According to the BME, prostatitis is an inflammatory process that occurs in men with damage to the parenchyma and interstitium in the prostate. Treatment of prostatitis in men is a long and difficult event, most often due to the complete ignorance of the disease at the beginning. What is prostatitis, what are its causes and the first signs, what you need to know about the subject of "diagnosis" and what modern methods are available for treating prostatitis. 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 beginning to the last "squeak" of treatment. Symptoms of prostatitis appear in men during active sexual activity between the ages of 25 and 45 years. In a thematic video you can find out everything related to the basics of the disease, its causes and symptoms, the specifics of its diagnosis and treatment.
The reasons for the development of prostatitis are many. In prostatitis, infectious factors have the greatest weight in the development of the disease:
- Acute form. The cocci flora acts as provocative grounds.
- Chronic form. The reasons for its development are more comprehensive, since the main factors of such prostatitis in men are: gonococci, Trichomonas, Gr + and Gr bacteria, Mycobacterium tuberculosis. In rare cases, the diagnosis shows mycoplasma, viruses, fungi, chlamydia, etc.
It is noteworthy that chronic prostatitis, which is caused by a pathogen that has penetrated the prostate, later has a pathogenic factor and can be bacterial 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 diseases.
Often one hears about only one type of prostatitis - infectious, but according to the WHO, bacterial prostatitis accounts for no more than 10% of all disease cases, 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 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 bacteria | + | + | + |
| 2 cat. Chronic bacteria | - | + | Unsure (whether or not) |
| 3a. Chronic pelvic pain syndrome of an inflammatory nature, non-bacterial | - | - | + |
| 3b. Prostatodynia, non-inflammatory pelvic pain syndrome | - | - | - |
| 4 cat. Asymptomatic inflammatory process | - | Unsure (yes or no) | Unsure (yes or no) |
The etiology of bacterial prostatitis in both acute and chronic manifestations has been studied in more detail, in most cases the bacteria of the family become the cause of the disease. Enterobacteriaceae (E. coli bacillus). The role of atypical microorganisms as the cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently not considered fully proven. Symptoms of prostatitis in men with evidence of compromised immunity, especially HIV, may be caused by yeast (Candida spp. ) Or Mycobacterium tuberculosis.
Before the advent of the antibiotic era, the gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, and it often became the cause of its abscessed form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have carefully studied the list of possible pathogenetic (prostatitis-provoking) factors that play an important role in the appearance of inflammation in the prostate in the absence of microorganisms. At the center of the causes of non-bacterial prostatitis are stagnant processes in the pelvis, circulatory disorders, intraprostatic urinary reflux and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man with prostatitis look like? For a person far from medicine and even more familiar with the problems of urology, the masculine appearance of an individual is no different from the crowd of others. And only an experienced specialist will understand, from the first ailments of the patient, where the root of the problem has matured and what ways to get rid of it.
The symptoms of prostatitis are often described in several sentences, highlighting the brightest moments, and this plays a cruel joke with a man. Relying on such imprecise definitions, he ignores really important bells and believes that the disease does not exist, although the clinical picture actually depends on the nature of the 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 nocturnal urging.
- Follicular prostatitis. Difficulty and frequent urination, sometimes with a delay. Pain when "peeing", worsened at the end of urination and when defecating. Light 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.
With prostatitis with abscess formation, the symptoms are lighter 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 area, visual symptoms can be observed: swelling, reddening of the skin with pronounced fluctuation. At the same time, the man's condition deteriorates sharply.
Without a thorough examination of the man, diagnosis and analysis of symptoms that may directly indicate the nature of the disease, comprehensive treatment for prostatitis cannot be instituted.
In general, it is customary to differentiate between the acute and chronic course of prostatitis, in a video on the Internet you can find out in detail which symptoms relate to one form or the other. Let's take a closer look at this problem.
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 for prostatitis depends on the prostatitis or its type.
In the chronicity stage, the following moments can be distinguished:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis disappears with the symptoms erased.
- A characteristic symptom of chronicity is a small amount of discharge from the urethra during bowel movements.
- The first symptoms, as a rule, do not express themselves, the pathological process itself develops over the years. It is preceded by a prostatosis (blockage of the capillaries), which changes smoothly 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, trichomonas, chlamydia and gonococci.
How does a man with chronic prostatitis feel? Patient reports show that the most common initial feeling of pain in the perineum is scanty discharge that most men simply don't pay attention to. The next stage is the association of the following symptoms: burning sensation in the urethra, sexual dysuria, general malaise. Frequent dropouts during sex make men depressed, irritable, or depressed.
It is important to understand that all of these signs do not necessarily appear in every specific case of chronicity, this makes it difficult to diagnose at an early stage of the disease, and 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 - no good, any specialist will confirm it. This type of prostatitis is characterized by 3 syndromes:
pains
The prostate itself does not hurt, but many nerve endings pass through it and are nearby that are inevitably involved in the inflammatory process. The pain can vary in severity - from mild pain that causes discomfort to severe pain that does not allow you to sleep soundly. Irradiation of pain is carried out in all surrounding areas (scrotum, sacrum, perineum), pain from prostatitis must be distinguished from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a malfunction of the urinary system, but the cause of this is revealed during diagnosis. The increased volume of the prostate inevitably compresses the urethra and the flow of urine is interrupted, followed by a frequent urge to use the toilet, a feeling of incomplete emptying of the bladder. With advanced prostatitis, compensatory hypertrophy of the muscular layer of the bladder and ureters occurs. At this point the symptoms of dysuria subside, but come back in an aggravated form.
Sex without pleasure
An intimate life in decline - it is these first symptoms that men notice and, as the reviews show, force them to see a doctor. Frequent nocturnal erections, an erased orgasm, poor erection and rapid ejaculation, pain associated with it - this is what worries the stronger sex most. In the advanced stage of chronicity, prostatitis is not expected to be good; erectile dysfunction often develops.
The degree of sexual disorder in men is not the same, someone starts intercourse and somehow completes it, wiping off the characteristic bells. For some, even the initially weak response of the penis to a charming stimulus turns into collapse and the onset of eerie experiences that turn into persistent depression. The specter of impotence is difficult for patients with problems with the prostate, almost always experts and relatives note that prostatitis spoils the character.
To learn more about the disease, you can study a thematic video, in which experts explain many nuances of the pathology.
What to write on the card
Which records appear in the patient's medical record and which final diagnosis is made depends on a number of primary studies, starting with the arrival of the patient at the urologist and his / her complaints (anamnesis) up to the final phase of the diagnostic measures. What exactly is required depends on the type of prostatitis, its neglect and the patient's consent to certain diagnostic procedures.
In general, the diagnosis consists of:
- Anamnese. The doctor inquires in detail about all complaints and symptoms, the requirements of the disease, etc.
- Urine analysis.
- Prostate massage (digital rectal examination + collection of secretions).
- Ultrasound of the prostate.
- Sperm diagrams.
- Prostate biopsy (if indicated).
What is the point of diagnostics and is it so important? Often times, reading patient reviews, you can understand that most men try to bypass many stages of diagnosis while motivations vary widely. The price of such indifference is your own health! It is important to remember that prostatitis is curable only if it is "caught" in a timely manner and the diagnosis is accurately made with the definition of the form of the disease and its cause.
This is how you get healthy forever
So the man understands that he has prostatitis, what to expect in the future and is it possible to return the lost health? It is important to understand that you need to get rid of prostatitis twice longer than it developed. When the pathological process has almost exceeded the man's attention, the treatment of prostatitis is carried out with his direct participation. Whether acute or chronic prostatitis can be cured - yes, if you follow all medical recommendations, a stable remission can be achieved during treatment in advanced cases of the chronic form.
The stages of prostatitis treatment depend directly on what the doctor finally found on the examination, the type of disease, the patient's age, and physical data.
The treatment regimen is always strictly individual, but the following points can be included:
- Antibacterial therapy.
- Methods of physiotherapy.
- Phytotherapy.
- Appointment of immune correctors.
- Urological massage.
- Physical therapy.
The price for each level of treatment is different, depending on the total cost of the prescribed drugs, additional methods, and the clinic. Preventive measures after treatment have one important reason - they prevent the disease from returning. Prevention is in direct and close contact with treatment; the basics of prevention are just as important as compliance with all medical guidelines during the course of therapy.
Treatment of the acute form
The phase of exacerbation requires taking antibiotics, drunk in a course. In the presence of a 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 relapse of the disease. Sometimes the doctor continues treatment for a long period of time, antibiotics are combined with analgesics for pain relief.
Treatment with antibiotics is carried out taking into account the following rules:
- A bacterial culture is required to determine the susceptibility 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 resources were used and the result.
The need for additional methods of treatment is determined by the attending physician. It should be noted that in the acute form of prostatitis, massage is contraindicated, as 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 the chronicity quickly, in principle the disease has developed over the years and it is not even within the power of doctors in their field to correct it in a few weeksdestroy you do not have 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, as well as preventing an exacerbation - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks, if the treatment is poorly effective, the drug is continued to be taken. Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs. In advanced cases, an operation with partial or complete removal of the prostate is performed.
Free from bacteria and symptoms
A characteristic difference in therapy is the absence of antibiotics, in the absence of the presence of pathogenic microflora they simply are not needed. But sometimes experts prescribe a short medication course within 2-4 weeks.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening of 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, the PSA method is used to diagnose, followed by 2 weeks of antibiotic treatment. After that, an individual symptomatic treatment is selected.
In general, the treatment of any type of prostatitis is a long-term phenomenon and is not always pleasant for the patient himself. In addition to physical complaints, a man also suffers mentally because his most valuable part of the body is affected - the genital area. Reviews from those who have cured the disease show that only strict adherence to medical prescriptions combined with diet and lifestyle changes will pay off. The price of a reckless attitude towards treatment is very high - a man not only loses his health, his whole life, character and relationships with others change. To prevent this from happening, it is necessary to monitor the health of the prostate and eliminate the causes of the development of diseases.