Prostatitis in men

Prostatitis is an inflammatory process that affects prostate tissue.This is one of the most common diseases in urologist practice.The disease is diagnosed mainly in men aged 25 to 30 years, but in old age the risk of developing pathology increases significantly.

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 prostate diseases, for example, benign hyperplasia or oncopathologies, are problems of the older age group.However, prostatitis does not fall into this category.Its symptoms usually appear in men between 30 and 50 years of age.Most often, the cause is an infectious lesion due to the penetration of pathogenic flora into the urogenital canal or 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 stand out: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often, the inflammatory process develops against the background of infection with STDs: chlamydia, gonococci, trichomonas, herpes virus, etc.As a rule, these forms of the disease are diagnosed in men under 35 years of age.Cases of treatment of pathology against the background of Mycobacterium tuberculosis infection are extremely rare.

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

• increased pressure in the prostate;
• autoimmune diseases (destruction of prostate cells by antibodies);
• muscle pain syndrome in the pelvic region;
• psycho-emotional disorders;
• motor activity deficit;
• excessive physical stress.

Primary 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:

• uncontrolled urination;
• discomfort, pain when emptying the bladder;
• potency disorder 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 bathroom;
• inability to obtain a long-lasting and high-quality erection, even with strong arousal.

Signs of acute prostatitis

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

• Catarrhal.The patient complains of frequent cravings, pain when urinating, pain in the perineum and sacrum.
• Follicular.The pain syndrome becomes intense, can radiate to the anus and intensify during evacuation.Urine is released in a thin stream.In some cases there is a delay.There is an increase in body temperature of up to 38 degrees over a long period (low-grade fever) or moderate hyperthermia.
• Parenchymal.The man begins to feel general intoxication of the body with chills and a temperature of up to 38-40°C.The pain in the perineum becomes sharp and throbbing.Defecation is difficult and normal emptying of the bladder is impossible, resulting in acute urinary retention (dysuria).

Chronic prostatitis symptoms

The chronic form of prostate inflammation may be a consequence of the absence or late treatment of the acute phase.However, in many men it develops immediately and is characterized by “blurred” symptoms.Among the main signs are:

• low fever (occasionally);
• mild pain in the perineum;
• discomfort when urinating;
• scanty secretion from the urogenital canal during defecation.

In general, the clinical picture changes over time, differs in intensity in different patients and can be hidden when trying to self-medicate.Symptoms of a chronic disorder may include a burning sensation in the urethra, pressure in the perineum, dysuria, impaired sexual function, and increased general fatigue.Against the background of potency problems, mental depression, irritability and anxiety appear.The fear of impotence leads to the development of complexes, but most men tend to postpone visiting the urologist because of the feeling of shame.

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

Of infectious etiology, the cause of the disease is a chronic inflammatory process due to infection with trichomonas, ureaplasma, chlamydia or gonococcus.Primary infection masks the signs of prostatitis and treatment does not eliminate prostate inflammation.Often, the addition of a concomitant problem goes unnoticed by man.

Let's consider in detail the three main symptoms of chronic prostatitis:

• Urinary disorder (dysuria).Inflammation increases the volume of the prostate gland, which leads to compression of the ureter.As 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.The compensatory mechanism during this period is manifested in hypertrophy of the bladder and ureter muscles, 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.The sensations range from mild and painful to very intense, which interferes with nighttime rest.Increased discomfort occurs with ejaculation, sexual abstinence, or excessive sexual activity.The pain radiates to the perineum, sacrum, scrotum and sometimes the lower back.
• Power violation.Lack of treatment in the early stages of prostatitis can lead to dyspotence, when the man experiences frequent nocturnal erections, deterioration in the quality of orgasm and accelerated ejaculation.In different patients, these signs manifest themselves with different intensity.Premature ejaculation occurs due to a decrease in the excitability threshold of the orgasmic center.In this case, the patient feels pain, which leads to the development of pain anticipation syndrome and gradual renunciation of sexual activity.In the absence of comprehensive treatment that addresses the mental aspect of the disorder, sexual disorders become increasingly worse.Ignoring the need to seek medical help for 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 more by suggestion than by objective physiological factors.In particular, psychogenic dyspotency is observed precisely with increased anxiety and obsessive complexes.The very idea of possible disturbances in men's health is difficult for these patients to bear.This greatly affects your character and your communication with others.Irritability, hypochondria, bad mood and depression appear.

Complications of prostatitis

Lack of adequate treatment for prostate inflammation leads to concomitant diseases.The fact is that the prostate is closely linked to other organs of the male genitourinary system.It is located around the bladder neck and urinary canal.Therefore, when the prostate enlarges, the urethra is compressed and the normal flow of urine is interrupted.Taking into account the peculiarities of physiology, if acute or chronic prostatitis is not treated in a timely manner, a number of serious pathologies and complications arise.

Related issues:

• formation of cysts, stones in the prostate;
• decrease in the amount of male hormones produced;
• 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 prostate inflammation that do not receive timely and comprehensive treatment pose a threat not only to health, but also to 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 the age of 40, when the risk of pathological processes in the prostate gland increases greatly.

Prostatitis diagnosis

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

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

To ensure an accurate diagnosis of prostatitis in men and related diseases, you need to avoid urinating for 2 to 3 hours before visiting a urologist.Otherwise, the test results may not be entirely correct, since when the bladder is emptied, the pathogenic microflora is eliminated.According to the characteristics of the clinical picture, the method of performing the ultrasound is selected: transrectal or abdominal (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Treatment methods for prostatitis

The main therapy is antibiotics.The use of modern pharmacological developments gives high results, although it is impossible to completely eliminate the risk of relapse.The doctor prescribes an antibacterial medication after culturing urine and/or prostate secretions for the type of pathogen.If acute prostatitis is diagnosed, oral antibiotic therapy takes about 4 to 6 weeks.In chronic or recurrent forms of the disease, treatment will take longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis), hospitalization and intravenous administration of antibiotics are required.

If there is difficulty urinating, the urologist prescribes medications that relieve hypertonicity of the bladder and prostate muscles, which normalizes urine flow and prevents stagnation.Some patients are treated with medications that reduce sex hormone levels.As a result, there is a decrease in the size of the prostate and, consequently, a feeling of discomfort when urinating, defecating and ejaculating.With severe prostate swelling, muscle relaxants help relieve excessive tension from the bladder sphincter and surrounding muscles.Nonsteroidal anti-inflammatory medications effectively combat pain.Furthermore, chronic prostatitis responds well to auxiliary physical therapy.Effective methods of this treatment are:

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

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

• activate local blood circulation and the growth of new vessels;
• stimulate the body's own regenerative capabilities;
• destroy fibrous foci and calcifications that cause pain and inflammatory processes.

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

For their part, the clinic's urologists ensure the development of an individual treatment regimen, taking into account the cause, form, stage of the disease, general well-being and the presence of concomitant pathologies.

Prostatitis prevention

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

• Smoking.The anatomical features of the location of the prostate lead to a constant lack of oxygen, and inhalation of tobacco smoke causes vasospasm, which further slows down local microcirculation processes.All experienced smokers have the problem of high blood pressure.
• Motor activity deficit.“Sedentary” work and a sedentary lifestyle lead to congestion in the pelvic organs.
• Alcohol abuse.Exceeding the daily alcohol limit affects overall health and makes the body more vulnerable to various infectious diseases.
• Stressful conditions.It is necessary to avoid situations that lead to anxiety, irritation and depressive disorders as much as possible.If necessary, contact a specialized specialist.
• Hypothermia.Exposure to low temperatures reduces immunity, which makes the body “open” to colds and inflammation.
• Fatigue, excessive physical activity.You should not forget about work and rest schedules, as well as lifting heavy weights.

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