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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 the practice of a urologist.The disease is diagnosed mainly in men between the ages of 25 and 30, but with older age the risk of developing pathologies 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 than 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 the ages of 30 and 50.Most often, the cause is an infectious lesion due to the penetration of pathogenic flora from 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 should be noted: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often the inflammatory process develops against the background of infections with sexually transmitted diseases: chlamydia, gonococci, 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 on the background of Mycobacterium tuberculosis infection are extremely rare.

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

  • increased pressure in the prostate gland;
  • autoimmune disorders (destruction of prostate cells by antibodies);
  • muscle pain syndrome in the pelvic area;
  • psychoemotional disorders;
  • deficit 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:

  • 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 need 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 achieve a high-quality and long-lasting 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 urges, pain when urinating, pain in the perineum and sacrum.
  • Follicular.The pain syndrome becomes intense, can radiate to the anus and intensify during defecation.Urine is released 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-grade fever) or moderate hyperthermia.
  • Parenchymatous.The man begins to feel general intoxication of the body with chills and temperature up to 38-40°C.The pain in the perineum becomes sharp and throbbing.The act of defecation is difficult and normal emptying of the bladder is impossible, resulting in acute urinary retention (dysuria).

Symptoms of chronic prostatitis

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

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

In general, the clinical picture changes over time, differs in intensity in different patients and can hide when self-medication is attempted.Symptoms of a chronic disorder may include burning sensation in the urethra, pressure in the perineum, dysuria, impaired sexual function, and increased general fatigue.Against the background of problems with potency, mental depression, irritability and anxiety arise.Fear of impotence leads to the development of complexes, but most men tend to postpone visiting the urologist out of a sense 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.

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

Let us 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.When its lumen decreases, a frequent need to urinate and the sensation of an incompletely empty bladder appear.Dysuric disorders in many men occur in the early stages of prostatitis.The compensatory mechanism during this period 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.The sensations range from mild and painful to very intense, interfering with a night's rest.Increased discomfort occurs with ejaculation, sexual abstinence, or excessive sexual activity.The pain radiates to the perineum, sacrum, scrotum, and sometimes to the lower back.
  • Violation of potency.Lack of treatment in the early stages of prostatitis can lead to dipotency, when a 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 orgasm center.In this case, the patient experiences pain, which leads to the development of pain anticipation syndrome and a gradual renunciation of sexual activity.In the absence of comprehensive treatment that addresses the mental factor of the disorder, sexual disorders become increasingly worse.Ignoring the need to see a doctor for prostatitis often leads to 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 dipotence is observed precisely with increased anxiety and obsessive complexes.The mere thought of possible male health disorders is difficult for these patients to bear.This greatly affects their character and communication with others.Irritability, hypochondria, grumpiness and depression appear.

Complications of prostatitis

Lack of adequate treatment for inflammation of the prostate leads to concomitant diseases.The fact is that the prostate gland is closely connected with other organs of the male genitourinary system.It is located around the neck of the bladder 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 timely, numerous pathologies and serious complications occur.

Related issues:

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

Some consequences of inflammation of the prostate 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 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 with each clinical case separately and uses all available diagnostic tools.A consultation with a urologist always begins with an investigation of symptoms, medical history and general examination.Then the doctor prescribes a series of tests, based on the results of which the diagnosis is made and an appropriate treatment is selected.As a rule, the exam package includes:

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

To ensure an accurate diagnosis of prostatitis in men and related disorders, it is necessary to refrain from urinating for 2-3 hours before visiting a urologist.Otherwise, the test results may not be entirely correct, since when the bladder is emptied, pathogenic microflora is eliminated.Based on the characteristics of the clinical picture, the method of performing ultrasound is selected: transrectal or abdominal (through the abdominal wall).After determining the cause and stage of the disease, a treatment 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 drug after culture of urine and/or prostatic secretion based on the type of pathogen.If acute prostatitis is diagnosed, oral antibiotic therapy lasts approximately 4-6 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 a course of intravenous antibiotics are required.

If there is difficulty urinating, the urologist prescribes drugs that relieve hypertonicity of the muscles of the bladder and prostate, which normalize the outflow of urine and prevent stagnation.Some patients are treated with drugs that reduce sex hormone levels.As a result, a decrease in the size of the prostate is observed and, as a result, a feeling of discomfort during urination, defecation and ejaculation.With severe swelling of the prostate gland, muscle relaxants help relieve overload of the bladder sphincter and adjacent muscles.Nonsteroidal anti-inflammatory drugs effectively combat pain.In addition, chronic prostatitis responds well to auxiliary physiotherapy.Effective methods of such treatment are:

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

Prostate massage is a frequently used urological technique.The doctor uses the method of digital stimulation of the prostate gland through the rectum to improve the outflow of secretions and restore the patency of the organ's ducts.A further effect is the improvement of blood circulation and the accelerated penetration of antibiotics into inflamed tissues.In addition to finger prostate massage, 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 on the inflamed area.The procedure helps:

  • activate local blood circulation and the growth of new vessels;
  • stimulate the body's regenerative abilities;
  • 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.Concrete 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 preparation of an individual treatment regimen, taking into account the cause, form, stage of the disease, general well-being and the presence of concomitant pathologies.

Prevention of prostatitis

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 gland lead to a constant shortage of oxygen, and inhalation of tobacco smoke causes vasospasm, which further slows down the processes of local microcirculation.All experienced smokers have the problem of high blood pressure.
  • Motor activity deficit.“Sedentary” work and a sedentary lifestyle lead to congestion of 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, you should contact a specialized specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, which makes the body “open” to colds and inflammations.
  • Fatigue, excessive physical activity.You should not forget about the work and rest schedule, 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 inflammation of the prostate you can always contact the urology department of our clinic.