Prostatitis (lat. prostatitis) is an acute or chronic inflammation of the prostate gland, which is diagnosed in 35–40% of men aged 25–55 years. The older the patient, the higher the risk of developing prostatitis.
When inflamed, the prostate increases in size and begins to compress the urethra. This process causes a narrowing of the lumen of the ureter, as a result of which the man begins to experience a frequent urge to urinate, and he has a feeling of incomplete emptying of the bladder. At the initial stage, the symptoms of prostatitis may be mild. However, over time, prostatitis becomes the cause of sexual disorders. In addition, pathology can lead to a number of complications:
- prostate abscess;
- cystitis.
Prostatitis or prostate adenoma?
These two diseases are often confused or mistaken for the same thing. Meanwhile, they have different natures and flow patterns.
Peculiarities |
Prostatitis |
BPH |
Patient age |
20–45 years |
over 45 years |
Nature of the disease |
inflammatory process |
tumor |
Pain syndrome |
present in acute form |
appears at stages 2–3 of the disease |
Fever |
pronounced |
absent |
Urination disorder |
appears in acute form |
always present |
Weakening of potency |
observed in both cases |
|
Prostatitis requires primarily drug treatment, while prostate adenoma is a benign tumor that is removed through surgery. At the same time, prostate adenoma can cause prostatitis, which is why any inflammatory process in the pelvic organs requires timely examination and treatment.
Causes of prostatitis
Infectious
Prostatitis can be caused by:
- Staphylococcus aureus;
- enterococcus;
- Pseudomonas aeruginosa;
- sexually transmitted infections;
- chronic infectious diseases (tonsillitis, sinusitis, etc. );
- other opportunistic pathogens.
Stagnant
Prostatitis appears as a result of:
- sedentary lifestyle;
- sedentary work;
- long periods of abstinence;
- excessive sexual activity;
- interruption of sexual intercourse.
The listed factors contribute to the disruption of capillary blood flow and the formation of stagnant processes in the prostate tissue.
Prostatitis begins to develop more intensively when favorable factors appear, which include:
- chronic constipation;
- hypothermia;
- unbalanced diet;
- urological diseases;
- frequent stress;
- intoxication of the body due to smoking or drinking alcohol;
- perineal injuries.
Types and symptoms of prostatitis
According to the form of its occurrence, prostatitis in men is divided into:
Acute prostatitis. One of the first signs of the course of the disease is a pronounced pain syndrome, which appears against the background of a rapidly developing inflammatory process. Swelling of the prostate gland occurs, triggered by exposure to pathogenic microflora. The condition requires emergency medical attention. In turn, acute prostatitis can have the following forms:
- catarrhal (frequent painful urination, pain in the sacrum and perineum, difficulty defecating);
- follicular (the pain intensifies and begins to radiate to the anus, when going to the toilet, urine flows out in a thin stream, body temperature rises to 37. 5 ºС);
- parenchymal (body temperature rises to 38–40 ºС, general intoxication of the body is observed, sharp throbbing pain in the groin area is noted, acute urinary retention occurs).
Chronic prostatitis is practically asymptomatic or has mild symptoms. In men, from time to time the temperature rises to 37-37. 5 ºС, there is mild pain in the perineum, which intensifies during urination or defecation. In addition, you may experience:
- weakening of erection;
- accelerated ejaculation;
- decrease in the severity of sexual sensations.
In some cases, chronic prostatitis becomes the outcome of an acute process, when the patient notes the so-called false improvement and refuses to see a urologist. As a rule, the result of self-medication at home is a number of complications: abscess or prostate adenoma, inflammation of the bladder, loss of fertility, etc.
Depending on the cause, prostatitis can be:
- herpetic,
- bacterial,
- infectious,
- fungal,
- purulent,
- chlamydial,
- gonorrheal,
- calculous,
- fibrous,
- stagnant.
Diagnosis of prostatitis
Palpation allows you to determine the size, shape and structure of organ tissue.
Laboratory research. Allows you to diagnose prostatitis and other prostate diseases in the early stages or in chronic cases in the absence of pronounced symptoms.
- general blood and urine analysis;
- a biochemical blood test is carried out to clarify the picture of the disease and determine the involvement of other internal organs and systems in the inflammatory process;
- PSA blood test;
- urine culture with antibiotic sensitivity testing.
- smear for urogenital infections to detect STDs.
Ultrasound is performed to identify structural changes in prostate tissue and detect neoplasms (cysts, tumors).
TRUS is performed through the rectum and allows you to obtain the most complete information about the condition of the gland and bladder.
MRI allows you to obtain detailed layer-by-layer images of the prostate and surrounding tissues in three different projections.
Treatment of prostatitis
Treatment methods depend on the identified causative agent of prostatitis, so the patient needs to undergo a comprehensive examination.
Treatment of acute prostatitis
Antibacterial therapy. Before prescribing antibiotics, the doctor will refer the patient for tests to identify the causative agent of the infection. After this, drugs are selected that will help suppress the activity of pathogenic microorganisms and eliminate the inflammatory process.
Symptomatic treatment. Additionally, the urologist may prescribe antipyretics, painkillers, diuretics, laxatives, vitamins, immunomodulators and other drugs.
Surgery. Performed in case of complications. For example, if an abscess develops, the doctor may perform a transurethral or transrectal opening of the abscess; in case of acute urinary retention, a cystoma may be required.
Treatment of chronic prostatitis
Antibacterial therapy. The course of treatment is 14–28 days, and it must be completed, even if the signs of prostatitis have disappeared after a week. Antibiotics are used to eliminate infection and suppress inflammatory processes in the body.
Symptomatic treatment. Depending on the indications, the urologist may prescribe painkillers, antispasmodics, anti-inflammatory, immunomodulatory, vascular and other drugs to the patient.
Manual or hardware massage. One of the most effective methods of treating prostatitis in men. Prostate massage helps remove stagnant secretions, improve blood and lymph flow, and restore metabolism in the affected organ.
Physiotherapeutic treatment. Depending on the indications, the urologist may prescribe electrical stimulation, laser or magnetic therapy. The procedures help improve blood circulation, have an anti-inflammatory effect, and help restore reproductive function.
Prevention of prostatitis
Preventing prostatitis is much easier than treating it later. To do this, just follow the following recommendations:
Annual examination. It is necessary to visit a urologist every year, even if there are no complaints about your health.
Sports activities. Regular physical activity helps improve metabolic processes throughout the body, including the prostate.
Refusal of promiscuous sexual intercourse. Sex is very important for men's health, but frequent changes of sexual partners can cause bacterial prostatitis and related complications.
Balanced diet. You need to eat at least 3 times a day. The diet should include low-fat fish and meat, cereals, fermented milk products, fresh vegetables and fruits. It is advisable to limit consumption or completely avoid carbonated drinks, fatty and smoked foods, baked goods, and spices.
Rejection of bad habits. Drinking alcohol and smoking reduce immunity and place additional stress on the body, creating favorable conditions for the development of many diseases.
Questions and answers
Question: How to distinguish acute prostatitis from chronic?
Answer: We should start with the fact that in its acute form the disease usually occurs in people under 30-35 years of age. Chronic prostatitis is considered non-ageing. The disease in its acute form usually quickly manifests itself with the following symptoms:
- a sharp increase in body temperature (up to 40 degrees);
- severe headache appears;
- fever begins.
Acute prostatitis is also characterized by constant pain in the groin, back, and perineum.
In its chronic form, prostatitis, on the contrary, may not show symptoms for a long time. Over time, a person develops a fever and periodic pain appears in the anus, scrotum, back and perineum.
Urination is impaired, purulent discharge from the anus and urethra begins. Chronic prostatitis also leads to erectile dysfunction. Ejaculation begins to be painful, and sexual intercourse is not enjoyable.
Question: What happens if prostatitis is not treated?
Answer: If a person does not receive treatment for diagnosed prostatitis, complications and concomitant pathologies may develop
- Vesiculitis. This disease is characterized by inflammatory processes in the seminal vesicles. As a result, pus enters the ejaculate and the quality of sperm decreases. Vesiculitis often leads to complete loss of reproductive functions.
- Colliculitis. A disease in which inflammatory processes affect the seminal tubercle. As a result, during sex, a man experiences severe pain, which leads to interruption of orgasm. Without therapy, a person develops impotence of a psychological nature.
- Abscess. It forms in the prostate and leads to intoxication of the body. Its rupture can lead to increased symptoms, and in some cases, lead to death.
- Infertility. It occurs against the background of deteriorating sperm quality and inflammatory processes in the testicles, spermatic cord and vesicles.
- Against the background of prostatitis, immunity often deteriorates. Approximately a third of all cases of the disease without therapy end in the development of oncology. Prostatitis must be treated in a specialized andrology clinic.
Question: Where should I go for treatment of prostatitis?
Answer: The diagnosis is usually made by a urologist based on a study of symptoms. To confirm prostatitis, various studies are usually prescribed:
- general blood and urine tests;
- smear for STDs;
- secret research;
- uroflowmetry;
- ultrasonography.
In some cases, a biopsy and spermogram are also prescribed.