Acute prostatitis is an acute inflammation of the prostate gland caused by an infection.During the disease, swelling of the prostate is formed, purulent foci are formed in its tissues.Statistical data gives us the right to claim that acute prostatitis is a common disease in men;with age, the risk of its occurrence increases.
The effectiveness of the treatment of acute prostatitis directly depends on the timely treatment of the patient.The disease quickly turns into a chronic form, the treatment is longer and more complicated.
Forms of acute prostatitis
If we talk about the clinical development of acute prostatitis in men, there are three forms (stages) of the disease:
- catarrh;
- follicular;
- parenchymatous.
The first to occur is catarrhal inflammation, which is characterized by the expansion of acini and the appearance of reactive edema of the interstitial tissue.This leads to significant enlargement of the prostate gland.The next stage is the rapid spread of inflammatory processes to the prostate lobules and excretory ducts.In particular, we are talking about the excretory ducts of the prostate glands leading to the back of the urethra.Inflammatory changes affect only mucous membranes.Excretory ducts lose their ability to contract, become significantly narrowed or completely blocked, creating obstacles to the release of prostate secretions.The catarrhal form is directly related to the infectious pathogen that migrated from the back of the urethra.Since the inflammatory process also affects prostate secretion, it can provoke the appearance of posterior urethritis.
In the follicular stage, the foci of inflammation reach individual lobules or the entire prostate gland and spread.Purulent foci appear, pus passes into the urethra.Prostate growth does not stop;destructive changes occur in tissues.
In the parenchymal phase of acute prostatitis, inflammatory processes affect the interstitial tissue of the prostate gland.This stage occurs after penetration of an infectious pathogen by contact or hematogenous routes, for example, after surgery.
At the beginning of the disease, parenchymal prostatitis is accompanied by the appearance of single pustules, which, in the process of development, are combined with prostate abscess.
As for follicular and parenchymal forms, during their development, inflammatory changes often occur in the back of the urethra and the neck of the bladder.
Prognosis and prevention of acute prostatitis
In most cases, timely etiotropic therapy can eliminate the symptoms of acute prostatitis.If treatment is not carried out, it is quite possible that an abscess will occur or the disease will become chronic.
Prevention of this disease usually means timely treatment of any infectious diseases in the body, as well as identification and treatment of sexually transmitted diseases and urethritis.A man should lead a healthy lifestyle, especially focusing on increasing physical activity.Also, the development of the disease is prevented by regular sexual life and the absence of unprotected casual contacts.Strict adherence to personal hygiene is another important requirement for a man of any age.
Causes of the disease
Acute prostatitis in men can occur at any age.The reason is often the penetration of various infectious pathogens.It can be E. coli, but also streptococci, staphylococci, Candida fungi, chlamydia, trichomonas.The most common route of entry is through the excretory ducts.The pathogen can also enter the prostate gland from the bladder undergoing an inflammatory process (for example, acute cystitis).Infection can also spread from nearby purulent foci.
Due to the presence of microorganisms, the inflammatory process in the prostate can occur for various reasons.Factors that increase your risk include:
- surgical interventions in the urethra;
- unprotected sex, inflammatory diseases of the genitourinary system in one partner;
- use of a urethral catheter;
- prostate stones etc.
The occurrence of acute prostatitis may not be related to infections.It can occur as a result of a sedentary lifestyle, hypothermia and various disorders that cause stagnation in the pelvic region.
Symptoms of acute prostatitis
Since there are different stages of acute prostatitis, the symptoms of the disease often depend on them.But there are common features that unite all forms.First of all, it is pain, general intoxication, as well as problems in the urinary process.
The catarrhal form is usually accompanied by severe pain, heaviness in the perineal region, frequent urination, painful sensations.During palpation, the doctor may notice an increase in the size of the prostate gland.Secretion test results may show high levels of white blood cells.
In the follicular form, the symptoms of acute prostatitis are more pronounced.A man feels pain in the perineum, spreading to the sacrum or penis.The process of urination is accompanied by pain, urine is retained, difficulties with defecation often occur.There is a general malaise and the patient has a fever.Palpation shows an enlarged prostate, its contours are asymmetrical.Focal pain may occur.Tests show an increase in the level of leukocytes and the presence of purulent threads in the urine.
The parenchymal form is accompanied by a sharp increase in body temperature, the values can reach 39.5 degrees.General symptoms are pronounced: tremors, loss of appetite and lack of strength.Urination is delayed, the process is accompanied by severe pain.Defecation becomes difficult, constipation worsens.
In such cases, treatment of acute prostatitis should be started immediately.If the process is started, there is a high probability of prostate abscess, paraprostatitis, phlebitis of the paraprostatic venous plexus.If the patient does not consult a doctor, the disease becomes chronic and the possibility of complete recovery is significantly reduced.
Diagnosis of acute prostatitis
When the patient contacts a urologist, the doctor determines the stage of the disease and diagnoses acute prostatitis.The specialist receives the information after conducting a thorough investigation.In this case, the methods used in the diagnosis consist of physical, instrumental and laboratory studies.
Physical examination consists of studying the state of the prostate gland from the rectum.Thus, the specialist gets the opportunity to assess the size, shape, consistency and presence of pain.As a result of the analysis of the secreted secretion, it is easy to determine that the number of lecithin grains decreases and the level of leukocytes increases.
Palpation of the gland also involves the collection and transfer of urine for examination.In most cases, acute prostatitis is signaled by an increase in the level of leukocytes.Urine culture, PCR and blood culture, analysis of urethral discharge are also prescribed.
In case of this disease, instrumental methods are represented by transrectal ultrasound diagnostics.If the patient has severe pain, the choice of examination is the transabdominal method.
When there is a question about surgical intervention, it is necessary to perform CT and MRI of the pelvis.
Treatment of acute prostatitis
Treatment of acute prostatitis is carried out in hospital.This is due to two factors.First, there is a risk of serious complications that can affect men's health and subsequently affect reproductive function and erection quality.Secondly, the disease is complex, accompanied by obvious symptoms and painful sensations.Treatment of acute prostatitis begins with drug treatment, prescribing etiotropic drugs to the patient.The most important role is played by antibacterial substances that suppress the activity of microorganisms.
To reduce the severity of pain, as well as to get rid of spasms, the patient is recommended to take antispasmodics and analgesics.Sometimes thermal enemas and rectal suppositories are used to alleviate the condition.After eliminating acute symptoms, it is possible to use physiotherapy.These procedures increase microcirculation, improve local immunity and help eliminate inflammation.Among the physiotherapeutic methods of treatment of acute prostatitis, the most effective are prostate massage, as well as microwave therapy and electrophoresis.For many years, prostate massage has been considered a particularly popular measure, which helps to relieve congestion;It is also recommended to be used regularly as a preventive measure for men who have reached the age of forty.
If there are problems with the urinary process, the catheter is not used;a trocar cystostomy is preferred instead.
Restoration of the prostate tissue is considered a full restoration of its functions, and laboratory tests show the absence of infectious pathogens and the return of prostate secretion to its normal composition.
Surgery is not widely used to treat prostatitis.It doesn't always work out.Surgical solution brings positive dynamics in less than half of the cases.The most common side effect of the surgery is erectile dysfunction, retrograde ejaculation is common, in which sperm enters the bladder during ejaculation, and sometimes narrowing of the urethra.The surgical method does not guarantee the prevention of relapse.Therefore, surgical intervention is applied only in certain cases, for example:
- the formation of a prostate abscess that must be opened and cleaned;
- lack of results of treatment using conservative methods in the form of drugs, traditional medicine, physiotherapeutic procedures;
- development of serious complications;
- presence of inflammation in the pelvic region;
- formation of paraproctitis (purulent abscess in cells localized around the rectum);
- the presence of blood in the urine;
- delayed urination and retention of urine (anuria);
- the presence of stones in the bladder and kidneys caused by prostatitis;
- suspicion of malignancy.