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Prostatitis

Prostatitis in men

Prostatitis is inflammation of the prostate gland tissue in men, which manifests itself by pain in the lower abdomen and urination disorders. The disease continues in acute and chronic forms, develops under the influence of infectious and non -infectious causes. Prostatitis is included in the five most frequent problems that men resort to the urologist.

The prostate gland is an organ of the male reproductive system that produces a liquid secret that is part of sperm and improves sperm mobility. The prostate has the form of chestnut, dimensions 2x3x3. 5 cm, is located in the middle of the pelvis cavity. An neck of the bladder and the initial department of the urethra pass through the center of the gland.

Acute prostatitis is quite rare (5 to 10 % of cases), but it is difficult and is a serious danger to male health. Especially young people are sick with an acute form of inflammation. Chronic prostatitis develops in men over 60 to 70 years old. The disease continues with moderately pronounced symptoms, but over time leads to the formation of erectile dysfunction and impaired urination.

The causes and risk factors of prostatitis in men

All causes of prostatitis in men can be divided into two large groups - infectious and non -infectious.

Acute inflammation of the prostateMost of the time, it has an infectious origin, this form of disease is especially common among men under 40 years of age. In the vast majority of cases, it is caused by bacterial flora:

  • Enterococci;
  • E. coli;
  • Klebsiella and proteins;
  • Gonococcus;
  • Pale treponema;
  • Chlamid;
  • Micobacteria of tuberculosis.

However, geniturinary or intestinal infection itself leads to inflammation of the prostate gland in 100 % of cases. For the development of bacterial prostatitis, predisposing factors are required, the main one is the systematic microtrauma of the gland. This happens with prostate biopsy, cystoscopies or operations in the pelvis. Other risk factors of infectious prostatitis include:

  • immunodeficiency (HIV infection, congenital pathology of the immune system);
  • Random sex life;
  • homosexual contacts;
  • chronic diarrhea or constipation;
  • obesity;
  • A sedentary lifestyle.

Pathogenic microorganisms penetrate the prostate gland of the urethra or rectum. The weakening of prostate immunological and microtrauma protection contributes to the development of acute inflammation. In this context, the tone of the plain muscles of the prostate increases, which leads to compression of the urethra and disturbance of urination.

Chronic prostatitisIt has a non -infectious origin and a more complex development mechanism. Inflammation is gradually formed and the exact cause of its occurrence has not been established. Risk factors of chronic non -bacterial prostatitis:

  • Increased pressure in the prostate gland (with benign hyperplasia or adenoma);
  • Increased pressure in the pelvic cavity;
  • chronic pelvic pain;
  • Autoimmune diseases;
  • rare sexual contacts;
  • Heavy physical activity;
  • Chronic stress.

The pathogenesis of chronic prostatitis is based on the stagnation of the secrecy of the gland, the deterioration of its blood supply, which leads to constant inflammation.

In approximately 6 % of cases, chronic bacterial prostatitis develops in men. The reason for this is insufficient or incomplete treatment of the acute form of the disease.

Types of prostatitis

Depending on the cause and mechanism of development, four cliniciansprostatitis forms:

  • Acute Bacterial;
  • chronic bacterial;
  • non -chronic bacterial (chronic pelvic pain syndrome);
  • asymptomatic inflammation.

The US National Health Institute distinguishes 4 types of prostatitis depending onDevelopment and Clinical:

  • I Type - Acute bacterial inflammation with general and local manifestations;
  • II Type - Chronic bacterial inflammation with periods of remissions and exacerbations;
  • IIIia - chronic non -bacterial (pathogenic microorganisms was not detected) inflammation) confirmed by the presence of leukocytes in the secret of the prostate or ejaculated;
  • IIIV Type - Non -inflammatory prostatitis, in which there are no pathogenic microorganisms and leukocytes in the secret of the gland;
  • Type IV - asymptomatic inflammation, which can only be confirmed histologically.

Depending onOf the nature of the pathological processIn the prostate gland, they distinguish:

  • Catarrone prostatitis - not complicated acute inflammation;
  • Stagnant or congestive prostatitis - chronic inflammation associated with the obstruction of the gland ducts and the accumulation of a prostatic secret in them;
  • Calculation Prostatitis - A chronic complication of the disease, accompanied by the formation of stones in the gland ducts;
  • Granumous prostatitis is an extremely rare form, which is accompanied by a thickening of the mucous membrane of the gland ducts.

Symptoms of prostatitis in men

The clinical image of prostatitis in men consists of signs of inflammation of the prostate gland, bladder and urethral neck compression, as well as the general manifestations of the disease. Gravity and symptom combinations differ depending on the shape and stage of prostatitis development.

Common manifestationsDiseases, regardless of form, serve:

  • lower abdomen pain, lower back, coccyx and sacred;
  • Violation of urination in the form of rapid desire, discomfort and intermittent flow;
  • Power violation and ejaculation.

The acute form of prostatitis begins suddenly, continues with pronounced symptoms, is often accompanied by various complications. Chronic inflammation develops gradually, is characterized by periods of exacerbations and remissions. With bacterial prostatitis, the first symptoms are signs of general poisoning (fever, nausea) and, with a non -infectious form of the disease, local prostate inflammation is of the main importance.

Signs of acute prostatitis

With acute prostate bacterial inflammation, the following symptoms appear in men:

  • Evil -Go -overall;
  • fever greater than 38 ° C;
  • nausea and vomiting;
  • Intense pain in the lower abdomen with radiation in the rectum;
  • frequent, but at the same time difficult urination;
  • itching and burning in the urethra;
  • cloudy of the urine, the appearance of blood or pus in it.

In the future, there is a complete recovery against the bottom of treatment, or the chronic form of bacterial prostatitis with various consequences.

Symptoms of chronic prostatitis

When forming chronic bacterial prostatitis after acute inflammation, a man is concerned with periodic pain in the lower abdomen, difficulty in urination, sometimes burning in the urethra. Pain can also spread to the lower back and coccyx, to the rectum, the penis and the scrotum. Symptoms usually occur during the period of prostatitis exacerbation and, during remission, a man's well remains normal.

Non -infectious prostatitis in men is also called chronic pelvic pain, which includes pain and signs of urination and sexual disorders. It is difficult for a man to urinate, since a urine flow is slow and intermittent, there is a burning sensation and a sensation of pressure on the urethra. With a prolonged course of the disease, the violation of power occurs, ejaculation becomes inferior and painful. Finally, a man's quality of life significantly suffers that psychological problems develop.

Pain with prostatitis

Pain syndrome with prostatitis is a constant and more pronounced symptom that is present in all forms of the disease. The mechanism of prostatitis pain is due to inflammation and edema of the gland, compression of the bladder neck receptors and the initial section of the urethra.

The acute form of the disease is accompanied by the most severe pain, since inflammation is infectious, leads to a massive edema of the gland. The pain is located in the prostate itself, but man feels not only in the lower abdomen, but also in the lower back, nucleus, straight and scrotum.

With chronic inflammation of the prostate, painful pain, but they are longer by nature, may not disappear even during the period of remission. Chronic pelvic pain syndrome is accompanied by unpleasant sensations especially in the prostate gland itself, as well as on the tail pipe, around the anus, the base of the penis and the scrotum. The discomfort bothers the man daily for at least three months.

Than the inflammation of the prostate is dangerous

Complications develop with acute and chronic prostatitis forms:

  • vesiculite (inflammation of seed bubbles);
  • coliculita (inflammation of seed tubers);
  • Prostate abscess (capsule abscess);
  • prostate fibrosis (the formation of scars in the gland tissue);
  • Prostate cysts;
  • prostate stones;
  • Infertility due to deterioration in sperm quality;
  • Erectile dysfunction caused by chronic pelvic pain and psychological disorders;
  • depression.

Prostate inflammation diagnosis

When the first signs of prostatitis appear, you need to contact a urologist. First of all, the doctor talks to the patient to determine the nature of complaints and collect an anamnesis. For this, the doctor asks the following questions:

  • How long the symptoms of the disease appeared;
  • Where pain is located, its character and conditions of occurrence;
  • There are problems with urination and ejaculation;
  • There are chronic diseases, including genitourinary infections.

To diagnose prostatitis, the doctor uses the following methods:

  • Retal examination of the prostate gland fingers;
  • General clinical blood tests;
  • Bacteriological examination of ejaculated or prostatic secretion;
  • Ultrasound examination of the pelvic organs;
  • Urofloometry;
  • Radiography or computed tomography of the prostate;
  • In rare cases, a prostate gland biopsy may be required, followed by histological examination.

Prostatitis treatment methods in men

For the treatment of prostatitis in men, conservative methods are mainly used, tactics depend on the cause and stage of disease development. With asymptomatic inflammation (type IV), active treatment is not required. In other forms of the disease, complex treatment is indicated, the acute form of prostatitis requires hospitalization in the hospital, chronic inflammation can be treated outpatiently.

First of all, the doctor gives recommendations Lifestyle corrections:

  • Smoking rejection and drink alcohol;
  • regular sex life;
  • EXCLUSION OF STRESS;
  • adequate physical activity;
  • balanced diet;
  • Exception of hypothermia and overheating.

A prerequisite for the successful treatment of prostatitis is Elimination of related diseases, especially urogenital infections.

Drug therapy  With prostatitis, it aims to suppress the inflammatory process, improving urination and pain relief. The following drug groups are used:

  • Antibiotics. Showed by acute bacterial inflammation, the doctor prescribes medications taking into account the results of the prostate secret microbiological examination. Medicines can be taken orally in the form of tablets or in the form of intramuscular injections. The course of treatment is usually 4 to 6 weeks, with an acute form of the disease. In chronic bacterial prostatitis, the duration of therapy is determined individually.
  • Alpha-blocker. Medicines are designed to improve urination as they relax the smooth muscles of the gland and eliminate compression of urethra prostatic. In the chronic form of the disease, they should be taken for a long time and sometimes for a lifetime.
  • Musorelaxants and anti -non -esteroidal inflammatory drugs. They are shown to eliminate pain syndrome caused by the inflammation of the gland and spasm of their muscles.
  • In chronic inflammation, medications are indicated to improve microcirculation, immunomodulators, antidepressants, medications to stimulate erection.

Acute inflammation of the prostate gland subject to drug treatment, in most cases, a complete recovery occurs within 1, 5-2 months. In the chronic form of the disease, therapy is performed for a long time, for several years or for a lifetime.

An important way of treating congestive prostatitis is the massage of the prostate gland through the rectum. The procedure is performed by an outpatient urologist. Massage helps remove muscle spasm, stimulates the release of a prostatic secret.

Physiotherapeutic procedures  shown in the chronic prostatitis course:

  • laser therapy;
  • electrophoresis and ultraphonophoresis;
  • microwave therapy;
  • Electrical stimulation;
  • acupuncture.

Surgical intervention  It is shown only with the development of complications - an abscess or prostate stones.

Prediction and prevention

The prognosis for recovery in acute bacterial prostatitis is favorable, subject to timely and complex treatment. The transition to a chronic form is observed in 6 to 10 % of cases. Non -bacterial prostatitis chronic, as a rule, cannot be completely healed. Complex therapy allows to reduce disease progression, preserve the quality of man's life and reduce the risk of complications.

Prevention of prostatitis development in men includes the following recommendations:

  • healthy lifestyle;
  • Regulation of the work and rest regime;
  • balanced diet and drinking way;
  • adequate physical activity;
  • Regular sex life (ejaculation);
  • Prevention of genitourinary infections;
  • Restriction of invasive manipulations (cystoscopy, urethra catheterization, prostate biopsy);
  • Prevention of genital lesions.