What is prostatitis? Early signs and symptoms, as well as treatment of acute and chronic stages

Prostatitis isa purely male disease. It is one of the most common lesions of the genitourinary system and occurs in approximately 80% of men, 4 of them before the age of 40.

The disease is not an isolated process: itexposes nearby organs to trauma and also poisons the entire body.

How does prostatitis develop?

The essence of the process is inflammation of the prostate or prostate gland.

The prostate is located in the pelvis, next to the bottom of the bladder. It is an odd organ that resembles a chestnut. The urethra passes through it. Behind the gland is the rectum and in front of it is the pubis.

The prostate is a fairly elastic organ, because its base is made up of muscle fibers and glandular cells. It consists of 2 lobes connected by an isthmus. This is the main source of urination-related problems. Densified and increasing in size with age, the isthmus exerts pressure on the urethra, disrupting the process of urinary excretion.

Prostateperforms such functions for the body:

Function	Gasoline
Secretory	Produces a secretion that is part of sperm. It dilutes it, sets the required pH level and increases sperm motility.
Engine	The gland's muscle fibers form the urinary sphincter, which helps hold urine.
Barrier	Contains zinc-peptide complex, lysozyme, cellular immunity factors, spermine, which prevent the development of infection in an ascending manner.

Prostatitis develops when an inflammatory process begins in the gland. At the same time, its size increases, compressing the urinary canal. This causes difficulty urinating.

Additionally, the enlarged prostate "intrudes" into the bladder, compressing it. As a result, the evacuation of urine is disrupted, it stagnates, now causing inflammation in the bladder. Long-term stagnation of urinary fluid in its "reservoir" leads to intoxication of the entire organism with the metabolic products included in its composition.

Contributing factors

The main reason for the development of prostatitis isinfection. These can be staphylococci, enterococci, Klebsiella, Pseudomonas aeruginosa and Escherichia coli, Proteus. Most often, prostatitis isa consequence of sexually transmitted diseases: syphilis or gonorrhea, chlamydia, trichomoniasis.

More rarely, the cause of the disease isinfectious processes of other systems: flu, tuberculosis, tonsillitis and others. Bacteria and viruses enter the prostate through lymphatic and blood circulation, as well as through sexual contact. Very often, pathogenic flora is introduced into the gland ascending from the urethra or descending from the bladder with infected urine.

Other factorsthat cause inflammation of the gland include:

• circulatory disorders in the pelvis. This can be caused by a sedentary lifestyle, excess weight and pelvic injuries. A particular risk group is represented by drivers who are constantly in a sitting position and experience vibration and pressure on the perineal area. Reduced blood circulation in the pelvis causes congestion and lack of oxygen in the prostate, which also causes the development of an infection,
• hypothermia,
• Hormonal imbalance,
• problems urinating,
• irregular sexual activity – too "violent" sex life, abstinence, interruption of sexual relations,
• chronic constipation,
• inflammation of the rectum,
• decreased immunity, which makes the body susceptible to infectious agents.

There is an opinion that the risk of developing the disease increases with regular consumption of alcohol and drugs.

Typification and symptoms of the disease

In the modern world, the division of prostatitis into types is carried out according to the classification of the National Institutes of Health of the United States in 1995. Itbased on clinical data, as well as the presence of leukocytes and pathogenic flora in seminal fluid, prostate secretion and urine:

1. Acute bacterial prostatitis.
2. Chronic bacterial prostatitis.
3. CPPS – chronic pelvic pain syndrome or chronic nonbacterial prostatitis.
4. Asymptomatic prostatitis.

Acute prostatitisis contagious in nature. There are several steps:

• catarrhalAccompanied by frequent and painful urination. The pain radiates towards the sacrum and perineum,
• follicular.The intensity of the pain increases. It also appears during defecation. Urination becomes difficult - urine comes out in a thin stream or drops. Hyperthermia up to 38°,
• parenchymatous.Characterized by acute urinary retention and stool problems. Severe pain in the perineum, lower back and above the pubis. Body temperature rises to 38-40°. Intoxication of the body develops, the symptoms of which are general weakness, nausea and increased heart rate.

During a digital examination by a urologist, an enlarged and dense prostate is palpated, warm and painful to the touch. A large number of leukocytes and bacteria are detected in urine.

Chronic prostatitiscan develop as a result of an acute illness or as a separate disease. The diagnosis is made if the process lasts 3 months or more.

Chronic prostatitis manifests itself by 3 main syndromes:

• painful. Interestingly, the prostate itself does not contain pain receptors. Pain appears when the inflammatory process grabs the nerve fibers of the small pelvis, in which there are quite a few of them. It's of a different nature. It can be insignificant or sharp and loud, disturbing even at night, calming down and starting again. It is located in the sacrum, scrotum, lower back and perineum.
• dysuric.The urge to urinate becomes more frequent. It becomes sluggish and there is a feeling of a heavy and not completely emptied bladder. Then the process may improve due to a compensatory increase in the bladder muscles, but soon resumes. A discharge appears from the urethra during bowel movements.
• sexual disorders– an increase in nocturnal erections or a decrease in them, blurred orgasm, pain during ejaculation and its acceleration. Worsening of sexual disorders, which ultimately lead to impotence. There is a concept of psychogenic dyspotence, when a man convinces himself that in his state violations in the intimate sphere are inevitable. And they are actually growing. With the development of sexual dysfunction, a man's mood also changes: he becomes irritable and depressed.

Often, the chronic form of prostatitis becomes a manifestation of hidden sexually transmitted infections.

Diagnosis of CPPSis placed if clinical manifestations of prostatitis are present, but the pathogens of the disease are not detected in biological fluids (urine, ejaculate and prostatic secretions). Leukocytes are determined at the same time.

The main diagnostic criterion is pain that does not disappear within 3 months.

Chronic pelvic pain syndrome is divided into 2 categories: inflammatory and non-inflammatory.

inflammatory CPPSdetermined when a large number of leukocytes are found in biological fluids. Bacteria are not detected.

Non-inflammatory CPPScharacterized by the absence of leukocytes and pathogenic flora in biological fluids.

In both cases, the symptoms of prostatitis persist.

Asymptomatic formThe disease is characterized by the absence of signs of inflammation of the prostate. It is discovered accidentally during histology of prostate tissue if the patient has been prescribed a prostate biopsy. A similar procedure is prescribed, for example, when PSA levels increase.

The disease, whatever its type (except the asymptomatic form), manifests itself, first of all, urinary disorders:

• pain when urinating,
• weak stream or trickle of urine,
• sensation of bladder that is not completely empty.

If such symptoms appear, do not delay in consulting a urologist. This will help stop the process at its first stage.

How to recognize the disease

The main criterion for making a diagnosis is the clinical picture and the patient's complaints.

But to finally confirm it,it is necessary to undergo a series of tests and examinations:

1. Examination by a urologist.The doctor should perform a rectal examination of the prostate. He passed the finger into the rectum. It is advisable to have a bowel movement before the examination. By manipulation, the shape and size of the gland, as well as its consistency, are determined. The procedure helps determine the presence of tumors and inflammation in the prostate. The digital examination collects prostate secretions.
2. Urine analysis.Two portions are examined: urine collected at the beginning of urination and urine collected at the end of the process. 1 serving indicates the condition of the urethra, 2 – kidneys and bladder. The presence of leukocytes in urine above normal (15 per field of view) indicates inflammation.
3. After collecting urine, a prostate massage is performed, which allows obtaining its secretion.If there is too little of it and it does not come out of the urethra, but remains on its walls, urine is collected after massage. It is as informative as the prostate discharge itself. Here leukocytes are also determined (there should be no more than 10) as well as lecithin grains and amyloid bodies. If the first analysis of glandular secretion did not show any abnormalities, this does not mean the absence of a process. Prostate juice may be too viscous and block the lumen of the ducts of the affected glands. Then the secretory secretion will be produced by healthy glandular cells. Therefore, it is necessary to carry out such analysis several times. Cultures of urine and prostate secretions are also taken to identify the causative agent of the disease and determine sensitivity to antibiotics.
4. General blood analysis.
5. Analysis of the presence of sexually transmitted diseases.
6. Ultrasound of the kidneys, bladder, TRUS,which allows you to thoroughly assess the condition of the prostate,
7. Uroflowmetry.It is used to assess the rate and time of urinary excretion. It is carried out using a special device consisting of sensors and a container. The patient just needs to urinate there in the usual way.
8. Blood PSA- prostate specific antigen. It is an indicator of the presence of tumor formations in the prostate - adenoma or cancer,
9. Prostate biopsy.It is carried out if the presence of cancer is suspected.

It is necessary to do a spermogram, which will confirm or rule out infertility.

Therapy for acute and chronic prostatitis

Acute prostatitis without complications is usually treated on an outpatient basis. Hospitalization is indicated in the event of serious poisoning or the development of complications.

Treatment of acute prostatitisstart with antibiotics. If the condition is strongly disturbed, they are administered without waiting for the results of the analysis. They use groups of antibacterial drugs capable of penetrating deep into the tissues of the prostate. They work on the types of bacteria that most often cause inflammation. These antibiotics include fluoroquinolones.

Upon receipt of testsantibiotic therapy can be adjusted differently. It all depends on the causative agent of the disease and its sensitivity to the drug. The treatment is also modified if no effect is observed after 2 days.

In cases of acute inflammation of the prostate, the administration of analgesics as well as non-steroidal anti-inflammatory drugs is indicated. In addition to oral medications, suppositories are also used, which also have an analgesic and anti-inflammatory effect: based on prostate extract, suppositories with propolis.

In case of serious poisoningcarry out detoxification therapy. To do this, use a glucose solution.

Prescribed medications that improve blood flow to the prostate. They ensure the drainage of lymph from the gland, relieve swelling and promote the elimination of toxins.

In case of acute prostatitis, it is forbidden to massage the gland, as this can provoke the development of sepsis.

Treatment of chronic prostatitis depends on the stage of the disease.

In the acute form, antibiotics are used. In the remission phase, therapy aims to maintain the normal functioning of the gland:

1. Medicines that normalize the microcirculation of organs.
2. Anti-inflammatory drugs.
3. It is important to maintain the body's immune function, which decreases under the influence of antibiotic treatment. For this, patients are prescribed immunostimulants.
4. In case of sexual dysfunction, it is possible to prescribe antidepressants and sedatives.
5. Prostate massage.
6. Physiotherapy:
   • laser,
   • ultrasound,
   • rectal electrophoresis,
   • Transrectal microwave hyperthermia.
7. Physiotherapy.

Physiotherapy for prostatitis helps to increase the tone of the pelvic floor muscles and reduce pain.

Prostate massage: purpose and technique

Prostate finger massage has several purposes.

It is used as a diagnosis, to obtain secretions from the glands and also as a method of treating chronic prostatitis.

MostA common method for this procedure is transrectal. In this case, the patient is placed on the right side with the knees bent. The doctor inserts the index finger into the anus, moving it along the rectum. Then, a massage is performed: gentle strokes of each lobe of the gland around it and along the ducts. At the end of the procedure, the furrow between the lobes is kneaded to release the secretory fluid.

You should focus on the patient's sensations: there should be no pain during manipulation. The procedure lasts 1 minute, the full course is 15 sessions.

An indicator of a high-quality massage is the release of a few drops of glandular secretion.

Such manipulation, above all,increases blood circulation in the prostate. This accelerates tissue repair and improves the passage of medications, clears congestion and relieves inflammation.

Massage helps strengthen the muscles of the gland and perineum. The procedure allows you to remove stagnant seminal fluid from the organ, due to which the prostate is cleansed of bacteria and toxins. Compression of the urethra is eliminated and urination is improved. Massage increases potency by increasing the circulation of seminal fluid.

In addition to the transrectal method, there is an instillation method and candle massage.

Instillation methodbegins with the introduction of a medicinal solution through the urethra. Then it is clamped and the prostate is massaged using the finger method. In this case, the healing solution penetrates the gland, thereby enhancing the effect of the procedure. At the end, the urethra is loosened, it is recommended to wait a bit to urinate. The medicine is reintroduced into the urethra.

Candle massagecarried out through the urethra using candles - special instruments for dilation and examination of tubular organs. The patient is in a right lateral position. The bougie is inserted into the urethra and held with one hand. With the second hand, stroke and press the penis up and down. The duration of the procedure is 1 minute, after which the drugs are administered intraurethrally. This massage is supported by antibiotic therapy.

Prostate finger massage– medical manipulation, which is carried out by a specialist according to clear indications.

A self-massage option is possible: to do this, rhythmically tense and relax the muscles around the anus. This procedure will be invisible to others and will help strengthen the gland.

Like any manipulation,Prostate massage has its contraindications:

• acute inflammation of the prostate,
• cancer or adenoma of the gland,
• hemorrhoids,
• stones, cystic formations in the prostate organ.

A professionally performed procedure will help restore the structure of the prostate and its function, and stimulation of sensitive points will eliminate sexual dysfunction.

Prostatitis and traditional medicine

In addition to medications, folk methods will also help to cope with prostate inflammation.Combine these 2 types of care, you will speed up the healing process and get rid of unpleasant sensations.

There are many home recipes that help fight prostatitis. Here are a few:

• Grind 500 grams of peeled raw pumpkin seeds in a meat grinder and mix with 200 grams of honey. Make small balls from the resulting mass. Consume before meals 2 times a day, slowly, chewing and dissolving carefully. Pumpkin seeds contain a high amount of zinc, which is essential for men's health.
• blueberries have an anti-inflammatory effect. By eating 200 grams of this berry per day, you will support your men's health,
• Parsley has primarily become famous as a culinary spice. But in addition to this, it also contains many useful substances, including those that the male body needs. Take parsley juice 1 tbsp. L. 3 times a day 30 minutes before meals. This will help relieve inflammation and improve sex life,
• take the green skin of the chestnuts with the thorns, chop them and pour boiling water over them. Use as tea
• Grind 300 grams of onion to a paste consistency, add 100 grams of honey, 600 ml of dry wine. Store for 1 week in a cool, dark place, stirring occasionally. Strain. Use 2 tbsp. L. 3 times a day before meals. Effective in the treatment of chronic prostatitis.

Some will help speed recoveryphysical exercise. They stimulate blood circulation in the pelvic region and, therefore, in the prostate.

1. Deep squats below knee level. The optimal number of times is 100. Perform 3 times a week. If you cannot do such a number at once, perform squats in several sets with pauses.
2. Scissors. Sit on the floor with your hands on the floor behind you. Stretch your legs in front of you, lift them off the floor. Cross them over each other. The movements resemble scissor work.
3. Lying on your back, bend your knees and bring them toward your chest. Wrap your arms around them. Hold the pose for up to 20 minutes.
4. Regular walking is also a great way to relieve congestion.

You cansupplement this complex with other exercises, which activate and warm the muscles.

Prostatitis in adolescents

It's hard to believe, but prostatitis, which was considered the domain of middle-aged and elderly people, is now significantly younger and is even found in adolescents. This negatively affects the condition of the whole body, as well as the reproductive capacity of young people.

That is whyit is important to understand the reasonswhich lead to prostatitis in adolescents:

• early sexual activity and sexual illiteracy.Unprotected sex contributes to the development of sexually transmitted infections, which can cause bacterial inflammation of the prostate,
• hypothermia– a factor contributing to the development of prostatitis. Temperature imbalance reduces immunity and exposes the body to infectious attacks,
• fashion trends– wearing clothes and underwear that are too tight disrupts blood circulation in the pelvis and leads to stagnation in this area,
• sedentary lifestyle– computer work of modern youth replaces sports, walks and other active hobbies,
• excessive sexual activityliterally exhausts the gland. Its functions are reduced, and the low quantity of secretion released and the deterioration of its quality make it more susceptible to infections.

Prostatitis manifests itself in different ways in young people. Some worry about obvious symptoms: hyperthermia, severe pain in the groin with radiation to neighboring organs and when urinating. For others, symptoms appear in a mild form. General weakness, decreased activity, low-grade fever and urethral discharge appear.

VeryIt is important not to ignore the signs of the disease, but to start treatment on time.. The neglected pathological process will leave traces on the state of the organ and on the lives of young men.

Preventive actions

It is better to prevent a disease than to treat it. Prostatitis prevention measures are quite simple and easy to follow.

1. First of all,reconsider your daily routine. If you have a sedentary job, be sure to introduce five-minute sports exercises into your routine. Stretch your body, move more. This is necessary so that the blood "flows" faster through the vessels. At the same time, avoid excessive physical activity, which exhausts the body.
2. Stop smoking. Tobacco smoke causes blood vessels to spasm and impair blood circulation, reducing the supply of oxygen to the prostate. Limit your consumption of alcoholic beverages.
3. Avoid hypothermia and nervous tension.
4. It is worth eating marinated dishes, as well as spices and pickles, as well as hot sauces in doses.
5. Regularity of sexual activity and adequacy of sexual intercourse should be observed.

Untreated prostatitis threatens a number of complications: transition to a chronic form, development of infertility, spread of the process to the kidneys and bladder. More serious consequences include prostate adenoma and cancer. It is possible that purulent foci – abscesses – appear in the gland and become septic.

As you can see, the disease is quite insidious. And, despite the delicacy of the problem, treatment should not be delayed. Block the process at the earliest stages of its development: only in this case will you preserve your health and virility.