Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate gland, located directly under the bladder and a minor part of the genital organs.

Every 7 men over 35 years old suffer from prostatitis, and with each 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 in 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 to 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 this leads to depletion of the gonads or congestion in the prostate.

Symptoms of prostatitis

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 (not higher than 37.5 degrees);
• pulling or cutting pain in the lower abdomen and perineum;
• frequent urge to urinate with a persistent feeling of incomplete emptying of the bladder;
• pain in the rectum and difficulty with bowel movements.

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 subside 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 urethra with irradiation 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 erased, not as pronounced as in the acute form.The following symptoms appear clinically:

• difficulties with erection;
• inability to complete sexual intercourse with ejaculation;
• decreased sex drive;
• mucus discharge from the urethra mixed with white flakes;
• 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, sluggish inflammatory process in the urethra irritates the nerve endings of the pelvis and provokes 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 such serious complications as complete erectile dysfunction, infertility and even prostate cancer.

In addition, 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 renal 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 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 gland, the patient is prescribed a number of examinations:

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

If the spread of the pathological process to the bladder is suspected, the patient additionally undergoes 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.

Acute non-bacterial form of prostatitis is treated comprehensively with the use of herbal remedies and anti-inflammatory drugs.

Treatment of acute bacterial prostatitis

The principles of treatment for 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 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, since the patient’s condition can be extremely severe.Therapy consists of an integrated approach:

• the patient must remain in bed;
• 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;
• Drugs from the group of non-steroidal anti-inflammatory drugs are indicated orally.These drugs not only reduce the inflammatory process, but also eliminate pain;
• analgesics - you can take tablets orally or insert rectal suppositories into the rectum;
• To eliminate intoxication of the body, 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 required only 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 comprehensive examination to assess the effectiveness of therapy.If necessary, the course of treatment is extended 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 for acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

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

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

Surgical treatment of chronic prostatitis

With advanced chronic prostatitis, the patient sometimes requires 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 applied.These electrical impulses act like an electric knife and partially remove prostate tissue.A huge advantage of this method of intervention is the absence of blood loss, since electric waves not only remove modified prostate tissue, but also immediately treat 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 he does not jump up to go to the toilet at night.Erectile function and normal ejaculation are also restored.The entire operation process is monitored by a doctor on a 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 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 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 treatment with leeches.Medical leeches are placed on the area of inflammation, which during their actions secrete a substance with saliva that brings the blood in order, eliminates congestion and quickly stops the inflammatory process.Leeches are used only special, medical, 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.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, medications can be additionally used that, under the influence of ultrasound, penetrate directly into the prostate tissue.
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 relieve 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;
• 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 for a long time give impetus to the degeneration of the disease into an adenoma, and then prostate cancer.