Prostatitis

Inflammation of the prostate today is the leader in the group of male diseases that are predominantly sexually transmitted. Its complications threaten infertility, decreased libido and impotence.

The symptoms of prostatitis are not only pain, urination disorders and inflammation of the spermatic cord. The most dangerous consequence of advanced inflammation can be cancerous degeneration of the prostate gland. While a timely diagnosed pathological process can be easily stopped.

Causes of inflammation

The risk of developing inflammation of the prostate increases due to several factors that predispose to the disease:

• Hypothermia, one-time or associated with the nature of work in the open air.
• A sedentary lifestyle leads to disruption of 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 previous illnesses, surgeries, emotional stress.
• Bad habits that lead to the development of intoxication: alcohol, smoking, strong coffee.
• Occupational injuries to the perineum of motorists, athletes, workers in dangerous industries.
• Promiscuous sexual life, interrupted sexual intercourse, unsensual intercourse with incomplete ejaculation, prolonged absence of intimacy (low need for sperm leads to stagnation in the gland).
• Venereal diseases.

Despite a rather large number of provocative moments, the essence of prostatitis is the occurrence of stagnation inside the organ against the background of disorders of blood circulation and lymphatic outflow.

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:

According to the course of the disease:

• Acute prostatitis. It represents more than 50% of cases of the disease in people aged up to 30-35 years.
• Chronic option. It is considered a non-age 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 gland, predominates in men under the age of 40, occurs on the background of ultrasound and does not extend beyond the boundaries of the organ.
• Non-bacterial pathological changes in the gland, predominantly chronic.
• Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.

According to the nature of structural changes in the prostate gland:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention. Clinically it resembles prostatic adenoma.
• Calcium inflammation of the prostate gland occurs due to the formation of stones within the prostate. Considered a harbinger of cancer.
• Congestive prostatitis, a consequence of a sedentary lifestyle, is diagnosed in one in two patients.

Signs of the disease

If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:

• Micturition disorder with the presence of a weak, intermittent, unusually short stream of urine, causing splashing, difficulty and pain before urination. The frequent need to empty the bladder occurs mainly at night.
• The pain, which is localized in the lower abdomen, radiates to the scrotum, perineum and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in semen (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 constant need to urinate.

Emptying of the bladder occurs with delay and burning sensation. The urine itself becomes cloudy and may contain blood. Irritability and fatigue occur.

The outcome of acute prostatitis can be complete resolution of the process (if treatment is started in a timely manner). 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 sperm, which not only reduces the quality of the ejaculate, but leads to the loss of reproductive function.
• Colliculitis - inflammatory changes in the seminal tubercle become the reason for the development of severe pain during sex, disruption of orgasm and impotence of a psychological nature.
• The formation of an abscess in the body of the prostate, its rupture and purulent damage to the rectum lead to an exacerbation of symptoms, severe intoxication of the body and even death.
• Stagnation in the tissues of the prostate 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 full sexual intercourse, premature ejaculation and prolonged sexual intercourse without orgasm are observed.
• Scar changes in the gland and spermatic cord lead to infertility, decreased sperm quality and sperm motility. Narrowing of the urethra interferes with the normal urination process; Bladder obstruction can cause acute urinary retention, requiring emergency surgery.

Chronic prostatitis

The main feature of the disease is the vagueness of clinical symptoms with a long and persistent course of the process. More often, the chronic form manifests itself 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, back;
• urinary disorder;
• mucous or mucopurulent discharge from the rectum, urethra, even in the absence of urination or defecation;
• erectile dysfunction, painful ejaculation, interrupted sexual intercourse, prolonged intercourse without feeling of satisfaction.

Inaction and improper treatment of chronic prostatitis can cause complications:

• Infertility is the result of chronic inflammation of the spermatic cord, vesicles, testes 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 35-40% of cases.

Diagnostics

The clinical picture of the disease is typical, so the diagnosis is not difficult. It is performed by a urologist on the basis of anamnesis, examination of the patient, a minimum of laboratory tests using the most modern medical devices:

• Rectal examination of the gland, sampling of secretions for examination (culture with determination of sensitivity to antibiotics).
• UAC, UAM, bacterial culture of urine.
• Pap test for sexually transmitted diseases, UGI examination.
• Daily monitoring of urinary rhythm, measurement of urination speed (uroflowmetry).
• Ultrasound or TRUS is performed for differential diagnosis.
• 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 scheme for the complex treatment of prostatitis is drawn up. When prescribing drugs, the form of the pathology and the presence of concomitant diseases are taken into account. The decision on where to conduct therapy (inpatient or outpatient) lies with the doctor. The course of treatment is carried out with careful laboratory monitoring of the results.

One of the most modern centers for the treatment of prostatitis is a specialized clinic. Since the problem of infertility is closely related to inflammatory urological diseases, medical professionals pay great attention to this problem.

In the clinics, each patient has the opportunity to undergo a full course of special examinations, receive psychological support, be treated with the latest generation drugs used in this area and learn about the latest methods of treating inflammation of the prostate. No less important in the complex therapy of prostatitis is the problem of effective rehabilitation of patients, clinical observation and prevention.

Treatment of acute prostatitis

Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.

Course treatment methods:

• The most effective treatment for prostatitis is etiotropic therapy. If the basis of prostatitis is an infection, the priority is a course of antimicrobial agents that relieve the manifestations of inflammation.
• Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers. NSAIDs can be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
• Physiotherapeutic methods are possible only in the subacute phase of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
• Massage is another effective method to influence the prostate. Opens the ducts, normalizes blood circulation in the scrotum and pelvis.
• Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
• The purulent process involves surgical intervention.
• Psychological consultations.

Treatment of chronic prostatitis

With a long-term effect (at least a month) on the prostate, there is no 100% cure guarantee. The priority goes to phytotherapy, immunocorrection, changing domestic 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, remove free radicals and prevent the proliferation of glandular tissue.
• Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
• Drugs that improve immunity not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the function 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 the "extra" secretion of the gland through the urethra, improve blood circulation and minimize congestion.
• Physiotherapy: laser, magnet, ultrasound, iontophoresis, hot sitz baths or herbal microenemas.
• In more severe cases, intravenous fluids with 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 a long-term individual program including daily routine, necessary rest, diet, dosed physical activity and sexual activity.
• If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland 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.

Prevention

To prevent the occurrence of an unpleasant disease for men, it is necessary to eliminate provoking factors and follow simple rules:

• Lead a healthy lifestyle, abandon bad habits.
• Don't get too cold.
• Drink at least 1. 5-2 liters of water a day.
• Strengthen your immune system, walk a lot, strengthen yourself.
• Engage in physical education and sports, visit fitness clubs.
• Avoid stressful situations.
• Practice a regular sex life with a regular partner.
• Consult a urologist regularly.

Questions and answers on the topic

What is prostatitis and how to recognize it?

Prostatitis is an inflammation of the prostate gland that can cause lower abdominal pain and problems urinating. Feeling like you need to go to the bathroom frequently, especially at night, or pain when urinating may be signs of prostatitis.

Why does prostatitis appear?

Prostatitis can occur due to infections, colds, stress or even a sedentary lifestyle. Sometimes it develops after a disease of the genitourinary system.

Is it possible to completely cure prostatitis?

Acute prostatitis can be completely cured with proper treatment. Chronic forms take longer to treat, but the right approach will help reduce symptoms and prevent flare-ups.

How is prostatitis treated?

Treatment includes antibiotics (if the cause is an infection), anti-inflammatory drugs, prostate massage, and physical therapy. Your doctor will choose the best treatment method based on your situation.

Can I exercise with prostatitis?

Light exercises such as walking or swimming are helpful. Vigorous exercise can worsen the condition, so it is important to consult a doctor.

How to prevent prostatitis?

For prevention, it is necessary to lead an active lifestyle, avoid hypothermia, monitor the health of the genitourinary system and timely treat infections. It is also important to avoid stress and follow a healthy diet.

Should I see a doctor if the symptoms go away on their own?

Yes, even if the symptoms disappear temporarily, it is important to consult a doctor. Untreated prostatitis can lead to complications that can worsen your health in the future.

Questions and answers on the topic

Is it possible to completely cure prostatitis?

Acute prostatitis can be completely cured with timely treatment. Chronic prostatitis may require long-term therapy to control symptoms, but with the right approach symptoms can be minimized and the patient's quality of life improves significantly.

Can I do physical activity if I have prostatitis?

Gentle exercises such as walking, swimming or yoga can be beneficial for prostatitis. However, it's best to avoid strenuous exercise and strength training, especially during a flare-up. Be sure to consult your doctor before starting to exercise.

Does prostatitis affect fertility?

Prostatitis can temporarily reduce fertility, as inflammation of the prostate gland can affect the quality of sperm. After successful treatment of prostatitis, fertility is usually restored.

Do I have to follow a special diet for prostatitis?

Yes, if you suffer from prostatitis, it is advisable to avoid spicy foods, alcohol, caffeine and fatty foods, as they can increase inflammation. It is useful to eat more vegetables, fruits, whole grains and drink enough water.

Can prostatitis go away on its own?

Prostatitis does not go away on its own and requires treatment. Without proper treatment, symptoms can worsen, leading to complications. If symptoms appear, you should see a doctor.

How long does treatment for prostatitis last?

The duration of treatment depends on the form of prostatitis. Acute prostatitis is usually treated within a few weeks, while chronic prostatitis may require longer treatment that can take months.

How to prevent prostatitis from recurring?

To prevent relapses it is important to follow your doctor's recommendations, lead an active lifestyle, avoid hypothermia, eat well and undergo regular medical examinations.