Prostatitis is one of the most common urological diseases in men.It is generally accepted that after 30 years 30% of men suffer from prostatitis, after 40 - 40%, after 50 - 50%, etc.At the same time, the real incidence is much higher than the recorded one, this is explained by the peculiarities of the diagnosis and the possibility that the disease manifests itself in a latent form.With prostatitis, numerous problems with urination occur, libido decreases and erectile function is impaired.
Prostatitis is one of the most common urological diseases in men.It is generally accepted that after 30 years 30% of men suffer from prostatitis, after 40 - 40%, after 50 - 50%, etc.At the same time, the real incidence is much higher than the recorded one, this is explained by the peculiarities of the diagnosis and the possibility that the disease manifests itself in a latent form.
The prostate gland is a small glandular-muscular organ located in the small pelvis under the bladder, covering the initial part of the urethra (urethra).The prostate gland produces a secretion which, mixed with seminal fluid, maintains the activity of spermatozoa and their resistance to various adverse conditions.
With prostatitis, numerous problems with urination occur, libido decreases and erectile function is impaired.The saddest thing is that, in the absence of adequate treatment, approximately 40% of patients experience some form of infertility, as the prostate gland is no longer able to produce a sufficient amount of high-quality secretion to ensure sperm motility.It is important to remember that similar symptoms can occur not only with prostatitis, but also with adenoma and prostate cancer.
Forms of prostatitis
According to the 1995 American National Institute of Health (NIH USA) criteria, there are four categories of prostatitis:
- Category I - Acute prostatitis;
- Category II - Chronic bacterial prostatitis;
- Category III - Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS):
- Category IIIa - Chronic prostatitis/chronic pelvic pain syndrome with signs of inflammation;
- Category IIIb - Chronic prostatitis/chronic pelvic pain syndrome without signs of inflammation;
- Category IV - Chronic asymptomatic (asymptomatic) prostatitis.
Chronic granulomatous prostatitis, which is not mentioned in this classification, also occasionally occurs.
Most experts distinguish 4 main forms of prostatitis:
- acute bacterial prostatitis,
- chronic bacterial prostatitis,
- non-bacterial prostatitis
- Prostatodynia.
Causes of prostatitis in men
In people under 35 the disease usually presents in the form of acute bacterial prostatitis.We speak of bacterial prostatitis when there is laboratory confirmation of the presence of infection.Most often these are chlamydia, trichomoniasis, gardnerellosis or gonorrhea.The infection enters the prostate gland from the urethra, bladder, rectum, and through the blood and lymph vessels of the pelvis.
However, recent studies show that in most cases the infection is due to existing disorders in the structure of the prostate tissue and the blood circulation within it.In non-bacterial prostatitis it is not possible to isolate bacteria, although this does not exclude their presence.
In older patients, chronic forms of the disease are diagnosed more often.
Prostatodynia is the presence of a clinical picture of prostatitis, thickening of the prostatic tissue without signs of inflammation.
Symptoms of prostatitis in men
The symptoms of prostatitis can be divided into 3 groups:
- urinary system disorders (frequent and painful urge to urinate, sensation of incomplete emptying of the bladder), lower abdominal pain;
- sexual function disorders (pain along the urethra and in the rectum during ejaculation, weak erection, premature ejaculation, loss of orgasm, etc.);
- increased anxiety and nervousness of a man, caused by fixation of patients' attention on their condition.
Acute prostatitis usually begins with an increase in body temperature up to 39-40°C with fever and chills.Urination is difficult and painful.Swelling of the prostate gland develops, which can cause acute urinary retention.
Chronic prostatitis proceeds more calmly, but at any time, under unfavorable factors, an exacerbation can occur.Maybe asymptomatic.
Complications of prostatitis
In the absence of timely treatment, prostatitis can cause the following complications:
- transition of acute to chronic prostatitis,
- bladder obstruction with acute urinary retention, requiring surgical treatment,
- development of male infertility,
- narrowing and healing of the urethra,
- recurrent cystitis,
- pyelonephritis and other kidney damage,
- abscess (suppuration) of the prostate, requiring surgery,
- Sepsis is a life-threatening complication that often develops in people with reduced immunity (patients with diabetes mellitus, renal failure).
Treatment of prostatitis in men
The modern arsenal for the diagnosis of prostate diseases is very broad.
The doctor will prescribe a bacteriological examination of the urine and prostate secretions.To clarify the location of a urinary tract infection, several portions of urine are examined.Also, a mandatory diagnostic method is digital examination of the prostate gland.This procedure is not very pleasant, but it is very informative.Your doctor may refer you for an ultrasound of the prostate and pelvic organs.If necessary, computed or magnetic nuclear tomography, cystoscopy, urography and prostate enzyme testing are prescribed.
When making a diagnosis, the doctor must exclude the presence of benign prostatic hyperplasia and prostate cancer.To quickly relieve pain in acute prostatitis, analgesics and warm baths can be recommended.
Bacterial prostatitis requires the prescription of antibiotics, the selection of which is carried out based on the results of bacteriological culture of secretions on nutrient media and the determination of the sensitivity of the pathogen to chemotherapy.
Nonbacterial prostatitis is treated with anti-inflammatory drugs.
Prevention of prostatitis
Avoid hypothermia and do not sit on cold objects.Follow a gentle diet (excluding alcohol, spicy, fried and canned foods).Regular sex life is also a way to prevent prostatitis (since one of the provoking factors is sperm stagnation and frequent erections without subsequent ejaculation).Equally important is the prevention of sexually transmitted diseases.
In adulthood, every man should undergo regular examinations (once a year) by a urologist.After prostatitis, preventive courses of outpatient treatment are carried out at least 2 times a year for a month and a course of sanatorium treatment.