According to BME, prostatitis is an inflammatory process that occurs in the prostate gland in men with damage to the parenchyma and interstitium. Treatment of prostatitis in men is a long and difficult event, most often due to the complete ignorance of the disease at its very beginning. What is prostatitis, what are their causes and the first signs, what you need to know about the subject of "diagnosis" and what modern methods of treating prostatitis exist. All men need to know about prostatitis in this review article.
Ab ovo - from the egg
We are not talking about the satyrs of Horace, in this case we are interested in everything related to prostatitis, from the very beginning to the last "squeak" of treatment. Symptoms of prostatitis are found in men during the period of active sexual life, from 25 to 45 years old, on a thematic video you can study in detail everything related to the foundations of the disease, its causes and symptoms, the peculiarities of diagnosis and treatment.
The reasons for the development of prostatitis are extensive. With prostatitis, infectious factors have the greatest weight in the development of the disease:
- Acute form. The coccal flora acts as provocative reasons.
- Chronic form. The reasons for its development are more extensive, as the primary factors of such prostatitis in men are: gonococci, Trichomonas, Gr + and Gr-bacteria, mycobacterium tuberculosis. In rare cases, the diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
It is noteworthy that chronic prostatitis, caused by a pathogen that has penetrated the prostate gland, may later have a non-pathogenic factor and be abacterial in nature. The acute form is more often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, hypodynamia and, as a result, a violation of blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
Often you can hear only one type of prostatitis - infectious, however, according to the WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is recorded in 90% of cases.
Table No. 1. Brief characteristics of pathology
| Categories for prostatitis | Acute infection | The presence of the pathogen in the secret of the prostate or the 3rd portion of urine | The level (increase) of leukocytes with m / s secretion or urine |
| 1 cat. Acute bacterial | + | + | + |
| 2 cat. Chronic bacterial | - | + | Uncertain (whether or not) |
| 3 a. Chronic pelvic pain syndrome of an inflammatory nature, non-bacterial | - | - | + |
| 3 b. Prostatodynia, non-inflammatory pelvic pain syndrome | - | - | - |
| 4 cat. Asymptomatic inflammatory process | - | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more fully, in most cases the bacteria of the family become the cause of the disease. Enterobacteriaceae (E. coli bacillus). The role of atypical microorganisms as a cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered not fully proven. Symptoms of prostatitis in men with signs of weakened immunity, in particular with HIV, can be caused by yeast (Candida spp. ) Or mycobacterium tuberculosis.
Before the advent of the era of antibiotics, the gonococcal flora (Neisseria gonorrhoeae) played a significant role in the development of prostatitis, especially often it became the cause of its abscessing form.
The causes of the abacterial form of prostatitis have not been completely studied, although urologists have thoroughly studied the list of possible pathogenetic (provoking prostatitis) factors that play an important role in the occurrence of inflammation in the prostate without the presence of microorganisms. So, at the heart of the causes of non-bacterial prostatitis are stagnant processes in the small pelvis, circulatory disorders, intraprostatic reflux of urine and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man look like with prostatitis? For a person who is far from medicine, and even more so not versed in the problems of urology, the male appearance of one individual is no different from the crowd of others. And only an experienced specialist, from the first complaints of the patient, will understand where the root of the problem has ripened and what ways to eliminate it will need to go.
Symptoms of prostatitis are often described in several phrases, highlighting the brightest moments, and this plays a cruel joke with a man. Relying on such imprecise definitions, he ignores really important bells, believing that the disease does not exist, although in fact the clinical picture depends on the nature of morphological changes in the prostate.
The earliest symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis. Dull pain in the perineum, radiating to the sacrum, frequent nighttime urges.
- Follicular prostatitis. Difficulty and frequent urination, sometimes with delay. Pain when "peeing", aggravated at the end of the process of urination, as well as bowel movements. Low-grade fever.
- Parenchymal prostatitis. There are symptoms of pronounced dysuria, often AUR, pain during natural recovery, general intoxication with a temperature of up to 40 C.
In case of prostatitis with abscess formation, the symptoms are brighter with the possible opening of the abscess into the rectum or into the prostate part of the urethra. With such a breakthrough, the symptoms subside. If the opening of an abscess occurs in the paraprostatic tissue or in the perineal region, visual symptoms can be observed: swelling, redness of the skin with pronounced fluctuation. At the same time, the man's condition deteriorates sharply.
Comprehensive treatment of prostatitis cannot be started without a thorough examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is customary to distinguish between the acute and chronic course of prostatitis; on a thematic video on the Internet, you can find out in detail which symptoms refer to one form or another. Let's consider this issue in more detail.
Acute - its typical symptoms are characterized by the manifestation of three stages: catarrhal, follicular and parenchymal. They are described in detail above.
The most interesting in terms of symptoms is the chronic form of prostatitis, as there are many variations in symptoms. In general, the effective treatment of prostatitis depends on prostatitis, or rather on its type.
In the stage of chronization, the following moments can be distinguished:
- Chronic prostatitis is rarely the outcome of an acute process.
- Primary prostatitis disappears with erased symptoms.
- A characteristic symptom of chronicity is scanty discharge from the urethra during bowel movements.
- The first symptoms, as a rule, are not expressed, the pathological process itself develops over the years. It is preceded by prostatosis (congestion in the capillaries), which smoothly turns into an abacterial form of inflammation of the prostate gland.
- Specific pathogenic microflora is not the cause of chronic prostatitis, but the chronic process itself is a complication of the inflammatory process due to the effects of ureaplasma, Trichomonas, chlamydia and gonococcus.
What does a man feel with chronic prostatitis? Patient reviews show that most often at first, minor pains in the perineum are felt, scanty discharge, which most men simply do not pay attention to. The next stage is the joining of the following symptoms: burning sensation in the urethra, sexual dysuria, general malaise. Frequent misfires during sex make men depressed, irritable or depressed.
It is important to understand that all these signs do not necessarily appear in each specific case of chronicity, this is what complicates the diagnosis at an early stage of the disease, in addition, the symptoms tend to change places, which is even more misleading.
Long-term syndromes
What can you expect from chronic prostatitis? If there is no timely diagnosis and treatment - nothing good, any specialist will confirm this. This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself does not hurt, but many nerve endings pass through it and are nearby, which inevitably become involved in the inflammatory process. The pain can be of different intensity - from a little aching, creating discomfort, to strong, not allowing you to sleep peacefully. Irradiation of pain occurs in all nearby areas (scrotum, sacrum, perineum), pain from prostatitis must be differentiated from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a malfunction in the urinary system, but what caused this is revealed during the diagnosis. The increased volume of the prostate inevitably compresses the urethra, and the flow of urine is disrupted, followed by the development of frequent urge to use the toilet, a feeling of incomplete emptying of the bladder. With advanced prostatitis, there is compensatory hypertrophy of the muscle layer of the bladder and ureters. At this time, the symptoms of dysuria subside, but return again in an intensified form.
Sex without pleasure
A declining intimate life - it is these first symptoms that men notice, and it is they, as the reviews show, that force them to see a doctor. Frequent nocturnal erections, an erased orgasm, poor erection and rapid ejaculation, pain during it - that's what worries the stronger sex the most. In the advanced stage of chronicity, nothing good can be expected from prostatitis; erectile dysfunction often develops.
The degree of sexual disorder in men is not the same, someone starts sexual intercourse and somehow completes it, brushing off the characteristic bells. For some, even the initial weak response of the penis to a charming stimulus becomes a collapse and the beginning of eerie experiences that turn into prolonged depression. The specter of impotence is difficult for patients with problems with the prostate gland, almost always experts and relatives notice that prostatitis spoils character.
To learn more about the disease, you can study a thematic video, where experts explain many of the nuances of pathology.
What to write on the card
What record will appear in the patient's medical record and what final diagnosis will be established depends on a series of primary studies, starting from the patient's arrival at the urologist and his complaints (history) to the very last stage of diagnostic measures. What exactly is required depends on the type of prostatitis, its neglect and the patient's consent to specific diagnostic procedures.
In general, the diagnosis consists of:
- Anamnesis. The doctor will ask in detail about all the complaints and symptoms, the prerequisites of the disease, etc.
- Urine analysis.
- Prostate massage (digital rectal examination + secretion collection).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does diagnostics give and is it so important? If you read the reviews of patients, you can often understand that most of the men are trying to evade many stages of diagnosis, while the motivations are very different. The price of such indifference is your own health! It is important to remember that prostatitis is curable only if it is "caught" on time and the diagnosis is made accurately with the definition of the form of the disease and its cause.
How to get healthy forever
So, the man understands that he has prostatitis, what awaits him in the future and is it possible to return the lost health? It is important to understand that you will have to get rid of prostatitis 2 times longer than it developed. Moreover, if the pathological process went almost beyond the attention of the man, then the treatment of prostatitis will take place with his direct participation. Whether acute or chronic prostatitis can be cured - yes, if you follow all the doctor's recommendations, in advanced cases of the chronic form, during treatment, it is possible to achieve a stable remission.
The stages of prostatitis treatment will directly depend on what the doctor ultimately found during the examination, on the type of disease, the patient's age and physical data.
The treatment regimen is always strictly individual, but the following points may be present in it:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Appointment of immunocorrectors.
- Urological massage.
- Physiotherapy.
The price of each stage of treatment is different, depending on the total cost of the prescribed drugs, additional methods and clinic. Preventive measures that follow treatment have an important rationale - they prevent the return of the disease. Prevention has direct and close contact with treatment, the basics of prevention are just as important as compliance with all the doctor's requirements during the course of therapy.
Treatment of the acute form
The period of exacerbation requires taking antibiotics, which are drunk in a course. In the presence of chlamydial infection, drugs of the cephalosporin series are indicated.
The duration of the course is significant, on average, antibiotics are drunk for at least 3-4 weeks to prevent a relapse of the disease. Sometimes the doctor continues treatment for a longer period, antibiotics are combined with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- Bacterial culture is required to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of drugs are taken into account.
- They take into account the previous course of treatment, when it was, what means were used and the result.
The need for additional methods of treatment is determined by the attending physician, it should be remembered that massage is contraindicated in the acute form of prostatitis, since it provokes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is important to remember that it is impossible to get rid of chronicity quickly, in principle, the disease has developed over the years and it is beyond the power of even the doctors in their field to destroy it in a couple of weeks, you do not need to take the word of those who cured the disease in 2-3 days. Treatment is aimed at stopping the focus of infection, restoring immunity in men and the work of the prostate gland, as well as preventing exacerbation - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks, with a low effectiveness of treatment, the drug continues to be taken. Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs. In advanced cases, surgery is provided with partial or complete excision of the prostate gland.
Free from bacteria and symptoms
A characteristic difference of therapy is the absence of antibiotics, without the presence of pathogenic microflora, they are simply not needed. But sometimes experts prescribe a short course of drugs in 2-4 weeks.
The treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening the patient's immune system.
Diet and lifestyle changes also underlie the treatment of non-bacterial prostatitis, baths, alpha-blockers are shown.
Prostatitis without symptoms is difficult to detect; in the diagnosis, the PSA method is used, followed by the appointment of a 2-week course of antibiotics as a treatment. After that, individual symptomatic treatment is selected.
In general, the treatment of any type of prostatitis is a long-term phenomenon and not always pleasant for the patient himself. In addition to physical discomforts, a man suffers psychologically, because his most valuable part of the body is affected - the intimate one. Reviews of those who have cured the disease show that only strict adherence to the doctor's prescriptions, coupled with diet and lifestyle changes, pays off. The price of a frivolous attitude to treatment is very high - a man loses not only health, his whole life, character and relationships with others are changing. To prevent this, it is necessary to monitor the health of the prostate gland and eliminate the causes of the development of diseases.