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Prostatitis

pain in a man with prostate

Prostatitis is a disease in which the prostate gland becomes inflamed.Prostatitis, the symptoms of which are most often found in men of reproductive age (20-40 years old), is diagnosed in an average of 35% of the population.

Depending on the origin, prostatitis can be bacterial or non-bacterial, depending on the nature of the course - acute or chronic.

When the first signs of prostatitis are detected, the choice of treatment method depends on the form of the disease.As a rule, specific and symptomatic treatment is carried out.

Prostatitis is not a disease that can be diagnosed by a photograph, as the disease has no visible manifestations.To notice the first symptoms at the right time, you need to listen to your health.

General description

The prostate gland, which is affected by the disease in question, is an exclusively male organ;Therefore, prostatitis can develop exclusively only in men.If we consider a similar area in women, and this is the distal third of the urethra, or urethra, then here they have the Skene glands.These glands are essentially analogous to the prostate, and if their inflammation develops, the symptoms may resemble those of prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.Because of it, the urination process is controlled, in addition, due to the presence of the prostate, a certain secret is released, which makes the sperm liquid.

Very often, prostatitis appears in combination with diseases such as vesiculitis or urethritis, in elderly patients - in combination with benign prostatic hyperplasia.

Prostatitis: causes

Bacterial prostatitis, as the name suggests, develops when exposed to the relevant pathogens.Basically, these are pathological agents that constantly stay on the surface of the skin or in the environment of the digestive tract.In this case, a certain combination of factors can cause the development of prostatitis.

The causes of prostatitis include a number of factors.So, this can be premature emptying of the bladder, the presence of diseases of the genitourinary system, constant hypothermia, irregular sex life, a sedentary lifestyle, bad habits, etc.The importance of this type of factor either causes the possibility of entry of microbial agents into the prostate gland, or causes disruption of the viscera, blood supply to those organs.processes.All this leads to the spread of microorganisms, as well as the development and progression of pathological inflammation.

If the infectious pathogen is not detected in the prostate, then a non-bacterial form of prostatitis is diagnosed.Various reasons can explain this form of pathology, although none of them has been proven at the moment.For example, some experts believe that in this form the disease can develop against the background of actual neurogenic disorders, while another part, on the contrary, focuses on the immune nature of the disease in this form.This is only a part of the existing theories about prostatitis.

Let's dwell on the acute and chronic forms of the disease.Acute prostatitis is based on the influence of a bacterial factor.As for chronic prostatitis, here this factor is not the main one, acting rather as a secondary and important factor in its impact only at the beginning of the disease.Over time, the pathogenetic mechanism can be supplemented by a neurogenic, autoimmune or an allergic factor, due to the influence of which the chronic form of inflammation is maintained even when there is no question of bacterial invasion.

Prostatitis: symptoms

Inflammation is accompanied by pain in the prostate, in particular, this is caused by damage to the excretory ducts of the acini, from the walls of which the epithelium peels off, which gradually accumulates with mucus in the tubules.In addition, microlites are also formed;they look like small pebbles.Mixing with the epithelium and mucous membrane, they cause the appearance of special plug formations, which, in turn, lead to blockage of the excretory ducts.Over time, such plugs turn into suffocation (or microabscesses), the lobules are no longer subject to drainage, they simply stop functioning.

Meanwhile, before the beginning of such a phase as the blockage of the excretory channels, as a rule, a lot of time passes, in some cases this time is counted in months, in others even years.The process progresses gradually, the patient may not notice anything special, especially since the production of secretions from the prostate does not stop.Another thing is when these microabscesses are created, this is already accompanied by the appearance of not very pleasant symptoms, manifested in different degrees of intensity.

As the first of these symptoms, patients notice some difficulties in urination.Due to the fact that the prostate enlarges against the background of the inflammatory process, the urethra is compressed to a certain extent.Further progression of the inflammatory process causes the development of bladder neck sclerosis;in an even more severe form of the pathological process, complete closure of the ureter occurs.

Another symptom is sexual dysfunction.Due to the pathological processes that occur in the disease, the mechanism of erection is subject to interruption and the orgasm is weakened.

There are other signs of prostatitis, in particular these include:

  • the appearance of a burning sensation in the urethra and perineum;
  • constant and frequent urge to urinate;
  • the appearance of discomfort during bowel movements;
  • "floating threads" in the urine;
  • the appearance of discharge stretching the urethra during defecation;
  • the appearance of prolonged nocturnal erections;
  • interrupted and difficult urination;
  • very fast shedding;
  • increased general fatigue;
  • reduced potency;
  • the manifestation of orgasm in a deleted form;
  • waiting for the development of other forms of complications in the area under consideration, against the background of which anxiety and general mental depression appear.

I want to add separately that the signs (symptoms) listed do not necessarily all appear overnight.The disease is characterized by a very variable pattern of its manifestation, this applies to different variants in each individual patient and for different periods of time during its course.

When considering the symptoms, it would be helpful to turn to the causes.Of course, the inflammatory process will not appear "out of the blue".We are mainly talking about pathogenic agents, which have already been mentioned above.Meanwhile, it was this factor that caused the formation of a wrong idea about the presence of some causative agents of prostatitis, which is still supported today by many specialists.However, there is no specific type of causative agent for this disease.At the same time, any chronic infectious disease can cause the development of prostatitis;it can be any type, be it sinusitis, tonsillitis, cholecystitis or any other disease.In this case, the pathogen can enter the prostate through the bloodstream, which is characterized by a rather powerful blood supply (otherwise its functionality would be questioned).

There is a certain risk group for prostatitis, in particular the following people fall into it:

  • persons whose professional activity falls under the criterion of "sedentary" work;
  • people with a sedentary lifestyle;
  • persons who have previously been diagnosed with a specific genitourinary infection;
  • people for whom the problem of chronic constipation is important;
  • persons who are promiscuous;
  • persons whose family relationships do not fall under the criteria of the rule;
  • people who abuse alcohol.

Often men are diagnosed with "bacterial prostatitis", "prostatitis in the stage of prostatosis".If a man is diagnosed with prostatosis, we can say that at this stage there is nothing to worry about.In the meantime, you will need to make some adjustments to your lifestyle.In other words, what we are talking about here is that the phenomena of stagnation discussed above are already happening, but there is no inflammation as such yet, this is about prostatosis.If such an option as abacterial prostatitis is considered, then here we are already talking about the beginning stage of the development of an inflammatory process in a man, but so far without an accompanying infection.

A distinctive feature of prostatitis is that it practically does not manifest itself in an acute form.In other words, when it appears, it is already a chronic process, which is explained by its often long and gradual development.Complete recovery due to the treatment provided for the disease or due to the spontaneous disappearance of the pathological process is estimated in isolated cases during the initial acute phase.The disease is characterized, as already mentioned, by its extremely slow progress, the manifestations of the symptoms generally have a mild form.

Prostatitis: the consequences

Acute prostatitis, if its manifestations are ignored and medical help is excluded, can cause the development of an abscess in the prostate gland, that is, the cause of the development of focal purulent inflammation in it.This is accompanied by an increase in temperature (within 39-40 degrees), which at the same time becomes febrile, that is, its differences exceed one degree.Patients also experience high fever, which periodically gives way to chills.The pain in the perineum becomes so strong that it makes urination difficult, while defecation becomes almost impossible because of the pain.After some time, swelling develops in the prostate gland, which, in turn, causes acute urinary retention.Meanwhile, it is rarely about acute prostatitis, which manifests itself against the background of a chronic spread of the pathological process - unless, at his own risk and risk, a man "endures and endures".

Returning to chronic prostatitis, we can say that it is characterized by the wave of its course, that is, periodically the symptoms of the chronic form of prostatitis appear more intensively, and periodically they are practically not felt.Because of this type of change, many patients choose a wait-and-see approach.Meanwhile, as mentioned above, the inflammatory process can worsen, spreading further and further.When it spreads, pyelonephritis can also develop.Meanwhile, the complications of prostatitis in most cases come down to diseases such as vesiculitis, in which the inflammatory process affects the seminal vesicles, as well as epididymo-orchitis, in which the testicles and appendages are inflamed.As a result of the transfer of the disease to a similar form of its spread, the development of infertility in a man can be indicated.Treatment of infertility is a long and complex process and, in some cases, completely impossible.The listed characteristics mainly fall under the development of a chronic form of prostatitis, due to the specific etiology of its occurrence (in particular, we are talking about STD).

diagnostic

Examination of patients to identify their specific type of prostate pathology can be performed in different ways.Meanwhile, in each specific case, an individual approach to the problem in question is important, on the basis of which it is already possible to determine the diagnostic option to obtain sufficient information about the disease.

To begin with, the doctor conducts a study of the patient's complaints, studies the medical history, if any, based on this, then a preliminary conclusion is made and the principles of an individual diagnostic algorithm are determined.We would like to add that the first consultation with a urologist (that is, this is the specialist you should turn to if disturbing symptoms of prostatitis appear) is not conclusive and reliable in establishing the diagnosis, because the first examination is only an opportunity for the doctor to determine what further diagnostic measures are needed.

Given the sensitivity of the problem, men are interested in what questions a urologist asks if they suspect prostatitis.In particular, he will ask about current problems related to urination, as well as how the patient himself evaluates his sexual function (ie, is there any change, what exactly has changed, since which period).In addition, the doctor will ask what diseases you currently have, etc.

This is followed by an examination, especially an external examination, a rectal examination, laboratory and instrumental examination.During an external examination, the doctor examines the man's genitals, determining whether there is accompanying redness, irritation, discharge, etc.

Then, after an external examination, the doctor moves to the next stage, which is the rectal examination.A rectal examination makes it possible to determine the general contours of the prostate, its consistency, boundaries, etc.

After that, you will need to receive results from instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which in expanded form means transrectal ultrasound.This is the most accurate method for identifying diseases in a man compared to standard ultrasound.

As for laboratory tests, this includes a smear, urine test, prostate secretion test, PCR (a laboratory test for the detection of sexually transmitted infections).

Based on the current classification of methods for the diagnosis of prostatitis, only a microscopic examination of the secretion obtained from the prostate gland, as well as any of the current diagnostic options that can reveal the presence of an inflammatory process in the lower genital tract, can be considered a necessary option.Other types of diagnostic methods act only as clarifying methods;they are necessary for differential diagnosis and for identifying existing complications of the underlying disease.In addition, it is important to remember that with overdiagnosis, this phase itself is prolonged and the symptoms only worsen.That is, here, as in any matter, the principle of the "golden mean" is appropriate.

Treatment of prostatitis

Treatment of prostatitis today is a serious problem, although this does not mean that the doctor cannot help and the disease should be left to chance.Indeed, it is not always possible to completely recover from prostatitis, but it is possible to eliminate the symptoms of the disease, as well as to achieve long-term and stable remission.Depending on how seriously a man takes the doctor's recommendations, how long the remission periods will last for him.

At its core, the treatment of prostatitis may contain a number of measures, in particular, antibacterial therapy methods, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.Only on the basis of a series of measures can the desired result be achieved;in general, the disease is difficult to treat, so it cannot be ignored.

Antibacterial therapy

This type of therapy is considered the basis of conservative treatment.The basis for the choice of antibacterial drugs are a number of factors, especially these:

  • the ability of the components of the proposed drug to enter the secretion and prostate tissue to create a concentration that exceeds the MIC values of pathogens;
  • features of the spectrum of antimicrobial activity (for example, the use of macrolide antibiotics determines the possibility of their good penetration into the prostate tissue, while they have no activity against gram-negative bacteria, respectively, they are the main etiological agents in the examination of the acute form of prostatitis).

What is worth noting is that acute prostatitis, when compared to the chronic form of the disease, is characterized by the fact that it allows the possibility of accumulation of aminoglycosides and beta-lactam antibiotics in the tissue of the gland and in concentrations that are sufficient to suppress the activity of most types of pathogens.This is due to increased perfusion of the prostate, as well as an increased degree of characteristic permeability of the hemoprostatic barrier.Another feature of the drugs of this group is that with the reduction of inflammation, the rate of their penetration into the prostate decreases.For this reason, switching to another type of oral medication is recommended.

Prostate massage

For the most part, experts consider this method of influence as a very effective solution in the treatment of prostatitis.The basic principles for achieving a therapeutic effect in this case are as follows:

  • restoration of channel patency;
  • improvement of muscle tone and blood circulation in the prostate gland;
  • increased penetration of antibiotics used in the tissue of the gland;
  • the possibility of activating microorganisms that are in an inactive state, thus increasing the results from the sale of antibacterial drugs.

How is prostate massage performed?To begin with, of course, it is important to establish a certain contact of trust between the doctor and the patient;this will ensure a greater relaxation of the patient, which, in turn, will make it possible to carry out the necessary manipulations with minimal pain and maximum efficiency.When preparing for a massage, the patient bends forward, spreading his legs about 60 cm wide and leaning on the examination table with his elbows.The doctor puts on gloves and puts a gel on the index finger (sometimes this gel has an analgesic effect).Then, with his free hand, he stretches the buttocks to such a width that it will be possible to palpate the anal sphincter using the index finger.The natural reaction to such contact is muscle contraction.Then, after their relaxation, the index finger is inserted into the ampulla of the rectum.

In some cases, patients experience dizziness and even fainting during these manipulations (on average in 10% of cases).These manifestations are mainly caused by fear, shame and excessive anxiety and if the massage is performed correctly they do not accompany it at all.A massage can be called successful when it is possible to get at least 4 secret drops secreted by the prostate.

The most popular method used in the treatment of chronic prostatitis is the use of massage according to the Manila Protocol.In this case, the massage is performed three times a week, a dynamic microbiological study is also performed and antibiotics are taken.

Immunotherapy

This direction in the treatment of prostatitis is often extremely necessary, because with the prolonged manifestation of inflammation in combination with the previous incorrect antibacterial treatment, the possibility of a negative impact on the general state of the immune system cannot be excluded.The treatment of prostatitis requires not only the elimination of the infection from the gland and, in fact, the inflammation, but also the prevention of the redevelopment of the inflammation in it.However, like other areas of treatment, immunotherapy should not be reduced to self-medication or treatment based on the recommendations of a pharmacist in a pharmacy;here you will need to consult an immunologist, and also, most likely, conduct some tests.

Physiotherapy

For prostatitis, this direction of treatment can be applied in a wide variety of impact options, however, regardless of the specific solution, the impact is focused on improving blood circulation in the pelvic organs, thus increasing the overall effectiveness of the implementation of antibacterial therapy measures.Physiotherapy can use ultrasonic waves, electromagnetic waves, laser therapy, increasing the temperature directly in the rectum, etc.If there is no possibility of physical therapy, the doctor may recommend micro-enemas with warm water and certain medications.

Lifestyle correction

This type of effect aims at both the treatment of prostatitis and its prevention.It should be treated the same as the main treatment, because if the predisposing factors for the development of prostatitis remain, then the disease will, sooner or later, be felt again.Taking this into account, you should make some changes in your life, this applies to playing sports, normalizing the waking/sleeping schedule, a balanced nutritious diet, walking, eliminating bad habits.

If symptoms indicating prostatitis appear, you should consult a urologist.