According to BME, prostatitis is an inflammatory process in men's prostate gland, which damages the parenchyma and interstitium.Treatment of prostatitis in men is a long and complicated task, in most cases due to complete ignorance at the beginning of the disease.What is prostatitis, what are its causes and first symptoms, what you need to know about the topic of "diagnosis" and the availability of modern methods of treatment of prostatitis.Everything men need to know about prostatitis is in this review article.
Ab ovo - from the egg
It is not about Horace's satires;in this case, we are interested in everything related to prostatitis, from the beginning of treatment to the last "squeal".Symptoms of prostatitis occur in men during active sexual activity, at the age of 25-45.In the thematic video, you can learn in detail everything related to the basics, causes and symptoms of the disease, diagnosis and treatment features.
The reasons for the development of prostatitis are wide.In prostatitis, infectious factors play the biggest role in the development of the disease:
- Sharp shape.Coccal flora act as provoking reasons.
- Chronic form.The reasons for its development are wider;the main factors of such prostatitis in men: gonococci, trichomonas, Gr+ and Gr- bacteria, mycobacterial tuberculosis.In rare cases, mycoplasmas, viruses, fungi, chlamydia, etc. are diagnosed.
Interestingly, chronic prostatitis caused by a pathogen that has penetrated the prostate gland can later become bacterial without the presence of a pathogenic factor.The acute form is often caused 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, disruption of blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You can often hear about only one type of prostatitis - infectious, but according to the 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 the pathogen in the prostate secretion or the 3rd part of the urine | The level (increase) of leukocytes in the urine or excretion. |
| 1 cat.Acute bacterial | + | + | + |
| 2 cats.Chronic bacterial | — | + | Uncertain (yes or no) |
| 3 a.Inflammatory non-bacterial chronic pelvic pain syndrome | — | — | + |
| 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 fully;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.In men with symptoms of weakened immunity, especially with HIV, symptoms of prostatitis may be caused by yeast fungi (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, especially often causing its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have thoroughly studied the list of possible pathogenetic (causing prostatitis) factors that play an important role in the occurrence of inflammation in the prostate gland without the participation of microorganisms.Thus, the causes of non-bacterial prostatitis are congestive processes in the pelvis, poor blood circulation, prostatic reflux of urine and autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man look like with prostatitis?For a person who is far from medicine and especially does not understand the problems of urology, the external male appearance of an individual does not differ from a crowd of others.And only an experienced specialist, based on the first complaints of the patient, will understand where the root of the problem is and what methods are needed to eliminate it.
Symptoms of prostatitis are often described in a few phrases, emphasizing the most surprising points, and this plays a cruel joke on a person.Relying on such imprecise definitions, although in fact the clinical picture depends on the nature of the morphological changes in the prostate gland, believing that the disease does not exist, it ignores really important signals.
The first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in the perineum, radiating to the sacrum, frequent calls at night.
- Follicular prostatitis.Difficulty and frequent urination, sometimes delayed.Pain during urination, which worsens at the end of the urination process, as well as defecation.Low-grade fever.
- Parenchymal prostatitis.There are signs of general intoxication with clear dysuria, often acute respiratory distress, pain during natural recovery, temperature up to 40 C.
With prostatitis with the formation of an abscess, the symptoms are more pronounced with the possible opening of the abscess into the rectum or the prostatic part of the urethra.With such a breakthrough, the symptoms decrease.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 clear undulation.The man's condition worsens sharply.
Complex treatment of prostatitis cannot be started without a comprehensive examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of the disease.
In general, it is customary to distinguish between acute and chronic prostatitis;In the thematic video on the Internet, you can learn in detail what symptoms there are in 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, because there are many variations in its symptoms.In general, the effective treatment of prostatitis depends on the prostatitis, or rather its type.
The following points can be distinguished in the chronicization stage:
- Chronic prostatitis rarely results from an acute process.
- Primary prostatitis passes with erased symptoms.
- A characteristic sign of chronicity is a small amount of discharge from the urethra during defecation.
- The first symptoms, as a rule, are not pronounced;the pathological process itself develops over the years.Before this, prostatosis (clogging of the capillaries) occurs, which gradually turns into a bacterial form of inflammation of the prostate gland.
- The cause of chronic prostatitis is not a specific pathogenic microflora, but the chronic process itself is a complication of the inflammatory process caused by ureaplasma, trichomonas, chlamydia and gonococci.
How does a man with chronic prostatitis feel?Patients' reviews show that at first they feel a small pain in the perineum and a small amount of discharge, 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 disorder.Often mistakes during sex make men depressed, angry or depressed.
It is important to understand that all these symptoms do not necessarily appear in each specific case of chronicity, this is what makes the diagnosis difficult in the early stages of the disease, in addition, the symptoms tend to change places, which is even more wrong.
Long term syndromes
What to expect from chronic prostatitis?In the absence of 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 nearby, which inevitably takes part in the inflammatory process.The pain can be of different intensity - from mild pain, causing discomfort, to severe, preventing you from getting a restful sleep.Radiation of pain occurs in all nearby areas (scrotum, sacrum, perineum);pain from prostatitis should be distinguished from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a problem with the urinary system, but what causes it is clarified during the diagnosis.The increased volume of the prostate inevitably compresses the urethra and disrupts the flow of urine, which is followed by the frequent urge to go to the toilet and the feeling of complete emptying of the bladder.With advanced prostatitis, there is compensatory hypertrophy of the muscle layer of the bladder and ureters.At this time, the symptoms of dysuria weaken, but return again in an intensified form.
Unpleasant sex
Intimate life in decline - these are the first signs that men notice and, as evidenced by the reviews, force them to consult a doctor.Frequent night erections, orgasm in a deleted form, weak erection and rapid ejaculation, pain during this time - this is what bothers 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 initiate intercourse and somehow complete it, ignoring the typical warning signs.For some, even the initial weak response of the penis to an attractive stimulus becomes the beginning of terrible experiences that turn into collapse and long-term depression.For patients with problems with the prostate gland, the dream of impotence is difficult;experts and relatives almost always note that the nature of prostatitis worsens.
To learn more about the disease, you can study the thematic video, where 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 made depends on a number of preliminary studies, starting from the patient's visit to the urologist and complaints (date) to the last stage of diagnostic measures.Exactly what is required depends on the type of prostatitis, its severity, and the patient's consent to specific diagnostic procedures.
In general, the diagnosis consists of the following:
- History.The doctor will discuss all complaints and symptoms, initial conditions of the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + collection of secretions).
- Ultrasound of the prostate gland.
- Spermograms.
- Prostate biopsy (if indicated).
What does the diagnosis give and is it so important?If you read the reviews of patients, 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 own health!It should be remembered that the treatment of prostatitis is possible only with timely "catch" and accurate diagnosis, determination of the form and cause of the disease.
How to be healthy forever
So, a man understands that he has prostatitis, what awaits him in the future and is it possible to restore lost health?It should be understood that it takes 2 times longer to get rid of prostatitis than to develop it.Moreover, if the pathological process proceeds practically without the man's attention, the treatment of prostatitis will take place with his direct participation.Can acute or chronic prostatitis be treated?Yes, if you follow all the doctor's recommendations, treatment in advanced cases of the chronic form can achieve stable remission.
The stages of prostatitis treatment will directly depend on what the doctor found during the examination, the type of disease, the patient's age and physical characteristics.
The treatment regimen is always strictly individual, but it may include the following points:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Determination of immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The cost of each stage of treatment is different and depends on the prescribed drugs, additional methods and the total cost of the clinic.After treatment, preventive measures have an important logic - they prevent the recurrence of the disease.Prevention has a direct and close relationship with treatment;The basics of prevention are as important as following all the doctor's requirements during therapy.
Treatment of the acute form
The period of exacerbation requires taking antibiotics in one course.In case of chlamydia infection, cephalosporin drugs are indicated.
The duration of the course of use is important;On average, antibiotics are taken for at least 3-4 weeks to prevent disease recurrence.Sometimes, the doctor combines antibiotics with analgesics to relieve pain and continue the treatment for a longer time.
Treatment with antibiotics is carried out taking into account the following rules:
- Bacterial culture is required to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of drugs are taken into account.
- They take into account the previous course of treatment, when it happened, what means were used and the result.
The need for additional treatment methods is determined by the attending physician;it should be remembered that massage is contraindicated in acute forms of prostatitis, because it causes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is necessary to remember that in principle it is impossible to get rid of chronicity quickly, the disease has developed over years and even doctors in their field cannot destroy it in a few 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 infection, restoring immunity in men and restoring prostate function, as well as preventing exacerbations - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks;If the treatment is inferior, the drug is continued.Antibacterial drugs are often prescribed together with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete excision of the prostate gland is provided.
No bacteria or symptoms
A characteristic difference between the therapy is the absence of antibiotics;without the presence of pathogenic microflora, they are simply not needed.However, sometimes specialists prescribe a short course of medication for 2-4 weeks.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening of the patient's immune system.
Diet and lifestyle changes are also the mainstay of treatment for non-bacterial 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.After that, symptomatic treatment is selected individually.
In general, the treatment of any prostatitis is a long-term phenomenon and is not always pleasant for the patient.In addition to physical discomfort, a man suffers psychologically, because the most valuable part of his body - the intimate part - is affected.Reviews of those who have cured the disease show that only strict adherence to the doctor's instructions, diet and lifestyle changes bear fruit.The price of a non-serious attitude to treatment is very high - a person not only loses his health, but changes his whole life, character and relationships with others.To prevent this, it is necessary to control the health of the prostate gland and eliminate the causes of the development of the disease.