Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate gland, located directly below the bladder and a small part of the genital organ.

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 increases under the influence of external and internal factors.

Reason

Inflammation of the prostate gland can develop for various reasons, doctors identify the main ones:

1. Violation of blood microcirculation in the pelvic organs - this leads to stagnation and contributes to an increase in the size of the prostate gland.Obesity and a sedentary and inactive lifestyle contribute to an unstable process.
2. If bacteria, viruses or protozoa enter the prostate tissue against the background of acute or chronic inflammatory processes occurring in other organs of the body, diseases such as tonsillitis, gonorrhea, urethritis, cystitis, influenza, and pyelonephritis can trigger prostatitis.Infectious agents can enter the prostate through the bloodstream and lymph if there is infection in distant areas and organs.
3. Getting injuries and bruises on the soft tissues of the abdomen, perineum and external genitalia - this leads to swelling and poor circulation in the injured area;
4. Body hypothermia.
5. Chronic constipation.
6. Hormonal disorders.
7. A stormy or, conversely, absent sex life is dangerous, both frequent intercourse (more than once a day) and infrequent intimate intercourse (less than once a week), as this leads to lack of gonads or congestion in the prostate.

Symptoms of prostatitis

There are acute and chronic forms of this disease.

Acute prostatitis is characterized by a sudden attack against the background of general well-being, which is clinically accompanied by the following symptoms:

• shivering and weakness;
• general lethargy;
• increased irritability and restlessness;
• increased body temperature (not higher than 37.5 degrees);
• pulling or cutting pain in the lower abdomen and perineum;
• a frequent urge to urinate with a constant feeling of incomplete emptying of the bladder;
• pain in the rectum and difficulty defecating.

In the absence of timely diagnosis and treatment, acute prostatitis can be complicated by purulent processes and the release of pus from the urethra during urination.

Symptoms of chronic prostatitis

When the disease becomes chronic, the clinical signs of prostatitis decrease and the patient feels that recovery has taken place.The characteristic signs of the chronic inflammatory process in the prostate gland are a burning sensation along the urethra with radiation to the perineum, which can increase with urination and defecation.Gradually the disease develops and causes impotence.Chronic prostatitis involves periods of remission and exacerbation, but even in moments of exacerbation the symptoms will be erased, unlike those expressed in the acute form.The following symptoms appear clinically:

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

A chronic, moist inflammatory process in the urethra irritates the pelvic nerve endings and causes a constant urge to urinate, especially at night.Many men are embarrassed to consult a doctor with such a complicated problem, which increases the risk of serious complications such as complete erectile dysfunction, infertility and even prostate cancer.

In addition, from the source of chronic infection in the prostate, pathogenic microorganisms enter the kidney 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 urethra creates favorable conditions for the formation of salt crystals, and then stones - very often prostatitis in men occurs in parallel with urolithiasis.

Diagnostic method

Urologists are 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 gland, the patient is prescribed several examinations:

• 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 discharge smear from the urethra - the resulting material is sent for study to the laboratory;
• urine analysis - general, etc.;
• Ultrasound of the pelvic organs and prostate gland.

If the spread of the pathological process to the bladder is suspected, the patient also undergoes a cystoscopy - an examination of the bladder wall 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

Treatment of acute and chronic forms of prostatitis is different, so patients are strongly advised not to self-medicate.

Non-bacterial forms of acute prostatitis are treated comprehensively with the use of herbal and anti-inflammatory drugs.

Treatment of acute bacterial prostatitis

The principle of treatment for the acute form of bacterial prostatitis directly depends on how pronounced the symptoms of the disease are.

A distinctive feature of bacterial prostatitis is the acute onset and increasing signs of body intoxication - 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.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 very severe.Therapy consists of an integrated approach:

• the patient must remain in bed;
• prescribed antibiotics - macrolides, fluoroquinolones, cephalosporins;
• Medicines are selected that improve blood microcirculation in the pelvic organs.They ensure the outflow of lymphatic and venous blood, which reduces the severity of swelling and inflammation in the prostate;
• Drugs from the group of non-steroidal anti-inflammatory drugs are indicated orally.These drugs not only reduce the inflammatory process, but also relieve pain;
• analgesics - you can take tablets orally or insert rectal suppositories into the rectum;
• To eliminate body hangover, physiological sodium solution with glucose is prescribed intravenously.

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

Surgical treatment

Surgery for prostatitis is only necessary if the patient has acute urinary retention and there is no way to empty the bladder.Surgery cannot be avoided if a prostate abscess occurs.

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

Chronic form treatment

Treatment of chronic prostatitis varies and largely depends on the stage of the pathological process.In case of exacerbation of the inflammatory process, therapy 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.These drugs are prescribed 2 times a day for at least 3 days, sometimes up to 5 days.
2. Drugs that help increase venous and lymph outflow.
3. Immunomodulators.
4. Antidepressants and sedatives help normalize sleep and relieve irritability.
5. Multivitamin complex 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

With advanced chronic prostatitis, patients sometimes require 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, where pulses of electric current are applied.This electrical impulse acts like an electric knife and removes part of the prostate tissue.The great advantage of this method of intervention is the absence of blood loss, because electric waves not only remove the modified prostate tissue, but also immediately treat the blood vessels, preventing bleeding.

Transurethral resection significantly reduced the patient's condition - after the operation, urination was restored, the man no longer had a burning sensation in the perineum, and he did not jump to go to the toilet at night.Erectile function and normal ejaculation are also restored.The entire operation process is monitored by the doctor on the monitor screen, so the risk of complications during or immediately after surgery 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 gland.The recovery period is 4-6 weeks, there is a high risk of post-operative 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.Medicinal leeches are placed in the area of inflammation, which during their action secrete substances with saliva that bring regular blood, relieve congestion and quickly stop the inflammatory process.Leeches are used only specially, medically, individually for each individual patient.After the procedure, the doctor places the used leech in a disinfectant solution where it dies.It is optimal to undergo at least 5 courses of hirudotherapy.
2. Cryodestruction - liquid nitrogen is used.This treatment method is indicated for patients who do not respond well to drug therapy, and for some 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 were completely restored.
4. Treatment with ultrasonic waves allows you to quickly stop the inflammatory process that occurs in the remission phase;during the exacerbation period, ultrasound therapy is not performed.To increase the therapeutic effect, drugs can also be used that, under the influence of ultrasound, penetrate directly into 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 the normal outflow of urine.Despite the effectiveness of the procedure, urethral stenting only eliminates the clinical symptoms of prostatitis, but does not relieve the patient from the chronic inflammatory process.

Consequences and complications

In the absence of qualified therapy, prostatitis quickly develops, becomes chronic and threatens men's health with severe complications, including:

• urolithiasis;
• pyelonephritis;
• the development of an abscess;
• the spread of the inflammatory process to the testicles and spermatic cord, 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 an adenoma, and then prostate cancer.