Prostatitis

Prostatitis is a disease in which the prostate gland becomes inflamed.Prostatitis, the most common symptom in men of reproductive age (20-40 years), is diagnosed on average in 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.As a rule, specific and symptomatic treatment is carried out.

Prostatitis is not a disease that can be diagnosed from a picture, because the disease has no visible manifestations.To see the first symptoms in time, you should listen to your own health.

General description

The prostate gland, which is affected by the disease in question, is an exclusively male organ;Therefore, prostatitis can develop exclusively only in men.If we consider the same area in women, and this is the distal third of the urethra, or urethra, then here they have Skene's gland.This gland is basically an analogue of the prostate, and if the inflammation develops, the symptoms may resemble prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.Because of that, the process of urination is controlled, in addition, it is due to the presence of the prostate that a certain secret is released, which makes the sperm liquid.

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 exposed to an associated pathogen.Basically, this is a pathological agent that is always on the surface of the skin or in the environment of the digestive tract.In this case, a combination of certain factors can cause the development of prostatitis.

The causes of prostatitis include various factors.So, this may be untimely emptying of the bladder, the presence of diseases of the genitourinary system, constant hypothermia, an irregular sex life, an inactive lifestyle, bad habits, etc.The connection of this type of factor either causes the possibility of microbial agents entering the prostate gland, or causes disruption of the blood supply to the pelvic organs, which are located in the development of the pelvic organs, or is stunted.All this leads to the proliferation of microorganisms, as well as the development and development of pathological inflammation.

If an infectious pathogen is not detected in prostatitis, then a non-bacterial form of prostatitis is diagnosed.Various reasons can explain this form of pathology, although none of them have been proven at this time.For example, some experts believe that in this form the disease can develop against the background of real neurogenic disorders, while other sections, on the contrary, focus on the immune nature of the disease in this form.These are just some of the existing theories about prostatitis.

Let us think about the acute and chronic forms of this disease.Acute prostatitis is based on the influence of bacterial factors.As for chronic prostatitis, here this factor is not the main one, acting as a secondary factor and important in its effect only at the beginning of the disease.Over time, the pathogenetic mechanism can be supplemented with neurogenic, autoimmune, or allergic factors, due to the influence of which the form of chronic inflammation is maintained even if there is no question of bacterial invasion.

Prostatitis: symptoms

Inflammation is accompanied by pain in prostatitis, in particular, this is caused by damage to the excretory ducts of the acini, from the walls of which the epithelium peels off, which gradually accumulates with mucus in the tubules.In addition, microliths are also formed;they look like small pebbles.Mixed with epithelium and mucus, they cause the appearance of a strange plug formation, which, in turn, causes blockage of the excretory duct.Over time, such plugs turn into suppuration (or microabses), the lobules are no longer subject to drainage, they simply stop working.

Meanwhile, before the onset of such a stage as excretory duct blockage, as a rule, a lot of time passes, in some cases this time is counted in several months, in others even years.This process takes place gradually, the patient may not notice anything special, mainly because the production of secretions by the prostate does not stop.Another thing is that when this microabscess is formed, this is already accompanied by the appearance of not so pleasant symptoms, which are shown in various degrees of intensity.

As the first symptom, the patient notes some difficulty in urinating.Due to the fact that the prostate enlarges against the background of the inflammatory process, the urethra is compressed to a certain extent.The further development of the inflammatory process causes the development of bladder neck sclerosis;in the form of a more severe pathological process, complete closure of the ureter occurs.

The next symptom is sexual dysfunction.Due to the pathological process that occurs in this disease, the erection mechanism is subject to disruption, and the orgasm becomes weak.

There are also other signs of prostatitis, in particular these include:

• the appearance of a burning sensation in the urethra and perineum;
• constant and frequent urge to urinate;
• the appearance of discomfort during bowel movements;
• "floating threads" in the urine;
• the appearance of urethral stretch discharge during defecation;
• the appearance of a prolonged nocturnal erection;
• intermittent and difficult urination;
• ejaculation too quickly;
• increased general fatigue;
• decreased potency;
• manifestation of orgasm in a suppressed form;
• expected development of other forms of complications in the area under consideration, against the background of which anxiety and general mental depression appear.

I would like to add separately that the signs (symptoms) listed do not necessarily all appear overnight.The disease is characterized by a very variable pattern of manifestations, this applies to different variants in each individual patient, and for different periods of time during its course.

When considering the symptoms, it is useful to return to the cause.Naturally, the inflammatory process will not appear "suddenly."We are mainly talking about pathogenic agents, which have been mentioned above.Meanwhile, it is this factor that causes the formation of a false idea about the presence of a specific causative agent of prostatitis, which is still supported by many experts today.However, there is no specific type of causative agent for this disease.At the same time, any chronic infectious disease can cause the development of prostatitis;it can be 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 sufficiently strong blood supply (otherwise, its function will be in question).

There are certain risk groups for prostatitis, in particular the following people fall into it:

• people whose professional activity falls under the criteria of "temporary" work;
• people with a sedentary lifestyle;
• people who have previously been diagnosed with certain genitourinary infections;
• people dealing with chronic constipation problems;
• adulterer;
• people whose family relationships do not fall under the criteria of regularity;
• people who abuse alcohol.

Often men are diagnosed with "abacterial prostatitis", "prostatitis in the stage of prostatosis".If a man is diagnosed with prostatosis, we can say that at this stage there is nothing to worry about.In the meantime, you will need to make certain adjustments to your lifestyle.In other words, what we are talking about here is that the stagnation phenomenon discussed above has already occurred, but there is no such inflammation yet, this concerns prostatosis.If such an option as abacterial prostatitis is considered, then here we are already talking about the initial stage of the development of the inflammatory process in a man, 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 explained by its often long and gradual development.Complete recovery due to the treatment given to the disease or due to the spontaneous disappearance of the pathological process is estimated in isolated cases during the initial acute stage.This disease is characterized, as already mentioned, by its very slow course, the manifestation of symptoms generally has a smooth form.

Prostatitis: consequences

Acute prostatitis, if its manifestations are ignored and if seeking medical help is excluded, can lead to the development of an abscess in the prostate gland, which is the cause of the development of focal purulent inflammation in it.This is accompanied by an increase in temperature (within 39-40 degrees), which at the same time becomes busy, that is, the difference is more than one degree.The patient also has a high fever, which periodically gives way to chills.The pain in the perineum becomes so severe that it is difficult to urinate, while defecation becomes almost impossible because of the pain.After some time, swelling develops in the prostate gland, which, in turn, causes acute urinary retention.Meanwhile, it rarely happens to acute prostatitis, which manifests itself against the background of chronic spread of the pathological process - unless, at his own peril and risk, a man "persists and endures."

Returning to chronic prostatitis, we can say that it is characterized by undulations of its own course, that is, periodically the symptoms of the chronic form of prostatitis appear more intense, and periodically they are practically not felt.Because of these types of changes, many patients choose a wait-and-see approach.Meanwhile, as shown above, the inflammatory process can get worse, spread further.When it spreads, even pyelonephritis can develop.Meanwhile, complications of prostatitis in most cases come to diseases such as vesiculitis, where the inflammatory process affects the seminal vesicles, as well as epididymo-orchitis, where the testicles and appendages become inflamed.As a result of the transfer of the disease in its similar form of spread, one can show the development of infertility in a man.Infertility treatment is a long and complex process, and, in some cases, completely impossible.The listed features are mainly under the development of the chronic form of prostatitis, due to the specific etiology of its occurrence (in particular, we are talking about STDs).

Diagnosis

Examination of patients to identify their specific type of prostate pathology can be carried out in various ways.Meanwhile, in each specific case, an individual approach to the problem at hand is important, on the basis of which it is possible to determine the diagnostic options in order to obtain sufficient information about the disease.

To begin with, the doctor conducts a survey of the patient's complaints, reviews the medical history, if any, based on this, preliminary conclusions are made later, and the principles of the individual diagnostic algorithm are determined.We would like to add that the first consultation with a urologist (that is, this is the specialist you should go to if symptoms disturbing prostatitis appear) is not final and reliable in making a diagnosis, because the first examination is only an opportunity for the doctor to determine the necessary further diagnostic steps.

Given the sensitivity of the problem, men are interested in what questions the urologist asks if they suspect prostatitis.In particular, he will ask about current problems related to urination, as well as how the patient himself evaluates his own sexual function (ie, are there any changes, what exactly has changed, since what period).In addition, the doctor will ask what diseases you have now, etc.

This is followed by examination, especially external examination, rectal examination, laboratory and instrumental examination.During the external examination, the doctor examines the man's genitals, determines whether there is a rash, irritation, discharge, etc.

Then, after the external examination, the doctor moves to the next stage, which is the rectal examination.Rectal examination makes it possible to determine the general contour of the prostate, consistency, borders, etc.

After this, you need to get results from instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which in its expanded form means transrectal ultrasound.This is the most accurate method to identify the disease in a man compared to standard ultrasound.

As for laboratory tests, this includes smears, urine tests, prostate secretion tests, PCR (laboratory tests to detect sexually transmitted infections).

Based on the current classification of methods for diagnosing prostatitis, only microscopic examination of secretions obtained from the prostate gland, as well as any topical diagnostic option that can detect the presence of an inflammatory process in the lower genital tract, can be considered a necessary option.Other types of diagnostic methods only act as explanatory methods;it is necessary for differential diagnosis and to identify existing complications of the underlying disease.In addition, it is important to remember that with overdiagnosis, this stage itself is prolonged, and the symptoms only get worse.That is, here, as in any matter, the principle of "golden mean" is appropriate.

Treatment of prostatitis

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

At its core, the treatment of prostatitis may contain several steps, in particular, antibacterial therapy methods, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.Only based on a set of these steps can the desired result be achieved;In general, this disease is difficult to treat, so it should not be ignored.

Antibacterial therapy

This type of therapy is considered the basis of conservative treatment.The basis for choosing an antibacterial drug is several factors, in particular:

• the ability of the components of the proposed drug to enter the secretions and tissues of the prostate to create concentrations exceeding the pathogen's MIC value;
• characteristic spectrum of antimicrobial activity (for example, the use of macrolide antibiotics determines the possibility of good penetration into the prostate tissue, while they do not have any activity against gram-negative bacteria, that is, they are the main etiological agents in considering the acute form of prostatitis).

What should be noted is that acute prostatitis, when compared to the chronic form of this disease, is characterized by the fact that it allows the possibility of the accumulation of aminoglycoside and beta-lactam antibiotics in the gland tissue, and in sufficient concentrations to suppress the activity of most types of pathogens.This is due to an increase in prostate perfusion, as well as an increase in the characteristic level of permeability of the hemoprostatic barrier.Another feature of drugs in this group is that when inflammation decreases, their level of penetration into the prostate decreases.For this reason, it is recommended to switch to another type of oral medication.

Prostate massage

For the most part, experts consider this method of influence as a relatively effective solution in the treatment of prostatitis.The basic principle to achieve a therapeutic effect in this case is as follows:

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

How is prostate massage done?To begin with, of course, it is important to establish a certain relationship of trust between doctor and patient;this will ensure greater patient relaxation, which, in turn, will make it possible to carry out the necessary manipulations with minimal pain and maximum efficiency.When preparing for the massage, the patient leans forward, spreads his legs about 60 cm wide and leans on the examination table with his elbows.The doctor wears gloves and applies gel to the index finger (sometimes this gel has an analgesic effect).Next, with his free hand, he stretches the buttocks so wide that it is possible to palpate the anal sphincter with the index finger.The natural response to such contact is muscle contraction.Next, after relaxing them, the index finger is inserted into the rectal ampulla.

In some cases, patients experience dizziness and even fainting during this manipulation (on average in 10% of cases).These manifestations are mainly caused by fear, shame and excessive anxiety, and if the massage is done correctly, they do not accompany him at all.A massage can be called successful when it is possible to get at least 4 drops of secretion secreted by the prostate.

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

Immunotherapy

This direction in the treatment of prostatitis is often very necessary, because with prolonged manifestations of inflammation in combination with previous improper antibacterial treatment, the possibility of negative effects on the general state of the immune system cannot be ruled out.Treatment of prostatitis requires not only eliminating the infection from the gland and, in fact, inflammation, but also preventing the re-development of inflammation in it.However, like other areas of treatment, immunotherapy cannot be reduced to self-medication or treatment based on the pharmacist's recommendation at the pharmacy;here you need to consult an immunologist, and also, most likely, conduct some tests.

Physiotherapy

For prostatitis, this treatment direction can be implemented in a variety of impact options, however, regardless of the specific solution, the effect is focused on improving blood circulation in the pelvic organs, thus increasing the overall effectiveness of the implementation of antibacterial therapy measures.Physiotherapy can use ultrasonic waves, electromagnetic waves, laser therapy, increasing the temperature directly in the rectum, etc.If there is no opportunity for physical therapy, the doctor may recommend microenemas with warm water and certain medications.

Lifestyle correction

This type of effect is intended for both the treatment of prostatitis and its prevention.It should be treated in the same way as the main treatment, because if the predisposing factors to the development of prostatitis remain, then the disease will, sooner or later, be felt again.Taking this into account, you should make certain changes in your life, this applies to playing sports, normalizing your waking/sleeping schedule, nutritious balanced diet, walking, eliminating bad habits.

If symptoms indicating prostatitis appear, you should consult a urologist.