Prostate inflammation today is a leader in the group of mainly sexually transmitted male diseases. Its complications threaten infertility, decreased libido and impotence.
The symptoms of prostatitis are not only pain, difficulty urinating and inflammation of the spermatic cord. The most dangerous consequence of advanced inflammation can be cancerous degeneration of the prostate. While a pathological process diagnosed in time is easily stopped.
Causes of inflammation
The risk of developing inflammation of the prostate increases due to various factors predisposing to the disease:
- Hypothermia, occasional or linked to the nature of outdoor work.
- A sedentary lifestyle leads to disruption in the functioning of the digestive system.
- Chronic somatic diseases (diabetes mellitus, hypertension).
- Foci of focal and perifocal infection (rhinitis, tonsillitis, stomatitis, gastritis).
- Persistent UGI (chlamydia, trichomoniasis, herpes virus).
- Stress, insomnia, chronic fatigue syndrome.
- Decreased immunity due to illness, surgery, emotional stress.
- Bad habits leading to the development of poisoning: alcohol, tobacco, strong coffee.
- Occupational injuries to the perineum of motorists, athletes, workers in hazardous industries.
- Promiscuous sex life, interrupted sexual intercourse, intercourse devoid of sensuality with incomplete ejaculation, prolonged absence of intimacy (low need for sperm leads to stagnation of the gland).
- Venereal diseases.
Despite a fairly large number of provocative moments, the essence of prostatitis is the appearance of stagnation inside the organ against the background of impaired blood circulation and lymphatic outflow.
Symptoms of prostatitis
Prostatitis can be suspected based on the following disorders in the functioning of the genitourinary system:
- discomfort when urinating, uncontrolled urination;
- potency disorder, weak erection, decreased libido;
- difficulty urinating, feeling of incomplete emptying of the bladder;
- pain in the perineum during prolonged sitting, for example while driving;
- infertility.
The acute stage of the disease causes significant discomfort. This phase is accompanied by the following symptoms:
- frequent painful urge to urinate;
- delay or inability to urinate;
- throbbing pain in the perineum, which is transmitted to the anus and intensifies during the act of defecation. As a result, difficulty defecating;
- general intoxication of the body, feverish state.
The chronic form of prostatitis is accompanied by other symptoms:
- slight increase in body temperature;
- constant fatigue;
- slight pain in the perineum, burning sensation in the urethra;
- discomfort during urination and defecation;
- weakening of sexual function and resulting psycho-emotional depression.
Classification
In modern urology, there is no uniform classification of the disease. However, practicing doctors prefer this option for classifying the inflammatory process in the prostate.
Depending on the progression of the disease:
- Acute prostatitis. It represents more than 50% of cases of illness in people aged 30 to 35 years maximum.
- Chronic option. It is considered an ageless category. It does not manifest itself for a long time, the impetus for its development is a cold or infection.
For the reason that caused the pathology:
- Bacterial inflammation of the prostate, predominates in men under 40 years of age, occurs against the background of ultrasound and does not extend beyond the boundaries of the organ.
- Non-bacterial pathological changes in the gland, mainly chronic.
- Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.
Depending on the nature of the structural changes in the prostate:
- Fibrous prostatitis is characterized by rapid and irreversible growth of the gland and requires radical intervention. Clinically, it resembles a prostate adenoma.
- Calculus inflammation of the prostate is due to the formation of stones inside the prostate. Considered a warning sign of cancer.
- Congestive prostatitis, a consequence of a sedentary lifestyle, is diagnosed in every second patient.
Signs of illness
If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:
- Disorder of urination with the appearance of an intermittent, weak, unusually short stream of urine, causing splashing, difficulty and pain before urinating. The frequent urge to empty the bladder occurs mainly at night.
- The pain, located in the lower abdomen, radiates to the scrotum, perineum and rectum.
- Sexual dysfunction.
- Ejaculation problems, changes in sperm (consistency, quantity).
Acute prostatitis
The disease begins with a sharp increase in temperature (up to 40 degrees), painful headache and fever. The symptoms that appear are accompanied by pain in the groin, perineum, back, discharge from the urethra, frequent urination and a constant urge to urinate.
Bladder emptying occurs with a delay and a burning sensation. The urine itself becomes cloudy and may contain blood. Irritability and fatigue appear.
The result of acute prostatitis can be a complete resolution of the process (if treatment is started on time). Since changes occur in many pelvic organs, they cannot be left to chance, otherwise the corresponding complications will arise:
- Vesiculitis is an inflammation of the seminal vesicles, causing the appearance of pus in the spermatozoa, which not only reduces the quality of ejaculate, but also leads to loss of reproductive function.
- Colliculitis - inflammatory changes in the seminal tubercle become the cause of the development of severe pain during sexual intercourse, interruption of orgasm and impotence of a psychological nature.
- The formation of an abscess in the body of the prostate, its rupture and purulent lesions of the rectum lead to exacerbation of symptoms, severe intoxication of the body, and even death.
- Stagnation of prostate tissues leads to changes in their structure, disruption of innervation, blood supply, both to the gland itself and to organs located nearby, with disruption of their functions. The erection becomes insufficient for complete sexual intercourse, premature ejaculation and prolonged sexual intercourse without orgasm are observed.
- Scar changes in the spermatic gland and cord lead to infertility, a decrease in sperm quality and motility. The stricture of the urethra interferes with the normal process of urination; Bladder obstruction can cause acute urinary retention, requiring emergency surgical care.
Chronic prostatitis
The main feature of the disease is the vagueness of clinical symptoms with a long and persistent course of the process. Most often, the chronic form occurs independently, as a primary pathology against the background of stagnation of blood in the vessels (prostatosis), abacterial prostatitis.
The main symptoms of chronic prostatitis are:
- fever;
- pain occurs in the scrotum, perineum, anus and back;
- urinary disorders;
- mucous or mucopurulent discharge from the rectum, urethra, even in the absence of urination or defecation;
- erectile dysfunction, painful ejaculation, interrupted sexual intercourse, prolonged sexual intercourse without a feeling of satisfaction.
Inaction and improper treatment of chronic prostatitis can lead to complications:
- Infertility is the result of chronic inflammation of the spermatic cord, vesicles, testicles and their appendages.
- Cystitis, pyelonephritis (other diseases of the genitourinary system) are a consequence of hematogenous and mechanical spread of microbes.
- Sepsis.
- Persistent decrease in immunity.
- Untreated prostatitis can cause cancer in 35 to 40% of cases.
Diagnostic
The clinical picture of the disease is typical, so the diagnosis is not difficult. It is carried out by a urologist on the basis of medical history, examination of the patient, a minimum of laboratory using the most modern medical devices:
- Rectal examination of the gland, collection of secretions for examination (culture with determination of sensitivity to antibiotics).
- UAC, UAM, urine bacterial culture.
- Smear for STDs, UGI examination.
- Daily monitoring of urination rhythm, measurement of urination rate (uroflowmetry).
- For differential diagnosis, ultrasound or TRUS is performed.
- If it is necessary to exclude oncology, a biopsy is performed, urography is performed and PSA is determined - prostate specific antigen.
- To diagnose infertility, a spermogram is prescribed - an analysis of ejaculate to determine a man's fertility.
Based on the results of the patient's examination, an individual complex treatment regimen for prostatitis is developed. When prescribing medications, the form of the pathology and the presence of concomitant diseases are taken into account. The decision about where to carry out treatment (inpatient or outpatient) is made by the doctor. The course of treatment is carried out with careful control of the laboratory results.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.
Course processing methods:
- The most effective treatment for prostatitis is etiotropic therapy. If prostatitis is an infection, a course of antimicrobial agents is a priority, which relieve the manifestations of inflammation.
- Pain syndrome is relieved by analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers. NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
- Physiotherapeutic methods are possible only in the subacute stage of the disease. They improve microcirculation and increase immunity: UHF, microwaves, electrophoresis, laser, magnetotherapy.
- Massage is another effective method of influencing the prostate. It opens the ducts, normalizes blood circulation in the scrotum and pelvis.
- Acute retention of renal filtrate can be corrected by catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist consultations.
The treatment of acute inflammation of the prostate is complex.
Effective treatment of acute prostatitis in men includes drugs of different pharmacological groups:
- Antibiotics.Drugs with a broad spectrum of activity are used, which have a bactericidal effect on most pathogens. Most often, antimicrobial therapy is an etiotropic measure, since in most cases the cause of prostate inflammation is microbial pathogens. For a bacterial infection, antibiotics are prescribed, for a viral infection, antiviral drugs are prescribed, and if protozoa are detected, anti-trichomonas drugs are prescribed. The choice of antimicrobial agents is carried out empirically or on the basis of the results of PCR, bacterioscopy and bacterial culture. The selection of antimicrobial agents, determination of their dose, frequency and duration of administration can be carried out exclusively by the attending physician. In addition to antibiotics, uroseptics can be prescribed, which have a disinfecting effect on the mucous membrane of the genitourinary tract.
- Anti-inflammatory drugs.Helps reduce the severity of tissue swelling and the intensity of pain. Typically, nonsteroidal anti-inflammatory drugs (NSAIDs) are used for this purpose.
- Vascular drugs– reduce tissue swelling, eliminate congestion in the prostate, thereby helping to reduce pain, improve blood circulation and local metabolic processes in the tissues.
- Enzymes– fluidifies prostate secretion and promotes the evacuation of pus. In addition, enzyme drugs increase the effectiveness of antimicrobial treatment by improving the absorption of their active substances by affected tissues.
- Diuretics (diuretics).They increase urine flow, which contributes to the mechanical "washing" of the infection.
- While taking antibiotics, patients are prescribed hepaprotectors that protect the liver parenchyma from toxic damage and improve its functional state.
- To eliminate and prevent the development of intestinal dysbiosis during antibiotic treatment, patients are prescribed probiotics.
- After the disappearance of acute inflammatory phenomena of the prostate, patients are prescribed physiotherapeutic treatment - medicinal electrophoresis, galvanization, magnetic, laser, mud therapy, etc. Such procedures improve local microcirculation and lymphatic drainage, metabolic processes and tissue nutrition, stimulate tissue repair, accelerate the final resolution of the inflammatory process, promote tissue restoration and normalization of the functional state of theprostate.
General activities must be carried out.
A diet for acute prostatitis in men is indicated, including sufficient intake of easily digestible proteins and vitamins.
During the period of exacerbation of inflammation, spicy, fried, fatty, salty foods and marinades are excluded from the diet.
Alcohol consumption is excluded, smoking cessation, abstinence from sexual intercourse and intense physical activity, including sports, are recommended.
It is necessary to normalize sleep, work and rest, and balance the emotional background.
During the period of illness, a person needs functional rest.
With timely and correct diagnosis and treatment of acute prostatitis in a medical institution, the prognosis is favorable - complete recovery occurs.
If acute prostatitis develops, seek medical attention immediately and do not self-medicate!
Treatment of chronic prostatitis
With a long-term (at least a month) effect on the prostate, there is no 100% guarantee of cure. Priority goes to medicinal plants, immunocorrection, changing household habits:
- Herbal preparations are widely used in urological practice. They are able to accumulate at the site of the most active pathological process, protect cells from oxidation, eliminate free radicals and prevent the proliferation of glandular tissue.
- Antibacterial therapy is selected individually, depending on the sensitivity of microbes to drugs.
- Medicines that strengthen immunity not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the functioning of the immune system.
- The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove "extra" secretion from the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, hot sitz baths or herbal microenemas.
- In severe cases, intravenous fluids containing diuretics are indicated. This stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- For constipation, herbal laxatives are used.
- The urologist and psychologist, together with the patient, develop an individual long-term program including a daily routine, the necessary rest, diet, dosed physical activity and sexual activity.
- If the chronic process resists treatment and the flow of urine is blocked, surgical intervention is prescribed: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland along with surrounding tissues (prostatectomy). Practiced in exceptional cases, it is fraught with impotence and urinary incontinence. Young people do not undergo surgery because it can cause infertility.
Treatment with medications
Treatment of prostatitis with antibiotic therapy must begin with a bacterial culture, the aim of which is to assess the body's sensitivity to this type of antibiotic. If urination is impaired, the use of anti-inflammatory drugs gives a good result.
Medicines are taken in the form of tablets, in acute cases, in the form of droppers or intramuscularly. Rectal suppositories are effective in treating chronic forms of prostatitis: with their help, drugs achieve their goals faster and have minimal effect on other organs.
Anticoagulants and anti-inflammatories have also proven effective.
Antibacterial therapy
Antibiotics are an effective remedy in the fight against bacterial prostatitis. In order to achieve the desired effect and not harm the body, the choice of medication, dosage and treatment regimen should be carried out by a doctor. To correctly select the most effective drugs, he will have to find out what type of pathogen caused prostatitis, and also test the patient's tolerance to antibiotics of a particular group.
Antibiotics from the fluoroquinolone group have proven effective in the treatment of chronic prostatitis. Their action is aimed at suppressing bacterial infection and strengthening the body's immunity. In addition to this, the bacteriostatic antibiotic trimethoprim is recommended for the prevention and treatment of concomitant diseases of the genitourinary system.
Treatment of prostatitis caused by mycoplasma and chlamydia can additionally be carried out with drugs from the group of macrolides and tetracyclines, which slow down the spread of infection.
The duration of taking antibacterial drugs is 2 to 4 weeks. In the event of positive dynamics, the course may be extended.
Physiotherapy
Physiotherapeutic techniques in the treatment of prostatitis are aimed at activating blood circulation in the pelvic region, improving metabolic processes in the prostate and cleaning the ducts. If physiotherapy is combined with taking antibiotics, the effect of the latter is enhanced.
The main methods include:
- magnetic therapy;
- laser therapy;
- electrophoresis;
- warming up;
- ultrasound;
- mud therapy;
- high frequency irradiation;
- physiotherapy.
One of the oldest methods, transrectal prostate massage, according to modern research, has no proven effectiveness.
Non-specific treatments
Nonspecific methods of treating prostatitis include:
- hirudotherapy;
- therapeutic fasting;
- acupuncture;
- diet according to the Ostrovsky method;
- alkalization of the body using the Neumyvakin method.
We strongly recommend that you discuss all non-traditional methods of treating prostatitis with your doctor.
Surgery
Surgical methods are used in complex and emergency cases:
- for drainage of purulent abscesses, which are removed by laparoscopic methods by puncture;
- in case of difficulty urinating due to damage to the urinary tract;
- with a large volume of the affected area;
- with a significant number of stones in the body of the gland.
Stones and sclerotic tissues are removed by endoscopic methods. In case of a large affected area or multiple stones, prostate resection is resorted to.
Transurethral resection is also effective for bacterial prostatitis. In this way, the risk of relapse can be reduced.
Folk remedies
Treatment of prostatitis with folk remedies is unlikely to be effective in itself, but in combination with medications and physiotherapeutic methods it may be applicable. These include: bee products, decoctions of herbs and seeds, tinctures of garlic, ginger, beaver, fresh vegetables, pumpkin seeds.
In acute cases of the disease, you should consult a doctor, and in no case should you self-medicate! If a purulent abscess ruptures, death is possible.
Suppositories for prostatitis
Treatment of prostatitis with rectal suppositories is much more effective than tablets, if only because the rectum is much closer to the prostate, which means the medication will work faster.
The composition of drugs for the treatment of prostatitis can be completely different: they are prescribed to solve a particular problem.
- Antibacterial agents are particularly effective against prostatitis caused by chlamydia.
- Analgesics are used for symptomatic treatment, they relieve pain well.
- Immunostimulants help improve blood circulation, relieve swelling and are used in complex therapy.
- Medicinal plants have a mild effect. Like candles on bee products, they are used in addition to the main treatment.
- Compositions based on ichthyol promote blood circulation in the area of the intestinal mucosa, which accelerates the alleviation of inflammatory processes and slightly improves immunity.
- Special enzyme products prevent scar tissue from forming. It is recommended to take it as part of complex therapy with antibiotics, anti-inflammatory drugs and painkillers.
Auxiliary drugs
For the symptomatic treatment of prostatitis in men, for example to relieve pain when urinating, you can also take antispasmodics, which relax smooth muscles and thus quickly relieve pain.
General health is promoted by anticoagulant and anti-inflammatory food supplements based on bee products, pumpkin oil and palm fruit extracts.
Diet and lifestyle
For the treatment of prostatitis, a proper and balanced diet and a healthy lifestyle are very important. Food should not contain spicy, fried, salty or marinated foods. In acute cases, alcohol is strictly prohibited.
Foods should contain enough fiber to prevent constipation. Protein content should be reduced. It is advisable to supplement the diet with herbs, ginger and pumpkin seeds.
Consequences of untreated prostatitis
Even if the symptoms of prostatitis have not appeared for a long time, it is necessary to regularly undergo examination by a urologist. Incompletely cured prostatitis may be accompanied by the formation of calcifications, which will subsequently need to be removed along with the gland. Experts are convinced that there is no other way to remove or dissolve stones.
In addition, pathogenic microorganisms can migrate to nearby organs, causing inflammation. Advanced prostatitis can cause the development of prostate adenoma and cancer.
Prevention
To prevent the occurrence of an unpleasant disease for men, you need to eliminate the provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't be too cold.
- Drink at least 1. 5 to 2 liters of water per day.
- Strengthen your immune system, walk a lot, toughen up.
- Take part in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Have a regular sex life with a regular partner.