According to the 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 undertaking, most often due to complete ignorance of the disease from the beginning.What is prostatitis, what are its causes and first signs, what you need to know on the topic of "diagnosis" and what modern methods exist for treating prostatitis.Everything men need to know about prostatitis is contained in this review article.
Ab ovo – from the egg
We are not talking about Horace's satires;in this case we are interested in everything related to prostatitis, from the beginning to the last "squeak" of the treatment.Symptoms of prostatitis occur in men during the period of active sexual activity, from 25 to 45 years.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.
The reasons for the development of prostatitis are broad.In prostatitis, infectious factors play the major role in the development of the disease:
- Acute form.The coccal flora acts as provoking causes.
- Chronic form.The reasons for its development are broader;The main factors of such prostatitis in men are: gonococci, trichomonas, Gr+ and Gr bacteria, mycobacterium tuberculosis.In rare cases, the diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
Interestingly, chronic prostatitis, caused by a pathogen that has penetrated the prostate gland, can subsequently have an abacterial character without the participation of a pathogenic factor.The acute form is often caused by external causes: hypothermia, trauma to the urethra or damage to the bladder following endoscopic examinations or various manipulations, physical inactivity and, consequently, reduced blood and lymphatic circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
We often hear about only one type of prostatitis: the infectious one, but according to the WHO, bacterial prostatitis represents 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 the 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 cats.Chronic bacterial | — | + | Uncertain (yes or no) |
| 3 a.m.Chronic pelvic pain syndrome of an inflammatory, non-bacterial nature | — | — | + |
| 3 b.Prostatodynia, non-inflammatory pelvic pain syndrome | — | — | — |
| 4 cats.Asymptomatic inflammatory process | — | Uncertain (yes or no) | Uncertain (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 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 weakened immunity, especially with HIV, the cause of the disease may be yeast fungi (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played a significant 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 thoroughly learned a list of possible pathogenetic factors (provokers of prostatitis) that play an important role in the onset of inflammation in the prostate without the presence of microorganisms.Therefore, the causes of prostatitis, which is non-bacterial in nature, are congestive processes in the pelvis, poor 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 far from medicine, and especially not understanding the problems of urology, the external male 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 lies and what ways will 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 plays a cruel joke on a man.Relying on such imprecise definitions, he ignores truly important signals, believing that the disease does not exist, although in reality the clinical picture depends on the nature of the morphological changes of 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 impulses.
- Follicular prostatitis.Difficulty and frequent urination, sometimes with delay.Pain when peeing, which intensifies at the end of the process of urination and defecation.Mild fever.
- Parenchymal prostatitis.There are symptoms of pronounced dysuria, often acute difficulty breathing, pain during natural recovery, general intoxication with a temperature up to 40 C.
In prostatitis with abscess formation the symptoms are more evident with possible opening of the abscess in the rectum or in the prostatic part of the urethra.With such a turn, the symptoms disappear.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 fluctuation.The man's condition worsens drastically.
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 usual to distinguish between acute and chronic prostatitis;in a thematic video on the Internet you can find out in detail which symptoms refer to 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 chronic form of prostatitis, as 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 phase the following points can be distinguished:
- Chronic prostatitis rarely results from an acute process.
- Primary prostatitis passes with erased symptoms.
- A characteristic symptom of chronicity is scanty secretion from the urethra during defecation.
- The first symptoms, as a rule, are not pronounced;the pathological process itself develops over the years.It is preceded by prostatosis (congestion of capillaries), which gradually turns into a non-bacterial 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 feel with prostatitis in the chronic phase?Patient reviews show that very often, at first, mild pain in the perineum and scanty secretions are felt, which most men simply 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 misfires 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 each specific case of chronicity, this complicates the diagnosis at an early stage of the disease, moreover the symptoms tend to change places, which is even more misleading.
Long-term syndromes
What can you 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 many nerve endings pass through it and are located nearby, which inevitably become involved in the inflammatory process.The pain can be of varying intensity: from slightly painful, which creates discomfort, to severe, which prevents you from falling asleep peacefully.The irradiation of pain occurs in all nearby areas (scrotum, sacrum, perineum);the pain caused by prostatitis must be differentiated from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a problem with the urinary system, but its cause is clarified during the diagnosis.The enlargement of the prostate inevitably compresses the urethra and the flow of urine is interrupted, followed by the development of a frequent need to go to the bathroom and a sensation of incomplete emptying of the bladder.With advanced prostatitis, compensatory hypertrophy of the muscle layer of the bladder and ureters occurs.At this time, the symptoms of dysuria weaken, but return again 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 night erections, orgasm in canceled form, poor erection and rapid ejaculation, pain during it - this is what especially worries the stronger sex.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 initiate sexual intercourse and somehow complete it, ignoring the characteristic warning signs.For some, even the initial weak reaction of the penis to a fascinating stimulus becomes a collapse and the beginning of terrible experiences that turn into a prolonged depression.The specter of impotence is difficult for patients with prostate problems;specialists and relatives almost always note that prostatitis deteriorates the 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 paper
Which entry will appear in the patient's medical record and which final diagnosis will be established depends on a series of primary studies, starting from the patient's arrival at the urologist and his complaints (history) to the 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 diagnostics consists of:
- History.The doctor will ask in detail all the complaints and symptoms, prerequisites for the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + secretion sampling).
- Ultrasound of the prostate.
- Spermograms.
- 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 motivations are very different.The price of such indifference is your health!It is important to remember that prostatitis is treatable only if it is “caught” in time and the diagnosis is made accurately, determining the form of the disease and its cause.
How to become healthy forever
So, a man understands that he has prostatitis, what awaits him in the future and is it possible to regain his lost health?It is important to understand that getting rid of prostatitis will take 2 times longer than it takes to develop.Moreover, if the pathological process proceeds practically without the attention of man, the treatment of prostatitis will occur 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 the treatment can achieve a stable remission.
The stages of treatment of prostatitis directly depend on what the doctor discovered 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 following treatment have an important rationale: they prevent the disease from returning.Prevention has direct and close contact with treatment;the basics of prevention are as important as compliance with all doctor's prescriptions during the course of therapy.
Treatment of the acute form
The period of exacerbation requires taking antibiotics, which are taken in one course.In the presence of chlamydia infection, cephalosporin-based drugs are indicated.
The duration of the usage cycle is significant;on average, antibiotics are taken for at least 3-4 weeks to prevent relapse of the disease.Sometimes the doctor continues the treatment for a longer period, combining antibiotics and analgesics to relieve the pain.
Treatment with antibiotics is carried out taking into account the following rules:
- A bacterial culture is required to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of drugs are taken into consideration.
- They take into account the previous course of treatment, when it occurred, what means were 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 causes the spread of a bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is important to remember that in principle it is 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 couple of weeks;it is not necessary to take the word of those who cured the disease in 2-3 days.Treatment is aimed at stopping the source of the infection, restoring immunity in men and the functioning of the prostate gland, as well as preventing exacerbations - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks;if the treatment is low, the drug is continued further.Very often antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgery with partial or complete excision of the prostate gland is provided.
No bacteria or symptoms
A characteristic difference between therapy is the absence of antibiotics;without the presence of pathogenic microflora, they are simply not needed.But sometimes experts prescribe a short course of drugs lasting 2-4 weeks.
The treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening of the patient's immune system.
Diet and lifestyle changes also form the basis of treatment for nonbacterial prostatitis;baths and alpha-blockers are indicated.
Asymptomatic prostatitis is difficult to identify;the PSA method is used for diagnosis, followed by a 2-week course of antibiotics as treatment.Subsequently, symptomatic treatment is selected individually.
In general, the 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 his most precious part of the body is affected: the intimate part.Reviews of those who have treated the disease show that only strict compliance with the doctor's instructions, along with changes in diet and lifestyle, bears fruit.The price of a frivolous attitude to treatment is very high: a man loses not only his health, his whole life, character and relationships with others change.To avoid this, it is necessary to monitor the health of the prostate gland and eliminate the causes of the development of the disease.