According to BME, prostatitis is an inflammatory process that occurs in the prostate gland in men with damage to the parenchyma and interstitium.Treatment of prostatitis in men is a long and complex endeavor, often due to complete ignorance of the disease at the beginning.What is prostatitis, what are its causes and its first signs, what you need to know about the subject of "diagnosis" and modern methods of treating prostatitis exist.Everything about prostatitis that men need to know is in this review article.
Ab ovo - from the egg
We are not talking about Horace's satire;in this case, we are interested in everything related to prostatitis, from the beginning to the last "decit" of treatment.Symptoms of prostatitis occur in men during the period of active sexual activity, from 25 to 45 years.In the thematic videos, you can study in detail everything related to the basis of the disease, causes and symptoms, features of diagnosis and treatment.
The reasons for the development of prostatitis are wide.In prostatitis, infectious factors play the biggest role in the development of the disease:
- Acute form.Coccal flora acts as a provoking factor.
- Chronic form.The reasons for the development are broader;The main factors of prostatitis in men are: gonococci, trichomonas, Gr+ and Gr- bacteria, mycobacterium tuberculosis.In rare cases, diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
It should be noted that chronic prostatitis, which is caused by pathogens that have penetrated the prostate gland, can then have an abacterial character without the participation of pathogenic factors.The acute form is often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder due to endoscopic examination or various manipulations, physical inactivity and, as a result, impaired blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You often hear about only one type of prostatitis - infectious, but according to the WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is registered in 90% of cases.
Table No.1. Brief features of pathology
| Category for prostatitis | Acute infection | The presence of pathogens in prostate secretions or the 3rd part of urine | The level (increase) of leukocytes in the urine or secretions |
| 1 cat.Acute bacteria | + | + | + |
| 2 cats.Chronic bacteria | — | + | Not sure (yes or no) |
| 3 a.Chronic pelvic pain syndrome is inflammatory, not bacterial | — | — | + |
| 3 b.Prostatodynia, a non-inflammatory pelvic pain syndrome | — | — | — |
| 4 cats.Inflammatory process without symptoms | — | Not sure (yes or no) | Not sure (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more fully;in most cases, the cause of the disease is family bacteria.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as a cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered not fully proven.Symptoms of prostatitis in men with signs of weak immunity, especially with HIV, the cause of this disease can be yeast fungi (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, especially often causing its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have carefully studied the list of possible pathogenetic factors (provocative prostatitis) that play an important role in the occurrence of inflammation in the prostate without the presence of microorganisms.Therefore, the cause of prostatitis, which is non-bacterial in nature, is a congestive process in the pelvis, poor circulation, intraprostatic urine reflux and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man with prostatitis look like?For someone who is far from medicine, and especially does not understand urological problems, the external male appearance of an individual is no different from other people.And only an experienced specialist, based on the first complaints of the patient, will understand where the cause of the problem is and how to eliminate it should be taken.
Symptoms of prostatitis are often described in a few phrases, highlighting the most interesting moments, and this plays a cruel joke on a man.Relying on the imprecise definition, he ignored a very important signal, believing that the disease does not exist, although in fact the clinical picture depends on the nature of the morphological changes in the prostate.
The first symptoms can be associated with the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in the perineum, radiating to the sacrum, frequent nocturnal urges.
- Follicular prostatitis.Difficulty and frequent urination, sometimes with delay.Pain during urination, stronger at the end of urination, as well as defecation.Low grade fever.
- Parenchymal prostatitis.There are clear symptoms of dysuria, often acute respiratory disorders, pain during natural recovery, general intoxication with a temperature of up to 40 C.
With prostatitis with the formation of an abscess, the symptoms are more obvious with the possibility of the opening of the abscess into the rectum or into the prostatic part of the urethra.With such success, the symptoms decrease.If the opening of the abscess occurs in the paraprostatic tissue or in the perineal area, visual symptoms can be observed: swelling, redness of the skin with significant fluctuations.The man's condition is getting worse.
Comprehensive treatment of prostatitis cannot be started without a thorough examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is customary to distinguish between acute and chronic prostatitis;on thematic videos on the Internet, you can find out in detail the symptoms associated with one form or another.Let's consider this issue in more detail.
Acute - its typical symptoms are characterized by the manifestation of three stages: catarrhal, follicular and parenchymal.They are described in detail above.
The most interesting in terms of symptoms is the form of chronic prostatitis, because it has many variations in symptoms.In general, the effective treatment of prostatitis depends on the prostatitis, or rather on its type.
In the chronic stage, the following can be distinguished:
- Chronic prostatitis rarely results from an acute process.
- Primary prostatitis passes with suppressed symptoms.
- A chronic characteristic symptom is a slight discharge from the urethra during defecation.
- The first symptoms, as a rule, are not expressed;the pathological process itself develops over many years.It is preceded by prostatosis (congestion in the capillaries), which gradually turns into an abacterial form of inflammation of the prostate gland.
- Specific pathogenic microflora is not the cause of chronic prostatitis, but the chronic process itself is a complication of the inflammatory process due to the effects of ureaplasma, trichomonas, chlamydia and gonococci.
How does a man with chronic prostatitis feel?Reviews from patients show that most often, at first, a small pain in the perineum and a slight discharge is felt, which most men do not pay attention to.The next stage is the addition of the following symptoms: burning in the urethra, sexual dysfunction, dysuria, general malaise.Frequent mistakes during sex lead men to depression, they become irritable or depressed.
It is important to understand that all these signs do not necessarily appear in every case of chronic pain, this is what complicates the diagnosis in the early stages of the disease, in addition, the symptoms tend to change places, which is more confusing.
Long term syndrome
What can you expect from chronic prostatitis?If there is no timely diagnosis and treatment, there is no good, any specialist will confirm this.This type of prostatitis is characterized by 3 syndromes:
ill
The prostate itself does not hurt, but many nerve endings pass through it and are nearby, which are inevitably involved in the inflammatory process.Pain can vary in intensity - from mild pain, causing discomfort, to severe, preventing you from falling asleep peacefully.Radiating pain occurs in all nearby areas (scrotum, sacrum, perineum);pain due to prostatitis must be distinguished from the symptoms of other similar diseases.
Dysuria
Dysuric syndrome always indicates problems in the urinary system, but what causes this is explained during diagnosis.An increase in the volume of the prostate inevitably compresses the urethra, and the flow of urine is disturbed, followed by the development of a frequent urge to go to the toilet, and the feeling of incomplete emptying of the bladder.With advanced prostatitis, there is compensatory hypertrophy of the muscular layer of the bladder and ureters.During this time, the symptoms of dysuria weaken, but return again in an intensified form.
Sex without pleasure
Deteriorating intimate life - these are the first symptoms that men notice, and they, as the reviews show, that force them to see a doctor.Frequent nocturnal erections, orgasms in the form of obliteration, weak erections and rapid ejaculation, pain during them - this is what worries the stronger sex the most.In the chronic stage, nothing good can be expected from prostatitis;erectile dysfunction often develops.
The level of sexual dysfunction in men is not the same;some initiate sexual intercourse and somehow complete it, ignoring the typical warning signs.For some people, even the initial weak reaction of the penis to charming stimuli becomes a collapse and the beginning of a terrible experience that turns into a long-lasting depression.The ghost of impotence is difficult for patients who have problems with the prostate gland;experts and relatives almost always realize that prostatitis deteriorates the character.
To learn more about this disease, you can study thematic videos where experts explain many nuances of pathology.
What to write on the card
What entry will appear in the patient's medical record and the final diagnosis that will be set depends on a series of primary studies, starting from the patient's arrival to the urologist and his complaints (history) to the last stage of the diagnostic step.What exactly is required depends on the type of prostatitis, its severity and the patient's consent to certain diagnostic procedures.
In general, diagnostics consist of:
- History.The doctor will ask in detail about all complaints and symptoms, prerequisites for the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + taking secretions).
- Ultrasound of the prostate.
- Spermogram.
- Prostate biopsy (if indicated).
What does diagnostics provide and is it so important?If you read patient reviews, you can often understand that most men try to avoid many stages of diagnosis, the motivation is very different.The price of such indifference is your own health!It is important to remember that prostatitis can be cured only if it is "caught" in time and the diagnosis is made accurately, determining the form of the disease and its cause.
How to be healthy forever
So, a man understands that he has prostatitis, what awaits him in the future and is it possible to regain lost health?It is important to understand that it will take 2 times longer to get rid of prostatitis than it takes to develop.Moreover, if the pathological process proceeds practically without the attention of the man, then the treatment of prostatitis will take place with his direct participation.Can acute or chronic prostatitis be treated?Yes, if you follow all the doctor's recommendations, in the case of an extended chronic form, treatment can achieve a stable remission.
The stage of treatment for prostatitis will directly depend on what the doctor finally finds during the examination, on the type of disease, the patient's age and physical characteristics.
The treatment regimen is always individual, but the following may be present in it:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Immunocorrector prescription.
- Urological massage.
- Therapeutic gymnastics.
The price of each level of treatment is different and depends on the total cost of prescribed drugs, additional methods and the clinic.Preventive measures following treatment have an important rationale - they prevent the return of the disease.Prevention has a direct and close relationship with treatment;The basics of prevention are as important as compliance with all the doctor's requirements during therapy.
Treatment of acute form
Periods of exacerbation require taking antibiotics, which are taken in courses.In the presence of chlamydial infection, cephalosporin drugs are indicated.
The duration of the course of use is important;on average, antibiotics are taken for at least 3-4 weeks to prevent the disease from recurring.Sometimes doctors continue treatment for a longer period, combining antibiotics with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- Bacterial cultures are needed to determine the sensitivity of microorganisms to drugs.
- Side effects and contraindications of drugs are taken into account.
- They take into account the previous course of treatment, when it happened, what methods were used and the results.
The need for additional treatment methods is determined by the attending physician;it should be remembered that in the form of acute prostatitis, massage is contraindicated, because it provokes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Chronic form treatment
It is important to remember that it is impossible to get rid of chronicity quickly in principle, the disease has been developing for years and even doctors in their field cannot destroy it in a few weeks;you don't have to take their word for it that cures disease in 2-3 days.Treatment is aimed at stopping the source of infection, restoring immunity in men and the function of the prostate gland, as well as preventing exacerbation - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks;if the treatment is low, the medicine is continued again.Often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete isolation of the prostate gland is provided.
No bacteria or symptoms
The characteristic difference between the therapies is the absence of antibiotics;in the absence of pathogenic microflora, they are not needed.But sometimes experts prescribe a short course of medication for 2-4 weeks.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy by strengthening the patient's immune system.
Diet and lifestyle changes also form the basis of non-bacterial prostatitis treatment.bath and alpha blocker are shown.
Asymptomatic prostatitis is difficult to identify;the PSA method is used for diagnosis, followed by a 2-week course of antibiotics as treatment.After this, symptomatic treatment is selected individually.
In general, the treatment of any type of prostatitis is a long-term phenomenon and is not always pleasant for the patient.In addition to physical discomfort, a man suffers psychologically, because the most valuable part of his body is affected - the intimate part.Reviews from those who have cured the disease show that only strict adherence to the doctor's instructions, coupled with diet and lifestyle changes, bear fruit.The price of frivolity towards treatment is very high - a man loses not only his health, his whole life, his character and relationships with others change.To avoid this, it is necessary to monitor the health of the prostate gland and eliminate the cause of the development of the disease.