In men, prostatitis is an inflammatory process involving the prostate tissue. The disease is accompanied by pain in the lower back, perineum, and pelvis. The main manifestations are pain in the perineum and dysfunction of the lower urinary tract.
Among all urological diseases, urologists most often encounter prostatitis. It can develop unexpectedly (acutely) against the background of the general state of health, or it can continue for a long time, with periods of exacerbation and remission, which indicates a chronic course. In addition, the second version of the disease is diagnosed much more often.
The disease is independent and can be combined with prostatic hyperplasia or prostate cancer.
Reasons for development
Inflammation does not occur by itself. The causes of prostatitis can be divided into bacterial and non-bacterial.
The acute infectious version usually occurs in men under the age of 35 due to damage to the prostate caused by Gram-negative bacteria - Escherichia coli, Proteus, Enterobacter. Inflammation also occurs due to sexually transmitted infections - gonorrhea, chlamydia. In the chronic form, there may be many more causes, and the list will include atypical microbes.
Factors provoking the development of the bacterial version are the following:
- protected sex;
- AIDS or HIV infection;
- diarrhea or constipation;
- anal sexual intercourse;
- sedentary lifestyle;
- inactive sex life;
- diabetes;
- hypothermia;
- violation of intimate hygiene.
- emotional disturbances;
- autoimmune disease;
- increased physical activity;
- lack of regular sex life;
- weight lifting work;
- chronic stress;
- congestion in the tissues of the prostate;
- previously proven fibrotic changes in the prostate (according to TRUS results).
What are the first signs of prostatitis to look out for?
The first manifestation of the disease is pain in the lower back and perineum, difficulty urinating. If you notice a weakening of the urine stream when going to the toilet, an unpleasant sensation or a burning sensation in the urethra, consult a urologist as soon as possible.
With the acute appearance of the disease, the temperature may rise, and the general well-being deteriorates. 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, which is why treatment is started late.
Symptoms of prostatitis
In men, the signs of prostatitis depend on the form of the disease. In acute form, the following manifestations are typical:
- pain in the lower back, sacrum, perineum;
- frequent or difficult urination;
- acute urinary retention;
- difficulty passing stool;
- thin stream of urine;
- temperature increase;
- chills;
- deterioration of general well-being.
The chronic form can appear after the acute phase of the disease, or it can develop as a primary disease. In men with a chronic course, the symptoms of prostatitis are mild. The pain is of low intensity, the temperature may rise slightly. The stream of urine thins, disturbances appear in the intimate sphere.
In the case of a chronic course, exacerbation of prostatitis with symptoms characteristic of the acute phase is possible. The pain may be absent or dull and aching.
Symptoms of acute prostatitis
Acute prostatitis occurs in several stages, which progress from one to the next if you do not consult a specialist and stop the development of the disease in time.
The first stage is called acute chronic prostatitis. It begins with frequent painful urination complaints. 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 pains become particularly intense, radiating to the anus and intensifying during defecation. Urination is very difficult, sometimes acute urinary retention occurs. The temperature does not exceed 38 degrees and can be higher only in rare cases.
Acute parenchymal prostatitis is expressed in severe poisoning, the temperature reaches 38 ° C and higher, chills appear. Urinary retention is often observed, sharp, throbbing pains appear in the perineum, and 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 small discharge from the urethra. Often these manifestations remain unnoticed even by the patient for a very long time.
In men, the signs of prostatitis can appear in different ways, but all of them can be classified into three groups - pain syndrome, urinary disorders, sexual life problems. The tissues of the prostate are devoid of receptors, so they cannot produce painful sensations. They appear when the inflammation begins to move to the pelvic organs, which are richly innervated. The pain of patients can be different - from barely noticeable discomfort to strong and intense, which disturbs sleep and the usual way of life. The pain can radiate to the sacrum, the scrotum, the lower back, and the perineum, so self-diagnosis is useless here.
Urinary problems begin at the moment when the volume of the prostate increases and, as the lumen of the ureter decreases, it begins to compress the urethra. Frequent urge to urinate, feeling of incomplete emptying of the bladder. Usually, such phenomena occur at the very beginning, in the early stages of the disease, and then the body compensates, but at a later stage, without proper treatment, they reappear.
Male potency problems can be expressed in different ways. Patients complain of deterioration of erection, accelerated ejaculation, and reduced sexual arousal. Gradually, sexual disorders become more pronounced, and in advanced stages, the symptoms of prostatitis are complemented by impotence.
Classification
Experts distinguish several categories of the disease:
- acute bacterial prostatitis characterized by symptoms of bacterial infection. In most cases, the causative agent of the disease 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 E. coli bacteria, enterococci, etc. Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also become pathogens;
- chronic pelvic pain syndrome in which infections are not detected. There are two types: inflammatory and non-inflammatory. The causes include: autoimmune processes, external factors (hypothermia, overheating), infrequent sex life, low physical activity, infrequent urination;
- asymptomatic prostatitis, detected by chance during a medical examination.
Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after a thorough diagnosis based on test data. In case of certain signs, you should consult a specialist.
Symptoms
The main symptom is a violation of the functioning of the urinary system. You should consult a specialist if you notice the following symptoms:
- if urination is difficult and the urine comes out intermittently;
- if there is discharge from the urethra during defecation;
- burning sensation in the urethra and perineum;
- if there are discomforts in the bladder and prostate during bowel movements;
- if the urge to urinate is increased and becomes more frequent;
- in case of pain in the rectum;
- if purulent bloody discharge appears from the urethra (floating "threads");
- with a frequent rise in body temperature;
- with the appearance of problems of an intimate nature (weakening of erection);
- when the erection occurs at night for an unexplained reason;
- if ejaculation during intercourse is too fast;
- if the sensations during orgasm are "erased";
- with rapid general fatigue;
- with an unreasonably anxious or depressed state, as well as manifestations of mental depression;
- with frequent depression, manifestations of mental depression to prevent complications;
- with general weakening of the body.
One or two symptoms are enough to see a urologist. Self-healing attempts usually lead to deterioration of the condition, the transition of the disease to 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 the 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 the formation of stones. Doctors call infertility a late sign of a progressive disease.
The signs of prostatitis are significantly different in acute and chronic forms. Especially in the chronic form, the symptoms are mild or not expressed at all.
Acute prostatitis is characterized by pronounced symptoms - general malaise, pain in the groin area. Men should see a professional 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 is significantly reduced or the urine is not collected;
- fever, frequent headache, 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 muscle and joint pain.
Chronic prostatitis is characterized by the following symptoms:
- pain in the perineum increases during urination;
- with frequent urges, the bladder does not empty completely;
- decreased sexual desire;
- 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, and irritability.
The bacterial form of chronic prostatitis is characterized by problems with ejaculation that become rapid and painful, discomfort in the vulva, frequent or involuntary urination, and intermittent flow of urine.
Chronic pelvic pain syndrome, which according to medical statistics is the most common form of prostatitis, is characterized by symptoms similar to those of chronic bacterial prostatitis: frequent urge to urinate, weakening of urine flow, pain in the penis and testicles, sexual dysfunction.
Possible complications
- vesiculitis;
- posterior urethritis or colliculitis;
- abscess of the gland itself;
- sclerosis or fibrosis of the prostate;
- cysts and prostate stones;
- infertility;
- ejaculation disorder;
- erectile dysfunction.
Diagnostics
A urologist deals with the diagnosis and therapy of any form of prostatitis. If a tumor is suspected, the patient may be referred to an oncologist. In the case of chronic, long-lasting, difficult-to-treat prostatitis, an immunologist's consultation 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 makes it possible to identify tumors, cysts, adenomas, and distinguish prostatitis from other urological and surgical diseases.
- Spermogram to rule out infertility.
Features of diagnosis in acute prostatitis
If the signs of the disease indicate acute prostatitis, the diagnosis is made based on instrumental and clinical examination data. Any manipulation that may affect the prostate is contraindicated, as it may cause acute pain or provoke the spread of infection.
Characteristics of the diagnosis of chronic bacterial prostatitis
In such cases, the diagnosis is determined on the basis of the following data: examination by the patient's doctor, bacteriological and microscopic examination of prostate secretions, study of ultrasound data.
Characteristics of the diagnosis of pelvic pain syndrome
Specialists prescribe diagnostic procedures for symptoms suggestive of chronic pelvic pain syndrome, taking into account the type of disease: inflammatory or non-inflammatory. Ultrasound is usually prescribed, as well as the following manipulations:
- examination of prostate secretion;
- molecular biology research;
- bacteriological research.
The choice of technique is determined by the doctor based on the initial examination.
Groups at risk
The most likely occurrence and development of prostatitis:
- in obese or sedentary men;
- in men doing sedentary work (office workers, programmers);
- in men whose body is exposed to shock and vibration (drivers of cars, including special equipment);
- in men with infectious diseases, including diseases of the urogenital system;
- in sexually hyperactive men and those who do not have a regular sex life;
- in depressed men with mental illness;
- alcoholics, drug addicts, etc.
Treatment
Patients with acute prostatitis identified without the development of complications are treated on an outpatient basis. Only in case of severe symptoms of poisoning and suspicion of a purulent process, hospitalization is carried out.
Antibiotics are the drugs of choice to fight inflammation. It is also used in chronic bacterial form. The medicine is selected individually, in the form of a course lasting 4-6 weeks. In severe cases, antibacterial agents are administered 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 drug treatment, the doctor prescribes prostate massage, and physiotherapy is used to improve blood circulation in the 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 should be taken into account:
- the cause of the disease;
- the course of the disease;
- individual characteristics of the body (presence of chronic and accompanying diseases).
A specific technique can be chosen for the treatment, or a complex one can be prescribed. Depending on the results of the diagnosis, urologists prescribe the following:
- Physiotherapy procedures: magnetic resonance therapy, procedures with laser equipment, ultrasound, reflexology, massages, hirudotherapy.
- Medical 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.
Appropriately selected drug complex for acute bacterial prostatitis:
- restores immunity;
- to treat infections (antibiotics);
- treat the prostate (antibacterial drugs).
Chronic prostatitis is difficult to treat, so a wide range of drugs are used: anti-inflammatory, antispasmodic, absorbent, antibacterial, vibration massage and finger massage, electrophoresis, EHF and UHF therapy, sinusoidally modulated currents.
In the diagnosis of pelvic pain syndrome, antibiotics and anti-inflammatory drugs, various physiotherapy, magnetic and laser therapy, electrical nerve stimulation, etc. are prescribed. are applied. . One of the effective methods is tissue drainage around the inflammatory focus.
Conservative or modern treatment is selected by the urologist based on the diagnostic data.
Tablets
Prostatitis can be prescribed in the form of tablets, antibacterial agents, pain relievers.
The course of antibiotic therapy is selected individually, depending on the results of the analysis of prostate secretion. The microflora causing the disease must be sensitive to the drug used. The course prescribed by the urologist must be completed, 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 eliminate pain, but also reduce inflammation.
The group of alpha-1-blockers includes prostatitis tablets for men, which help with urination disorders. They relax the smooth muscles and restore the patency of the urethra compressed by the inflamed prostate.
Injections for prostatitis
In men, antibacterial agents against prostatitis are also used in the form of injections. In case of severe inflammation, and in the absence of antibiotics in tablet form, injectable drugs are prescribed, to which the pathogen is sensitive. You can make antispasmodic injections to quickly restore urination, which is difficult due to urinary tract spasm and compression of the prostate.
Injectable prostatitis medications work faster than oral medications, so they are sometimes preferred.
Prostatitis surgery
The most terrible complications are the enlargement of the seminal vesicles and the abscess. Medicines for the treatment of the disease are not able to cope with the disease in such a difficult situation, therefore surgery is required at the first manifestations.
In the absence of timely intervention, the purulent process spreads beyond the organ, so the consequences of complicated prostatitis can be life-threatening.
Prediction and prevention
The acute form without treatment often becomes chronic, which periodically worsens. Complete recovery is not always possible, however, with timely access to the doctor and taking all the prescribed medications, discomfort, urination problems and pain can be eliminated.
Self-treatment 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 consumption of coffee, spices and alcohol, and to remain sexually active as long as possible.
Typical symptoms 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. The growth of the gland begins in adolescence under the influence of male sex hormones, and by adulthood its weight can reach 20 grams. It plays an important role in the male reproductive system, producing a secret that is one of the components of sperm. Unfortunately, in mature and elderly men, hyperplasia of the gland or malignant tumor of the organ often occurs.
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 has reached the second stage, then the tumor is localized in the prostate gland, has not grown into neighboring tissues and does not metastasize.
Prostate cancer symptoms are practically absent in the early stages, this is the insidious nature of the disease. The man does not complain, feels well and sees no reason to go to the doctor. Therefore, this type of tumor is often found in a neglected state. An exception may be patients who have previously been diagnosed with a benign prostate tumor, in which case they are regularly monitored by a specialist and tested for a specific prostate antigen and undergo an ultrasound scan. They have every chance to detect the tumor in the initial stage. But it is worth noting that detecting prostate cancer is not always easy. Even with a biopsy, the results can be clear, but there is already oncology. This is due to errors in the method, the needle simply does not fall on the location of the localized focus. If prostate pathology is suspected, especially if it is cancer, a fusion biopsy should be performed, which combines the capabilities of ultrasound and MRI in real time, giving the doctor the opportunity to visualize the organ as accurately as possible.
Some of the symptoms are the result of prostate pathology, while others are caused by mechanical compression and obstruction of the urethra.
Since the bladder must be emptied regularly, if this process is disrupted, urine may remain in it, inflammation may occur, and bacterial infection may also occur. If measures are not taken, the process will spread further, and it 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 lymphatic tissues. Because of this, the person's regional lymph nodes increase, his bones hurt, he loses weight sharply, he becomes weak.
Treating prostate cancer is not an easy task, but it can be solved. By recognizing the local process in time, a full recovery can be achieved, and with more advanced stages, life can be extended. If you notice the symptoms described above, contact a qualified clinic for 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.