According to the BME, prostatitis is an inflammatory process that occurs in the prostate in men with damage to the parenchyma and interstitium.The treatment of prostatitis in men is a long and complex undertaking, most often due to a total ignorance of the disease in its early stages.What is prostatitis, what are its causes and first signs, what you need to know on the topic of “diagnosis” and what are the modern methods of treating prostatitis.Everything men need to know about prostatitis is in this review article.
Ab ovo – from the egg
We are not talking about the satires of Horace;in this case, we are interested in everything related to prostatitis, from the very beginning to the last “squeak” of treatment.Symptoms of prostatitis occur in men during the period of active sexual activity, from 25 to 45 years old.In the thematic video you can study in detail everything related to the basics of the disease, its causes and symptoms, features of diagnosis and treatment.
There are many reasons for the development of prostatitis.In prostatitis, infectious factors play the greatest role in the development of the disease:
- Acute form.The coccal flora acts as provoking causes.
- Chronic form.The reasons for its development are more extensive;the main factors of such prostatitis in men are: gonococci, trichomonas, Gr+ and Gr- bacteria, mycobacterium tuberculosis.In rare cases, the diagnosis reveals mycoplasma, viruses, fungi, chlamydia, etc.
It should be noted that chronic prostatitis, caused by a pathogen that penetrated the prostate, can subsequently have an abacterial character without the participation of a pathogenic factor.The acute form is often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, physical inactivity and, as a result, impaired blood and lymphatic circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
We often hear about only one type of prostatitis - infectious, but according to WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is recorded in 90% of cases.
Table n°1.Brief characteristics of pathology
| Categories for prostatitis | Acute infection | The presence of a pathogen in the secretion of the prostate or in the 3rd portion of urine | Level (increase) of leukocytes in urine or secretions |
| 1 cat.Acute bacterial | + | + | + |
| 2 cat.Chronic bacterial | — | + | Unsure (yes or no) |
| 3 a.m.Chronic pelvic pain syndrome of an inflammatory, non-bacterial nature | — | — | + |
| 3b.Prostatodynia, non-inflammatory pelvic pain syndrome | — | — | — |
| 4 cats.Asymptomatic inflammatory process | — | Unsure (yes or no) | Unsure (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more thoroughly;In most cases, the cause of the disease is bacteria from the family.Enterobacteria (E. coli bacillus).The role of atypical microorganisms as the cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently not considered fully proven.Symptoms of prostatitis in men with signs of weakened immunity, especially with HIV, the cause of the disease may be yeast (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, often causing its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have perfectly learned a list of possible pathogenetic (provoking prostatitis) factors that play an important role in the appearance of inflammation of the prostate without the presence of microorganisms.So, the causes of prostatitis, which is non-bacterial in nature, are congestive processes in the pelvis, poor circulation, intraprostatic urinary reflux and an autoimmune aseptic inflammatory process.
Sick or not, that is the question
What does a man with prostatitis look like?For a person far from medicine, and especially not understanding the problems of urology, the external masculine appearance of an individual is no different from the crowd of others.And only an experienced specialist, based on the patient's first complaints, will understand where the root of the problem is and what means will need to be taken to eliminate it.
Symptoms of prostatitis are often described in a few sentences, highlighting the most striking moments, which is a cruel joke for a man.Relying on such inaccurate definitions, he ignores truly important signals, believing that the disease does not exist, when in reality the clinical picture depends on the nature of morphological changes in the prostate.
The very first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in the perineum, radiating towards the sacrum, frequent nocturnal urges.
- Follicular prostatitis.Difficulty and frequent urination, sometimes late.Pain when urinating, intensifying at the end of the urination process, as well as defecation.Mild fever.
- Parenchymal prostatitis.There are symptoms of pronounced dysuria, often acute respiratory distress, pain during natural recovery, general intoxication with a temperature of up to 40 C.
In prostatitis with abscess formation, the symptoms are more severe with possible opening of the abscess into the rectum or the prostatic part of the urethra.With such progress, the symptoms disappear.If the opening of the abscess occurs in the paraprostatic tissue or in the perineal region, visual symptoms can be observed: swelling, redness of the skin with pronounced fluctuation.The man's condition deteriorates sharply.
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 a thematic video on the Internet, you can find out in detail which symptoms relate to one form or another.Let's consider this question 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 form in terms of symptoms is the chronic form of prostatitis, as it has many variations in symptoms.In general, effective treatment of prostatitis depends on the prostatitis, or rather its type.
At the chronicization stage, the following points can be distinguished:
- Chronic prostatitis rarely results from an acute process.
- Primary prostatitis disappears with cleared symptoms.
- A characteristic symptom of chronicity is scanty discharge from the urethra during defecation.
- As a rule, the first symptoms are not pronounced;the pathological process itself develops over the years.It is preceded by prostatosis (congestion of the capillaries), which gradually transforms into an abacterial form of inflammation of the prostate.
- 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?Patient reviews show that most often, at first, minor pain in the perineum and rare discharge are felt, to which most men simply do not pay attention.The next stage is the addition of the following symptoms: burning sensation in the urethra, sexual dysfunction, dysuria, general malaise.Frequent failures during sexual intercourse lead men to depression, they become irritable or depressed.
It is important to understand that all these signs do not necessarily appear in each specific case of chronicity, this is what complicates the diagnosis at an early stage of the disease, moreover, the symptoms tend to change place, which is even more misleading.
Long-term syndromes
What can we expect from chronic prostatitis?If there is no timely diagnosis and treatment, there is nothing good, any specialist will confirm this.This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself does not hurt, but there are many nerve endings passing through it and located nearby, which are inevitably involved in the inflammatory process.The pain can vary in intensity - from mildly painful, creating discomfort, to intense, preventing you from falling asleep peacefully.Radiation of pain occurs to all neighboring areas (scrotum, sacrum, perineum);Pain caused by prostatitis must be differentiated from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a problem in the urinary system, but its cause is clarified during diagnosis.The increased volume of the prostate inevitably compresses the urethra and the flow of urine is disrupted, followed by the development of a frequent urge to go to the toilet and a feeling of incomplete emptying of the bladder.In advanced prostatitis, there is compensatory hypertrophy of the muscular layer of the bladder and ureters.At this stage, the symptoms of dysuria weaken, but reappear in an intensified form.
Sex without pleasure
A declining intimate life, these are the first symptoms that men notice, and it is they, as reviews show, that force them to consult a doctor.Frequent nocturnal erections, orgasm in erased form, poor erection and rapid ejaculation, pain during it - this is what worries the stronger sex the most.In the advanced stage of chronicity, nothing good can be expected from prostatitis;erectile dysfunction often develops.
The degree of sexual dysfunction in men is not the same;some begin sex and end it one way or another, dismissing the characteristic warning signs.For some, even the initial weak reaction of the penis to a charming stimulus turns into a breakdown and the beginning of terrible experiences that develop into prolonged depression.The specter of impotence is difficult to live with for patients with prostate problems;specialists and relatives almost always notice that prostatitis deteriorates character.
To learn more about the disease, you can study a thematic video in which experts explain many nuances of the pathology.
What to write on the card
Which entry will appear in the patient's medical record and which final diagnosis will be established depends on a series of primary studies, from the patient's arrival to the urologist and his complaints (history) to the very last stage of diagnostic measures.What exactly is needed depends on the type of prostatitis, its severity and the patient's consent to specific diagnostic procedures.
In general, the diagnosis consists of:
- History.The doctor will ask you in detail about all complaints and symptoms, prerequisites for the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + secretion collection).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does the diagnosis bring and is it so important?If you read patient reviews, you will often understand that most men try to avoid many stages of diagnosis, the motivations are very different.The price of such indifference is your own health!It is important to remember that prostatitis is curable only if it is “detected” in time and the diagnosis is made accurately, determining the form of the disease and its cause.
How to stay healthy forever
So, a man understands that he suffers from 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 took to develop.Moreover, if the pathological process proceeded practically without the attention of the man, the treatment of prostatitis will take place with his direct participation.Is acute or chronic prostatitis curable?Yes, if you follow all the doctor's recommendations, in advanced cases of chronic form, treatment can achieve stable remission.
The stages of treatment for prostatitis will directly depend on what the doctor ultimately finds during the examination, the type of disease, the age and physical characteristics of the patient.
The treatment regimen is always strictly individual, but the following points may be present in it:
- Antibacterial therapy.
- Physiotherapeutic methods.
- Phytotherapy.
- Prescription of immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The price of each stage of treatment is different and depends on the total cost of prescribed drugs, additional methods and the clinic.Preventive measures after treatment have an important justification: they prevent the disease from returning.Prevention is in direct and close contact with treatment;the basics of prevention are as important as compliance with all the doctor's requirements during treatment.
Treatment of acute form
The period of exacerbation requires taking antibiotics, which are taken as a course of treatment.In the presence of Chlamydia infection, cephalosporins are indicated.
The duration of the course of use is important;on average, antibiotics are taken for at least 3-4 weeks to prevent relapses of the disease.Sometimes the doctor continues treatment for longer, combining antibiotics with painkillers to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- Bacterial culture is necessary to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of medications are taken into account.
- They take into account the previous treatment, when it took place, the means used and the result.
The need for additional treatment methods is determined by the attending physician;it should be remembered that in acute forms of prostatitis, massage is contraindicated, as it provokes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of chronic form
It is important to remember that it is in principle impossible to quickly get rid of chronicity, the disease has developed over the years and even doctors in their field cannot destroy it in a few weeks;you do not need to take the word of those who cured the disease in 2-3 days.Treatment is aimed at stopping the source of infection, restoring immunity in men and the functioning of the prostate, as well as preventing exacerbations - this takes time.
The duration of antibiotic therapy lasts from 4 to 12 weeks;if treatment is weak, treatment is continued.Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete excision of the prostate is proposed.
No bacteria or symptoms
A characteristic difference between the therapies is the absence of antibiotics;without the presence of pathogenic microflora, they are simply not needed.But sometimes experts prescribe short-term drug treatment, 2 to 4 weeks.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening the patient's immune system.
Diet and lifestyle changes also form the basis of treatment for nonbacterial prostatitis;baths and alpha-blockers are indicated.
Prostatitis without symptoms is difficult to identify;the PSA method is used for diagnosis, followed by a 2-week course of antibiotics as treatment.After that, symptomatic treatment is selected individually.
In general, treatment of any type of prostatitis is a long-term phenomenon and not always pleasant for the patient.In addition to physical discomfort, a man suffers psychologically, because the most precious part of his body is affected: the intimate part.Reviews of those who have cured the disease show that only strict adherence to the doctor's instructions, combined with changes in diet and lifestyle, bears fruit.The price of a frivolous attitude to treatment is very high - a man not only loses his health, but his whole life, his character and relationships with others change.To avoid this, it is necessary to monitor the health of the prostate and eliminate the causes of the development of the disease.