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Prostatitis

Prostatitis in men

Prostatitis is an inflammation of the tissue of the prostate in men, which manifests itself through pain in the lower abdominal and urine disorders. The disease takes place in acute and chronic forms, which develop under the influence of infectious and non -infectious causes. Prostatitis is included in the five most common problems that men turn to the urologist.

The prostate is an organ of the male reproductive system that creates a liquid secret that is part of the sperm and improves sperm mobility. The prostate has the shape of the chestnut, the dimensions 2x3x3, 5 cm are located in the middle of the pelvic cavity. A neck of the bladder and the initial department of the urethra through the middle of the gland.

Acute prostatitis is quite rare (5-10 % of cases), but is difficult and is a serious danger to male health. Most of the time, young men are sick with an acute form of inflammation. In men, chronic prostatitis develops most often between the ages of 60 and 70. The disease takes place with moderately pronounced symptoms, but leads to the formation of erectile dysfunction and impaired urination over time.

The causes and risk factors of prostatitis in men

All causes of prostatitis in men can be divided into two large groups - infectious and not infectious.

Acute inflammation of the prostate glandMost of the time it has an infectious origin, this form of the disease is common, especially in men under the age of 40. In most cases it is caused by the bacterial flora:

  • Enterococci;
  • E. coli;
  • Klebsiella and Proteas;
  • Gonococcus;
  • Pale treponema;
  • Chlamydia;
  • Mycobacteria of tuberculosis.

However, the genitals or intestinal infection itself leads to inflammation of the prostate gland in 100 % of cases. For the development of bacterial prostatitis, predisposing factors are required, the main microtraum of which is the gland. This is done with prostate biopsy, cystoscopies or operations in the pool. Other risk factors for infectious prostatitis are:

  • Immune deficiency (HIV infection, congenital pathology of the immune system);
  • random sex life;
  • Homosexual contacts;
  • Chronic diarrhea or constipation;
  • Obesity;
  • A sitting lifestyle.

Pathogenic microorganisms penetrate the prostate from the urethra or rectum. The weakening of immune protection and the microtrauma of the prostate contributes to the development of acute inflammation. Against this background, the tone of the smooth muscles of the prostate increases, which leads to compression of urethral and urine disorders.

Chronic prostatitisIt has a non -infectious origin and a more complex development mechanism. Inflammation is gradually formed and the exact cause of its occurrence was not determined. Risk factors of chronic non -bacterial prostatitis:

  • increased pressure in the prostate (with benign hyperplasia or adenoma);
  • increased pressure in the pelvic cavity;
  • Chronic pelvic pain;
  • Autoimmune diseases;
  • rare sexual contacts;
  • severe physical activity;
  • Chronic stress.

The pathogenesis of chronic prostatitis is based on the stagnation of the secret of the gland, the deterioration of its blood supply, which leads to constant inflammation.

In approximately 6 % of cases, chronic bacterial prostatitis develops in men. The reason for this is inadequate or incomplete treatment of the acute form of the disease.

Types of prostatitis

Depending on the cause and the development mechanism four clinical clinicForms of prostatitis:

  • acute bacteria;
  • Chronic bacteria;
  • Chronically non -bacterial (chronic pelvic pain syndrome);
  • Asymptomatic inflammation.

The National American Institute of Health distinguishes 4 types of prostatitis dependentFrom the development stage and the clinic:

  • I type - acute bacterial inflammation with general and local manifestations;
  • II -Type - Chronic bacterial inflammation with remission and exacerbations;
  • Iiia -type -chronic non -bacterial (pathogenic microorganisms have not been proven) confirmed inflammation by the presence of leukocytes in the secret of the prostate or the ejaculate;
  • IIIV type - non -inflammatory prostatitis, in which there are no pathogenic microorganisms and leukocytes in the secret of the gland;
  • IV type - Asymptomatic inflammation, which can only be confirmed histologically.

DependentFrom the nature of the pathological processIn the prostate gland, they differentiate:

  • Catarrhal -prostatitis - acute uncomplicated inflammation;
  • Stagnating or constant prostatitis - chronic inflammation in connection with the obstruction of the glandular channels and the accumulation of a prostate secret in them;
  • Calcula prostatitis - a complication of a chronic form of the disease, accompanied by the formation of stones in the channels of the gland;
  • Granumatous prostatitis is an extremely rare shape accompanied by a thickening of the mucous membrane of the glandular channels.

Symptoms of prostatitis in men

The clinical image of prostatitis in men consists of signs of inflammation of the prostate, the compression of the neck of the bladder and urethra as well as the general manifestations of the disease. The severity and combinations of symptoms differ depending on the shape and stage of the development of prostatitis.

Common manifestationsDiseases serve regardless of the form:

  • Pain in the lower abdomen, the lower back, coccyx and sacrum;
  • Violation of urination in the form of a quick urge, symptoms and burning, intermittent electricity;
  • Violation of potency and ejaculation.

The acute form of prostatitis suddenly begins, with pronounced symptoms, is often accompanied by various complications. Chronic inflammation gradually develops, it is characterized by periods of exacerbations and remissions. In bacterial prostatitis, the first symptoms are signs of general poisoning (fever, nausea) and with a non -fiery form of the disease, local inflammation of the prostate is of the utmost importance.

Signs of acute prostatitis

In the case of acute bacterial inflammation of the prostate, the following symptoms occur in men:

  • general malaise;
  • Fever of more than 38 ° C;
  • Nausea and vomiting;
  • severe pain in the lower abdomen with radiation in the rectum;
  • Often, but at the same time difficult urination;
  • Itching and burning in the urethra;
  • Topping of the urine, the appearance of blood or pus in it.

In the future, a complete recovery will occur against the background of the treatment or the chronic form of bacterial prostatitis with various consequences.

Symptoms of chronic prostatitis

In the formation of chronic bacterial prostatitis after acute inflammation, a man is concerned about regular pain in the lower abdomen, difficulties, urinating difficulties, sometimes burning in the urethra. The pain can also spread to the lower back and the Kokcyx, to the rectum, the penis and the scrotum. The symptoms usually occur during the deterioration in prostatitis, and during the remission, a man's borehole remains normal.

Non -infectious prostatitis in men is also called chronic pelvic pain, which includes both pain as well as signs of urine and sexual disorders. It is difficult to urinate for a man because a urine current is sluggish and temporarily, there is a burning feeling and a feeling of pressure in the urethra. In the event of a long course of the disease, there is an effectiveness injury and ejaculation becomes inferior and painful. Ultimately, a man's quality of life suffers significantly, psychological problems develop.

Pain with prostatitis

Pain syndrome with prostatitis is a constant and pronounced symptom that is present in all forms of the disease. Pain mechanism in prostatitis is due to inflammation and edema of the gland, the compression of the receptors in the neck of the bladder and the first section of the urethra.

The acute form of the disease is accompanied by the severe pain, since inflammation is infectious, leads to a massive edema of the gland. The pain is localized in the prostate itself, but the man feels him not only in the lower abdomen, but also in the lower back, in the core, in the rectum and in the scrotum.

With chronic inflammation of the prostate, painful pain, but they are longer in nature, may not disappear during the remission period. The syndrome of chronic pelvic pain is accompanied by unpleasant sensations primarily in the prostate itself and in the coccyx around the anus on the base of the penis and the scrotum. The man disrupts uncomfortably at least three months a day.

When the prostate inflammation is dangerous

Complications develop with both acute and chronic forms of prostatitis:

  • Vesiculite (inflammation of the seed bubbles);
  • Colliculite (inflammation of seed tubercles);
  • Prostate abscess (abscess in the capsule);
  • Prostate fibrosis (the formation of scars in the gland tissue);
  • Cysts in the prostate;
  • Prostate stones;
  • Infertility due to a deterioration in the quality of sperm;
  • erectile dysfunction both by chronic pelvic pain and through mental illnesses;
  • Depression.

Diagnosis of inflammation of the prostate gland

If the first signs of prostatitis occur, you have to contact a urologist. First, the doctor speaks to the patient to determine the type of symptoms and collect an anamnesis. For this, the doctor asks the following questions:

  • how long the symptoms of the disease have occurred;
  • where the pain is located, its character and its occurrence conditions;
  • Are there any problems with urination and ejaculation?
  • Are there chronic diseases, including the genitarian infections?

For the diagnosis of prostatitis, the doctor uses the following methods:

  • Fingerrectal examination of the prostate;
  • General clinical blood tests;
  • Bacteriological examination of ejaculates or prostate cremie;
  • Ultrasound examination of the pelvic organs;
  • Urofloometry;
  • Radiography or computer tomography of the prostate;
  • In rare cases, a biopsy of the prostate gland may be required, followed by a histological examination.

Treatment methods of prostatitis in men

Conservative methods are mainly used for the treatment of prostatitis in men. Tactics depends on the cause and the stage of the development of the disease. With asymptomatic inflammation (type IV), no active treatment is required. Complex treatment is indicated in other forms of the disease. The acute form of prostatitis requires a hospital stay in the hospital, chronic inflammation can be treated on an outpatient basis.

First, the doctor gives recommendations Lifestyle corrections:

  • Rejection of smoking and alcohol;
  • Regular sex life;
  • Exclusion of stress;
  • appropriate physical activity;
  • balanced diet;
  • Exception of hypothermia and overheating.

A prerequisite for the successful treatment of prostatitis is Elimination of related diseases, especially urogenital infections.

Pharmaceutical therapy  In prostatitis, it aims to suppress the inflammatory process, improve urine and relieve pain. The following groups of drugs are used:

  • Antibiotics. After acute bacterial inflammation, the doctor prescribes medication taking into account the results of the microbiological examination of the secret of the prostate. Medications can be taken orally in the form of tablets or in the form of intramuscular injections. The course of treatment is usually 4-6 weeks with an acute form of the disease. In chronic bacterial prostatitis, the therapy duration is determined individually.
  • Alpha blocker. The medication is intended to improve urination because they relax the smooth muscles of the gland and eliminate the compression of the prostate of the urethra. In the chronic form of the disease, they have to be taken for a long time and sometimes for life.
  • Musorelaxants and non -steroid anti -inflammatory medication. It is shown that they eliminate the pain syndrome caused by inflammation of the gland and the cramp of its muscles.
  • In chronic inflammation, medication for improving microcirculation, immune modulators, antidepressants and medication for stimulation of the erection are displayed.

In most cases, acute inflammation of the prostate gland, which is accessible to drug treatment, occurs in most cases a complete recovery within 1, 5 to 2 months. In the chronic form of the disease, therapy takes place for several years or for life for a long time.

An important method for the treatment of prostatitis with congestive prostatitis is the massage of the prostate gland through the rectum. The procedure is carried out on an outpatient basis by a urologist. The massage helps to remove muscle cramp, the release of a prostatic secret.

Physiotherapeutic methods  Shown in the chronic course of prostatitis:

  • Laser therapy;
  • Electrophoresis and ultrafonophoresis;
  • Microwave therapy;
  • Electrical stimulation;
  • Acupuncture.

Surgical intervention  It is only shown with the development of complications - an abscess or prostate stones.

Prognosis and prevention

The forecast for recovery in acute bacterial prostatitis is favorable for timely and complex treatment. The transition to a chronic form is observed in 6-10 % of cases. Chronic non -bacterial prostatitis can generally not be completely healed. Complex therapy enables you to slow down the progression of the disease, to preserve the quality of the man's life and to reduce the risk of complications.

Preventing the development of prostatitis in men includes the following recommendations:

  • Healthy lifestyle;
  • Regulation of the regime of work and calm;
  • balanced nutritional and drinking mode;
  • appropriate physical activity;
  • Regular sex life (ejaculation);
  • Prevention of genitarians;
  • Restriction of invasive manipulations (cystoscopy, catheterization of urethra, prostate biopsy);
  • Prevention of genital injuries.