Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate, located directly under the bladder and in a small part of the genitals.

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

Reasons

Prostate inflammation can develop for several 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, flu and pyelonephritis can provoke prostatitis.Infectious agents can enter the prostate through the blood and lymphatic flow if there is infection in distant areas and organs.
3. Injuries and bruises received in 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 sex (more than once a day) and rare intimate relationships (less than once a week), as it leads to depletion of the gonads or congestion of the prostate gland.

Prostatitis symptoms

There are acute and chronic forms of the disease.

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

• chills and weakness;
• general malaise;
• increased irritability and nervousness;
• increased body temperature (no more than 37.5 degrees);
• pulling or cutting pain in the lower abdomen and perineum;
• frequent urge to urinate with persistent sensation of incomplete emptying of the bladder;
• pain in the rectum and difficulty having a bowel movement.

In the absence of timely diagnosis and 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 decrease and the patient feels that recovery has occurred.The characteristic signs of a chronic inflammatory process in the prostate are a burning sensation along the urethra radiating 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 be dull, not as pronounced as in the acute form.The following symptoms appear clinically:

• erection difficulties;
• inability to complete sexual intercourse with ejaculation;
• decreased sexual desire;
• mucous discharge from the urethra mixed with white flakes;
• feeling of incomplete emptying of the bladder;
• dull pain in the lower back, 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 slow, chronic inflammatory process in the urethra irritates the nerve endings in the pelvis and causes a constant urge to urinate, especially at night.Many men are embarrassed to consult a doctor with such a delicate problem, which increases the risk of developing serious complications such 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 then stones - 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, 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;
• smear of secretions from the urethra - the resulting material is sent for study to the laboratory;
• urine analysis - general, etc .;
• Ultrasound of the pelvic organs and prostate.

If there is a suspicion of the spread of the pathological process to the bladder, the patient is additionally subjected to 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 prostate adenoma and other urological diseases with a similar clinical course.

Treatment

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 and anti-inflammatory remedies.

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 an acute onset and increasing signs of body intoxication - nausea, vomiting, headache, high body temperature.The process of emptying the bladder is accompanied by cutting pains in the lower abdomen and perineum, which radiate to the lower back.A purulent process often occurs and an abscess develops in the prostate gland.

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

• the patient must remain bedridden;
• antibiotics are prescribed - macrolides, fluoroquinolones, cephalosporins;
• drugs are selected that improve blood microcirculation in the pelvic organs.They ensure the outflow of lymph and venous blood, which reduces the severity of swelling and inflammation in the prostate;
• Medicines from the non-steroidal anti-inflammatory group are indicated orally.These medications not only reduce the inflammatory process, but also eliminate pain;
• pain relievers - you can take tablets orally or insert rectal suppositories into the rectum;
• To eliminate intoxication from the body, a physiological sodium solution 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 there is no way 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 complete examination to assess the effectiveness of the therapy.If necessary, the course of treatment is prolonged 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 in acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. intake of non-steroidal anti-inflammatory medications.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 flow.
3. Immunomodulators.
4. Antidepressants and sedatives help normalize sleep and eliminate irritability.
5. Multivitamin complexes rich in zinc, selenium, B vitamins.

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

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

Surgical treatment of chronic prostatitis

In advanced chronic prostatitis, the patient sometimes requires surgical intervention.This can be done in two ways:

• transurethral resection;
• prostatectomy.

Transurethral resection

This surgical treatment method 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 electrical current are applied.These electrical impulses act like an electric knife and partially remove prostate tissue.A great advantage of this method of intervention is the absence of blood loss, as the electrical waves not only remove the modified prostate tissue, but also immediately treat the blood vessels, preventing bleeding.

Transurethral resection significantly alleviates the patient's condition - after the operation, urination is restored, the man no longer feels a burning sensation in the perineum and does not jump to go to the toilet at night.Erectile function and normal ejaculation are also restored.The entire process of the operation 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 involves risks for the patient.During the operation, the doctor removes all or most of the prostate.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 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 leech treatment.Medical leeches are placed in the area of inflammation, which during their actions secrete a substance with their saliva that orders the blood, eliminates congestion and quickly stops the inflammatory process.Leeches are used only in a special, medical and individual way for each patient.After the procedure, the doctor places the used leech in a disinfectant solution in which it dies.It is ideal to undertake 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.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 ultrasonic 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 additionally 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, urethral stent implantation 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 progresses rapidly, becomes chronic and threatens men's health with its serious complications, including:

• urolithiasis;
• pyelonephritis;
• abscess development;
• 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 congestive processes over a long period drive the degeneration of the disease into adenoma and then into prostate cancer.