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Prostatitis in men

Prostatitis is an inflammatory process that affects the tissue of the prostate gland.This is one of the most common diseases in the practice of urologists.The disease is diagnosed mainly in men from the age of 25-30 years, but at an older age the risk of developing pathology increases significantly.

Forms distinguish between acute and chronic prostatitis.In the second case, inflammation is characterized by a long course with periodic relapses.This condition is more common than acute.

Causes of prostatitis

Many diseases of the prostate gland, for example, benign hyperplasia or oncopathology, are problems of the older age group.However, prostatitis does not fall into this category.Symptoms usually appear in men between the ages of 30 and 50.Often, the cause is an infectious lesion due to the penetration of pathogenic flora from the urogenital tract or glands of the genitourinary system.This is explained by the proximity of the urethra and anus.

Among the most common causative agents of bacterial (infectious) prostatitis, gram-negative organisms should be noted: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often the inflammatory process develops against the background of infection with STIs: chlamydia, gonococci, trichomonas, herpes virus, etc.As a rule, this form of the disease is diagnosed in men under the age of 35.Cases of pathological treatment against the background of infection by Mycobacterium tuberculosis are very rare.

There are also non-bacterial types of prostatitis.Among their main reasons:

  • increased pressure in the prostate gland;
  • autoimmune disorders (destruction of prostate cells by antibodies);
  • muscle pain syndrome in the pelvic area;
  • psychoemotional disorders;
  • motor activity deficit;
  • excessive physical stress.

The main symptoms of prostatitis

a man with signs of prostatitis

This disease is accompanied by a complex of disorders that affect the functioning of the entire urinary system.Among the main symptoms:

  • uncontrollable urination;
  • discomfort, pain when emptying the bladder;
  • potency disorders in men of reproductive age;
  • pain in the perineum when sitting for a long time;
  • frequent and strong urge to urinate;
  • difficulty emptying the bladder;
  • decreased libido and erectile problems;
  • reproductive dysfunction (infertility);
  • a feeling of incomplete emptying of the bladder after going to the toilet;
  • inability to achieve a high-quality and lasting erection even with strong stimulation.

Symptoms of acute prostatitis

The symptoms of the disease in acute form and the general clinical picture differ depending on the stage of the pathological process:

  • Catarrhal.Patients complain of frequent urges, pain when urinating, pain in the perineum and sacrum.
  • follicular.The pain syndrome becomes intense, can radiate to the anus and intensify during defecation.Urine is released in a thin stream.In some cases there are delays.There is an increase in body temperature up to 38 degrees in a long period (low-grade fever) or moderate hyperthermia.
  • Parenchymatous.The man started experiencing general body intoxication with chills and a temperature of up to 38-40°C.Pain in the perineum becomes sharp and throbbing.Defecation is difficult, and normal emptying of the bladder is impossible, resulting in acute urinary retention (dysuria).

Symptoms of chronic prostatitis

The chronic form of prostate inflammation may be the result of the absence or incorrect treatment in the acute stage.However, in most men it develops immediately and is characterized by "fuzzy" symptoms.Among the main signs are:

  • low fever (sometimes);
  • mild pain in the perineum;
  • discomfort when urinating;
  • slight discharge from the urogenital tract during defecation.

In general, the clinical picture changes over time, varies in intensity in different patients and can be hidden when trying self-medication.Symptoms of chronic disorders may include a burning sensation in the urethra, pressure in the perineum, dysuria, impaired sexual function and increased general fatigue.Against the background of problems with potency, mental depression, irritability and anxiety arise.The fear of impotence leads to the development of the complex, but most men tend to postpone a visit to a urologist because of the feeling of shame.

Primary chronic prostatitis develops over a long period of time.Stagnation of blood in the capillaries (prostatosis) causes the initial stage of non-bacterial inflammation, which leads to the onset of the disease.

With an infectious etiology, the cause of this disease is a chronic inflammatory process due to infection with trichomonas, ureaplasma, chlamydia or gonococci.The primary infection masks the symptoms of prostatitis, and the treatment does not eliminate the inflammation of the prostate.Often the addition of concomitant problems remains unnoticed by a man.

Let's consider in detail the three main symptoms of chronic prostatitis:

  • Urinary disorders (dysuria).Inflammation increases the volume of the prostate gland, which leads to compression of the ureter.When the lumen decreases, a frequent urge to urinate and a feeling of the bladder not being completely empty appear.Dysuric disorders in most men occur in the early stages of prostatitis.The compensatory mechanism during this period is shown in the hypertrophy of the bladder and ureter muscles, which reduces the symptoms of dysuria, but with the development of inflammation they increase again.
  • Pain syndrome.There are no pain receptors in prostate tissue.Pain occurs when the inflammatory process spreads to other pelvic organs and their nerve pathways.The sensations range from light and painful to very intense, which disturbs a night's rest.Increased discomfort occurs with ejaculation, sexual abstinence, or excessive sexual activity.Pain radiates to the perineum, sacrum, scrotum and sometimes to the lumbar region.
  • Potential violation.Lack of treatment in the early stages of prostatitis can cause dyspotence, when a man experiences frequent erections at night, deterioration in the quality of orgasms and accelerated ejaculation.In different patients, these signs show themselves with different intensity.Premature ejaculation occurs due to a decrease in the pleasure threshold of the orgasmic center.In this case, the patient experiences pain, which leads to the development of pain expectation syndrome and the gradual rejection of sexual activity.In the absence of comprehensive treatment that addresses the mental factors of the disorder, sexual disorders worsen.Ignoring the need to seek medical help for prostatitis often ends in impotence.

The degree of sexual dysfunction varies depending on individual factors.Some men are so afraid of erectile dysfunction that their problems arise because of suggestion rather than objective physiological factors.In particular, psychogenic dyspotency is observed precisely with increased anxiety and obsessive complexes.The thought of possible male health disorders is difficult for such patients to bear.This greatly affects their character and communication with others.Irritability, hypochondria, irritability and depression appear.

Complications of prostatitis

Lack of adequate treatment for prostate inflammation leads to concomitant diseases.The fact is that the prostate gland is closely related to other organs of the male genitourinary system.It is located around the bladder neck and urinary tract.Therefore, when the prostate enlarges, the urethra is compressed and the normal outflow of urine is interrupted.Taking into account the peculiarities of physiology, if acute or chronic prostatitis is not treated in time, some serious pathologies and complications arise.

Related problems:

  • cyst formation, prostate stones;
  • reduction in the amount of male hormones produced;
  • decreased sexual desire (libido);
  • erectile dysfunction (erectile dysfunction);
  • infertility (in 40% of patients with chronic prostatitis);
  • prostate adenoma (benign tumor);
  • prostate cancer.

Some of the consequences of prostate inflammation that do not receive timely and comprehensive treatment pose a threat not only to health, but also to the patient's life (in particular, oncological pathologies may develop).Therefore, at the first symptoms of prostatitis, you should consult a urologist.You should also remember about regular preventive examinations after 40 years, when the risk of pathological processes in the prostate gland increases greatly.

Diagnosis of prostatitis

Many urological problems have similar symptoms, so specialists work with each clinical case separately and use all available diagnostic tools.A consultation with a urologist always begins with a survey of symptoms, medical history and a general examination.Then the doctor prescribes a series of tests, based on the results of which the diagnosis is made and adequate treatment is selected.As a rule, the exam package includes:

  • digital rectal examination of the prostate to determine the size, structure of the prostate gland and degree of urethral compression;
  • Ultrasound of the urinary system (prostate, bladder, kidneys);
  • laboratory tests of urine, prostate secretion, ejaculation;
  • tests for urogenital infections;
  • urodynamic studies.

To ensure an accurate diagnosis of prostatitis in men and related disorders, you need to hold urine for 2-3 hours before visiting a urologist.Otherwise, the test results may not be completely correct, because when the bladder is emptied, the pathogenic microflora is washed away.In accordance with the characteristics of the clinical picture, the ultrasound method is chosen: transrectally or abdominally (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Treatment methods for prostatitis

The main therapy is antibiotics.The use of modern pharmacological developments gives high results, although it is impossible to completely eliminate the risk of relapse.Doctors prescribe antibacterial drugs after culture of urine and/or prostate secretions for the type of pathogen.If acute prostatitis is diagnosed, oral antibiotic therapy takes about 4-6 weeks.In the form of chronic or recurrent disease, treatment will take longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis), hospitalization and a course of intravenous antibiotics are required.

If there is difficulty urinating, urologists prescribe drugs that relieve the hypertonicity of the muscles of the bladder and prostate gland, which normalize the outflow of urine and prevent stagnation.Some patients are treated with drugs that reduce sex hormone levels.As a result, there is a decrease in the size of the prostate and, thus, discomfort during urination, defecation and ejaculation.With severe swelling of the prostate gland, muscle relaxants help relieve excessive fatigue of the bladder sphincter and adjacent muscles.Non-steroidal anti-inflammatory drugs are effective in combating pain.Also, chronic prostatitis responds well to additional physiotherapy.Effective treatment methods are:

  • the introduction of drugs into the urethra;
  • prostate massage;
  • shock wave therapy (SWT);
  • magnetic laser therapy (MLT);
  • electrophoresis;
  • ozone therapy;
  • intravenous laser blood irradiation (ILBI);
  • ultraviolet blood irradiation (UFOI).

Prostate massage is a frequently used urological technique.Doctors use the method of digital stimulation of the prostate gland through the rectum to increase the outflow of secretions and restore the patency of the organ ducts.An additional effect is better blood circulation and accelerated penetration of antibiotics into the inflamed tissue.In addition to prostate finger massage, hardware methods are also possible.Shock wave therapy shows good results in the treatment of prostatitis.The basis of this medical technology is short-term exposure to low-frequency sound waves on the inflamed area.Helpful procedures:

  • activates local blood circulation and the growth of new vessels;
  • stimulate the body's own regenerative abilities;
  • destroy the fibrous focus and calcification that cause pain and inflammatory processes.

After a course of shock wave therapy, prostatitis symptoms are relieved and a good preventive effect is observed.Significant results can only be achieved with an integrated approach to the problem.In addition, the patient's responsible attitude towards medical prescriptions is important.

For their part, clinical urologists ensure the preparation of an individual treatment regimen, taking into account the cause, form, stage of the disease, general well-being and the presence of concomitant pathologies.

Prevention of prostatitis

To minimize the risk of relapse, it is necessary to reduce the negative impact on the body.Among the provoking factors are:

  • Smoking.The anatomical features of the location of the prostate gland lead to constant oxygen starvation, and the inhalation of tobacco smoke causes vasospasm, which in turn slows down the local microcirculation process.All experienced smokers have high blood pressure.
  • Motor activity deficit."Sedentary" work and an inactive lifestyle lead to congestion in the pelvic organs.
  • Alcohol abuse.Exceeding the daily limit of alcohol affects overall health and makes the body more susceptible to various infectious diseases.
  • A stressful situation.It is necessary to avoid situations that lead to anxiety, irritation, and depressive disorders as much as possible.If necessary, you should contact a specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, which makes the body "open" to colds and inflammation.
  • Fatigue, excessive physical activity.You should not forget about the schedule of work and rest, as well as lifting heavy weights.

Preventive measures will help prevent the development of acute prostatitis and relapse of chronic prostatitis.For questions about the diagnosis and treatment of prostate inflammation, you can always contact the urology department of our clinic.