Every second man of reproductive age (up to fifty years old) is prone to a disease as delicate as acute prostatitis, in which, under the influence of certain factors, the prostate (prostatic gland) becomes inflamed, causing various forms of disorders of sexuality. functions, fertility and psycho-emotional states. Be attentive to what your body says and don't neglect timely treatment.
What is acute prostatitis
If a man feels discomfort and even pain when urinating, he should immediately consult a doctor, since acute prostatitis is a disease of infectious etiology that causes inflammation of the prostate, followed by the formation of edema of the glandular tissue, formation of purulent foci in it. If you do not pay attention to the signs of acute inflammation of the prostate, the pathological process can turn into a chronic form that is difficult to treat and there is very little time for reflection - the transformation takes place in a matter of days.
However, more serious complications are possible than its transition to a chronic form. There is a risk of sepsis - a general infection of the blood and an ascending infection of the urinary tract with the development of pyelonephritis and cystitis. In these cases, the patient is hospitalized urgently, the condition can be critical. Although sepsis as a complication is rare, it can occur in patients with immunosuppressive conditions - intoxication, fever, severe symptoms, weakness. Therefore, blood cultures are necessary to detect microorganisms.
Symptoms of acute prostatitis
Every man needs to know and remember the symptoms of acute prostatitis. The general signs of the disease are manifested:
- Sharp pain when urinating.
- Body intoxication.
- Urination disorders (intermittent, weak and strained stream).
- Frequent urge to go to the bathroom at night.
These are external symptoms of prostatitis, but with a deeper study, leukocytes, traces of mucus and pus in the secreting fluid of the prostate are found in the urine. On palpation, a dense, enlarged organ is felt, pressing will be painful. The further development of the inflammatory process is characterized by heaviness and pain in the perineum, radiating to the penis, sacrum and rectum. As a result, it becomes difficult for the patient to empty the bladder and defecate due to the severe pain. Body temperature can rise up to 38°C.
Causes of acute prostatitis
Since this disease is bacterial inflammatory in nature, the following infectious agents are the causes of acute prostatitis:
- Gram-negative - Klebsiella, E. coli, Proteus.
- Gram-positives - enterococci, staphylococci, streptococci.
- Urogenital - trichomoniasis, chlamydia, ureaplasmosis, gonorrhea, candidiasis, mycoplasmosis.
The microbial microflora penetrates the glandular tissue of the prostate, as a rule, via the transcanalicular route (through the urethra and the excretory ducts of the prostate). In cystitis, the infection migrates to the prostate from the bladder. Other possible routes of bacterial penetration are opened during endourethral manipulations (catheter placement, urethral bougienage, cystoscopy, urethroscopy). Pathogenic microorganisms migrate to the prostate from distant pathogenic foci in caries, sinusitis, tonsillitis, cholecystitis, pyoderma, bronchitis.
There is a high probability of infection of the intestine with proctitis, hemorrhoidal fissures, colitis. Non-infectious factors that can cause an attack of prostatitis are congestive (congestive) venous phenomena in the pelvic area and impaired drainage of the acini of the gland. Congestion can be caused by irregular or, conversely, excessive sexual activity, interruption of sexual intercourse, sedentary lifestyle, frequent constipation, frequent alcohol intoxication, varicose veins of the small pelvis, hypothermia.
Acute forms of prostatitis
The clinical development of this disease is considered to be in three stages, which at the same time are forms of acute pancreatitis. That's it:
- The first stage is the catarrhal form.
- The second stage is the follicular form.
- The third stage is the parenchymal form.
Acute prostatitis in men begins with catarrhal inflammation, characterized by the expansion of acini, the occurrence of edema of the glandular tissue and, as a result, an increase in the size of the organ. The excretory ducts of the prostate glands, which open into the posterior urethra, are actively involved in the inflammatory process. The lobes and ducts of the prostate become inflamed, their contractility is disturbed, they narrow and obstruct, which can make it difficult for the prostate secret to secrete.
In the catarrhal stage, the pathological process stops in the mucous layers and does not deepen. In the process of progression, the disease spreads to the entire prostate. Acute follicular bacterial prostatitis develops. At the analysis in urine pus comes to light. Gland tissues change destructively, swelling continues to increase. The follicular form is still relatively easily treatable.
In addition, a parenchymal form of the disease develops, the result of which may be a prostate abscess, that is, chronic prostatitis. So symptoms like:
- An increase in body temperature to 39°C and above.
- Manifestations of intoxication: weakness, chills, thirst, lack of appetite.
- Frequent urges to the bathroom for minor needs are accompanied by sharp, throbbing pains.
- Inability to empty the bladder.
- Flatulence.
- Tenesmus.
- Constipation.
- Discharge of mucus from the anus.
Diagnosis of acute prostatitis
At the first suspicion of inflammation of the prostate, run to the doctor. Correct and comprehensive diagnosis of acute prostatitis is very important for a quick and successful treatment. The doctor will first analyze the history, clarify when pain sensations appear in the perineum, whether they increase or decrease during ejaculation, urination, defecation. Make sure the doctor should study the patient's medical history: what diseases were transferred, if there were any sexually transmitted infections.
The urologist will palpate the external genitals to determine developmental pathologies, visible signs of prostatitis and rectal examination - palpation of the prostate through the anus. To create a complete clinical picture, it will be necessary to pass the following exams:
- Urinalysis to determine the level of leukocytes and the presence of purulent threads.
- Blood test.
- Culture smear - the contents and scrapings of the urethra are taken to determine the growth of bacteria and their sensitivity to antibiotics.
- Determination of urine velocity (uroflowmetry).
- Ultrasound of the prostate to detect diffuse changes in the gland and its abscess formation.
- A blood test to determine the presence of pathogens from diseases such as syphilis, gonorrhea, mycoplasmosis, chlamydia.
- PCR diagnostics.
Treatment of acute prostatitis
After a complete diagnosis, they start the treatment of acute prostatitis. It is based on antibiotic therapy, the aim of which is to suppress infectious pathogens. In addition, conservative treatment of prostatitis includes the use of:
- Anti-inflammatory drugs.
- Means that improve blood circulation.
- Analgesics and antispasmodics.
- Drugs that support metabolic processes in the prostate.
- Multivitamins.
- Herbal agents.
- Immunomodulators.
Advanced forms of inflammation of the prostate with the appearance of purulent foci require surgical intervention. Transurethral (through the wall of the urethra) or transrectal (through the wall of the anus) drainage is performed. Surgery may be necessary in case of pathological urinary retention. A puncture epicystostomy is performed - an incision is made in the abdominal cavity, into which a tube is inserted to divert urine.
drugs
Treatment of acute prostatitis in men with medication (pills, injections) is the basis of successful therapy. With well-prescribed antibiotic therapy, the infection can be overcome in a few days. However, it is recommended to continue treatment for four weeks to achieve complete eradication of pathogenic microflora. The drugs used in the disease are:
- Etiotropic (antibiotics) - destroying pathogens.
- Pathogenetics (NSAIDs) - eliminating congestion in the prostate.
- Symptomatic (analgesics, antipyretics) - relieving pain, organ muscle spasms and other symptoms.
To treat inflammation of the prostate, the doctor may prescribe a drug complex, which will include:
- Injections - contribute to the penetration of the drug into the tissues of the body in a short time.
- Candles (rectal) - analgesic, antibacterial effect.
- Instillations - delivery of the drug to the prostate through the urethral opening.
- Microclysters with herbal decoctions.
- Antibacterial drugs with broad spectrum of action, if a specific causative agent of the disease is not identified.
Antibiotics for acute prostatitis
The main causative agents of prostatitis are pathogenic bacteria that cause inflammation in the prostate tissues. Therefore, antibiotics for acute prostatitis are the mainstay of treatment and are prescribed only after the microflora sensitivity test. Antimicrobials used for inflammation are divided into the following groups:
- Fluoroquinolones.
- Penicillins.
- Cephalosporins.
- Macrolides.
- Tetracyclines.
- Aminoglycosides.
Prevention of acute prostatitis
In order for a man to always be healthy, full of strength, the prevention of acute prostatitis is important, including:
- Regular sex life with regular partner, excluding casual relationships.
- Condom use.
- Stop smoking, drugs, alcohol.
- Proper nutrition.
- personal hygiene.
- Annual preventive exams at the urologist.
- Take vitamins and zinc preparations.
It is important to completely cure diseases of Organs genitourinary organs (urethritis, cystitis, pyelonephritis, balanoposthitis). Undertreated diseases can cause the development of an inflammatory process in the prostate. Among other things, we must not forget about increasing physical activity. In the cold season, hypothermia should be avoided. Prostate massage is very helpful for men's health. However, if the disease has already made itself felt, massage is contraindicated and even impossible due to organ pain.