Prostatitis in men is an inflammatory process associated with inflammation of the prostate (prostate). This disease is most common in men over 30 years of age. This disease causes pain in the lower back, perineum, or pelvic region, is accompanied by a violation of the normal urination process, and in its severe form leads to erectile dysfunction and severe problems with the partner.
Among couples with infertility, about a quarter of cases are precisely the male factor that causes conception. Male infertility is a violation of the quality of sperm and the quantitative content of ejaculate.
The prostate (prostate) refers to the male reproductive system. It is chestnut-shaped, located in front of the rectum, below the bladder, and surrounds the urethra (urethra). When the prostate gland becomes inflamed, it compresses the urethra, leading to further urination problems. The main function of the prostate is to produce a secretion (fluid) that is part of the sperm and dilutes it, which ensures the normal mobility of the sperm.
Prostatitis is very common in the practice of a urologist. It can occur suddenly or gradually, continuously and for a long time (chronic prostatitis). The chronic form of this disease is more common than the acute form. Chronic prostatitis ranks fifth among the twenty major urological diagnoses.
Because prostatitis is the active focus of the infection in the body, it requires mandatory treatment, even if its symptoms do not bother you.
Causes of prostatitis
The list of causes of inflammation of the prostate is very varied:
- diseases of the urogenital system (cystitis, urethritis, pyelonephritis);
- sexually transmitted infections (trichomoniasis, gonorrhea);
- infections associated with pneumonia, influenza, tonsillitis, furunculosis;
- chronic constipation, which forces a person to strain himself regularly;
- sedentary lifestyle and irregular sex life leading to stagnation of secrecy;
- urinary retention - swollen bladder increases pressure on the prostate;
- frequent hypothermia (or overheating);
- injuries in the pool area;
- hormonal disorders that weaken the immune system.
Very often the appearance of prostatitis is caused by piogenic microbes: E. coli, streptococci and staphylococci, mycoplasmas, Candida fungi, Trichomonas, tuberculosis bacillus. They multiply very quickly and destroy the prostate tissue, which manifests itself in inflammation.
In most cases, the occurrence of prostatitis causes an infection that enters the prostate gland through the urethra. It sometimes enters the body through blood or lymph and leaves the bladder or rectum.
Important! Decreased immunity is very dangerous for patients with chronic prostatitis because the prostate becomes inflamed quickly due to fatigue, stress, lack of sleep, malnutrition and other harmful factors.
In the absence of a sedentary lifestyle and a permanent sex life, the blood supply to the pelvic organs deteriorates, leading to oxygen starvation and congestion in the prostate tissues. The stagnant secret is an ideal environment for the development of inflammatory pathogenic microorganisms.
Types and forms of prostatitis
Prostatitis is divided into types and forms depending on the cause of the disease:
They are distinguished by their type:
Bacterial prostatitis- Inflammation due to infection. Bacterial prostatitis occurs in both young and elderly men.
congestive prostatitis- inflammation caused by stagnation of the secretions. It develops in men who have a sedentary lifestyle and do not have a regular sex. This form can be quickly supplemented by an infection, and then the stagnant process is complicated by the bacterial form.
Calculous prostatitis- stones form in the prostate gland. Untreated chronic prostatitis can cause this complication. This disease affects older men who have not followed the advice of a urologist.
They are distinguished according to the form of flow:
Acute form of prostatitis- it is an inflammation of the prostate caused by an infectious agent, characterized by the appearance of edema and purulent foci in the tissues. 30-58% of men of reproductive age (30-50 years) face such a diagnosis.
Chronic form of prostatitispersistent or recurrent urogenital symptoms caused by a bacterial infection of the prostate gland. The chronic form accounts for 10% of all cases of prostatitis.
Symptoms of prostatitis
Generalsymptoms of prostatitisare:
- pain in the lumbar region;
- discomfort during bowel movements;
- pain in the perineum or pelvic region;
- disorders of the lower urinary tract.
The acute stage of prostatitis is accompanied by general intoxication syndrome. This disease is characterized by a sharp manifestation of symptoms with a vivid clinical picture:
- sharp rise in body temperature, chills, nausea, vomiting and malaise;
- pain syndrome and chills in the joints and muscles;
- an increase in the size of the prostate and the occurrence of discomfort in the perineal area;
- frequent urination and urinary retention.
Purulent septic disease, which affects the blood, can develop underlying certain inflammatory processes. In such a situation, the patient should be hospitalized as a matter of urgency: in the case of sepsis, treatment of prostatitis should be performed only at the clinic.
Atbacterial chronic prostatitissymptoms are usually absent, so treatment only begins when a urinary tract infection is detected, which is a complication of the disease. In this case, you can observe:
- pain during ejaculation;
- appearance of blood in the ejaculate;
- presence of secretions from the urethra;
- erectile dysfunction may occur.
If the study did not show that the chronic pain is caused by pathologies of the prostate, thenchronic non-bacterial prostatitisor the so-calledchronic pelvic pain syndrome. With this disease, a person's quality of life is significantly reduced, as it leads to various psychological and sexual disorders:
- increased fatigue;
- feeling of helplessness;
- erectile dysfunction;
- painful ejaculation;
- pain after intercourse, etc.
Similar symptoms may apply to other urological diseases, so prostatitis cannot be diagnosed on its own. For example, urinary incontinence and pain occur in prostate adenoma, cystitis, various oncological tumors in the urinary tract, and so on.
Diagnosis of prostatitis
Immediately after identifying the first signs of an inflammatory process in the prostate, the patient should consult a urologist. Your doctor will need to rule out many diseases with similar manifestations and determine which type of disease you belong to.
To confirm that the patient has no other conditions (such as appendicitis, oncology, cystitis, adenoma), the doctor must perform the necessary tests:
- collecting a medical history (questioning the patient);
- general inspection;
- rectal examination;
- studying the secret of the prostate;
- analysis of sexually transmitted infections;
- ultrasound of the prostate, scrotum and pelvic organs.
At the appointment, the urologist should clarify with the patient the duration of the clinical manifestations of the disease, the localization and nature of the pain (e. g. , in the barrier, scrotum, penis, and inside the thigh), the characteristic changes in sperm (pus and blood).
Your doctor will diagnose you with chronic bacterial prostatitis, the symptoms of which will last for at least three months.
The survey includes:
- Digital rectal examination of the gland to determine the extent and consistency of prostate enlargement.
- Analysis of prostate secretion, urine and / or ejaculate.
- Identification of urogenital infection.
- Urodynamic examination.
- Ultrasound examination of the urinary system (kidney, prostate, bladder with residual urine).
- Cultural study of prostate secretion and microscopic examination of different parts of urine and prostate secretion.
- Androflor is a comprehensive study of the microbiocenosis of the urogenital tract in men by PCR, which determines the qualitative and quantitative composition of the microflora.
After identifying the cause of the disease, your doctor will recommend a treatment procedure. It should be recalled that standard methods are only able to detect infection in 5-10% of cases, which eventually leads to prostatitis.
The patient must make a thorough diagnosis because the success of the treatment depends on the accuracy of the results.
Treatment of prostatitis
Once the urologist has made a diagnosis, determined the cause and form of the prostatitis, you should prescribe treatment.
Drug therapy plays a leading role in the treatment of the disease:
Antibacterial therapy
In the first stage of therapeutic therapy, inflammation must be eliminated. Antibiotics are the main treatment for acute bacterial prostatitis and for chronic bacterial prostatitis. Your doctor will choose an antibacterial medicine depending on which bacterium caused the disease. The patient should take the antibiotic orally for 4-6 weeks. Healing of chronic or recurrent prostatitis takes longer. In very severe cases, hospitalization may be required where an intravenous course of antibiotics is given. This is usually done with acute bacterial prostatitis.
Treatment with alpha1-blocker
If you have difficulty urinating, your doctor will prescribe alpha1-blockers to help you pass urine and relax the muscles in your prostate and bladder. Muscle relaxants relieve the pain caused by swelling of the prostate gland, which puts pressure on adjacent muscles. Non-steroidal anti-inflammatory drugs (NSAIDs) help relieve painful syndrome.
In addition, your doctor may prescribe additional medications: biostimulants, extracts of various plants and insects in the form of rectal suppositories. Unfortunately, the use of drugs alone in the treatment of prostatitis is still not enough.
Sequence of action should be followed in the treatment of this disease. The treatment of prostatitis is always complex.
Physiotherapy in the treatment of prostatitis
You can also use physiotherapy in the categories of chronic prostatitis:
- massage of the prostate (prostate);
- laser therapy;
- microwave hyperthermia and heat therapy;
- electrical stimulation with modulated currents by skin or rectal electrodes;
- acupuncture (acupuncture).
Alternative methods, such as hirudotherapy (treatment with medical leeches), are sometimes used to treat prostatitis, but the effectiveness and safety of this method have not been proven.
Introduction of stem cells
Cell therapy (stem cell injection) is a promising method today for treating prostatitis, even in its early stages of development. Regarding the injection of stem cells into the prostate, only hypotheses about its mechanisms and empirical data obtained by individual research groups can be made.
Surgical treatment of prostatitis
Surgical methods are used to treat the complications of prostatitis (abscess and purulence of the seminal vesicles).
Treatment of chronic pelvic pain syndrome requires special consideration. Asymptomatic inflammatory prostatitis does not require treatment.
Diet and lifestyle for prostatitis
Prostatitis does not require a special diet, but consuming large amounts of vegetables, lean meats and dairy products improves bowel function. It is necessary to enrich your body with adequate amounts of fiber, foods rich in vitamin E (wheat germ, corn oil, etc. ), replace sugar with natural honey. Proper nutrition with inflammation of the prostate helps improve bowel function and reduces the chances of relapse or speeds up healing. The patient should limit themselves to coffee consumption, exclude alcohol, drink plenty of fluids, and follow a healthy lifestyle.
Preventive measures to prevent prostatitis
If a man follows a proper lifestyle: follows proper nutrition, sports, there is very little chance of developing chronic prostatitis. Refusing bad habits and casual sex is a prevention of illness.
Important! There are primary and secondary prevention to prevent the development of prostatitis in men.
Primary- is intended to prevent the occurrence of the disease. The essence of this is a balanced diet, a schedule of physical activity, timely treatment of any infectious disease of the body, and regular protected sexual contact, and so on.
Secondary- aims to prevent the recurrence of existing chronic prostatitis and provides regular urological examinations and prophylactic treatment with multivitamins, restorative drugs and sports.