Prostatitis is an inflammation of the prostate tissue. Today, this is the most common urological disease, affecting mainly sexually active men. According to various data, in the group of patients aged 20–40 years, the prevalence of chronic prostatitis ranges from 20 to 35%. Moreover, this diagnosis in combination with benign prostatic hyperplasia is increasingly found in the older age group.
Lack of timely effective treatment leads to complications such as erectile dysfunction and infertility.
Types of prostatitis
The classification used today is based on the division of all types of prostatitis, depending on the presence of an infectious pathogen, leukocytes in the prostate secretion, as well as clinical manifestations. According to it, there are 4 categories of prostatitis, each of which has certain symptoms:
| Category of prostatitis | Signs | Prevalence |
|---|---|---|
| Acute bacterial | 1. Frequent urination, burning sensation. 2. Difficulty urinating with pain. 3. Pain on palpation in the lower abdomen. 4. Pain on palpation of the prostate. 5. A lot of leukocytes, bacteria and mucus in the urine. 6. High temperature, feeling unwell. |
up to 5% |
| Chronic bacterial | The signs are the same as for acute bacterial infections, but are less pronounced and without systemic manifestations and purulent contents in the urine. There may also be blood in the semen, pain in the perineum and testicles, and a large number of leukocytes in the semen and prostate secretions. | 5–10% |
| Chronic nonbacterial (inflammatory, non-inflammatory) | The signs are the same as for the previous categories, but microorganisms are not detected in prostate secretions, urine, or semen. And with a non-inflammatory variant, there may not be an increase in the concentration of leukocytes in prostate secretions, sperm and urine. | 80–90% |
| Asymptomatic inflammatory | There are no clinical manifestations. An inflammatory process is observed in urine, semen and prostate secretions. | Unknown |
Signs and symptoms of prostatitis
Signs of prostatitis can be laboratory and clinical. In the first case, characteristic changes are detected in the general analysis of blood, urine and prostatic secretions. Clinical signs refer to the symptoms that accompany this disease.
These include:
- Increased body temperature.
- Pain in the perineum or lower abdomen.
- Frequent urination.
- Presence of blood in urine or ejaculate.
- Pain when urinating.
Depending on the type of prostatitis, the severity of symptoms may vary. In acute forms, the first signs of prostatitis in men appear suddenly, which becomes a reason to consult a doctor. Chronic prostatitis, on the contrary, is asymptomatic and makes itself felt only during periods of exacerbation. The first signs of exacerbation of chronic prostatitis are aching pain in the perineum and urinary disturbances in the form of a sluggish stream of urine and the inability to urinate even with a strong desire. Without timely treatment, the disease leads to the development of complications, which are manifested by erectile dysfunction, ejaculation disorders and infertility.
Diagnostics
With chronic prostatitis, the signs of the disease can vary significantly. Most often, patients experience 4 main syndromes:
- Painful. As a rule, complaints are made of pain in the lower abdomen, perineum, sacrum, and genitals. It can occur both at rest and during exercise.
- Dysuric. Patients note frequent or difficult urination, thinning of the stream or its sluggishness, a sudden urge to urinate, as well as incomplete emptying of the bladder.
- Sexual. Characterized by a violation of potency. Some scientists associate this with pathologically high excitability of the nerve endings of the prostate, caused by prolonged inflammation.
- Reproductive. There is not only a violation of sperm formation, but also a decrease in the volume of ejaculate and a change in the composition of prostate secretions.
According to some authors, in recent years, reproductive and sexual syndromes are becoming more common.
Along with subjective complaints, digital rectal examination of the prostate is important. It is important to assess the shape, condition of the borders, consistency, condition of the seminal vesicles, as well as the presence of pain.
Laboratory tests for prostatitis may include:
- General blood and urine test.
- Microscopy of prostate secretion or urine.
- Bacteriological examination of urine or prostate secretion.
- PCR test for sexually transmitted infections.
- Uroflowmetry and determination of residual urine.
Laboratory data can be accompanied by instrumental studies, including ultrasound, CT, MRI, etc.
How to treat signs of prostatitis
Symptom management is just one area of treatment. It also aims to restore normal prostate function and prevent complications.
In the case of bacterial forms of prostatitis, the treatment plan includes antibacterial drugs that eliminate the pathogen. In this case, it is possible to influence the immediate cause of inflammation. The treatment program is always selected individually after a comprehensive examination and a final diagnosis.
One of the most prescribed drugs for the treatment of chronic abacterial prostatitis is prostate extract, which has an organotropic effect on the prostate gland.
Prostate extract helps reduce swelling, reduce inflammation and improve secretory function, increasing the tone of the bladder muscles. The drug also helps improve microcirculation in the tissues of the prostate gland, reduces the risk of thrombosis of small vessels, reduces pain, restores urination and normalizes sexual function.
Onfirst stagetreatment, prostate extract is prescribed in the form of suppositories, and forsecond stagetablets are used for therapy. There is alsoenhanced forma drug that contains twice as much active ingredient as compared to classic suppositories. Due to this diversity, the doctor can take an individual approach to prescribing treatment for each patient.