Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate gland, located directly under the bladder and a smaller part of the genital organs.

Every 7 men over 35 years old suffer from prostatitis and with each goal the risk of developing an inflammatory process in the prostate under the influence of external and internal factors increases.

Reasons

Inflammation of the prostate gland can develop for various reasons, doctors identify the main ones:

1. Violation of blood microcirculation in the pelvic organs: this leads to stagnant processes and contributes to an increase in the size of the prostate gland.Obesity and a sedentary, sedentary lifestyle contribute to stagnant processes.
2. If bacteria, viruses or protozoa enter the prostate tissue against the background of an acute or chronic inflammatory process occurring in other organs of the body, diseases such as tonsillitis, gonorrhea, urethritis, cystitis, influenza and pyelonephritis can provoke prostatitis.Infectious agents can enter the prostate through the blood and lymphatic flow if there is an infection in distant areas and organs.
3. Wounds and bruises sustained on the soft tissues of the abdomen, perineum and external genitalia - this leads to swelling and poor circulation in the area of injury;
4. Hypothermia of the body.
5. Chronic constipation.
6. Hormonal disorders.
7. A stormy or, conversely, absent sex life is harmful, both frequent sexual intercourse (more than once a day) and rare intimate intercourse (less than once a week), as this leads to depletion of the gonads or congestion of the prostate.

Symptoms of prostatitis

There are acute and chronic forms of the disease.

Acute prostatitis is characterized by a sudden onset in a context of general well-being, which is clinically accompanied by the following symptoms:

• chills and weakness;
• general malaise;
• increased irritability and nervousness;
• increased body temperature (not exceeding 37.5 degrees);
• pulling or cutting pain in the lower abdomen and perineum;
• frequent need to urinate with persistent sensation of incomplete emptying of the bladder;
• rectal pain and difficulty with bowel movements.

In the absence of diagnosis and timely treatment, acute prostatitis can be complicated by a purulent process and the release of pus from the urethra during urination.

Signs of chronic prostatitis

When the disease becomes chronic, the clinical signs of prostatitis regress and the patient believes that healing has occurred.Characteristic signs of a chronic inflammatory process in the prostate gland are a burning sensation along the urethra with irradiation to the perineum, which can intensify with urination and defecation.Gradually the disease progresses and causes impotence.Chronic prostatitis involves periods of remission and exacerbation, but even during moments of exacerbation the symptoms will disappear, not as pronounced as in the acute form.Clinically the following symptoms appear:

• difficulty with erection;
• inability to complete sexual intercourse with ejaculation;
• decreased sexual desire;
• mucus discharge from the urethra mixed with white flakes;
• sensation of incomplete emptying of the bladder;
• annoying pain in the lumbar region, pubis and groin;
• weak urine flow - this is observed due to narrowing of the lumen of the urethra against the background of its compression by the enlarged prostate.

A chronic, slow inflammatory process in the urethra irritates the nerve endings of the pelvis and causes a constant need to urinate, especially at night.Many men are ashamed to consult a doctor for such a delicate problem, which increases the risk of developing such serious complications as complete erectile dysfunction, infertility and even prostate cancer.

Furthermore, from the source of chronic infection in the prostate, pathogenic microorganisms enter the kidneys through the blood and lymph, causing acute inflammation, urinary retention and increasing the risk of developing kidney failure.

The constant accumulation of urine in the bladder and urethra creates favorable conditions for the formation of salt crystals and therefore stones: very often prostatitis in men occurs in parallel with urolithiasis.

Diagnostic methods

A urologist is involved in the diagnosis, treatment and prevention of prostatitis.To make a diagnosis, determine the form and cause of the inflammatory process in the prostate gland, the patient is prescribed a series of tests:

• palpation of the prostate - carried out through the rectum and allows you to detect an increase in size, pain, secretion of pus or mucus after palpation;
• a spot of discharge from the urethra: the resulting material is sent for study to the laboratory;
• urinalysis - general, etc.;
• Ultrasound of the pelvic organs and prostate.

If the spread of the pathological process to the bladder is suspected, the patient additionally undergoes cystoscopy - examination of the walls of the bladder using a flexible device equipped with an optical system at the end.

When diagnosing prostatitis, it is very important to differentiate the pathological process from prostatic adenoma and other urological diseases with a similar clinical course.

Treatment

The treatment of acute and chronic forms of prostatitis is different, so patients are strongly advised not to self-medicate.

The acute non-bacterial form of prostatitis is treated comprehensively with the use of herbal remedies and anti-inflammatory drugs.

Treatment of acute bacterial prostatitis

The principles of treatment of acute forms of bacterial prostatitis directly depend on how pronounced the symptoms of the disease are.

A distinctive feature of bacterial prostatitis is the acute onset and rapidly increasing signs of intoxication of the body: nausea, vomiting, headache, high body temperature.The process of emptying the bladder is accompanied by excruciating pain in the lower abdomen and perineum, radiating to the lower back.Very often a purulent process occurs and an abscess develops in the prostate.

Treatment of acute bacterial prostatitis is carried out in a hospital setting, as the patient's condition can be extremely serious.The therapy consists of an integrated approach:

• the patient must remain in bed;
• antibiotics are prescribed: macrolides, fluoroquinolones, cephalosporins;
• drugs that improve blood microcirculation in the pelvic organs are selected.They ensure the outflow of lymph and venous blood, reducing the severity of swelling and inflammation of the prostate;
• Drugs from the group of non-steroidal anti-inflammatory drugs are indicated orally.These drugs not only reduce the inflammatory process, but also eliminate pain;
• analgesics: you can take tablets orally or insert rectal suppositories into the rectum;
• To eliminate intoxication of the body, a physiological solution of sodium with glucose is prescribed intravenously.

Important!Prostate massage is strictly prohibited as there is a high risk of developing sepsis.

Surgical treatment

Surgery for prostatitis is necessary only if the patient develops acute urinary retention and is unable to empty the bladder.Surgery cannot be avoided if a prostate abscess occurs.

The course of treatment for prostatitis lasts 14 days, after which the patient again undergoes a comprehensive examination to evaluate the effectiveness of therapy.If necessary, the course of treatment is extended and adjusted.

Treatment of the chronic form

Treatment of chronic prostatitis differs and largely depends on the stage of the pathological process.In case of exacerbation of the inflammatory process, therapy is carried out in the same way as for acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. course of taking nonsteroidal anti-inflammatory drugs.The drugs are prescribed 2 times a day for at least 3 days, sometimes up to 5 days.
2. Drugs that help improve venous and lymphatic outflow.
3. Immunomodulators.
4. Antidepressants and sedatives help to normalize sleep and eliminate irritability.
5. Multivitamin complexes rich in zinc, selenium, B vitamins.

In the remission phase of the inflammatory process of the prostate, physiotherapy treatment is indicated for the patient:

• prostate massage;
• ultrasound;
• electrophoresis;
• magnetotherapy;
• microwave hyperthermia.

Surgical treatment of chronic prostatitis

With advanced chronic prostatitis, the patient sometimes requires surgery.This can be done in two ways:

• transurethral resection;
• prostatectomy.

Transurethral resection

This method of surgical treatment is a minimally invasive procedure, although it is performed under general anesthesia.During the procedure, a resectoscope is inserted under the urethra, through which pulses of electric current are applied.These electrical pulses act like an electric knife and partially remove the prostate tissue.A huge advantage of this method of intervention is the absence of blood loss, since the electric waves not only remove the modified prostate tissue, but also immediately heal the blood vessels, preventing bleeding.

Transurethral resection significantly alleviates the patient's condition: after the operation, urination is restored, the man no longer has a burning sensation in the perineum and no longer jumps up to go to the toilet at night.Erectile function and normal ejaculation are also restored.The entire operating process is monitored by a doctor on the monitor screen, so the risk of complications during or immediately after surgery is minimal.

Prostatectomy

Prostatectomy is a major abdominal surgery and always carries risks for the patient.During the operation, the doctor removes all or most of the prostate gland.The recovery period is 4-6 weeks, the risk of developing postoperative complications is high, but sometimes this method of surgical intervention is the only way to alleviate the patient's condition and eliminate the consequences of severe prostatitis.

Other treatments for chronic prostatitis

Other methods of treating chronic prostatitis include:

1. hirudotherapy - or treatment with leeches.Medical leeches are placed on the area of inflammation, which during their action secrete a substance together with saliva that puts the blood back in order, eliminates congestion and quickly stops the inflammatory process.Leeches are used only special, medical, individual for each individual patient.After the procedure, the doctor immerses the used leech in a disinfectant solution in which it dies.It is optimal to undergo at least 5 cycles of hirudotherapy.
2. Cryodestruction: liquid nitrogen is used.This method of treatment is indicated for patients who do not respond well to drug therapy and for some reason surgery is contraindicated for them.
3. Microwave therapy is a special method: electromagnetic waves are applied to the prostate area.Already after 1 procedure, tissue swelling is reduced, blood circulation is normalized and congestion is eliminated.After a course of electromagnetic therapy, the patient's urination and erectile function are completely restored.
4. Treatment with ultrasound waves allows you to quickly stop the inflammatory process that occurs in the remission phase;during the period of exacerbation, ultrasound therapy is not performed.To enhance the therapeutic effect, drugs can also be used which, under the influence of ultrasound, penetrate directly into the prostate tissue.
5. Urethral stent - the essence of the procedure is to install a special stent in the urethra, which expands the lumen of the urethra and promotes normal outflow of urine.Despite the effectiveness of the procedure, the urethral stent only eliminates the clinical symptoms of prostatitis, but does not relieve the patient from the chronic inflammatory process.

Consequences and complications

In the absence of qualified therapy, prostatitis rapidly progresses, becomes chronic and threatens men's health with its serious complications, including:

• urolithiasis;
• pyelonephritis;
• development of abscesses;
• spread of the inflammatory process to the testicles and spermatic cords, leading to infertility;
• erectile dysfunction and impotence;
• necrotic changes in prostatic tissue.

Sometimes prostatitis and chronic congestive processes for a long time give impetus to the degeneration of the disease into an adenoma and then into prostate cancer.