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Prostatitis

Prostatitis in men

Prostatitis is inflammation of the fabric of the prostate gland in men, which manifests itself from pain in the disorders of the abdomen and lower urination. The disease proceeds in acute and chronic forms, develops under the influence of infectious and non -infectious causes. Prostatitis is included in the five most frequent problems that men turn to the urologist.

The prostate gland is an organ of the male reproductive system that produces a liquid secret that is part of the sperm and improves the mobility of the spermatozoa. The prostate has the shape of chestnuts, size 2x3x3, 5 cm, is found in the middle of the cavity of the pelvis. A bladder neck and the initial department of the urethra cross the center of the gland.

Acute prostatitis is quite rare (5-10 % of cases), but it proceeds it is difficult and it is a serious danger to male health. Mostly young people are sick of an acute form of inflammation. Chronic prostatitis develops in men most often aged between 60 and 70 years. The disease proceeds with moderately pronounced symptoms, but over time leads to the formation of erectile dysfunction and compromised urination.

The causes and risk factors of prostatitis in men

All causes of prostatitis in men can be divided into two large groups: infectious and non -infectious.

Acute inflammation of the prostate glandVery often it has an infectious origin, this form of the disease is particularly common among men under the age of 40. In the vast majority of cases, it is caused by the bacterial flora:

  • Enterococci;
  • E. coli;
  • Klebsiella and Proteas;
  • Gonococcus;
  • Pale treponema;
  • clamidia;
  • Tuberculosis mycobacteria.

However, the same parenting or intestinal infection leads to the inflammation of the prostate gland in 100 % of cases. For the development of bacterial prostatitis, predisposing factors are needed, the main one is the systematic microtrauma of the gland. This happens with prostate biopsy, cystoscopies or operations in the pelvis. Other risk factors of infectious prostatitis include:

  • immunodeficiency (HIV infection, congenital pathology of the immune system);
  • random sex life;
  • homosexual contacts;
  • chronic diarrhea or constipation;
  • obesity;
  • A sedentary lifestyle.

Pathogenic microorganisms penetrate the prostate gland from urethra or rectum. The weakening of immune protection and prostate microtrauma contribute to the development of acute inflammation. In this context, the tone of the smooth muscles of the prostate increases, which leads to the compression of urethra and urination disorders.

Chronic prostatitisIt has a non -infectious origin and a more complex development mechanism. Inflammation gradually forms and the exact cause of its presence has not been established. Risk factors of non -kiss chronic prostatitis:

  • increase in pressure in the prostate gland (with hyperplasia or benign adenoma);
  • increase in pressure in the pelvic cavity;
  • chronic pelvic pains;
  • autoimmune diseases;
  • rare sexual contacts;
  • heavy physical activity;
  • Chronic stress.

The pathogenesis of chronic prostatitis is based on the stagnation of the secret of the gland, on the deterioration of its blood supply, which leads to constant inflammation.

In about 6 % of cases, chronic bacterial prostatitis develops in men. The reason for this is an insufficient or incomplete treatment of the acute form of the disease.

Types of prostatitis

Depending on the cause and the development mechanism, four cliniciansforms of prostatitis:

  • acute bacterial;
  • chronic bacterial;
  • Chronic pelvic pelvic pain syndrome (chronic pelvic pain syndrome);
  • Asymptomatic inflammation.

The National American Institute of Health distinguishes 4 types of prostatitis according toFrom the development phase and the clinic:

  • The type - acute bacterial inflammation with general and local events;
  • II type - chronic bacterial inflammation with periods of remissions and exacerbations;
  • IIIA TYPE - Non -Bacterial (pathogenic microorganisms) confirmed by the presence of leukocytes in the secret of the prostate or ejaculate has not been detected;
  • IIIV of type - non -inflammatory prostatitis, in which there are no pathogenic microorganisms and leukocytes in the secret of the gland;
  • Type IV - Asymptomatic inflammation, which can only be confirmed histologically.

Depending onFrom the nature of the pathological processIn the prostate gland, they distinguish:

  • Catarrale prostatitis - simple acute inflammation;
  • Stagnant or congestive prostatitis - chronic inflammation associated with the obstruction of the ducts of the gland and the accumulation of a prostate secret in them;
  • Calculation prostatitis - a complication of a chronic form of the disease, accompanied by the formation of stones in the ducts of the gland;
  • Granumatosa prostatitis is an extremely rare form, which is accompanied by a thickening of the mucous membrane of the ducts of the gland.

Symptoms of prostatitis in men

The clinical picture of prostatitis in men consists of signs of inflammation of the prostate gland, compression of the neck of the bladder and urethra, as well as the general manifestations of the disease. Gravity and combinations of symptoms differ according to the form and stage of the development of prostatitis.

Common eventsDiseases, regardless of form, need:

  • pain in the lower abdomen, in the lower part of the back, coccyx and sacrum;
  • violation of urination in the form of rapid impulse, discomfort and burning, intermittent flow;
  • Violation of power and ejaculation.

The acute form of prostatitis starts suddenly, proceeds with pronounced symptoms, is often accompanied by various complications. Chronic inflammation develops gradually, it is characterized by periods of exacerbations and remissions. With bacterial prostatitis, the first symptoms are signs of general intoxication (fever, nausea) and with a non -infectious form of the disease, the local inflammation of the prostate is of the main importance.

Signs of acute prostatitis

With acute prostate bacterial inflammation, the following symptoms appear in men:

  • general malaise;
  • fever of over 38 ° C;
  • nausea and vomiting;
  • severe pain in the lower abdomen with radiation in the rectum;
  • frequent, but at the same time a difficult urination;
  • itching and burning in the urethra;
  • Urine outposting, the aspect of blood or pus in it.

In the future, a complete recovery occurs against the background of the treatment or the chronic form of bacterial prostatitis develops with various consequences.

Symptoms of chronic prostatitis

When the chronic bacterial prostatitis is formed after acute inflammation, a man is worried about periodic pains in the lower abdomen, the urination of difficulties, sometimes burning in the urethra. Pain can also spread in the lower back and coccyx, rectum, penis and scrotum. Symptoms usually occur during the period of exacerbation of prostatitis and during remission, the well -being of a man remains normal.

Non -infectious prostatitis in men is also called chronic pelvic pain, which includes both pain and signs of urination and sexual disorders. It is difficult for a man to urinate, since a flow of urine is slow and intermittent, there is a burning sensation and a sense of pressure in the urethra. With a prolonged course of the disease, a violation of power occurs, ejaculation becomes lower and painful. In the end, the quality of life of a man suffers significantly, psychological problems develop.

Pain with prostatitis

Pain syndrome with prostatitis is a constant and more pronounced symptom, which is present in all forms of the disease. The pain mechanism in prostatitis is due to the inflammation and edema of the gland, compression of the receptors in the neck of the bladder and the initial section of the urethra.

The acute form of the disease is accompanied by the most serious pain, since inflammation is contagious, leads to a huge edema of the gland. The pain is located in the prostate itself, but man feels it not only in the lower abdomen, but also in the lower back, in the nucleus, in the rectum and in the scrotum.

With chronic inflammation of the prostate, painful, but they are of a longer nature, they may not disappear even during the remission period. Chronic pelvic pain syndrome is accompanied by unpleasant sensations mainly in the prostate gland itself, as well as in the coccyx, around the anus, at the base of the penis and scrotum. The discomfort disturbs the man every day for at least three months.

Prostate inflammation is dangerous

Complications develop both with acute and chronic forms of prostatitis:

  • bladder (inflammation of seed bubbles);
  • coliculite (inflammation of seed tubercles);
  • prostate abscess (abscess in the capsule);
  • prostate fibrosis (the formation of scars in the gland tissue);
  • cysts in the prostate;
  • Prostate stones;
  • infertility due to the deterioration of the quality of the sperm;
  • Erectile dysfunction caused by both chronic pelvic pain and psychological disorders;
  • depression.

Diagnosis of inflammation of the prostate gland

When the first signs of prostatitis appear, it is necessary to contact a urologist. First of all, the doctor speaks with the patient to determine the nature of the complaints and collect an anamnesis. For this, the doctor asks the following questions:

  • How long the symptoms of the disease appeared;
  • where the pain is located, its character and the conditions of occurrence;
  • There are problems with urination and ejaculation;
  • There are chronic diseases, including parental infections.

To diagnose prostatitis, the doctor uses the following methods:

  • Rectal examination of the finger of the prostate gland;
  • General clinical blood tests;
  • bacteriological examination of ejaculating or prostate secretion;
  • ultrasound examination of the pelvic organs;
  • Urofloometry;
  • X -ray or computerized tomography of the prostate;
  • In rare cases, a biopsy of the prostate gland may be necessary, followed by an histological examination.

Methods of prostatitis treatment in men

For the treatment of prostatitis in men, conservative methods are mainly used, tactics depend on the cause and phase of the development of the disease. With asymptomatic inflammation (type IV), active treatment is not necessary. In other forms of the disease, complex treatment is indicated, the acute form of prostatitis requires hospitalization to hospital, chronic inflammation can be treated on an outpatient basis.

First of all, the doctor gives recommendations on Lifestyle corrections:

  • refusal of smoke and drinking alcohol;
  • regular sex life;
  • exclusion of stress;
  • adequate physical activity;
  • balanced diet;
  • Exception of hypothermia and overheating.

A prerequisite for the success of the treatment of prostatitis is Elimination of related diseases, in particular urogenital infections.

Drug therapy  With prostatitis, it is aimed at suppressing the inflammatory process, improving urination and relief of pain. The following groups of drugs are used:

  • Antibiotics. Shown by acute bacterial inflammation, the doctor prescribes drugs taking into account the results of the microbiological examination of the prostate secret. Medicines can be taken orally in the form of tablets or in the form of intramuscular injections. The course of treatment is generally 4-6 weeks with an acute form of the disease. In chronic bacterial prostatitis, the duration of the therapy is determined individually.
  • Alpha-blockers. The drugs are designed to improve urination, while relaxing the smooth muscles of the gland and eliminate the compression of the prostate of the urethra. In the chronic form of the disease, they must be taken for a long time and sometimes for life.
  • Musorelassants and anti -inflammatory drugs nonsteric. It is shown that they eliminate the pain syndrome caused by the inflammation of the gland and spasm of its muscles.
  • In chronic inflammation, drugs are indicated to improve microcirculation, immunomodulators, antidepressants, drugs to stimulate erection.

The acute inflammation of the prostate gland susceptible to pharmacological treatment, in most cases, a complete recovery occurs within 1, 5-2 months. In the chronic form of the disease, therapy is carried out for a long time, for several years or for life.

An important way to treat congestive prostatitis is the massage of the prostate gland through the rectum. The procedure is performed by a urologist, on an outpatient basis. The massage helps to remove muscle spasm, stimulates the release of a prostate secret.

Physiotherapy procedures  shown in the chronic course of prostatitis:

  • laser therapy;
  • Electrophoresis and ultra -seporesis;
  • microwave therapy;
  • electrical stimulation;
  • acupuncture.

Surgery  It is shown only with the development of complications: an abscess or prostate stones.

Forecast and prevention

The prognosis for the recovery in acute bacterial prostatitis is in favor of timely and complex treatment. The transition to a chronic form is observed in 6-10 % of cases. Non -kiss chronic prostatitis, as a rule, cannot be completely cared for. Complex therapy allows you to slow down the progression of the disease, preserve the quality of man's life and reduce the risk of complications.

The prevention of the development of prostatitis in men includes the following recommendations:

  • healthy lifestyle;
  • regulation of the working and rest regime;
  • balanced diet and methods of consumption;
  • adequate physical activity;
  • regular sex life (ejaculation);
  • Prevention of parental infections;
  • Restriction of invasive manipulations (cystoscopy, urethra catheterization, prostate biopsy);
  • Prevention of genital injuries.