Prostatitis: symptoms, treatment, prevention

Prostatitis in men is an inflammatory process involving prostate tissue. The disease is accompanied by pain that occurs in the lower back, perineum, in the pelvis. The main manifestations are perineal pain and lower urinary tract dysfunction.

Among all urological diseases, urologists often encounter prostatitis. It can develop unexpectedly (sharply) against the background of the general state of health, or proceed for a long time, with periods of exacerbation and remission, which indicates a chronic course. In addition, the second variant of the disease is diagnosed much more often.

The disease is independent and can also be combined with prostatic hyperplasia or prostate cancer.

Reasons for the development

Inflammation does not appear on its own. The causes of prostatitis can be divided into bacterial and non-bacterial.

The acute infectious variant usually occurs in men under 35 years old due to damage to the prostate gland 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 other 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 in intimate hygiene.
• emotional disorders;
• autoimmune diseases;
• increased physical activity;
• lack of regular sex life;
• work associated with 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 to look out for?

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 stream of urine, you felt discomfort or a burning sensation in the urethra, contact a urologist as soon as possible.

With an acute onset of the disease, the temperature may rise, general well-being deteriorates. Such a patient should be treated immediately with antibiotics and anti-inflammatories.

In some cases, the disease can be asymptomatic for a long time, so it starts late to treat it.

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 lumbar region, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficulty defecating;
• a thin stream of urine;
• temperature increase;
• goosebumps;
• deterioration of general well-being.

The chronic form can occur after the acute phase of the disease or evolve 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 appear in the intimate sphere.

In the chronic course, exacerbations of prostatitis with symptoms characteristic of the acute phase are possible. The pain may be absent or have a dull, aching character.

Symptoms of Acute Prostatitis

Acute prostatitis occurs in several stages, which pass from one to another, if you do not contact a specialist and do not 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 lumbar region and in the sacrum, as well as in the perineum, initially a slight pain appears, which quickly increases.

Without treatment, the second stage occurs - acute follicular. At this time, the pains become especially severe, radiate to the anus and are aggravated during defecation. Urination is very difficult, sometimes there is acute urinary retention. 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 above, 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 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 mild pain when urinating or in the perineum, with small discharge from the urethra. Often these manifestations go unnoticed even by the patient for a long time.

Signs of prostatitis in men can occur in different ways, but they are all combined into three groups - pain syndrome, urinary disorder, problems with sex life. Prostate tissues are devoid of receptors, therefore they cannot give painful sensations. They appear when inflammation begins to move to the pelvic organs, which are richly innervated. Pain in patients can be different - from barely noticeable discomfort to strong and intense, which interferes with sleep and the usual way of life. The pain can radiate to the sacrum, scrotum, lumbar region, perineum, so self-diagnosis is useless here.

Problems with urination begin at the moment when the prostate enlarges and begins to squeeze the urethra with a decrease in the lumen of the ureter. There is frequent urge to urinate, feeling of incomplete emptying of the bladder. Usually, such phenomena are expressed at the very beginning of the disease, in its initial stages, then they are compensated by the body, but later, without proper treatment, they reappear.

Potency problems in men can also be expressed in different ways. Patients complain of worsening erection, accelerated ejaculation, decreased sexual arousal. Gradually, sexual disorders become more pronounced, and at an advanced stage, the symptoms of prostatitis are complemented by impotence.

Classification

Experts distinguish several categories of the disease:

• Acute bacterial prostatitis, characterized by symptoms of a bacterial infection. The causative agent of the disease in most cases is Escherichia coli. Less often, enterococci and other bacteria are isolated;
• 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 go undetected. There are two types: inflammatory and non-inflammatory. Among the causes: autoimmune processes, external factors (hypothermia, overheating), rare sex life, low physical activity, rare 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 the examination data. You should contact a specialist if you have certain signs.

Symptoms

The main symptom is a violation of the functioning of the urinary system. You should contact a specialist if you experience the following symptoms:

• if urination is difficult and urine passes intermittently;
• if during bowel movements there is discharge from the urethra;
• with burning sensation in urethra and perineum;
• if during bowel movement there are unpleasant sensations in the bladder and prostate;
• if the urge to urinate has increased and become more frequent;
• in case of pain in the rectum;
• if there is purulent bloody discharge from the urethra ("floating" threads);
• with frequent increase in body temperature;
• with the appearance of problems of an intimate nature (weakening of the erection);
• when erections appear at night for an unexplained reason;
• if ejaculation during intercourse is too fast;
• whether the sensations during orgasm are "erased";
• with rapid general fatigue;
• with manifestations of an overly anxious or depressed state, as well as a state of mental depression;
• with frequent depression, manifestations of mental depression in anticipation of complications;
• with a general weakening of the body.

To contact a urologist, one or two symptoms are enough. Attempts to cure on their own, as a rule, lead to a worsening of the condition, the transition of the disease to a chronic or severe form. At worst, an untimely visit to the doctor can lead to infertility or complete impotence.

If the patient does not consult a doctor in a timely manner or neglects treatment, the following symptoms may appear:

• pain in the perineum;
• pain near the scrotum;
• pain at the base of the root of the penis (pain).

Aching pains indicate the formation of stones. Doctors call late sign infertility a progressive disease.

Signs of prostatitis in acute and chronic forms differ significantly. In particular, in the chronic form, signs can be mild or not expressed.

Acute prostatitis is characterized by pronounced symptoms - general malaise, pain in the groin area. Men need to contact specialists 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 formed 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 muscles and joints.

Chronic prostatitis is characterized by the following symptoms:

• during urination, pain in the perineum increases;
• with frequent impulses, the bladder is not completely emptied;
• decreased sexual desire;
• discomfort during intercourse.

One of the signs of the chronic form is a significant disturbance of the emotional background, characterized by insomnia, increased nervousness, whims, irritability.

The bacterial form of chronic prostatitis is characterized by problems with ejaculation, which becomes rapid and painful, discomfort in the pubic area, frequent or involuntary urination, and intermittent urinary stream.

Chronic pelvic pain syndrome, which, according to medical statistics, is the most common form of prostatitis, is characterized by signs similar to symptoms of chronic bacterial prostatitis: frequent urge to urinate, weakening of the urinary stream, pain in the penis, testicles , sexual dysfunction.

Possible Complications

• vesiculitis;
• posterior urethritis or colculitis;
• abscess of the gland itself;
• sclerosis or fibrosis of the prostate;
• prostate cysts and stones;
• infertility;
• ejaculation disorder;
• erectile dysfunction.

Diagnosis

The urologist deals with the diagnosis and treatment of any form of prostatitis. If a tumor is suspected, the patient may be referred for an appointment with an oncologist. In long-term chronic prostatitis, which is difficult to treat, consultation with an immunologist may be necessary.

1. Bacteriological culture of urine.
2. Analysis of prostate secretion for microflora and antibiotic sensitivity.
3. Rectal examination of the prostate.
4. Ultrasound of the prostate, which allows you to identify tumors, cysts, adenomas, as well as to differentiate prostatitis from other urological and surgical diseases.
5. Spermogram to rule out infertility.

Diagnostic features in acute prostatitis

If the signs of the disease indicate acute prostatitis, the diagnosis is made on the basis of instrumental data and clinical examinations. Any manipulations that can affect the prostate gland are contraindicated, as they can cause acute pain or provoke the spread of infection.

Diagnostic features in chronic bacterial prostatitis

The diagnosis in such cases is determined on the basis of the following data: examination of the patient by the doctor, bacteriological and microscopic examination of prostate secretion, study of ultrasound data.

Diagnostic features in pelvic pain syndrome

Specialists prescribe diagnostic procedures for the 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 prostatic secretion;
• molecular biological research;
• bacteriological research.

The choice of technique is determined by the physician according to the initial examination.

Groups of risk

The most likely occurrence and development of prostatitis:

• in obese men or with a sedentary lifestyle;
• in men with sedentary work (office workers, programmers);
• in men whose body is subject to tremors and vibrations (car drivers, including special equipment);
• in men who have had infectious diseases, including diseases of the genitourinary system;
• in sexually hyperactive men and those who don't have sex regularly;
• in men in a state of depression, suffering from mental illness;
• in alcoholics, drug addicts, etc.

Treatment

Patients with identified 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 the chronic bacterial form. The drug is selected individually, given in a course of 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 alpha-1 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 medicine, the doctor prescribes a 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 is taken into account:

• the cause of the illness;
• the course of the disease;
• individual characteristics of the body (the presence of chronic and concomitant diseases).

For treatment, you can choose a specific technique or prescribe a complex. Specialists in the field of urology, depending on the results of the diagnosis, prescribe:

• Physiotherapeutic 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, physical therapy and anti-inflammatory drugs are prescribed.

In some cases, experts may recommend muscle relaxants and hormone therapy, as well as antioxidants that help reduce inflammation and protect cells from free radicals.

Properly selected complex of drugs for acute bacterial prostatitis:

• restores immunity;
• treats infections (antibiotics);
• treats the prostate (antibacterial drugs).

Chronic prostatitis is difficult to treat, so an extensive list of drugs is used: anti-inflammatory, antispasmodic, absorbable, 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 types of physical therapy, magnetic and laser therapy, electrical nerve stimulation, 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.

pills

In the form of tablets for prostatitis, antibacterial agents, analgesics can be prescribed.

The course of antibiotic therapy is selected individually, depending on the result of the analysis of prostate secretion. 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 return or become chronic.

Analgesics for prostatitis help to eliminate unpleasant symptoms. For this, non-steroidal anti-inflammatory drugs are used, which not only eliminate pain, but also relieve inflammation.

Pills from prostatitis for men, which help to treat impaired urination, belong to the group of alpha 1 blockers. They relax smooth muscles and restore the permeability of the urethra squeezed by the 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 inflammation, as well as in the absence of tablet antibiotics, to which the pathogen is sensitive. You can do injections of antispasmodics to quickly restore urination, which is difficult due to spasm of the urinary tract and compression of the prostate gland.

Injectable prostatitis medications work faster than oral medications, which is why they are sometimes preferred.

operation for prostatitis

The most formidable complications are suppuration of seminal vesicles and abscess. Drugs for the treatment of the disease are not able to cope with the disease in such a difficult situation, therefore, the operation is indicated at the first manifestations.

In the absence of timely intervention, the purulent process spreads beyond the organ, so the consequences of prostatitis in a complicated form can be fatal.

Forecast and prevention

The acute form without treatment often becomes chronic, which periodically worsens. Full recovery is not always possible, however, with timely access to a doctor and taking all prescribed medications, discomfort, problems with urination and pain can be eliminated.

Self-treatment at home and the use of folk methods can often be fatal.

To prevent prostatitis, it is recommended to avoid hypothermia, timely empty the bladder, limit the use of coffee, spices and alcohol, and remain sexually active as long as possible.

Typical signs of prostate cancer

The prostate is a small organ that only men have. It resembles a sponge in its structure, is located under the bladder and surrounds the urethra. The growth of the gland begins in adolescence under the influence of male sex hormones, in adulthood its weight can reach 20 grams. It plays an important role in the male reproductive system, producing a secret, one of the components of sperm. But, unfortunately, in mature and elderly men, hyperplasia of the gland or malignant neoplasms of the organ 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 located in the prostate, it has not grown into neighboring tissues and has not allowed metastases.

Symptoms of prostate cancer in the early stages are practically absent, this is the insidiousness of the disease. The man does not complain, he feels fine and sees no reason to go to the doctor. That is why often this type of tumor is already found in a neglected state. An exception may be patients who have already been diagnosed with benign neoplasms of the prostate, in which case they are periodically observed by a specialized doctor and tested for a specific prostate antigen, undergo an ultrasound of the gland. They have every chance of detecting a tumor at its very beginning. But it is worth mentioning 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 into the place of the localized focus. If prostate pathology is suspected, especially if there is cancer, a fusion biopsy should be performed, which combines the resources of ultrasound and magnetic resonance imaging in real time, giving the physician the opportunity to visualize the organ as accurately as possible.

Some of the symptoms are a consequence of the pathology of the prostate, while others are caused by mechanical compression and blockage of the urethra.

Since the bladder must be emptied regularly, if this process is disturbed, urine can be retained in it, inflammation can occur, and a bacterial infection can arise. If no measures are taken, the process will spread and this already threatens with pyelonephritis and kidney problems.

In stage 4, prostate cancer manifests itself even more clearly. Metastases are most often found in bone, spine and lymph. Because of this, a person's regional lymph nodes increase, bones ache, he sharply loses weight and weakens.

Treating prostate cancer is not an easy task, but it can be done. With timely detection of a local process, complete healing can be achieved, and with more advanced stages, life can be extended. If you notice the symptoms described above, contact a professional clinic for examination.

Make an appointment, the doctors at the clinic have many years of experience in the treatment of urological diseases and succeed even in the most difficult cases.