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Prostatitis in men

Prostatitis is an inflammatory process that affects the tissue of the prostate gland.This is one of the most common diseases in urologist's practice.The disease is diagnosed mainly in men from the age of 25-30, but the risk of developing the pathology increases significantly with age.

The form distinguishes between acute and chronic prostatitis.In the latter case, the inflammation is characterized by a long course with periodic relapses.This condition is much more common compared to the acute one.

Causes of prostatitis

Many diseases of the prostate gland, for example, benign hyperplasia or oncopathology, are a problem of the older age group.However, prostatitis does not fall into this category.Its symptoms usually appear in men between the ages of 30 and 50.Most often, the cause is an infectious injury due to the penetration of pathogenic flora from the urogenital canal or the glands of the genitourinary system.This is explained by the proximity of the urethra and anus.

Among the most common causative agents of bacterial (infectious) prostatitis, gram-negative organisms should be noted: Pseudomonas, Escherichia coli, Serration, Enterobacteriaceae and Proteus.Often, the inflammatory process develops against the background of STI infection: chlamydia, gonococcus, trichomonas, herpes virus, etc., as a rule, such forms of the disease are diagnosed in men under the age of 35.Cases of treatment of pathology against the background of infection with Mycobacterium tuberculosis are extremely rare.

There are also non-bacterial types of prostatitis.Among their main reasons:

  • increased pressure in the prostate gland;
  • autoimmune disorders (destruction of prostate cells by antibodies);
  • muscle pain syndrome in the pelvis;
  • psychoemotional disorders;
  • lack of motor activity;
  • Excessive physical stress.

Primary signs of prostatitis

A man with signs of prostatitis

The disease is accompanied by a complex of disorders that affect the functioning of the entire urinary system.Among the main symptoms:

  • uncontrollable urination;
  • discomfort, pain when emptying the bladder;
  • Violation of potency in men of reproductive age;
  • pain in the perineum when sitting for a long time;
  • frequent and strong urge to urinate;
  • Difficulty emptying the bladder;
  • Decreased libido and erection problems;
  • reproductive dysfunction (infertility);
  • Feeling of incomplete emptying of the bladder after going to the toilet;
  • Inability to achieve a high-quality and long-lasting erection even during strong arousal.

Signs of acute prostatitis

The symptoms of the disease in an acute form and the general clinical picture differ depending on the stage of the pathological process:

  • catarrhal.The patient complains of frequent urges, pain during urination, pain in the perineum and scrotum.
  • Follicular.The pain syndrome intensifies, may spread to the anus and intensify during defecation.Urine is excreted in a thin stream.In some cases there is a delay.There is an increase in body temperature up to 38 degrees for a long period (low fever) or moderate hyperthermia.
  • Parenchymatous.A man begins to feel general intoxication of the body with chills and a temperature up to 38-40°C.The pain in the perineum becomes sharp and sharp.The act of defecation is difficult and the normal emptying of the bladder is impossible, which leads to acute retention of urine (dysuria).

Symptoms of chronic prostatitis

The chronic form of prostate inflammation can be the result of the absence of an acute stage or timely treatment.However, in many men it develops immediately and is characterized by "vague" symptoms.Among the main signs are:

  • low-grade fever (sometimes);
  • mild pain in the perineum;
  • discomfort during urination;
  • Scanty discharge from the urogenital canal during defecation.

In general, the clinical picture changes over time, varies in intensity in different patients, and can become hidden when trying to self-medicate.Symptoms of the chronic disorder may include a burning sensation in the urethra, pressure in the perineum, dysuria, sexual dysfunction, and increased general fatigue.Mental depression, irritability and anxiety appear against the background of potency problems.The fear of impotence leads to the development of complexes, but most men stop visiting a urologist due to a sense of shame.

Primary chronic prostatitis develops over a long period of time.Stagnation of blood in the capillaries (prostatosis) causes the initial stage of non-bacterial inflammation, which leads to the onset of the disease.

With an infectious etiology, the cause of the disease is a chronic inflammatory process caused by trichomonas, ureaplasma, chlamydia or gonococcus.The primary infection hides the signs of prostatitis, and its treatment does not exclude inflammation of the prostate.Often, the addition of an accompanying problem goes unnoticed by men.

Let's take a closer look at the three main symptoms of chronic prostatitis:

  • Urinary disorder (dysuria).Inflammation increases the volume of the prostate gland, which causes the urethra to contract.When its lumen decreases, there is a frequent urge to urinate and a feeling of an incompletely empty bladder.Dysuric disorders in many men occur in the early stages of prostatitis.During this period, the compensatory mechanism is manifested in the hypertrophy of the muscles of the bladder and ureters, which reduces the symptoms of dysuria, but with the development of inflammation, they increase again.
  • Pain syndrome.There are no pain receptors in prostate tissue.Pain occurs when the inflammatory process spreads to other pelvic organs and their nerve pathways.Sensations range from mild and painful to very intense, preventing a good night's rest.Increased discomfort occurs during ejaculation, sexual abstinence or excessive sexual activity.The pain radiates to the perineum, sacrum, scrotum and sometimes in the lower back.
  • Violation of potency.Lack of treatment in the early stages of prostatitis can lead to dyspotence, when a man has frequent night erections, deterioration of orgasm quality and accelerated ejaculation.In different patients, these signs appear with different intensity.Premature ejaculation occurs due to a decrease in the excitability threshold of the orgasmic center.In this case, the patient experiences pain, which leads to the development of pain anticipation syndrome and gradual refusal of sexual activity.In the absence of comprehensive treatment that addresses the mental factor of the disorder, sexual disorders tend to worsen.Neglecting to seek medical help in case of prostatitis often ends in impotence.

The degree of sexual dysfunction varies depending on individual factors.Some men are so afraid of erectile dysfunction that their problems arise from suggested rather than objective physiological factors.In particular, psychogenic dyspotency is observed precisely with increased anxiety and obsessive complexes.Thinking about possible disorders of men's health is difficult for such patients.This greatly affects their character and communication with others.Irritability, hypochondria, grumpiness and depression appear.

Complications of prostatitis

Lack of adequate treatment of prostate inflammation leads to concomitant diseases.It is a fact that the prostate gland is closely connected with other organs of the male reproductive system.It is located at the neck of the bladder and urethra.Therefore, when the prostate enlarges, the urethra is compressed and the normal flow of urine is disturbed.Given the peculiarities of physiology, if acute or chronic prostatitis is not treated in time, a number of serious pathologies and complications arise.

Related problems:

  • formation of cysts, prostate stones;
  • decrease in the amount of produced male hormones;
  • decreased sexual desire (libido);
  • erectile dysfunction (erectile dysfunction);
  • infertility (in 40% of patients with chronic prostatitis);
  • prostate adenoma (benign tumor);
  • prostate cancer.

Some consequences of inflammation of the prostate, which does not receive timely and comprehensive treatment, threaten not only the health, but also the patient's life (in particular, oncological pathologies may develop).Therefore, at the first symptoms of prostatitis, you should consult a urologist.You should also remember about regular preventive examinations after 40 years, when the risk of pathological processes in the prostate gland increases significantly.

Diagnosis of prostatitis

Many urological problems have similar symptoms, so the specialist works on each clinical case separately and uses all available diagnostic tools.A consultation with a urologist always begins with a survey of symptoms, medical history and general examination.Then the doctor prescribes a series of tests, based on the results of which a diagnosis is made and adequate treatment is selected.As a rule, the examination package includes:

  • digital rectal examination of the prostate to determine the size, structure and level of urethral compression;
  • ultrasound of the urinary system (prostate, bladder, kidneys);
  • laboratory tests of urine, prostate secretion, ejaculation;
  • testing for urogenital infections;
  • Urodynamic study.

To ensure an accurate diagnosis of prostatitis and related disorders in men, you should refrain from urinating 2-3 hours before the visit to the urologist.Otherwise, the test results may not be completely correct, because pathogenic microflora is washed away when emptying the bladder.According to the characteristics of the clinical picture, the method of ultrasound is selected: transrectally or abdominally (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Methods of treatment of prostatitis

The main therapy is antibiotics.The use of modern pharmacological development gives high results, although the risk of relapse cannot be completely eliminated.The doctor will prescribe an antibacterial drug after a urine culture and/or prostate secretion depending on the type of pathogen.In case of diagnosis of acute prostatitis, oral antibiotic therapy is about 4-6 weeks.In chronic or recurrent forms of the disease, the treatment will last longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis) hospitalization and intravenous antibiotics are required.

In case of difficulty urinating, the urologist prescribes medications that relieve the hypertonicity of the muscles of the bladder and prostate gland, which normalizes the flow of urine and prevents stagnation.Some patients are treated with drugs that reduce the level of sex hormones.As a result, the size of the prostate decreases and, accordingly, discomfort during urination, defecation and ejaculation.In case of severe swelling of the prostate gland, myorelaxants help to overload the bladder sphincter and surrounding muscles.Non-steroidal anti-inflammatory drugs effectively fight pain.Also, chronic prostatitis responds well to supportive physical therapy.Effective methods of such treatment are:

  • instillation of medication into the urethra;
  • prostate massage;
  • shock wave therapy (SWT);
  • magnetic laser therapy (MLT);
  • electrophoresis;
  • ozone therapy;
  • intravenous laser blood irradiation (ILBI);
  • Ultraviolet irradiation of blood (UFOI).

Prostate massage is a commonly used urological technique.The doctor uses the method of digital stimulation of the prostate gland to enhance the flow of secretions through the rectum and restore the permeability of the organ's ducts.An additional effect is the improvement of blood circulation and accelerated penetration of antibiotics into inflamed tissues.In addition to prostate finger massage, hardware methods are also possible.Shock wave therapy shows good results in the treatment of prostatitis.The basis of this medical technology is the short-term impact of low-frequency sound waves on the inflamed area.The procedure helps:

  • activation of local blood circulation and growth of new vessels;
  • stimulation of the body's own regenerative abilities;
  • destroy fibrous centers and calcifications that provoke pain and inflammatory processes.

After a course of shock wave therapy, symptoms of prostatitis are relieved and a good preventive effect is observed.Expressed results can be achieved only with an integrated approach to the problem.In addition, the patient's responsible attitude towards medical prescription is important.

In turn, the clinic's urologists provide preparation of an individual treatment regimen taking into account the cause, form, stage, general well-being and presence of accompanying pathologies.

Prevention of prostatitis

To reduce the risk of relapse, it is necessary to reduce the negative impact on the body.Among the provoking factors are:

  • smokingThe anatomical features of the location of the prostate gland cause constant oxygen starvation, and inhalation of tobacco smoke causes vasospasm, which further slows down local microcirculation processes.All experienced smokers have problems with high blood pressure.
  • Lack of motor activity."Sedentary" work and a sedentary lifestyle lead to swelling of the pelvic organs.
  • Alcohol abuse.Exceeding the daily limit of alcohol affects the overall health and makes the body more vulnerable to various infectious diseases.
  • stressful conditions.It is necessary to avoid as much as possible situations that cause anxiety, irritability and depressive disorders.If necessary, you should contact a specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, which makes the body "open" to colds and inflammation.
  • Fatigue, excessive physical activity.Do not forget about the schedule of work and rest, as well as lifting heavy weights.

Preventive measures will help prevent the development of acute prostatitis and relapses of chronic prostatitis.For questions related to the diagnosis and treatment of prostate inflammation, you can always contact the urology department of our clinic.