Prostatitis: symptoms, treatment, prevention

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

Among all urological diseases, urologists encounter prostatitis the most. It can develop unexpectedly (acute) against the background of general health, or it can last for a long time with periods of exacerbation and remission, indicating a chronic course. Moreover, the second variant of the disease is diagnosed more often.

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

Reasons for development

Inflammation does not appear by itself. The causes of prostatitis can be divided into bacterial and non-bacterial.

The acute infectious variant usually occurs as a result of damage to the prostate gland by gram-negative bacteria - Escherichia coli, Proteus, Enterobacter in men under the age of 35. Also, inflammation occurs due to infection with sexually transmitted infections - gonorrhea, chlamydia. In the chronic form, there may be more causes, and the list will include atypical microbes.

Predisposing factors for the development of the bacterial variant are:

• unprotected sex;
• AIDS or HIV infection;
• diarrhea or constipation;
• anal intercourse;
• sedentary lifestyle;
• inactive sex life;
• diabetes;
• hypothermia;
• intimate hygiene violations.
• emotional disorders;
• autoimmune diseases;
• increased physical activity;
• lack of regular sex life;
• work related to lifting weights;
• chronic stress;
• congestion in the tissues of the prostate gland;
• previously confirmed fibrotic changes in the prostate (according to TRUS results).

What are the first symptoms of prostatitis?

The first manifestations of the disease are pain in the back and perineum, difficulty urinating. You should contact a urologist as soon as possible if you feel a weakening of the flow of urine, discomfort or burning sensation in the urethra while going to the toilet.

With the acute onset of the disease, the temperature may rise, the general well-being deteriorates. Such a patient should be treated immediately by combining 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

Symptoms of prostatitis in men depend on the form of the disease. In the acute form, the following manifestations are characteristic:

• pain in the back, sacrum, perineum;
• frequent or difficult urination;
• acute urinary retention;
• difficulty in defecation;
• a thin stream of urine;
• increase in temperature;
• trembling;
• deterioration of general well-being.

The chronic form can occur after the acute stage of the disease or develop as the main disease. Symptoms of prostatitis in men with a chronic course are mild. The pain is of low intensity, the temperature may rise slightly. The flow of urine becomes thin, disorders appear in the intimate area.

In a chronic course, exacerbation of prostatitis with symptoms characteristic of the acute stage is possible. There may be no pain or it may have a dull, aching character.

Symptoms of acute prostatitis

Acute prostatitis occurs in several stages that will pass from one to another if you do not contact a specialist and stop the development of the disease in time.

The first stage is called acute catarrhal prostatitis. It often begins with complaints of painful urination. In the lower back and sacrum, as well as in the perineum, a slight pain appears at first, which increases rapidly.

Without treatment, the second stage occurs - acute follicular. At this moment, the pains are especially strong, radiating to the anus and intensifying during defecation. Urination is very difficult, sometimes there is acute urinary retention. The temperature does not exceed 38 degrees and can be higher only in rare cases.

Acute parenchymal prostatitis is expressed by severe intoxication, the temperature reaches 38 ° C and above, tremors appear. Urinary retention is often observed, sharp, throbbing pains appear in the perineum, defecation is difficult.

Symptoms of chronic prostatitis

Sometimes chronic prostatitis occurs against the background of an acute inflammatory process. This is a separate disease with a main 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. However, bright manifestations are very rare, more often the disease occurs during urination or with a small pain in the perineum, with a small discharge from the urethra. Often, these manifestations are even ignored by the patient for a very long time.

Symptoms of prostatitis in men can occur in different ways, but all of them are united in three groups - pain syndrome, urinary disorders, sexual life problems. The tissues of the prostate are devoid of receptors, so they cannot give painful sensations. They appear when the inflammation begins to move towards the pelvic organs, which are richly innervated. Pain in patients can be different - from barely noticeable discomfort to strong and intense, which disrupts sleep and the usual way of life. Pain can spread to the sacrum, scrotum, lower back, perineum, so self-diagnosis is useless here.

Urinary problems begin when the volume of the prostate increases and the urethra begins to compress the urethra as the lumen decreases. There is a frequent urge to urinate, a feeling of incomplete emptying of the bladder. Usually, such phenomena are expressed at the very beginning, early stages of the disease, then are compensated by the body, but appear again at a later stage, without adequate treatment.

Problems related to potency in men can also be expressed in different ways. Patients complain of deterioration of erection, acceleration of ejaculation, decrease of sexual arousal. Gradually, sexual disorders become more pronounced, and in the 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 bacterial infection. In most cases, the causative agent of the disease is Escherichia coli. In slightly less cases, enterococci and other bacteria are isolated;
• chronic bacterial prostatitis, which is a recurring form of the disease. The causative agent of the disease is E. coli bacteria, enterococci, etc. Trichomonas, fungi, chlamydia, viruses, mycoplasmas can also be pathogenic;
• chronic pelvic pain syndrome where infections are not detected. There are two types: inflammatory and non-inflammatory. Among the reasons: autoimmune processes, external factors (hypothermia, fever), infrequent sexual life, low physical activity, infrequent urination;
• Asymptomatic prostatitis discovered accidentally during medical examination.

Only a qualified specialist can accurately name the type of prostatitis and determine the course of treatment after a comprehensive diagnosis based on examination data. If you have certain symptoms, you should contact a specialist.

Symptoms

The main symptom is urinary system dysfunction. You should contact a specialist if you have the following symptoms:

• if urination becomes difficult and urine passes 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 increased and was frequent;
• when there is pain in the rectum;
• if there is purulent bloody discharge from the urethra (floating "strings");
• with a frequent increase in body temperature;
• with the appearance of problems of an intimate nature (weakening of erection);
• when night erections appear for an incomprehensible reason;
• if ejaculation is too fast during intercourse;
• if feelings are "erased" during orgasm;
• with rapid general fatigue;
• with manifestations of unreasonable anxiety or depressive state, as well as a state of mental depression;
• manifestations of mental depression while waiting for complications, often with depression;
• with general weakening of the body.

One or two symptoms are enough to contact a urologist. Attempts at self-healing, as a rule, lead to the deterioration of the condition and the transition of the disease to a chronic or severe form. In the worst case, an untimely visit to the doctor can lead to infertility or complete impotence.

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

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

Painful pain indicates the formation of stones. Doctors call infertility a late sign of a progressive disease.

Symptoms of prostatitis in acute and chronic forms differ significantly. In particular, in the chronic form, symptoms may be mild or not expressed at all.

Acute prostatitis is characterized by obvious symptoms - general malaise, pain in the groin. Men should consult specialists in the following cases:

• the urge to urinate became very frequent;
• during defecation and urination, the pain intensifies in the perineum and radiates to the groin;
• complete emptying of the bladder is impossible;
• the amount of urine produced per day was significantly reduced or urine was 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, and frequent pain in muscles and joints.

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, characterized by insomnia, increased irritability, moodiness, irritability.

The bacterial form of chronic prostatitis is characterized by problems with ejaculation, which are quick and painful, discomfort in the public area, frequent or involuntary urination, and intermittent urination.

According to medical statistics, chronic pelvic pain syndrome, which is the most common form of prostatitis, is characterized by symptoms similar to symptoms of chronic bacterial prostatitis: frequent urge to urinate, decreased flow 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;
• cysts and stones of the prostate gland;
• infinity;
• violation of ejaculation;
• erectile dysfunction.

Diagnostics

A urologist diagnoses and treats any form of prostatitis. If a tumor is suspected, the patient may be referred to an oncologist. In chronic long-term prostatitis, which is difficult to treat, consultation of an immunologist may be required.

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

Features of diagnosis in acute prostatitis

If the symptoms of the disease indicate acute prostatitis, the diagnosis is made on the basis of instrumental and clinical examination data. Any manipulations that may affect the prostate are contraindicated, as they may cause severe pain or cause the spread of infection.

Features of diagnosis in chronic bacterial prostatitis

In such cases, the diagnosis is determined on the basis of the following information: examination by the patient's doctor, bacteriological and microscopic examination of the secretion of the prostate gland, study of ultrasound data.

Features of diagnosis in pelvic pain syndrome

Experts prescribe diagnostic procedures for symptoms indicating 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 study.

The choice of the technique is determined by the doctor based on the initial examination.

Risk groups

The most likely and development of prostatitis:

• in men who are obese or lead a sedentary lifestyle;
• in men with sedentary jobs (office workers, programmers);
• in men whose body is exposed to shaking and vibration (car drivers, including special equipment);
• in men with infectious diseases, including diseases of the genitourinary system;
• in men who are sexually hyperactive and those who do not have regular sex;
• in men suffering from mental illness, in a state of depression;
• in alcoholics, drug addicts, etc.

Treatment

Patients with established acute prostatitis are treated on an outpatient basis. Hospitalization is carried out only with signs of severe intoxication and suspicion of a purulent process.

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 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 muscles of the prostate gland and bladder. 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 applied to improve blood circulation in this organ. Surgical treatment is used only when abscesses and suppuration of 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;
• the course of the disease;
• individual characteristics of the body (presence of chronic and accompanying diseases).

A special technique can be chosen for treatment or a complex can be prescribed. Specialists in the field of urology determine depending on the results of the diagnosis:

• Physiotherapy procedures: magnetic resonance therapy, procedures using laser equipment, ultrasound, reflexology, massages, hirudotherapy.
• Treatment.
• diet and psychotherapy.
• Surgical intervention.

When bacterial prostatitis is diagnosed, broad-spectrum antibiotics, immunomodulators and multivitamin complexes are prescribed.

When non-bacterial prostatitis is diagnosed, physiotherapy and anti-inflammatory drugs are prescribed.

In some cases, specialists may recommend muscle relaxants and hormone therapy, as well as antioxidants that 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).

Treatment of chronic prostatitis is difficult, so a wide list of drugs is used: anti-inflammatory, spasmolytic, absorbable, antibacterial, vibration massage and finger massage, electrophoresis, EHF and UHF therapy, sinusoidal modulated currents.

When diagnosing pelvic pain syndrome, antibiotics and anti-inflammatory drugs, various types of physiotherapy, magnetic and laser therapy, electrical stimulation of nerves, etc. is used. One of the effective methods is the drainage of tissues around the inflammation site.

Conservative or modern treatment is selected by a urologist based on diagnostic data.

Tablets

For prostatitis, in the form of tablets, antibacterial substances, pain relievers can be prescribed.

The course of antibiotic therapy is selected individually depending on the result of the analysis of prostate secretion. The microflora causing 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 relieve pain, but also relieve inflammation.

Prostatitis pills for men, which help to treat urinary disorders, belong to the group of alpha 1-blockers. They relax the smooth muscles and restore the opening of the urethra compressed by the inflamed prostate.

Injections for prostatitis

Antibacterial substances are also used in the form of injections for prostatitis in men. Injection forms of drugs are prescribed for severe inflammation, 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, so surgery is indicated at the first manifestations.

If there is no timely intervention, the purulent process spreads outside the body, so the consequences of prostatitis in a complicated form can be life-threatening.

Prognosis and prevention

Without treatment, the acute form often becomes chronic, which periodically worsens. A complete recovery is not always possible, but by visiting the doctor in time and taking all prescribed medications, discomfort, urination and pain problems can be eliminated.

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

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

Typical symptoms of prostate cancer

The prostate gland is a small organ found only in men. It is sponge-like in structure, located under the bladder and wrapped around the urethra. The growth of the gland begins in adolescence under the influence of male sex hormones, and its weight can reach 20 grams by adulthood. It plays an important role in the male reproductive system, producing a secret that is one of the constituents of sperm. But, unfortunately, hyperplasia of the glands or malignant neoplasms of the organ are often detected in adult and elderly men.

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 reaches the second, the tumor is localized in the prostate gland, has not grown into neighboring tissues and does not allow metastases.

In the early stages, the symptoms of prostate cancer are practically absent, this is the insidious nature of the disease. The man has no complaints, feels well and sees no reason to consult a doctor. Therefore, this type of tumor is often neglected. An exception may be patients who have previously been diagnosed with benign neoplasms of the prostate gland, in which case they are periodically observed by a specialist doctor and checked for specific prostate antigen, undergo an ultrasound examination of the gland. They have every chance to detect a tumor at the beginning. However, it should be noted that detecting prostate cancer is not always easy. Even with a biopsy, the results may be clear, but there is already oncology. This is due to the errors of the method, the needle simply does not fall into the place of the localized focus. If pathology of the prostate gland is suspected, especially if it is cancer, a fusion biopsy should be performed, which combines the capabilities of ultrasound and MRI in real time, which allows the doctor to visualize the organ as accurately as possible.

Some symptoms are the result of pathology of the prostate gland, while others are caused by mechanical compression and obstruction of the urethra.

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

Stage 4 prostate cancer shows itself more clearly. Metastases are most common in bones, spine and lymph. For this reason, a person's regional lymph nodes increase, his bones ache, he 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, complete treatment 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 of the clinic have many years of experience in the treatment of urological diseases and succeed even in the most difficult cases.