Prostatitis in men is an inflammatory process involving prostate tissue. The disease is accompanied by pain that occurs in the lower back, perineum, and pelvis. The main manifestations are pain in the perineum and dysfunction of the lower urinary tract.
Of all urological diseases, prostatitis is most often encountered by urologists. It can develop unexpectedly (acutely) against the background of general health or last for a long time, with periods of exacerbation and remission, which indicates a chronic course. Moreover, the second variant of the disease is diagnosed much more often.
The disease is independent, and can be combined with prostate hyperplasia or prostate cancer.
Reasons for development
Inflammation does not occur on its own. The causes of prostatitis can be divided into bacterial and non-bacterial.
The acute infectious variant most often occurs in men younger than 35 years old due to damage to the prostate by gram-negative bacteria - Escherichia coli, Proteus, Enterobacter. Also, inflammation occurs due to infection with sexually transmitted infections - gonorrhea, chlamydia. In the chronic form, there can be many more reasons, and the list will include atypical microbes.
The provoking factors for the development of the bacterial variant are:
- unprotected sex;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal sexual contact;
- sedentary lifestyle;
- inactive sex life;
- diabetes;
- hypothermia;
- violations of intimate hygiene.
- emotional disorders;
- autoimmune diseases;
- increased physical activity;
- lack of regular sex life;
- work related to lifting weights;
- chronic stress;
- congestion in prostate tissues;
- previously confirmed fibrotic changes in the prostate (according to TRUS results).
What are the first signs of prostatitis that you should pay attention to?
The first manifestations of the disease are pain in the lower back and perineum, difficulty urinating. If, when going to the toilet, you noticed a weakening of the urine, felt discomfort or a burning sensation in the urethra, you should contact a urologist as soon as possible.
With the acute onset of the disease, the temperature may rise, the general condition worsens. Such a patient should be treated immediately with a combination of antibiotics and anti-inflammatory drugs.
In some cases, the disease can be asymptomatic for a long time, so treatment is started late.
Symptoms of prostatitis
Signs of prostatitis in men depend on the form of the disease. In the acute form, the following manifestations are characteristic:
- pain in the lower back, sacrum, perineum;
- frequent or difficult urination;
- acute retention of urine;
- defecation difficulties;
- thin stream of urine;
- rise in temperature;
- chills;
- deterioration of general well-being.
The chronic form can arise after the acute phase of the disease or develop as a primary disease. Symptoms of prostatitis in men with a chronic course are mild. The pain is of low intensity, the temperature may rise slightly. The stream of urine becomes thin, disorders occur in the intimate sphere.
In the chronic course, exacerbation of prostatitis with symptoms characteristic of the acute phase is possible. Pain may be absent or have a dull, aching character.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which will pass from one to another, if you do not consult a specialist and stop the development of the disease in time.
The first stage is called acute catarrhal prostatitis. It starts with complaints of frequent painful urination. In the lower back and sacrum, as well as in the perineum, there is a slight pain at first, which quickly increases.
Without treatment, the second stage occurs - acute follicular. At this moment, the pain becomes particularly intense, radiates to the anus, and intensifies during defecation. Urination is very difficult, sometimes there is acute retention of urine. The temperature does not exceed 38 degrees and only in rare cases can it be higher.
Acute parenchymal prostatitis is expressed in severe intoxication, the temperature reaches 38 ° C and more, chills appear. Urinary retention is often observed, sharp, throbbing pains appear in the perineum, the act of defecation is difficult.
Symptoms of chronic prostatitis
Sometimes chronic prostatitis occurs against the background of an acute inflammatory process. This is a separate disease in which there is a primary chronic course that develops over a long period of time.
Often, the chronic course begins as a complication of the inflammatory process caused by various infectious agents - chlamydia, trichomonas, gonococcus. But vivid manifestations are very rare, more often the disease occurs with minor pain during urination or in the perineum, with a small discharge from the urethra. Often these manifestations remain unnoticed even by the patient for a very long time.
Signs of prostatitis in men can appear in different ways, but they are all united in three groups - pain syndrome, urination disorder, problems with sex life. Prostate tissues are devoid of receptors, so they cannot give painful sensations. They appear when the inflammation starts to spread to the pelvic organs, which are richly innervated. Pain in patients can be different - from barely noticeable discomfort to strong and intense, which disturbs sleep and the usual way of life. Pain can radiate to the sacrum, scrotum, lower back, perineum, so self-diagnosis is useless here.
Problems with urination begin at the moment when the prostate increases in volume and begins to squeeze the urethra with a decrease in the lumen of the ureter. There is a frequent urge to urinate, a feeling of incomplete emptying of the bladder. Usually, such phenomena are expressed at the very beginning of the disease, in the early stages, then they are compensated by the body, but at a later stage, without adequate treatment, they reappear.
Problems with potency in men can also be expressed in different ways. Patients complain of worsening erection, accelerated ejaculation, decreased sexual arousal. Gradually, sexual disorders become more and more pronounced, and in the advanced stage the symptoms of prostatitis are supplemented by impotence.
Classification
Experts distinguish several categories of diseases:
- acute bacterial prostatitis, characterized by symptoms of bacterial infection. The causative agent of the disease in most cases is Escherichia coli. Enterococci and other bacteria are isolated somewhat less often;
- chronic bacterial prostatitis, which is a recurrent form of the disease. The causative agents of the disease are bacteria E. coli, enterococci, etc. Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also become pathogenic;
- chronic pelvic pain syndrome, in which infections are not detected. There are two types: inflammatory and non-inflammatory. Among the causes: autoimmune processes, external factors (hypothermia, overheating), infrequent sex life, low physical activity, infrequent urination;
- asymptomatic prostatitis, discovered accidentally during a medical examination.
Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after detailed diagnosis based on examination data. You should see a specialist if you have certain signs.
Symptoms
The main symptom is a violation of the functioning of the urinary system. Consult a specialist if you have the following symptoms:
- if urination is difficult and urine flows intermittently;
- if there is discharge from the urethra during bowel movements;
- with a burning sensation in the urethra and perineum;
- if there are unpleasant sensations in the bladder and prostate during bowel movements;
- if the urge to urinate has increased and become more frequent;
- in case of pain in the rectum;
- if there are purulent bloody discharges from the urethra (floating "threads");
- with frequent increase in body temperature;
- with the appearance of problems of an intimate nature (weakening of erection);
- when erections appear at night for an inexplicable reason;
- if ejaculation during intercourse is too fast;
- if sensations during orgasm are "erased";
- with rapid general fatigue;
- with manifestations of an unreasonably anxious or depressed state, as well as a state of mental depression;
- with frequent depressions, manifestations of mental depression in anticipation of complications;
- with general weakening of the organism.
One or two symptoms are enough to contact a urologist. Attempts to self-heal, as a rule, lead to a worsening of the condition, transition of the disease into a chronic or severe form. In the worst case, an untimely visit to the doctor can cause infertility or complete impotence.
If the patient did not consult a doctor in time or neglected treatment, the following symptoms may appear:
- pain in the perineum;
- pain near the scrotum;
- pain at the root of the penis (pain).
Aching pains indicate stone formation. Doctors call infertility a late sign of a progressive disease.
Signs of prostatitis in acute and chronic forms differ significantly. Especially, in the chronic form, the signs can be mild or not expressed at all.
Acute prostatitis is characterized by pronounced symptoms - general weakness, pain in the groin area. Men should contact a specialist if:
- the urge to urinate became very frequent;
- pain during defecation and urination intensifies in the perineum and radiates to the groin;
- complete emptying of the bladder is impossible;
- the amount of urine produced per day has significantly decreased or urine is not collected;
- fever, frequent headaches, general weakness.
Acute bacterial prostatitis is characterized by fever and chills, pain in the lumbosacral region (severe), pain in the perineum and rectum, acute urinary retention, frequent pain in the muscles and joints.
Chronic prostatitis is characterized by the following symptoms:
- pain in the perineum increases during urination;
- with frequent urges, the bladder is not completely emptied;
- decreased sex drive;
- discomfort during intercourse.
One of the signs of the chronic form is a significant disturbance of the emotional background, which is characterized by insomnia, increased nervousness, capriciousness, irritability.
The bacterial form of chronic prostatitis is characterized by problems with ejaculation, which becomes fast and painful, discomfort in the pubic area, frequent or involuntary urination, intermittent stream of urine.
Chronic pelvic pain syndrome, which, according to medical statistics, is the most common form of prostatitis, is characterized by signs similar to the symptoms of chronic bacterial prostatitis: frequent urge to urinate, weakening of urine, pain in the penis, testicles, sexual dysfunction.
Possible complications
- vesiculitis;
- posterior urethritis or colliculitis;
- abscess of the gland itself;
- sclerosis or fibrosis of the prostate;
- prostate cysts and stones;
- infertility;
- ejaculation disorder;
- erectile dysfunction.
Diagnostics
A urologist deals with diagnosis and therapy of any form of prostatitis. If a tumor is suspected, the patient can be referred to an oncologist. In case of chronic long-term prostatitis, which is difficult to treat, consultation with an immunologist may be necessary.
- Bacteriological culture of urine.
- Analysis of prostate secretion for microflora and sensitivity to antibiotics.
- Rectal examination of the prostate.
- Ultrasound of the prostate, which enables the identification of tumors, cysts, adenomas, as well as distinguishing prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
Characteristics of diagnosis of acute prostatitis
If the signs of the disease indicate acute prostatitis, the diagnosis is made based on instrumental and clinical examination data. All manipulations that can affect the prostate are contraindicated, because they can cause acute pain or cause the spread of infection.
Features of the diagnosis of chronic bacterial prostatitis
In such cases, the diagnosis is made on the basis of the following data: examination by the patient's doctor, bacteriological and microscopic examination of prostate secretions, study of ultrasound data.
Features of diagnosis of pelvic pain syndrome
Specialists prescribe diagnostic procedures for symptoms that indicate chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory. As a rule, ultrasound is prescribed, as well as the following manipulations:
- study of prostate secretion;
- molecular biological research;
- bacteriological research.
The choice of technique is determined by the doctor based on the initial examination.
Risk groups
The most likely occurrence and development of prostatitis:
- in men who are obese or lead a sedentary lifestyle;
- in men with sedentary work (office workers, programmers);
- in men whose body is exposed to tremors and vibrations (car drivers, including special equipment);
- in men who had infectious diseases, including diseases of the genitourinary system;
- in men who are sexually hyperactive and in those who do not have sex regularly;
- in men in a state of depression, suffering from mental illness;
- in alcoholics, drug addicts, etc.
Treatment
Patients with established acute prostatitis without the development of complications are treated on an outpatient basis. Only with severe symptoms of intoxication and suspicion of a purulent process, hospitalization is carried out.
Antibiotics are the drugs of choice to fight inflammation. They are also used in chronic bacterial form. The drug is selected individually, it is taken as a course of 4-6 weeks. In severe cases, antibacterial agents are given intravenously, in all other cases - orally, in the form of capsules or tablets.
Another drug used for prostatitis is alpha1-blockers, which are prescribed in the presence of residual urine confirmed by ultrasound. They help facilitate urination, relax the prostate and bladder muscles. NSAIDs help relieve pain.
Treatment of prostatitis is carried out only comprehensively and consistently. In addition to taking medication, the doctor will prescribe a course of prostate massage, and physiotherapy is used to improve blood circulation in this organ. Surgical treatment is used only when abscesses and suppuration of the seminal vesicles appear.
The choice of treatment for prostatitis depends on many factors and is determined individually. When choosing treatment methods, the following are taken into account:
- the cause of the disease;
- disease course;
- individual characteristics of the body (presence of chronic and accompanying diseases).
For treatment, a certain technique can be chosen or a complex can be prescribed. Specialists in the field of urology, depending on the results of the diagnosis, prescribe:
- Physiotherapy procedures: magnetic resonance therapy, procedures with laser equipment, ultrasound, reflexology, massages, hirudotherapy.
- Treatment.
- diet and psychotherapy.
- Surgical intervention.
When diagnosing bacterial prostatitis, broad-spectrum antibiotics, immunomodulators and multivitamin complexes are prescribed.
When diagnosing non-bacterial prostatitis, physiotherapy and anti-inflammatory drugs are prescribed.
In some cases, experts may recommend muscle relaxants and hormone therapy, as well as antioxidants to help reduce inflammation and protect cells from free radicals.
Correctly selected drug complex for acute bacterial prostatitis:
- restores immunity;
- treats infections (antibiotics);
- treats the prostate (antibacterial drugs).
Chronic prostatitis is difficult to treat, so a wide list of drugs is used: anti-inflammatory, antispasmodic, absorptive, antibacterial, vibration massage and finger massage, electrophoresis, EHF and UHF therapy, sinus modulated currents.
When diagnosing pelvic pain syndrome, antibiotics and anti-inflammatory drugs, various types of physiotherapy, magnetic and laser therapy, electrostimulation of nerves, etc. are used. One of the effective methods is tissue drainage around the focus of inflammation.
Conservative or modern treatment is chosen by the urologist based on diagnostic data.
Tablets
In the form of tablets for prostatitis, antibacterial agents, painkillers can be prescribed.
The course of antibiotic therapy is selected individually depending on the result of the prostate secretion analysis. The microflora that caused the disease must be sensitive to the drug used. It is necessary to complete the course of treatment prescribed by the urologist, otherwise the cause will not be eliminated, the disease will recur or become chronic.
Painkillers for prostatitis help to get rid of unpleasant symptoms. For this, non-steroidal anti-inflammatory drugs are used, which not only remove pain, but also reduce inflammation.
Prostatitis tablets for men, which help in the treatment of difficult urination, belong to the group of alpha 1-blockers. They relax the smooth muscles and restore the patency of the urethra compressed by an inflamed prostate.
Injections for prostatitis
Antibacterial agents for prostatitis in men are also used in the form of injections. Injectable forms of drugs are prescribed for severe inflammations, as well as in the absence of tablet forms of antibiotics, to which the pathogen is sensitive. You can make injections of antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of the prostate.
Injectable prostatitis drugs work faster than oral drugs, so they are sometimes preferred.
Surgery for prostatitis
The most terrible complications are suppuration of the seminal vesicles and abscess. Medicines for the treatment of the disease cannot cope with the disease in such a difficult situation, therefore surgery is indicated at the first manifestations.
In the absence of timely intervention, the purulent process spreads outside the organ, so the consequences of prostatitis in a complicated form can be life-threatening.
Prognosis and prevention
The acute form without treatment often becomes chronic, which occasionally worsens. A complete recovery is not always possible, however, with a timely approach to the doctor and taking all prescribed medications, discomfort, problems with urination and pain can be eliminated.
Self-medication at home and the use of folk methods can often be life-threatening.
In order to prevent prostatitis, it is recommended to avoid hypothermia, to empty the bladder in time, to limit the use of coffee, spices and alcohol, and to remain sexually active as long as possible.
Typical signs of prostate cancer
The prostate is a small organ that only men have. Its structure resembles a sponge, it is located under the bladder and wraps around the urethra. Growth of the gland begins in adolescence under the influence of male sex hormones, and in adulthood its weight can reach 20 grams. It plays an important role in the male reproductive system, creating secretion, one of the components of sperm. But, unfortunately, in mature and elderly men, gland hyperplasia or malignant organ neoplasms are often found.
How to recognize cancer
As the tumor grows and progresses, the symptoms of prostate cancer depend on the stage of the process. If the disease is still in the first stage or even reached the second, then the tumor is localized in the prostate, has not grown into neighboring tissues and has not metastasized.
Symptoms of prostate cancer in the early stages are practically absent, this is the insidious nature of the disease. The man does not complain, he feels well and sees no reason to go to the doctor. This is why this type of tumor is often already in a neglected state. Exceptions may be patients who have previously been diagnosed with benign prostate neoplasms, in which case they are occasionally examined by a specialist doctor and tested for a specific prostate antigen, and undergo an ultrasound of the gland. They have every chance to detect the tumor at the very beginning. But it is worth noting that detecting prostate cancer is not always easy. Even with a biopsy, the results may be clear, but the oncology is already there. This is due to the errors of the method, the needle simply does not fall on the place of localized focus. If prostate pathology is suspected, especially if it is cancer, it is necessary to perform a fusion biopsy, which combines the possibilities of ultrasound and magnetic resonance in real time, giving the doctor the opportunity to visualize the organ as precisely as possible.
Some of the symptoms are the result of prostate pathology, while others are caused by mechanical compression and blockage of the urethra.
Given that the bladder must be emptied regularly, if this process is disrupted, it can lead to urine retention, inflammation and bacterial infection. If measures are not taken, the process will spread, and this already threatens pyelonephritis and kidney problems.
In stage 4, prostate cancer manifests itself even more clearly. Metastases are most often found in the bones, spine and lymph. Because of this, the person's regional lymph nodes increase, bones hurt, he suddenly loses weight and becomes weak.
Treating prostate cancer is not an easy task, but it can be done. With timely detection of the local process, a complete cure can be achieved, and in more advanced stages, life can be extended. If you notice the symptoms described above, contact a professional clinic for an examination.
Make an appointment, the clinic's doctors have many years of experience in the treatment of urological diseases and achieve success even in the most difficult cases.