According to the BME, prostatitis is an inflammatory process that occurs in men in the prostate gland with damage to the parenchyma and interstitium.Treating prostatitis in men is a lengthy and complex undertaking, mostly due to complete ignorance of the disease from the very beginning.What is prostatitis, what are the causes and first signs, what you need to know about “diagnosis” and what modern methods of treating prostatitis exist.Everything men need to know about prostatitis can be found in this review article.
Ab ovo – from the egg
We are not talking about the satires of Horace here;In this case, we are interested in everything related to prostatitis, from the beginning to the last “squeak” of treatment.Symptoms of prostatitis appear in men during the period of active sexual activity between the ages of 25 and 45.In the thematic video you can study in detail everything related to the basics of the disease, its causes and symptoms, as well as features of diagnosis and treatment.
The reasons for the development of prostatitis are varied.In prostatitis, infectious factors play the largest role in the development of the disease:
- Acute form.The coccal flora acts as a provoking cause.
- 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, mycoplasma, viruses, fungi, chlamydia, etc. are detected during the diagnosis.
It is noteworthy that chronic prostatitis caused by a pathogen that has penetrated the prostate can subsequently have an abacterial character without the involvement 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 lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
Often you 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 No. 1. Brief characteristics of pathology
| Categories for prostatitis | Acute infection | The presence of a pathogen in the prostate secretion or in the 3rd part of the urine | Levels (increase) of leukocytes in urine or secretion |
| 1 cat.Acute bacterial | + | + | + |
| 2 Cat. Chronic bacteria | — | + | Unsure (yes or not) |
| 3 a.Chronic pelvic pain syndrome of an inflammatory nature, not bacterial | — | — | + |
| 3 b.Prostatodynia, non-inflammatory pelvic pain syndrome | — | — | — |
| 4 Cat. Asymptomatic inflammatory process | — | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied in more detail;In most cases, family bacteria are the cause of the disease.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as the cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently not fully proven.Symptoms of prostatitis in men with signs of weakened immunity, especially with HIV, may include yeast fungi (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, the gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis and particularly frequently caused its abscess form.
The causes of the abacterial form of prostatitis have not yet been fully understood, although urologists have thoroughly learned a list of possible pathogenetic (causing prostatitis) factors that play an important role in the occurrence of inflammation in the prostate without the presence of microorganisms.The causes of prostatitis, which is not of a bacterial nature, are congestion processes in the pelvis, poor blood circulation, intraprostatic reflux of urine and an autoimmune aseptic inflammatory process.
Sick or not – that is the question
What does a man with prostatitis look like?For a person who is far from medicine and does not understand the problems of urology in particular, the external male appearance of an individual does not differ from the mass of others.And only an experienced specialist, based on the patient's first complaints, will understand where the cause of the problem lies and what ways need to be taken to eliminate it.
The symptoms of prostatitis are often described in a few sentences, highlighting the most striking moments, and this is a cruel joke for a man.By relying on such imprecise definitions, he ignores really important signals and believes that the disease does not exist, although in fact the clinical picture depends on the nature of the 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 to the sacrum, frequent nocturnal urges.
- Follicular prostatitis.Difficulty and frequent urination, sometimes with delay.Pain when peeing, which increases at the end of urination and bowel movements.Mild fever.
- Parenchymal prostatitis.Symptoms of pronounced dysuria appear, often acute shortness of breath, pain during natural recovery, general intoxication with a temperature of up to 40 ° C.
In prostatitis with abscess formation, the symptoms are more pronounced and there is a possibility of the abscess opening into the rectum or into the prostatic part of the urethra.With such a breakthrough, the symptoms subside.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 pronounced fluctuations.The man's condition worsens dramatically.
Comprehensive treatment of prostatitis cannot be started without a thorough examination of the man, diagnosis and analysis of symptoms, which can give a direct indication of the nature of the disease.
In general, it is customary to distinguish between acute and chronic prostatitis;You can find out in detail what symptoms relate to one form or another from a thematic video on the Internet.Let's consider this problem 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.
As for symptoms, the chronic form of prostatitis is the most interesting because it has many variations in symptoms.In general, effective treatment for prostatitis depends on the type of prostatitis.
The following points can be distinguished in the chronization stage:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis proceeds with deleted symptoms.
- A characteristic symptom of chronicity is scanty discharge from the urethra during bowel movements.
- The first symptoms are usually not pronounced;The pathological process itself develops over the years.It is preceded by prostatosis (blockage of capillaries), which gradually turns into an abacterial form of inflammation of the prostate gland.
- A 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 action of ureaplasma, trichomonas, chlamydia and gonococci.
How is a man with prostatitis in the chronic stage?Reviews of patients show that most often initially, slight pain is felt in the perineal area and scanty discharge, to which most men simply do not pay attention.In the next stage, the following symptoms appear: burning in the urethra, sexual dysfunction, dysuria, general malaise.Frequent interruptions in sex lead to depression in men, they become irritable or depressed.
It is important to understand that all of these signs do not necessarily occur in every single case of chronicity.This makes diagnosis difficult at an early stage of the disease.Additionally, the symptoms tend to change location, which is even more misleading.
Long-term syndromes
What can you expect from chronic prostatitis?If there is no timely diagnosis and treatment, nothing good will happen, as any specialist will confirm.This type of prostatitis is characterized by 3 syndromes:
pain
The prostate itself does not hurt, but many nerve endings pass through it and are located nearby, which inevitably become involved in the inflammatory process.The pain can vary in intensity - from mild pain that causes discomfort to severe pain that prevents you from falling asleep peacefully.The pain radiates to all surrounding areas (scrotum, sacrum, perineum);Pain due to prostatitis must be distinguished from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a problem in the urinary system, but the cause of this is clarified during diagnosis.Due to the increased volume of the prostate, the urethra is inevitably compressed, the flow of urine is disturbed, frequent trips to the toilet and the feeling of incomplete emptying of the bladder occur.In advanced prostatitis, there is compensatory hypertrophy of the muscular layer of the bladder and ureters.At this point, the symptoms of dysuria weaken but return in an increased form.
Sex without pleasure
An intimate life that is in decline - these are the first symptoms that men notice, and it is they, reviews show, that force them to see a doctor.Frequent nightly erections, orgasms in an extinguished 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 occurs.
The extent of sexual dysfunction is not the same among men;Some begin intercourse and somehow end it, putting aside the characteristic warning signs.For some, even the initial weak reaction of the penis to an enchanting stimulus leads to a collapse and the onset of terrible experiences, leading to prolonged depression.The specter of impotence is difficult for patients with prostate problems;Professionals and relatives almost always note that prostatitis worsens character.
To learn more about the disease, you can watch a thematic video in which experts explain many of the nuances of pathology.
What should be written on the card?
Which entry appears in the patient's medical record and which final diagnosis is made depends on a number of primary studies, starting with the patient's arrival at the urologist and his complaints (anamnesis) to the very final stage of diagnostic measures.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:
- Story.The doctor will ask in detail about all complaints and symptoms, conditions of the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + secretion collection).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does diagnostics do and is it so important?Reading the reviews of patients, one can often understand that most men try to avoid many stages of diagnosis, the motivations are very different.The price of this indifference is your own health!It is important to remember that prostatitis is curable only if it is “caught” in a timely manner and the diagnosis is made accurately, determining the form of the disease and its cause.
How to get healthy forever
So a man understands that he suffers from prostatitis.What awaits him in the future and is it possible to regain the lost health?It is important to understand that it takes twice as long to get rid of prostatitis than it took for it to develop.In addition, if the pathological process proceeded practically without the man's attention, the treatment of prostatitis occurs with his direct participation.Is acute or chronic prostatitis curable?Yes, if you follow all the doctor's recommendations, in advanced cases of the chronic form, treatment can achieve stable remission.
The stages of treatment of prostatitis directly depend on what the doctor ultimately found out during the examination, on the type of disease, age and physical characteristics of the patient.
The treatment regimen is always strictly individual, but the following points may be included in it:
- Antibacterial therapy.
- Physiotherapeutic methods.
- Phytotherapy.
- Prescription of immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The price of each level of treatment is different and depends on the total cost of the prescribed medications, additional methods and the clinic.Preventative measures following treatment have an important reason: they prevent the disease from recurring.Prevention is directly and closely related to treatment;The basics of prevention are just as important as compliance with all medical instructions during the course of therapy.
Treatment of the acute form
The period of exacerbation requires the use of antibiotics, which are taken in one course.If a chlamydial infection is present, cephalosporin medications are indicated.
The duration of use is important;On average, antibiotics are taken for at least 3-4 weeks to prevent the disease from recurring.Sometimes the doctor continues treatment for a longer period of time, combining antibiotics with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- To determine the sensitivity of microorganisms to the drug, bacterial culture is required.
- Side effects and contraindications of medications are taken into account.
- They take into account the previous course of treatment, the time at which it was carried out, the means used and the result.
The need for additional treatment methods is determined by the attending physician;It should be noted 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 the chronic form
It is important to remember that it is fundamentally impossible to quickly eliminate chronicity, since 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 rely on 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 prostate function, as well as preventing exacerbations - this takes time.
Antibiotic therapy lasts 4 to 12 weeks;if the treatment is minor, the medication is continued.Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete removal of the prostate is planned.
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.However, sometimes experts prescribe a short course of medication of 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 for treating nonbacterial prostatitis;Baths and alpha blockers are indicated.
Prostatitis without symptoms is difficult to recognize;The PSA method is used for diagnosis, followed by a two-week course of antibiotics as treatment.The symptomatic treatment is then 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 the physical inconvenience, a man also suffers psychologically because his most valuable part of the body is affected - the intimate area.Reviews of people who have cured the disease show that only strict adherence to the doctor's instructions, coupled 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, his whole life, character and relationships with others change.To prevent this, it is necessary to monitor the health of the prostate and eliminate the causes of the disease.