Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate, located directly under the bladder and in a small part of the genitals.

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

Reasons

Inflammation of the prostate can develop 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 increase in the size of the prostate.Obesity and a sedentary lifestyle contribute to the stagnation of processes.
2. If bacteria, viruses or protozoa enter the prostate tissue against the background of an acute or chronic inflammatory process occurring in other organs of the body, diseases such as tonsillitis, gonorrhea, urethritis, cystitis, influenza and pyelonephritis can cause prostatitis.Infectious agents can enter the prostate through blood and lymph flow if there is infection in distant areas and organs.
3. Received injuries and bruises to the soft tissues of the abdomen, perineum and external genitalia - this leads to swelling and poor circulation in the area of injury;
4. Hypothermia of the body.
5. Chronic constipation.
6. Hormonal disorders.
7. A stormy or, conversely, absent sex life is harmful, both frequent sexual intercourse (more than once a day) and rare intimate relations (less than once a week), because this leads to exhaustion of the gonads or congestion of the prostate.

Symptoms of prostatitis

There are acute and chronic forms of the disease.

Acute prostatitis is characterized by a sudden onset against the background of general well-being, which is 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 a persistent feeling of incomplete emptying of the bladder;
• pain in the rectum and difficulty having a bowel movement.

In the absence of timely diagnosis and 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 he has recovered.Characteristic signs of a chronic inflammatory process in the prostate are a burning sensation along the urethra with irradiation to the perineum, which can intensify with urination and defecation.Little by little, the disease progresses and causes impotence.Chronic prostatitis involves periods of remission and exacerbation, but even during moments of exacerbation the symptoms will be cleared, although not as pronounced as in the acute form.The following symptoms appear clinically:

• erection difficulties;
• inability to complete sexual intercourse with ejaculation;
• decreased libido;
• discharge of mucus from urethra mixed with white flakes;
• sensation of incomplete emptying of the bladder;
• throbbing pain in the lumbar region, pubis and groin;
• weak stream of urine - this is observed as a result of narrowing of the lumen of the urethra against the background of its compression by enlarged prostate.

A chronic, sluggish inflammatory process in the urethra irritates the nerve endings in the pelvis and causes a constant urge to urinate, especially at night.Many men are embarrassed to consult 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, from the source of chronic infection of the prostate, pathogenic microorganisms enter the kidneys through blood and lymph, causing acute inflammation, urinary retention and increasing the 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 alongside urolithiasis.

Diagnostic methods

A urologist is involved in the diagnosis, treatment and prevention of prostatitis.To make a diagnosis, determine the form and cause of the inflammatory process in the prostate, the patient is prescribed a number of tests:

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

If a spread of the pathological process to the bladder is suspected, the patient additionally undergoes cystoscopy - examination of the walls of the bladder using a flexible device equipped with an optical system at its end.

When diagnosing prostatitis, it is very important to differentiate 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, therefore patients are strongly advised not to self-medicate.

The acute nonbacterial form of prostatitis is treated comprehensively using medicinal plants and anti-inflammatory drugs.

Treatment of acute bacterial prostatitis

The principles of treatment of acute forms of bacterial prostatitis directly depend on the intensity of the symptoms of the disease.

A distinctive feature of bacterial prostatitis is the sudden onset and rapid increase in signs of intoxication of the body - nausea, vomiting, headache, high body temperature.The process of emptying the bladder is accompanied by cutting pains in the lower abdomen and perineum, which radiate to the lower back.Very often, a purulent process occurs and an abscess develops in the prostate.

Treatment of acute bacterial prostatitis is carried out in a hospital setting, as the patient's condition can be extremely serious.The therapy consists of an integrated approach:

• the patient must remain in bed;
• antibiotics are prescribed - macrolides, fluoroquinolones, cephalosporins;
• drugs are selected to improve blood microcirculation in the pelvic organs.They ensure the flow of lymph and venous blood, which reduces the severity of swelling and inflammation of the prostate;
• Medicines from the group of nonsteroidal anti-inflammatory drugs are indicated orally.These drugs not only reduce the inflammatory process, but also eliminate pain;
• pain relievers - you can take tablets orally or insert rectal suppositories into the rectum;
• To eliminate intoxication from the body, a physiological sodium solution containing glucose is prescribed intravenously.

Important!Prostate massage is strictly prohibited because there is a high risk of developing sepsis.

Surgical treatment

Prostatitis surgery is only necessary if the patient develops acute urinary retention and there is no way to empty the bladder.Surgery cannot be avoided in the event of a prostate abscess.

Treatment of prostatitis lasts 14 days, after which the patient again undergoes a complete examination to assess the effectiveness of the treatment.If necessary, the duration of treatment is extended and adjusted.

Treatment of chronic form

Treatment of chronic prostatitis differs and largely depends on the stage of the pathological process.In case of exacerbation of the inflammatory process, treatment is carried out in the same way as for acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. taking a course of non-steroidal anti-inflammatory drugs.Medicines are prescribed 2 times a day for at least 3 days, sometimes up to 5 days.
2. Medicines that help improve venous and lymphatic flow.
3. Immunomodulators.
4. Antidepressants and sedatives help normalize sleep and eliminate irritability.
5. Multivitamin complexes rich in zinc, selenium, B vitamins.

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

• prostate massage;
• ultrasound;
• electrophoresis;
• magnetic therapy;
• microwave hyperthermia.

Surgical treatment of chronic prostatitis

In cases of 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, although it is performed under general anesthesia.During the procedure, a resectoscope is inserted under the urethra, through which pulses of electric current are applied.These electrical pulses act like an electric knife and partially remove prostate tissue.A huge advantage of this method of intervention is the absence of blood loss, since electrical waves not only remove the changed prostate tissue, but also immediately treat blood vessels, preventing bleeding.

Transurethral resection significantly relieves the patient's condition - after the operation, urination is restored, the man no longer has a burning sensation in the perineum and he does not jump to go to the toilet at night.Erectile function and normal ejaculation are also restored.The entire surgical process is monitored by a doctor on a monitor screen, so the risk of complications during or immediately after the operation is minimal.

Prostatectomy

Prostatectomy is a major abdominal surgery 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.Medical leeches are placed on the area of inflammation, which, in the process of their actions, secrete a saliva-containing substance that puts the blood in order, eliminates congestion and quickly stops the inflammatory process.Leeches are used only in a special, medical and individual way for each patient.After the procedure, the doctor places the used leech in a disinfectant solution in which it dies.It is optimal to complete 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 treatment and, for whatever reason, surgery is contraindicated for them.
3. Microwave therapy is a special method: electromagnetic waves are applied to the prostate area.Already after 1 procedure, tissue swelling is reduced, blood circulation is normalized and congestion is eliminated.After a course of electromagnetic therapy, the patient's urination and erectile function are completely restored.
4. Ultrasound wave treatment allows you to quickly stop the inflammatory process that occurs in the remission phase;during the period of exacerbation, ultrasound therapy is not carried out.To enhance the therapeutic effect, drugs can also be used that, under the influence of ultrasound, directly penetrate the prostate tissue.
5. Urethral stent - the essence of the procedure is to install a special stent in the urethra, which expands the lumen of the urethra and promotes normal urine flow.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

In the absence of qualified treatment, prostatitis progresses rapidly, becomes chronic and threatens a man's health with its serious complications, including:

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

Sometimes prostatitis and chronic congestive processes for a long time give an impetus to the degeneration of the disease into adenoma, and then into prostate cancer.