Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate gland, located immediately below the bladder and a small part of the genitals.

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

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 lymph flow if there is infection in distant areas and organs.
3. Received injuries and bruises of the soft tissues of the abdomen, perineum and external genital organs - this leads to swelling and poor blood circulation in the area of injury;
4. Hypothermia of the body.
5. Chronic constipation.
6. Hormonal disorders.
7. Violent or, on the contrary, a lack of sex life is harmful, both frequent sex (more than once a day) and infrequent intimate relations (less than once a week), because it leads to exhaustion of the gonads or congestion in the prostate.

Symptoms of prostatitis

There is an acute and chronic form of the disease.

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

• chills and weakness;
• general malaise;
• increased irritability and nervousness;
• elevated body temperature (not higher than 37.5 degrees);
• pulling or cutting pain in lower abdomen and perineum;
• frequent urge to urinate with a constant feeling of incomplete emptying of the bladder;
• pain in the rectum and difficulty moving the bowels.

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 disappear and the patient feels that recovery has occurred.Characteristic signs of a chronic inflammatory process in the prostate gland are a burning sensation along the course of the urethra with radiation to the perineum, which may increase during urination and defecation.Gradually the disease progresses and causes impotence.Chronic prostatitis includes periods of remission and exacerbation, but even at times of exacerbation the symptoms will be erased and not as pronounced as in the acute form.The following symptoms are clinically manifested:

• difficulty with erection;
• inability to complete intercourse with ejaculation;
• decreased sexual desire;
• discharge of mucus from the urethra mixed with white scales;
• a feeling of incomplete emptying of the bladder;
• nagging pain in the lumbar region, pubis and groin;
• weak stream of urine - this is observed as a result of 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 in the pelvis and provokes a constant urge to urinate, especially at night.Many men are afraid to consult a doctor with such a delicate problem, which increases the risk of developing such serious complications as complete erectile dysfunction, infertility and even prostate cancer.

In addition, from the focus of chronic infection in the prostate through the blood and lymph, pathogenic microorganisms enter the kidneys, which cause acute inflammation, urinary retention and increase 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 then stones - very often prostatitis in men appears in parallel with urolithiasis.

Diagnostic methods

The urologist deals with the diagnosis, treatment and prevention of prostatitis.In order to make a diagnosis, determine the form and cause of the inflammatory process in the prostate gland, the patient is prescribed a number of tests:

• palpation of the prostate - performed through the rectum and allows you to detect an increase in size, pain, discharge of pus or mucus after palpation;
• smear from discharge from the urethra - the resulting material is sent for examination in the laboratory;
• urine analysis - general, etc.;
• Ultrasound of the pelvic organs and the prostate gland.

If the spread of the pathological process in the bladder is suspected, the patient additionally undergoes a cystoscopy - an 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 distinguish the pathological process from prostate 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 advised not to self-medicate.

The acute non-bacterial form of prostatitis is treated comprehensively with the help of herbal medicines and anti-inflammatory agents.

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 cutting pain in the lower abdomen and perineum, which radiates 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 severe.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 provide outflow of lymph and venous blood, which reduces the severity of swelling and inflammation in the prostate;
• Drugs from the group of nonsteroidal anti-inflammatory drugs are indicated orally.These drugs not only reduce the inflammatory process, but also eliminate pain;
• analgesics - you can take tablets by mouth or insert rectal suppositories into the rectum;
• In order to eliminate the 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 only necessary if the patient develops acute urinary retention and has no way to empty the bladder.Surgery cannot be avoided if a prostate abscess occurs.

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

Treatment of chronic form

The treatment of chronic prostatitis is different 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 in acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. course intake of non-steroidal anti-inflammatory drugs.Medicines are prescribed 2 times a day for at least 3 days, sometimes up to 5 days.
2. Medicines that help improve venous and lymphatic drainage.
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, the patient is indicated for physiotherapy treatment:

• prostate massage;
• ultrasound;
• electrophoresis;
• magnetic therapy;
• microwave hyperthermia.

Surgical treatment of chronic prostatitis

In advanced chronic prostatitis, the patient sometimes needs surgical intervention.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 delivered.These electrical pulses act like an electric knife and partially remove the prostate tissue.A huge advantage of this method of intervention is the lack of blood loss, because the electric waves not only remove the modified tissue of the prostate, 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 does not jump to the toilet at night.Erectile function and normal ejaculation are also restored.The entire operation process is monitored by a doctor on the monitor screen, so the risk of complications during or immediately after the operation is minimal.

Prostatectomy

A prostatectomy is a major abdominal operation and always involves risks for the patient.During the operation, the doctor removes all or most of the prostate gland.The recovery period is 4-6 weeks, there is a high risk of developing postoperative complications, but sometimes this method of surgical intervention is the only way to relieve 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.In the area of inflammation, medical leeches are placed, which during their action release a substance with saliva, which brings the blood into order, removes congestion and quickly stops the inflammatory process.Leeches are used only special, medicinal, individual for each individual patient.After the procedure, the doctor places the used leech in a disinfectant solution in which it dies.It is optimal to undergo at least 5 courses 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.After just 1 procedure, tissue swelling decreases, blood circulation normalizes, and congestion is eliminated.After a course of electromagnetic therapy, the patient's urination and erectile function were completely restored.
4. Treatment with ultrasound waves allows you to quickly stop the inflammatory process that occurs in the remission phase;in the period of exacerbation, ultrasound therapy is not performed.To enhance the therapeutic effect, you can additionally use drugs that penetrate directly into the prostate tissue under the influence of ultrasound.
5. Urethral stenting - the essence of the procedure is to install a special stent in the urethra, which expands the lumen of the urethra and promotes the normal outflow of urine.Despite the effectiveness of the procedure, urethral stenting only eliminates the clinical symptoms of prostatitis, but does not free the patient from the chronic inflammatory process.

Consequences and complications

In the absence of qualified therapy, prostatitis quickly progresses, becomes chronic and threatens a man's health with its severe complications, including:

• urolithiasis;
• pyelonephritis;
• development of an abscess;
• spread of the inflammatory process to the testicles and spermatic cords, which leads to infertility;
• erectile dysfunction and impotence;
• necrotic changes in prostate tissue.

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