According to the BME, prostatitis is an inflammatory process that occurs in the prostate gland of men with damage to the parenchyma and interstitium.The treatment of prostatitis in men is a long and complex task, which in most cases is due to complete ignorance of the disease from its beginnings.What is prostatitis, what are its causes and first signs, what you need to know on the topic of “diagnosis” and what modern methods exist to treat prostatitis.Everything men need to know about prostatitis 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 “squeak” of the 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 basic concepts of the disease, its causes and symptoms, features of diagnosis and treatment.
The reasons for the development of prostatitis are wide.In prostatitis, infectious factors play the most important role in the development of the disease:
- Acute form.The coca flora acts as a provoking cause.
- Chronic form.The reasons for its development are broader;The main factors of 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 should be noted that chronic prostatitis, caused by a pathogen that has penetrated the prostate gland, may 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, physical inactivity and, as a result, impaired blood and lymph 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 abacterial 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 the secretion of the prostate or in the third portion of urine. | Level (increase) of leukocytes in urine or secretions. |
| 1 cat.acute bacterial | + | + | + |
| 2 cats.chronic bacterial | — | + | Uncertain (yes or no) |
| 3a.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 further studied;In most cases, the cause of the disease is bacteria from the family.Enterobacteria (E. coli bacillus).Currently, the role of atypical microorganisms as the cause of prostatitis (ureplasma, chlamydia, mycoplasma) is not considered completely 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 an important role in the development of prostatitis, especially causing its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have thoroughly studied a list of possible pathogenic factors (provoking prostatitis) 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 not bacterial in nature, are congestive processes in the pelvis, poor circulation, intraprostatic urinary reflux 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 without understanding the problems of urology, the external masculine appearance of an individual is no different 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 is 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 the man.Relying on such inaccurate definitions, he ignores really important signs, believing that the disease does not exist, although in reality 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 the perineum, radiating to the sacrum, frequent nighttime desires.
- Follicular prostatitis.Difficulty and frequent urination, sometimes with delay.Pain when urinating, which intensifies at the end of the urination process, as well as when defecating.Mild 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 vivid with possible opening of the abscess into the rectum or into the prostatic part of the urethra.With such progress, the symptoms disappear.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 fluctuations.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 relate 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, since it has many variations in symptoms.In general, effective prostatitis treatment depends on the prostatitis, or rather its type.
In the chronization stage the following points can be distinguished:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis passes with erased symptoms.
- A characteristic symptom of chronicity is poor 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 (congestion in the capillaries), which gradually turns into an abacterial form of inflammation of the prostate.
- 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 chronic stage prostatitis?Patient reviews show that most often at first there is a slight pain in the perineum and scant discharge, 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 sexual relations 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 chronicity, this is what 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 be expected 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 and near it, which inevitably become involved in the inflammatory process.The pain can be of different intensity, from mild pain that causes discomfort to intense pain that prevents you from falling asleep peacefully.Radiation of pain 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 in the urinary system, but the cause becomes clear during diagnosis.The increased volume of the prostate inevitably compresses the urethra and the flow of urine is disturbed, followed by the development of a frequent urge to go to the toilet and a feeling of incomplete emptying of the bladder.With advanced prostatitis, compensatory hypertrophy of the muscular layer of the bladder and ureters occurs.At this time, the symptoms of dysuria weaken, but return again in an intensified form.
Sex without pleasure
A declining intimate life - these are the first symptoms that men notice and it is they, as the reviews show, that force them to consult a doctor.Frequent night erections, erased orgasm, poor erection and rapid ejaculation, pain during it - this is what worries the stronger sex the most.In the advanced phase 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 relations and somehow complete them, ignoring characteristic warning signs.For some, even the penis's initial weak reaction to a charming stimulus turns into a breakdown and the beginning of terrible experiences that develop into prolonged depression.The spectrum of impotence is difficult for patients with prostate problems;Specialists and relatives almost always note that prostatitis deteriorates character.
To learn more about the disease, you can watch a thematic video where experts explain many of the nuances of the pathology.
What to write on the card
Which entry will appear in the patient's medical history and what final diagnosis will be established depends on a number 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 required 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 you in detail about all the complaints and symptoms, the previous conditions of the disease, etc.
- Urine analysis.
- Prostate massage (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 so much indifference is your own health!It is important to remember that prostatitis is curable only if it is “detected” in time and an accurate diagnosis is made, determining the form of the disease and its cause.
How to be healthy forever
So, a man understands that he has prostatitis, what awaits him in the future and is it possible to regain his lost health?It is important to understand that it will take 2 times more to get rid of prostatitis than to develop it.In addition, if the pathological process passed practically without the man's attention, then the treatment of prostatitis will be carried out with his direct participation.Is acute or chronic prostatitis curable?Yes, if all the doctor's recommendations are followed, 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 discovered during the examination, on the type of disease, the age and physical characteristics of the patient.
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 of each stage of treatment is different and depends on the total cost of the prescribed medications, additional methods and the clinic.Preventive measures after treatment have an important reason: they prevent the recurrence 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 acutely.
The exacerbation period requires taking antibiotics, which are taken in one course.In the presence of chlamydial infection, cephalosporins are indicated.
The duration of the course of use is significant;On average, antibiotics are taken for at least 3 to 4 weeks to prevent relapse of the disease.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 required 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 treating physician;It must be remembered that in acute forms of prostatitis, massage is contraindicated, as it causes 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 get rid of chronicity quickly, the disease has developed over the years and even doctors in their field cannot destroy it in a couple of weeks;It is not necessary to trust the word of 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, as well as preventing exacerbations;this takes time.
The course of antibiotic therapy lasts 4 to 12 weeks;If the treatment is low, the medication is continued.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 is provided.
No bacteria or 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 medication for 2 to 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 the patient's immune system.
Diet and lifestyle changes also form the basis of nonbacterial prostatitis treatment;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 this, 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 inconveniences, a man suffers psychologically, because the most valuable part of the body is affected: the intimate part.Reviews of those who have cured the disease show that only strict compliance with the doctor's instructions, along with changes in diet and lifestyle, bears fruit.The price of a frivolous attitude towards treatment is very high: a man loses not only his health, but his entire life, character and relationships with others change.To prevent this, it is necessary to monitor the health of the prostate and eliminate the causes of the development of the disease.