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Prostatitis

pain in a man with prostatitis

Prostatitis is a disease in which the prostate gland becomes inflamed.Prostatitis, the symptoms of which most often occur in men of reproductive age (20-40 years), 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.In general, specific and symptomatic treatment is carried out.

Prostatitis is not a disease that can be diagnosed from a photograph, as the disease has no visible manifestations.In order to notice the first symptoms in time, you need to listen to your own health.

General description

The prostate gland affected by the disease in question is an exclusively male organ;accordingly, prostatitis can only develop in men.If we consider a similar area in women, and this is the distal third of the urethra, or urethra, then here are Skene's glands.These glands are essentially analogues of the prostate, and when they become inflamed, the symptoms can resemble those of prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.Thanks to this, the process of urination is regulated, and thanks to the presence of the prostate, a certain secret is released, which makes the sperm liquid.

Quite often, prostatitis occurs 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 you are exposed to relevant pathogens.Basically, these are pathological agents that constantly reside on the surface of the skin or in the environment of the digestive system.In this case, a certain combination of factors can cause the development of prostatitis.

The causes of prostatitis include many factors.So it can be premature emptying of the bladder, the presence of diseases of the urogenital system, constant hypothermia, irregular sex life, sedentary lifestyle, bad habits, etc.The significance of these types of factors is either the possibility of microbial agents entering the prostate gland or disrupting the blood supply to the organs that are located in the pelvis or in the developmental processes in the pelvis.All this leads to the proliferation of microorganisms and the development and progression of pathological inflammations.

If the infectious agent is not detected in prostatitis, then a non-bacterial form of prostatitis is diagnosed.Various reasons can explain this pathological form, although none of them have been proven at the moment.For example, some experts believe that the disease in this form 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 just some of the existing theories about prostatitis.

Let's deal with 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 factor, rather it acts as a secondary factor and is important only at the beginning of the disease.Over time, the pathogenetic mechanism may be supplemented by a neurogenic, autoimmune, or allergic factor, as a result of which the chronic form of inflammation persists even if there is no question of bacterial invasion.

Prostatitis: symptoms

In prostatitis, inflammation is accompanied by pain, which is caused especially by damage to the excretory ducts of the acini, the epithelium of which detaches from the walls and gradually accumulates with mucus in the tubules.In addition, microliths are also formed;they look like small pebbles.Mixed with the epithelium and mucus, they cause the appearance of specific plug formations, which in turn lead to the blockage of the excretory channels.Over time, such plugs turn into suppuration (or microabscesses), the lobes are no longer exposed to drainage, they simply stop.

Meanwhile, before the beginning of such a stage as the blockage of the excretory ducts, usually a lot of time passes, in some cases this time is calculated in months, in others even years.The process progresses gradually, the patient may not notice anything special, especially because the production of secretions by the prostate does not stop.Another thing is that when these microabscesses form, it is associated with the appearance of not very pleasant symptoms, which are manifested in varying intensity.

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

The next symptom is sexual dysfunction.Due to the pathological processes occurring in the disease, the erection mechanism is interrupted, and the orgasm is weakened.

There are other signs of prostatitis, especially these:

  • the appearance of a burning sensation in the urethra and perineum;
  • persistent and frequent urge to urinate;
  • the appearance of discomfort during defecation;
  • "floating threads" in the urine;
  • the appearance of urethral discharge during defecation;
  • the appearance of a prolonged nocturnal erection;
  • frequent and difficult urination;
  • too fast ejaculation;
  • increased general fatigue;
  • reduced potency;
  • the manifestation of orgasm in a deleted form;
  • we can expect the development of other forms of complications in the examined area, in the background of which anxiety and general mental depression appear.

I would like to add that the listed signs (symptoms) do not necessarily appear overnight.The disease is characterized by a very diverse pattern of manifestations, which applies to different versions and different periods of its course in each patient.

When considering the symptoms, it would be useful to return to the causes.Of course, the inflammatory process does not appear "immediately".We are mainly talking about pathogens, which have already been discussed above.At the same time, this factor caused the formation of a false idea about the presence of certain pathogens of prostatitis, which is still supported by many specialists today.However, this disease does not have a specific pathogen.At the same time, any chronic infectious disease can cause the development of prostatitis;it can be of 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 strong blood supply (otherwise its functionality would be questionable).

Prostatitis has a risk group, especially the following people:

  • persons whose professional activity falls under the criterion of "sedentary work";
  • persons leading a sedentary lifestyle;
  • people who have previously been diagnosed with a certain urinary tract infection;
  • persons for whom the problem of chronic constipation is relevant;
  • promiscuous persons;
  • persons whose family relationships do not fall under the criterion of regularity;
  • persons who abuse alcohol.

Often, men are diagnosed with "abacterial prostatitis", "prostatitis in the prostatic stage".If a man is diagnosed with prostatitis, it can be said that there is nothing to worry about at this stage.In the meantime, you will need to make certain adjustments to your lifestyle.In other words, the stagnation phenomena discussed above are already taking place, but there is no inflammation as such yet, this applies to prostatitis.If we consider such a possibility, for example, abacterial prostatitis, then we are already talking about the initial stage of a man's inflammatory process, 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 manifests itself, it is already a chronic process, which is often explained by its long and gradual development.Due to the treatment of the disease or the spontaneous cessation of the pathological process, complete recovery is estimated in individual cases in the initial acute stage.As already mentioned, the disease is characterized by an extremely slow course, and the manifestation of symptoms is usually mild.

Prostatitis: consequences

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

Returning to chronic prostatitis, we can say that it is characterized by its own fluctuating course, that is, periodically the symptoms of the chronic form of prostatitis appear more intensively, and periodically they are practically not felt.Because of these types of changes, many patients choose a wait-and-see approach.Meanwhile, as indicated above, the inflammatory process can worsen and spread further.When it spreads, even pyelonephritis can develop.Meanwhile, the complications of prostatitis in most cases can be traced back to diseases such as vesiculitis, in which the inflammatory process affects the seminal vesicles, and epididymo-orchitis, in which the testicles and appendages become inflamed.As a result of the transmission of the disease in a similar form of spread, it can indicate the development of infertility in a man.Treatment of infertility is a long and complex process, and in some cases it is completely impossible.The listed characteristics mainly belong to the development of the chronic form of prostatitis, due to its specific etiology (in particular, we are talking about STDs).

Diagnosis

Examination of patients to identify a specific type of prostate pathology can be done in several ways.Meanwhile, in each specific case, an individual approach to the given problem is important, on the basis of which the diagnostic option can be determined to obtain sufficient information about the disease.

Initially, the doctor conducts a survey of the patient's complaints, examines the medical history, if any, draws a preliminary conclusion based on this, and determines the basic principles of the individual diagnostic algorithm.We would like to add that the first consultation with a urologist (namely, the specialist who should be consulted in case of disturbing symptoms of prostatitis) is not final and reliable in establishing a 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 the urologist asks if he suspects prostatitis.In particular, you will ask about current problems with urination, as well as how the patient assesses his own sexual function (ie, has there been any change, what exactly has changed, and over what period of time).In addition, the doctor will ask what diseases you currently have, etc.

This is followed by the examination, especially the external examination, rectal examination, laboratory and instrumental examination.During the external examination, the doctor examines the man's genitals and determines whether there are accompanying rashes, irritation, secretions, etc.

Then, after an external examination, the doctor moves on to the next stage, which is the rectal examination.A rectal examination allows for the general contours, consistency, boundaries, etc. of the prostate.

After that, you need to get the results of instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which in its extended form means transrectal ultrasound.This is the most accurate method of identifying diseases in men compared to the usual ultrasound.

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

Based on the current classification of methods for the diagnosis of prostatitis, only the microscopic examination of the secretion obtained from the prostate gland, as well as any local diagnostic option that can demonstrate the presence of the inflammatory process in the lower genital tract, can be considered.Other types of diagnostic methods work only as a clarifying method;they are necessary for differential diagnosis and identification of existing complications of the underlying disease.In addition, it is important to note that in the case of overdiagnosis, this stage itself is prolonged, and the symptoms only worsen.In other words, here, as in everything, the principle of the "golden mean" is appropriate.

Treatment of prostatitis

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

In essence, the treatment of prostatitis can include a number of measures, especially methods of antibacterial therapy, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.The desired result can only be achieved based on the totality of these measures;usually the disease is difficult to treat and therefore cannot be ignored.

Antibacterial therapy

This type of therapy is the basis of conservative treatment.The selection of antibacterial drugs is based on many factors, in particular:

  • the ability of the components of the proposed drug to enter the secretions and tissue of the prostate to create concentrations exceeding the MIC values of the pathogens;
  • Features of the spectrum of antimicrobial action (for example, the use of macrolide antibiotics determines the possibility of good penetration into the prostate tissue, while they have no activity against gram-negative bacteria, namely, taking into account the acute form of prostatitis, the main etiological agents).

It is noteworthy that acute prostatitis, in comparison with the chronic form of the disease, is characterized by the fact that it allows the accumulation of aminoglycosides and beta-lactam antibiotics in the tissues of the gland, and in a concentration sufficient to suppress the activity of most types of pathogens.This is due to the increased perfusion of the prostate, as well as the increased permeability characteristic of the hemoprostatic barrier.Another characteristic of drugs belonging to this group is that their penetration into the prostate decreases as inflammation decreases.For this reason, it is recommended to switch to another type of oral medication.

Prostate massage

Experts consider this method of influence to be a fairly effective solution in the treatment of prostatitis.The basic principles of achieving the therapeutic effect in this case are as follows:

  • restoring channel patency;
  • improving muscle tone and blood circulation in the prostate gland;
  • increased penetration of the used antibiotics into the glandular tissue;
  • the possibility of activating microorganisms in an inactive state, thereby improving the results from the sale of antibacterial drugs.

How is the prostate massage done?In the beginning, of course, it is important to establish a certain relationship of trust between the doctor and the patient;this ensures greater relaxation of the patient, which in turn allows the necessary manipulations to be performed with minimal pain and maximum efficiency.In preparation for the massage, the patient leans forward, spreads his legs approximately 60 cm wide, and rests his elbows on the examination table.The doctor puts on gloves and applies a gel to the index finger (sometimes this gel has a pain-relieving effect).Then, with his free hand, he spreads the buttocks so wide that he can feel the anal sphincter with his index finger.The natural response to such contact is muscle contraction.Then, after relaxing them, insert your index finger into the ampoule of the rectum.

In some cases, patients experience dizziness and even fainting during these manipulations (on average in 10% of cases).These manifestations are primarily caused by excessive fear, shame and anxiety, and if the massage is performed correctly, they are not accompanied at all.A massage can be considered successful if at least 4 drops of secretions selected by the prostate can be obtained.

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

Immunotherapy

This direction is often extremely necessary in the treatment of prostatitis, because a negative effect on the general condition of the immune system cannot be ruled out in the case of a combination of long-term manifestations of inflammation and previous incorrect antibacterial treatment.The treatment of prostatitis requires not only the removal of the infection of the gland and even the inflammation, but also the prevention of the re-emergence of the inflammation.Similar to other areas of treatment, however, immunotherapy cannot be limited to self-medication or treatment based on the recommendation of a pharmacy pharmacist;here you need to consult an immunologist and probably do some tests.

Physiotherapy

In the case of prostatitis, this line of treatment can be implemented in a variety of ways, however, regardless of the specific solution, the effect is aimed at improving the blood circulation of the pelvic organs, thereby increasing the overall effectiveness of the implementation of antibacterial therapeutic measures.Physiotherapy uses ultrasound waves, electromagnetic waves, laser therapy, raising the temperature directly in the rectum, etc.you can use it.If physical therapy is not an option, the doctor may recommend microenemas with warm water and certain medications.

Lifestyle correction

This type of effect is aimed both at treating and preventing prostatitis.It should be treated in the same way as the main treatment, because if the predisposing factors to the development of prostatitis remain, sooner or later the disease will make itself felt again.Taking this into account, you need to make certain changes in your life, this applies to sports, normalizing the waking/sleeping schedule, a nutritious, balanced diet, going for walks, eliminating bad habits.

If symptoms suggestive of prostatitis appear, a urologist should be consulted.