According to the BME, prostatitis is an inflammatory process that occurs in the prostate in men with damage to the parenchyma and interstitium.Treatment of prostatitis in men is a long and complex undertaking, most often due to complete ignorance of the disease at the very beginning.What is prostatitis, what are its causes and first signs, what should you know about the subject of "diagnosis" and what modern methods of prostatitis treatment exist.Everything men need to know about prostatitis is in this review article.
Ab ovo – from an egg
We are not talking about Horace's satires;in this case, we are interested in everything related to prostatitis, from the very beginning to the last "squeak" of treatment.Symptoms of prostatitis appear in men during the period of active sexual activity, from 25 to 45 years.In the thematic video, you can study in detail everything related to the basics of the disease, its causes and symptoms, features of diagnosis and treatment.
The reasons for the development of prostatitis are extensive.In prostatitis, infectious factors play the biggest role in the development of the disease:
- Acute form.The coccal flora acts as a provocateur.
- Chronic form.The reasons for its development are more extensive;the primary factors of such prostatitis in men are: gonococci, trichomonas, Gr+ and Gr- bacteria, tuberculosis mycobacteria.In rare cases, the diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
It is important to note that chronic prostatitis, which is caused by a pathogen that has penetrated the prostate, may subsequently have an abacterial character without the participation of a pathogenic factor.The acute form is often caused by external causes: hypothermia, trauma to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, physical inactivity and, as a result, impaired circulation of blood and lymph in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You can often hear about only one type of prostatitis - infectious, but according to the WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is registered in 90% of cases.
Table no.1. Brief characteristics of the pathology
| Categories for prostatitis | Acute infection | The presence of pathogens in prostate secretions or the 3rd portion of urine | Level (increase) of leukocytes in urine or secretions |
| 1 cat.Acute bacterial | + | + | + |
| 2 cats.Chronic bacterial | — | + | Uncertain (yes or no) |
| 3 a.Chronic pelvic pain syndrome of an inflammatory nature, non-bacterial | — | — | + |
| 3 b.Prostatodynia, non-inflammatory pelvic pain syndrome | — | — | — |
| 4 cats.Asymptomatic inflammatory process | — | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations was studied in more detail;in most cases, the cause of the disease is bacteria from the family.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as a cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered unproven.Symptoms of prostatitis in men with signs of weakened immunity, especially HIV, can be caused by yeast fungi (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played a significant role in the development of prostatitis, especially often causing its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have learned in detail a 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.Therefore, the causes of prostatitis, which is non-bacterial in nature, are congestive processes in the pelvis, poor circulation, intraprostatic urine reflux and autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man with prostatitis look like?For a person who is far from medicine, and especially does not understand the problems of urology, the external male appearance of one person is no different from a crowd of others.And only an experienced specialist, based on the patient's first complaints, will understand where the root of the problem is and what methods should be taken to eliminate it.
Symptoms of prostatitis are often described in a few phrases, highlighting the most memorable moments, and this plays a cruel joke on the man.Relying on such incorrect definitions, he ignores really important signals, considering that the disease does not exist, although in fact the clinical picture depends on the nature of the morphological changes in the prostate.
The first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in the perineum, radiation in the sacrum, frequent nocturnal urges.
- Follicular prostatitis.Difficult and frequent urination, sometimes delayed.Pain during urination, which intensifies at the end of the urination process, as well as defecation.Low temperature.
- Parenchymal prostatitis.Symptoms of pronounced dysuria appear, often acute respiratory distress, pain during natural recovery, general intoxication with a temperature of up to 40 C.
In prostatitis with the formation of an abscess, the symptoms are more pronounced with the possible opening of the abscess into the rectum or into the prostatic part of the urethra.With such penetration, the symptoms subside.If an abscess opens in the paraprostatic tissue or in the perineal area, visual symptoms can be observed: swelling, redness of the skin with pronounced fluctuation.The man's condition suddenly worsens.
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 common to distinguish between acute and chronic prostatitis;on the thematic video on the Internet, you can find out in detail which symptoms relate to this or that form.Let's consider this question in more detail.
Acute - its typical symptoms are characterized by manifestation in three stages: catarrhal, follicular and parenchymal.These are detailed above.
The most interesting in terms of symptoms is the chronic form of prostatitis, because there are many variations in symptoms.In general, the effective treatment of prostatitis depends on the prostatitis, that is, on its type.
In the chronology phase, the following points can be distinguished:
- Chronic prostatitis rarely occurs as a result of an acute process.
- Primary prostatitis passes with erased symptoms.
- A characteristic symptom of chronicity is scanty discharge from the urethra during defecation.
- The first symptoms, as a rule, are not expressed;the pathological process itself develops over years.It is preceded by prostatosis (clogged capillaries), which gradually turns into an abacterial form of prostate inflammation.
- 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 action of ureaplasma, trichomoniasis, chlamydia and gonococci.
How does a man with prostatitis in the chronic phase feel?Reviews of patients show that most often at first they feel minor pain in the perineum and scanty discharge, which most men simply do not pay attention to.The next stage is the addition of the following symptoms: burning in the urethra, sexual dysfunction, dysuria, general weakness.Frequent mistakes in ignition during sex make men depressed, they become irritable or depressed.
It is important to understand that all these signs do not necessarily appear in every specific case of chronicity, this is what makes it difficult to diagnose in the early stages of the disease, in addition, the symptoms tend to change places, which is even more deceptive.
Long-term syndromes
What can you expect from chronic prostatitis?If there is no timely diagnosis and treatment, there is nothing good, as every specialist will confirm.This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself does not hurt, but numerous nerve endings pass through it and are inevitably involved in the inflammatory process.The pain can be of different intensity - from mild pain, creating discomfort, to strong, preventing you from falling asleep peacefully.Irradiation of pain occurs in all nearby areas (scrotum, sacrum, perineum);pain from prostatitis must be distinguished from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a problem in the urinary system, but what caused it is clarified during diagnostics.The increased volume of the prostate inevitably compresses the urethra, and the flow of urine is disturbed, accompanied by the development of a frequent urge to go to the toilet, and a feeling of incomplete emptying of the bladder.In advanced prostatitis, there is compensatory hypertrophy of the muscle layer of the bladder and ureter.At this moment, the symptoms of dysuria weaken, but return again in an intensified form.
Sex without pleasure
Intimate life that is in decline - these are the first symptoms that men notice, and, as the reviews show, they are the ones that make them go to the doctor.Frequent night erections, orgasm in a deleted form, poor erection and rapid ejaculation, pain during it - this is what worries the stronger sex the most.In the advanced stage of the chronic disease, nothing good can be expected from prostatitis;erectile dysfunction often develops.
The degree of sexual dysfunction in men is not the same;some initiate sexual intercourse and somehow end it, ignoring the characteristic warning signs.For some, even the initial weak reaction of the penis to a charming stimulus becomes a collapse and the beginning of terrible experiences that turn into long-term depression.The specter of impotence is difficult for patients with prostate problems;specialists and relatives almost always notice that prostatitis worsens the character.
To learn more about the disease, you can study the thematic video in which experts explain the many nuances of the pathology.
What to write on the card
Which entry will appear in the patient's medical record and which final diagnosis will be made depends on a series of primary studies, starting from the patient's visit to the urologist and his complaints (anamnesis) to the last stage of diagnostic measures.What exactly is needed depends on the type of prostatitis, its severity and the patient's consent to specific diagnostic procedures.
In general, diagnostics consists of:
- History.The doctor will ask in detail about all complaints and symptoms, prerequisites for the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + collection of secretions).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does diagnostics provide and is it so important?If you read patient reviews, you can often understand that most men try to avoid many stages of diagnosis, the motivations are very different.The price of such indifference is your health!It is important to remember that prostatitis is curable only if it is "caught" in time and an accurate diagnosis is made, along with determining the form of the disease and its cause.
How to become healthy forever
So, a man understands that he has prostatitis, what awaits him in the future and is it possible to restore lost health?It is important to understand that it will take 2 times longer to get rid of prostatitis than it should have developed.Moreover, if the pathological process took place practically without the attention of the man, then the treatment of prostatitis will take place with his direct participation.Is acute or chronic prostatitis curable?Yes, if you follow all the doctor's recommendations, in advanced cases of the chronic form, stable remission can be achieved with treatment.
The stages of prostatitis treatment will directly depend on what the doctor finally discovered during the examination, on the type of disease, the patient's age and physical characteristics.
The treatment regimen is always strictly individual, but the following points may be present in it:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Prescribing immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The price of each stage of treatment is different and depends on the total price of prescribed drugs, additional methods and the clinic.Preventive measures after treatment have an important reason - they prevent the return of the disease.Prevention has direct and close contact with treatment;the basics of prevention are important, as is compliance with all the doctor's requirements during therapy.
Treatment of acute form
The period of exacerbation requires taking antibiotics, which are taken continuously.Cephalosporin drugs are indicated in the presence of chlamydial infection.
The duration of the course of use is significant;on average, antibiotics are taken for at least 3-4 weeks to prevent recurrence of the disease.Sometimes the doctor continues treatment for a long time, combining antibiotics with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- To determine the sensitivity of microorganisms to the drug, a bacterial culture is required.
- Side effects and contraindications of drugs are taken into account.
- They take into account the previous course of treatment, when it took place, which means were used and the result.
The need for additional treatment methods is determined by the doctor;it should be remembered that in acute forms of prostatitis, massage is contraindicated, because it causes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is important to remember that in principle you cannot get rid of chronicity quickly, the disease has been developing for years and even doctors in their field cannot destroy it in a few weeks;you don't have to believe those who cured the disease in 2-3 days.Treatment is aimed at stopping the source of infection, restoring immunity in men and the functioning of the prostate, as well as preventing exacerbations - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks;if healing is low, healing continues.Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete excision of the prostate is planned.
No bacteria or symptoms
A characteristic difference between the therapies 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 of 2-4 weeks.
The treatment of abacterial prostatitis is based on the application of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy while strengthening the patient's immune system.
Diet and lifestyle changes also form the basis of treatment for nonbacterial prostatitis;baths and alpha-blockers are indicated.
Prostatitis without symptoms is difficult to recognize;The PSA method is used for diagnosis, followed by a two-week course of antibiotics as treatment.After that, symptomatic treatment is selected individually.
In general, the treatment of any type of prostatitis is a long-term phenomenon and is not always pleasant for the patient.In addition to physical discomfort, a man also suffers psychologically, because his most valuable part of the body - the intimate part - is affected.Reviews of those who have cured the disease show that only strict adherence to the doctor's instructions, along with diet and lifestyle changes, bears fruit.The price of a frivolous attitude towards treatment is very high - a person not only loses his health, his whole life, character and relationships with others change.To prevent this, it is necessary to monitor the health of the prostate and eliminate the causes of the development of the disease.