Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate, located just below the bladder and a small part of the sexual organs.

Every 7th man over 35 years old suffers from prostatitis, and with each goal the risk of developing an inflammatory process in the prostate gland increases under the influence of external and internal factors.

Reasons

Inflammation of the prostate can arise 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 enlargement of the prostate gland.Obesity and a sedentary lifestyle contribute to stagnant processes.
2. When bacteria, viruses or protozoa invade the prostate tissue against the background of an acute or chronic inflammatory process in other organs of the body, diseases such as tonsillitis, gonorrhea, urethritis, cystitis, influenza and pyelonephritis can provoke prostatitis.Infectious agents can enter the prostate via the blood and lymph flow when there is an infection in distant areas and organs.
3. Received injuries and bruising to the soft tissues of the abdomen, perineum and external genitalia – this leads to swelling and poor blood circulation in the area of injury;
4. hypothermia of the body.
5. Chronic constipation.
6. Hormonal disorders.
7. A stormy or, conversely, lack of sex life is harmful both with frequent sex (more than once a day) and with rare intimate relationships (less than once a week), as it causes depletion of the gonads or blockage of the prostate gland.

Symptoms of prostatitis

There are acute and chronic forms of the disease.

Acute prostatitis is characterized by a sudden onset with general well-being, 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 persistent feeling of incomplete bladder emptying;
• Pain in the rectum and difficulty in defecation.

Without 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 are a burning sensation along the urethra radiating into the perineum, which can increase during urination and bowel movements.Gradually the disease progresses and leads to impotence.In chronic prostatitis there are periods of remission and exacerbation, but even in moments of exacerbation the symptoms disappear and are not as pronounced as in the acute form.The following clinical symptoms occur:

• difficulty with erection;
• Inability to complete sexual intercourse with ejaculation;
• decreased sex drive;
• Mucous discharge from the urethra, mixed with white flakes;
• feeling of incomplete bladder emptying;
• excruciating pain in the lumbar region, pubic bone and groin area;
• Weak urine stream – This is observed as a result of narrowing of the urethral lumen 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 triggers a constant urge to urinate, especially at night.Many men are embarrassed to see 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, pathogenic microorganisms from the source of chronic infection in the prostate enter the kidneys through the blood and lymph, causing acute inflammation, urinary retention and an increased risk of developing kidney 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 and determine the form and cause of the inflammatory process in the prostate, the patient is prescribed a number of examinations:

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

If there is a suspicion that the pathological process has spread to the bladder, the patient is additionally subjected to cystoscopy - an examination of the bladder walls using a flexible device, which at the end is equipped with an optical system.

When diagnosing prostatitis, it is very important to distinguish 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 discouraged from self-medicating.

The acute nonbacterial form of prostatitis is comprehensively treated with herbal remedies and anti-inflammatory drugs.

Treatment of acute bacterial prostatitis

The principles of treatment of acute forms of bacterial prostatitis directly depend on how pronounced the symptoms of the disease are.

A characteristic feature of bacterial prostatitis is an acute onset and rapidly increasing signs of intoxication of the body – nausea, vomiting, headaches, high body temperature.The process of emptying the bladder is accompanied by cutting pain in the lower abdomen and perineal area, which radiates to the lower back.Very often a purulent process occurs and an abscess develops in the prostate.

Treatment of acute bacterial prostatitis occurs in the hospital, as the patient's condition can be extremely serious.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 exclude poisoning of the body, a physiological sodium solution with glucose is prescribed intravenously.

Important!Prostate massage is strictly prohibited due to the high risk of sepsis.

Surgical treatment

Surgery for prostatitis is necessary only if the patient develops acute urinary retention and there is no possibility of emptying the bladder.If a prostate abscess occurs, surgery cannot be avoided.

Treatment of 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 is different and largely depends on the stage of the pathological process.If the inflammatory process worsens, therapy is carried out in the same way as for acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. regular use 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 improve venous and lymphatic drainage.
3. Immunomodulators.
4. Antidepressants and sedatives help normalize sleep and eliminate irritability.
5. Multivitamin complexes rich in zinc, selenium and B vitamins.

In the remission phase of the inflammatory process of the prostate, the patient is shown physiotherapeutic treatment:

• prostate massage;
• Ultrasonic;
• electrophoresis;
• magnetic field 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 surgical treatment method is a minimally invasive procedure, but is carried out under general anesthesia.During the procedure, a resectoscope is inserted under the urethra through which electrical current pulses are applied.These electrical pulses act like an electric knife and partially remove prostate tissue.A major advantage of this method of intervention is the absence of blood loss, as electric waves not only remove altered prostate tissue, but also treat blood vessels immediately, thereby preventing bleeding.

Transurethral resection significantly alleviates the patient's condition - after the operation, urination is restored, the man no longer feels burning in the perineum and no longer jumps up at night to go to the toilet.Erectile function and normal ejaculation are also restored.The entire course of the operation is monitored by a doctor on a monitor, so the risk of complications during or immediately after the operation is minimal.

Prostatectomy

Prostatectomy is a major abdominal operation and always carries risks for the patient.During the operation, the doctor removes all or most of the prostate.The recovery period is 4-6 weeks, there is a high risk of 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.Medicinal leeches are placed on the area of inflammation, which, acting with saliva, secrete a substance that brings the blood in order, eliminates congestion and quickly stops the inflammatory process.Leeches are only used specifically, medicinally and individually 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 whom surgery is contraindicated for some reason.
3. Microwave therapy is a special method in which electromagnetic waves are applied to the prostate area.Already after one procedure, tissue swelling is reduced, blood circulation is normalized and congestion is eliminated.After electromagnetic therapy, the patient's urination and erectile function are completely restored.
4. Treatment with ultrasound waves allows you to quickly stop the inflammatory process that occurs in the remission phase;Ultrasound therapy is not performed during the exacerbation phase.To enhance the therapeutic effect, medications can also be used that penetrate directly into the prostate tissue under the influence of ultrasound.
5. Urethral stenting - The essence of the procedure is the installation of 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 of the chronic inflammatory process.

Consequences and complications

Without qualified therapy, prostatitis rapidly progresses, becomes chronic and endangers the man's health with serious complications, including:

• urolithiasis;
• pyelonephritis;
• abscess development;
• Spread of the inflammatory process to testicles and spermatic cords, leading to infertility;
• erectile dysfunction and impotence;
• necrotic changes in prostate tissue.

Sometimes prostatitis and chronic stasis processes over a long period of time give the impetus to the degeneration of the disease into an adenoma and then into prostate cancer.