequently have an abacterial nature without the involvement 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, lack of physical activity and, as a result, impaired blood and lymph circulation in the small 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 abacterial prostatitis is registered in 90% of cases.
Table No. 1. Brief description of the pathology
| Categories for prostatitis | Acute infection | The presence of a pathogen in the secretion of the prostate or the 3rd portion of urine | Level (increase) of leukocytes in the urine or secretions |
| 1 cat.Acute bacterial | + | + | + |
| 2 floorChronic bacterial | — | + | Not sure (yes or no) |
| 3 a.Chronic pelvic pain syndrome of an inflammatory nature, non-bacterial | — | — | + |
| 3 b.Prostatodynia, non-inflammatory pelvic pain syndrome | — | — | — |
| 4th floorAsymptomatic inflammatory process | — | Not sure (yes or no) | Not sure (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more fully;in most cases, the cause of the disease is bacteria from the family.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as a 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 (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played an important 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 learned in detail a list of possible pathogenetic (prostatitis-provoking) factors that play an important role in the occurrence of inflammation of the prostate without the presence of microorganisms.Thus, the causes of prostatitis, which is non-bacterial in nature, are stagnant processes in the pelvis, poor blood circulation, intraprostatic reflux of urine and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a person with prostatitis look like?To a person far from medicine and especially without an understanding of the problems of urology, the male appearance of one individual is no different from a crowd of others.And only an experienced specialist, based on the first complaints of the patient, will understand where the root of the problem is and what ways to eliminate it will have to be taken.
The symptoms of prostatitis are often described in a few phrases, highlighting the brightest moments, and this plays a cruel joke on the man.Relying on such inaccurate definitions, he ignores really important signals, believing that the disease does not exist, although in fact the clinical picture depends on the nature of the morphological changes in the prostate.
The first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in perineum radiating to sacrum, frequent nocturnal urges.
- Follicular prostatitis.Difficult and frequent urination, sometimes delayed.Pain during urination, intensifying at the end of the process of urination, as well as defecation.Subfebrile temperature.
- 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 possible opening of the abscess in the rectum or in the prostatic part of the urethra.With such a breakthrough, the symptoms subside.If the opening of the abscess occurs in the paraprostatic tissue or in the perineal area, visual symptoms can be observed: swelling, redness of the skin with pronounced fluctuation.The man's condition is rapidly deteriorating.
Comprehensive treatment of prostatitis cannot begin without a thorough examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
It is generally accepted to distinguish between acute and chronic prostatitis;on a thematic video on the Internet, you can find out in detail which symptoms refer to one form or another.Let's look at this question in more detail.
Acute - its typical symptoms are characterized by the manifestation of three stages: catarrhal, follicular and parenchymal.These are detailed above.
The most interesting in terms of symptoms is the chronic form of prostatitis, as there are many variations in symptoms.In general, the effective treatment of prostatitis depends on the prostatitis, or rather, its type.
In the chronicling stage, the following points can be distinguished:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis proceeds with erased symptoms.
- A characteristic symptom of chronicity is scanty discharge from the urethra during defecation.
- The first symptoms, as a rule, are not expressed;the pathological process itself develops over the years.It is preceded by prostatosis (stagnation in the capillaries), which gradually turns into an abacterial form of inflammation of the prostate gland.
- The cause of chronic prostatitis is not a 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 person with chronic prostatitis feel?Reviews of patients show that most often at the beginning a slight pain in the perineum and scanty discharge is 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 interruptions 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 specific case of chronification, this complicates the diagnosis at an early stage 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, there is nothing 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 are inevitably involved in the inflammatory process.The pain can be of different intensity - from slightly painful, creating discomfort, to strong, preventing you from sleeping peacefully.Pain radiation occurs in all nearby areas (scrotum, sacrum, perineum);Pain from prostatitis should be distinguished from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a problem in the urinary system, but the reason for this is clarified during diagnosis.The increased volume of the prostate inevitably presses the urethra and the outflow of urine is disturbed, followed by the development of frequent urges to go to the toilet and a feeling of incomplete emptying of the bladder.In advanced prostatitis, there is compensatory hypertrophy of the muscle layer of the bladder and ureters.At this time, the symptoms of dysuria weaken, but return again in an intensified form.
Sex without pleasure
Intimate life, which is in decline - these are the first symptoms that men notice, and it is they, as the reviews show, that force them to visit a doctor.Frequent night erections, orgasm in an erased form, poor erection and rapid ejaculation, pain during it - this is what worries the stronger sex.In an advanced stage of chronification, nothing good can be expected from prostatitis;erectile dysfunction often develops.
The degree of sexual dysfunction in men is not the same;some initiate intercourse and somehow complete it, ignoring the telltale warning signs.For some, even the initial weak response of the penis to an attractive stimulus turns into a collapse and the beginning of terrible experiences that turn into a long-term depression.The specter of impotence is difficult for patients with prostate gland problems;specialists and relatives almost always notice that prostatitis worsens the character.
To learn more about the disease, you can study the thematic video, where experts explain many of the nuances of the pathology.
What should I write on the card?
What entry will appear in the patient's medical record and what final diagnosis will be established depends on a series of primary examinations, starting from the arrival of the patient to the urologist and his complaints (anamnesis) 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 + secretion collection).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does the diagnosis give and is it so important?If you read the reviews 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 is curable only if it is "caught" in time and an accurate diagnosis is made, determining the form of the disease and the cause of its occurrence.
How to get healthy forever
So, a person 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 it will take 2 times longer to get rid of prostatitis than it takes to develop it.In addition, if the pathological process proceeds practically without the attention of the man, then the treatment of prostatitis will be carried out with his direct participation.Can we treat acute or chronic prostatitis?Yes, if you follow all the doctor's recommendations, in advanced cases of the chronic form, treatment can achieve a stable remission.
The stages of prostatitis treatment will depend directly on what the doctor eventually found during the examination, on the type of disease, the patient's age and physical characteristics.
The treatment regimen is always strictly individual, but the following points may be present in it:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Prescribing immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The cost of each stage of treatment is different and depends on the total cost of the prescribed drugs, additional methods and the clinic.Preventive measures after treatment have an important rationale - they prevent the return of the disease.Prevention has direct and close contact with treatment;the basics of prevention are as important as compliance with all the doctor's requirements during the course of therapy.
Treatment of acute form
The period of exacerbation requires taking antibiotics, which are taken in a course.In the presence of chlamydial infection, cephalosporin drugs are indicated.
The duration of the course of use is significant;on average, antibiotics are taken for at least 3-4 weeks to prevent recurrence of the disease.Sometimes the doctor continues the treatment for a longer period, combining antibiotics with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- A bacterial culture is required to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of drugs 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 bacterial infection in the body, followed by bacteremia and sepsis.
Treatment of 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 their field cannot destroy it in a few weeks;you do not need to believe those who cured the disease in 2-3 days.Treatment is aimed at stopping the source of infection, restoring immunity in men and the functioning of the prostate gland, 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 medicine continues further.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 gland is planned.
No bacteria and no symptoms
A 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 course of drugs of 2-4 weeks.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening of the patient's immune system.
Dietary and lifestyle changes are also the mainstay 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.Symptomatic treatment is then 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 the physical discomfort, the man also suffers psychologically, because his most valuable part of the body - the intimate part - is affected.The reviews of those who have cured the disease show that only strict adherence to the doctor's instructions, combined with diet and lifestyle changes, bears fruit.The price of not taking treatment seriously is very high - a person loses not only his health, his whole life, character and relationships with others change.To prevent this, it is necessary to monitor the health of the prostate gland and eliminate the causes of the development of the disease.