Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate, which is located directly below the bladder and a smaller part of the genital organs.

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

Reasons

Inflammation of the prostate can develop for various reasons, and 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, sedentary lifestyle contribute to stagnant 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 if there is infection in distant areas and organs.
3. Acquired injuries and bruises on the soft tissues of the abdomen, perineum and external genitalia - this leads to swelling and poor circulation in the area of the 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 infrequent intimate intercourse (less than once a week), because it 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 appearance against the background of general well-being, which is clinically accompanied by the following symptoms:

• tremors and weakness;
• general weakness;
• increased irritability and nervousness;
• increased body temperature (not more 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 with bowel movements.

In the absence of diagnosis and timely 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 radiation to the perineum, which can be intensified by urination and defecation.Gradually the disease progresses and causes impotence.Chronic prostatitis includes periods of remission and exacerbation, but even in moments of exacerbation the symptoms will be erased and not as pronounced as in the acute form.Clinically, the following symptoms occur:

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

The chronic, slow inflammatory process in the urethra irritates the pelvic nerve endings and causes a constant need to urinate, especially at night.Many men are ashamed 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 in the prostate, pathogenic microorganisms enter the kidneys through blood and lymph, causing acute inflammation, urinary retention and increasing the risk of kidney failure.

The constant accumulation of urine in the bladder and ureter creates favorable conditions for the formation of salt crystals and subsequently stones - very often prostatitis in men occurs in parallel with urolithiasis.

Diagnostic methods

The urologist is involved in the diagnosis, treatment and prevention of prostatitis.To establish a diagnosis, determine the form and cause of the inflammatory process in the prostate, the patient is prescribed a series of examinations:

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

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

When diagnosing prostatitis, it is very important to distinguish the pathological process from prostate adenoma and other urological diseases with a similar clinical course.

Treatment

The treatment of acute and chronic forms of prostatitis is different, so patients are expressly advised not to self-medicate.

The acute non-bacterial form of prostatitis is comprehensively treated with the use of herbal medicines and anti-inflammatory drugs.

Treatment of acute bacterial prostatitis

The principles of treatment of acute forms of bacterial prostatitis directly depend on how pronounced the symptoms of the disease are.

The peculiarity of bacterial prostatitis is the acute onset and rapidly growing signs of intoxication of the body - nausea, vomiting, headache, high body temperature.The process of emptying the bladder is accompanied by cutting pain in the lower abdomen and perineum, which radiates 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 hospital conditions, because the patient's condition can be extremely difficult.The therapy consists of an integrated approach:

• the patient must remain in bed;
• antibiotics are prescribed - macrolides, fluoroquinolones, cephalosporins;
• selected drugs that improve blood microcirculation in the pelvic organs.They ensure the outflow 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 remove pain;
• analgesics - you can take tablets orally or insert rectal suppositories into the rectum;
• In order to remove intoxication of the body, a physiological solution of sodium with glucose is prescribed intravenously.

Important!Prostate massage is strictly prohibited, as 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 if a prostate abscess occurs.

The course of prostatitis treatment lasts 14 days, after which the patient again undergoes a comprehensive examination to assess the effectiveness of the therapy.If necessary, the course of treatment is extended and adjusted.

Treatment of the chronic form

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

Treatment of chronic prostatitis during remission is as follows:

1. course intake 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 improve venous and lymphatic drainage.
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 physiotherapy treatment:

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

Surgical treatment of chronic prostatitis

In advanced chronic prostatitis, the patient sometimes needs surgical intervention.This can be done in two ways:

• transurethral resection;
• prostatectomy.

Transurethral resection

This method of surgical treatment is a minimally invasive procedure, although it is performed under general anesthesia.During the procedure, a resectoscope is inserted under the urethra through which electric current pulses are applied.These electrical pulses act like an electric knife and partially remove the prostate tissue.The huge advantage of this method of intervention is the absence of blood loss, because the electric waves not only remove the modified tissue of the prostate, but also immediately heal the blood vessels, preventing bleeding.

Transurethral resection significantly eases 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 up to go to the toilet at night.Erectile function and normal ejaculation also return.The entire process of the operation is monitored by the doctor on the monitor screen, so the risk of complications during or immediately after the operation is minimal.

Prostatectomy

Prostatectomy is a major abdominal surgery and always involves 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 developing 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 leech treatment.Medicinal leeches are placed at the site of inflammation, which by their action secrete a substance with saliva that brings the blood into order, removes the blockage and quickly stops the inflammatory process.Leeches are used only special, medical, individual for each individual patient.After the procedure, the doctor places the used leech in a disinfectant solution in which it dies.It is optimal to undergo at least 5 courses of hirudotherapy.
2. Cryodestruction - liquid nitrogen is used.This method of treatment is indicated for patients who respond poorly to drug therapy, and for some reason surgery is contraindicated.
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. Treatment with ultrasound waves allows you to quickly stop the inflammatory process that occurs in the phase of remission;in the period of exacerbation, ultrasound therapy is not performed.In order to enhance the therapeutic effect, you can additionally use drugs that penetrate directly into the prostate tissue under the influence of ultrasound.
5. Stenting of the urethra - the essence of the procedure is the installation of a special stent in the urethra, which expands the lumen of the urethra and promotes the normal outflow of urine.Despite the effectiveness of the procedure, urethral stenting only removes the clinical symptoms of prostatitis, but does not free the patient from the chronic inflammatory process.

Consequences and complications

In the absence of qualified therapy, 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 impetus to the degeneration of the disease into adenoma and then prostate cancer.