Prostatitis

Prostatitis is a disease in which inflammation of the prostate occurs.Prostatitis, the symptoms of which most often occur in men of childbearing age (20-40 years), is diagnosed on average in 35% of the population.

Depending on the origin, prostatitis can be bacterial or non-bacterial, depending on the nature of the course - acute or chronic.

When the first signs of prostatitis are detected, the choice of treatment method depends on the form of the disease.As a rule, targeted and symptomatic treatment is carried out.

Prostatitis is not a disease that can be diagnosed from a photo, since the disease has no visible manifestations.In order to notice the first symptoms in time, you should listen to your own health.

General description

The prostate affected by the disease is an exclusively male organ;Accordingly, prostatitis can only develop in men.If we look at a similar area in women, and this is the distal third of the urethra or urethra, then here they have the Skene's glands.These glands are essentially analogues of the prostate and when inflammation develops, symptoms can resemble those of prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.This controls the process of urination, in addition, the presence of the prostate releases a certain secret that makes the sperm liquid.

Very often, prostatitis occurs in older patients in combination with diseases such as vesiculitis or urethritis - in combination with benign prostatic hyperplasia.

Prostatitis: causes

Bacterial prostatitis occurs, as the name suggests, when it comes into contact with relevant pathogens.Basically, these are pathogens that are constantly on the surface of the skin or in the area around the digestive tract.In this case, a certain combination of factors can lead to the development of prostatitis.

The causes of prostatitis include various factors.So, this can be premature emptying of the bladder, the presence of diseases of the genitourinary system, constant hypothermia, irregular sexual life, a sedentary lifestyle, bad habits, etc.The relevance of this type of factors either leads to the ability of microbial pathogens to enter the prostate, or leads to a disruption in the blood supply to the organs located in the pelvis, or leads to the development of stagnant processes.All this leads to the proliferation of microorganisms, as well as the development and progression of pathological inflammation.

If the infectious pathogen is not detected in prostatitis, the diagnosis is a nonbacterial form of prostatitis.Various reasons can explain this form of pathology, although none of them are currently proven.For example, some experts believe that the disease in this form can develop against the background of actual neurogenic disorders, while another part, on the contrary, focuses on the immune nature of the disease in this form.This is only part of the existing theories regarding prostatitis.

Let's dwell on the acute and chronic forms of the disease.Acute prostatitis is due to the influence of a bacterial factor.As for chronic prostatitis, this factor is not the main factor here, but rather acts as a secondary factor and is important in its action only at the beginning of the disease.Over time, the pathogenetic mechanism can be supplemented by a neurogenic, autoimmune or allergic factor, due to the influence of which the chronic form of inflammation is maintained even when there is no question of bacterial invasion.

Prostatitis: symptoms

The inflammation in prostatitis is accompanied by pain, in particular this is caused by damage to the excretory ducts of the acini, from the walls of which the epithelium peels off, which gradually accumulates in the tubules with mucus.In addition, microliths also form;they look like small pebbles.The mixing with epithelium and mucus leads to strange plug formation, which in turn leads to blockage of the excretory ducts.Over time, such plugs turn into suppurations (or microabscesses), the lobules are no longer subject to drainage, they simply stop functioning.

As a rule, a lot of time passes before the onset of such a stage as blockage of the excretory tract, in some cases this time is calculated in months, in others even in years.The process progresses gradually, the patient may not notice anything special, especially since the production of secretions by the prostate does not stop.Another thing is that the formation of these microabscesses is already accompanied by the appearance of not very pleasant symptoms that manifest themselves in varying degrees of intensity.

The first of these symptoms is that patients notice difficulty urinating.Due to the fact that the prostate enlarges against the background of the inflammatory process, a certain compression of the urethra occurs.Further progression of the inflammatory process leads to the development of sclerosis of the bladder neck;In an even more serious form of the pathological process, complete occlusion of the ureter occurs.

The next symptom is sexual dysfunction.Due to the pathological processes occurring in the disease, the erection mechanism is disrupted and orgasm is weakened.

There are also other signs of prostatitis, in particular these are:

• the appearance of a burning sensation in the urethra and perineum;
• persistent and frequent urge to urinate;
• the appearance of discomfort during bowel movements;
• “floating threads” in urine;
• the appearance of urethral distention discharge during bowel movements;
• the appearance of prolonged nocturnal erections;
• intermittent and difficult urination;
• too rapid ejaculation;
• increased general fatigue;
• reduced potency;
• Manifestation of orgasm in a deleted form;
• Expectation of the development of other forms of complications in the area under consideration, against the background of which anxiety and general psychological depression occur.

I would like to separately add that the listed signs (symptoms) do not necessarily all appear overnight.The disease is characterized by a very different pattern of its manifestation, which refers to different variants in each individual patient and to different periods of time in its course.

When looking at the symptoms, it would make sense to go back to the causes.Of course, the inflammatory process does not come “out of the blue”.These are primarily pathogens that were already mentioned above.Meanwhile, it was this factor that led to the formation of a false idea about the presence of certain pathogens of prostatitis, which is still held by many specialists today.However, there is no specific type of pathogen for this disease.At the same time, any chronic infectious disease can lead to the development of prostatitis;It can be of any type, be it sinusitis, tonsillitis, cholecystitis or any other disease.In this case, the pathogen can enter the prostate via the bloodstream, which is characterized by a fairly strong blood supply (otherwise its functionality would be at risk).

There is a certain risk group for prostatitis, which includes, in particular, the following people:

• Persons whose professional activities fall under the criterion of “sedentary” work;
• people with a sedentary lifestyle;
• People previously diagnosed with a specific genitourinary infection;
• people for whom the problem of chronic constipation is relevant;
• people who are promiscuous;
• Persons whose family relationships do not fall under the criterion of order;
• People who abuse alcohol.

In men, “abacterial prostatitis”, “prostatitis in the stage of prostatosis”, is often diagnosed.If a man is diagnosed with prostatosis, we can say that there is no particular cause for concern at this stage.In the meantime, you will need to make certain adjustments to your lifestyle.In other words: We are talking here about the fact that the symptoms of stagnation discussed above are already occurring, but there is no inflammation as such yet, it is prostatosis.If an option such as abacterial prostatitis is considered, then here we are already talking about the stage of the beginning of the development of an inflammatory process in a man, but so far without an accompanying infection.

A distinctive feature of prostatitis is that it practically does not manifest itself in an acute form.In other words: when it manifests itself, it is already a chronic process, which is explained by its often long and insidious development.Complete recovery due to treatment of the disease or due to the spontaneous disappearance of the pathological process is expected in individual cases in the initial acute stage.The disease, as already mentioned, is characterized by an extremely slow course, the manifestations of symptoms generally have a smoothed form.

Prostatitis: consequences

Acute prostatitis, if its manifestations are ignored and the search for medical help is excluded, can lead to the development of an abscess in the prostate gland, i.e.h.to the cause of the development of purulent focal inflammation in it.This is accompanied by an increase in temperature (within 39-40 degrees), which at the same time becomes hectic, that is, its differences exceed one degree.Patients also suffer from high fever, which periodically leads to chills.The pain in the perineum becomes so severe that urination becomes difficult and bowel movements become almost impossible due to the pain.After some time, the prostate becomes swollen, which in turn causes an acute urge to urinate.Meanwhile, acute prostatitis, which manifests itself against the background of chronic spread of the pathological process, rarely occurs - unless a man “endures and endures” at his own peril and peril.

Back to chronic prostatitis: we can say that it is characterized by a wave-like course, i.e.h.the symptoms of the chronic form of prostatitis periodically become more pronounced and periodically are practically not felt.Because of this type of change, many patients choose to take a wait-and-see approach.In the meantime, as suggested above, the inflammatory process can worsen and continue to spread.If it spreads, pyelonephritis can even develop.Complications of prostatitis in most cases are due to diseases such as vesiculitis, in which the inflammatory process affects the seminal vesicles, as well as epididymitis, in which testicles and appendages become inflamed.As a result of the transmission of the disease in a similar form of its spread, one can indicate the development of infertility in a man.Treating infertility is a long and complex process and in some cases completely impossible.The listed features mainly fall under the development of a chronic form of prostatitis due to the specific etiology of their occurrence (especially sexually transmitted diseases).

diagnosis

Examination of patients to identify their specific type of prostate pathology can be carried out in several ways.What is important in each individual case is an individual approach to the problem at hand, on the basis of which the diagnostic option can be determined in order to obtain sufficient information about the disease.

First, the doctor conducts a survey of the patient's complaints, examines the medical history if necessary, on this basis a preliminary conclusion is then drawn and the basis of an individual diagnostic algorithm is determined.We would like to add that the first consultation with a urologist (namely, this is the specialist to whom you should go if disturbing symptoms of prostatitis appear) is not definitive and reliable for making a diagnosis, since the first examination is only an opportunity for the doctor to determine what further diagnostic measures are necessary.

Given the sensitivity of the problem, men are interested in what questions a urologist asks if they suspect prostatitis.In particular, he will ask about current problems with urination and also about how the patient assesses his own sexual function (i.e. are there any changes, what exactly has changed and since then).In addition, the doctor will ask you what diseases you currently have, etc.

This is followed by an examination, in particular an external examination, a rectal examination, a laboratory and an instrumental examination.During an external examination, the doctor examines the man's genitals and determines whether there are accompanying rashes, irritation, discharge, etc.

After an external examination, the doctor then moves on to the next step, the rectal examination.A rectal examination makes it possible to determine the general contours of the prostate, its consistency, boundaries, etc.

After that, you need to obtain results from instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which in an expanded form means transrectal ultrasound.This is the most accurate method of detecting diseases in men compared to standard ultrasound.

Laboratory tests include a smear test, a urine test, a prostate secretion test and PCR (a laboratory test used to detect sexually transmitted infections).

Based on the current classification of methods for diagnosing prostatitis, only a microscopic examination of the secretion obtained from the prostate gland, as well as all topical diagnostic options that can detect the presence of an inflammatory process in the lower genital tract, can be considered as a necessary option.Other types of diagnostic methods are only for clarification;They are necessary for differential diagnosis and to detect existing complications of the underlying disease.In addition, it is important to remember that if you overdiagnose this stage, it will prolong itself and the symptoms will only get worse.That is, here, as in every matter, the principle of the “golden mean” applies.

Treatment of prostatitis

Treatment of prostatitis is a serious problem today, but this does not mean that a doctor cannot help and the disease should be left to chance.In fact, it is not always possible to completely recover from prostatitis, but it is possible to eliminate the symptoms of the disease and achieve long-term and sustainable remission.Depending on how seriously a man takes the doctor's recommendations, how long the periods of remission will last for him.

At its core, the treatment of prostatitis can include a number of measures, in particular, methods of antibacterial therapy, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.Only on the basis of a series of these measures can the desired result be achieved;In general, the disease is difficult to treat and therefore cannot be ignored.

Antibacterial therapy

This form of therapy is considered the basis of conservative treatment.The basis for the selection of antibacterial drugs is a number of factors, in particular these:

• the ability of the components of the proposed drug to penetrate the secretions and tissues of the prostate and produce a concentration exceeding the MIC values of the pathogens;
• Features of the spectrum of antimicrobial action (for example, the use of macrolide antibiotics determines the possibility of their good penetration into the prostate tissue, while they have no effect against gram-negative bacteria, i.e. they are the main etiological pathogens when considering the acute form of prostatitis).

It is noteworthy that acute prostatitis, in comparison with the chronic form of the disease, is characterized by the possibility of accumulation of aminoglycosides and beta-lactam antibiotics in the glandular tissue, in concentrations sufficient to suppress the activity of most types of pathogens.This is due to increased blood flow to the prostate, as well as increased permeability, which is characteristic of the hemoprostatic barrier.Another feature of the drugs in this group is that as the inflammation subsides, the degree of their penetration into the prostate decreases.For this reason, it is recommended to switch to another oral medication.

Prostate massage

For the most part, experts consider this method of influence to be a fairly effective solution in the treatment of prostatitis.The basic principles for achieving a therapeutic effect in this case are as follows:

• Restoration of milk duct patency;
• improving muscle tone and blood flow to the prostate;
• increased penetration of the antibiotics used into the glandular tissue;
• the possibility of activating microorganisms that are in an inactive state, thereby improving the results of sales of antibacterial drugs.

How is a prostate massage performed?First of all, it is of course important to establish a certain level of trusting contact between doctor and patient;This ensures greater relaxation of the patient, which in turn allows performing the necessary manipulations with minimal pain and maximum efficiency.When preparing for a massage, the patient bends forward, spreads his legs about 60 cm wide and supports himself with his elbows on the examination table.The doctor puts on gloves and applies a gel to the index finger (sometimes this gel has an analgesic effect).He then uses his free hand to spread his buttocks so far that the anal sphincter can be felt with his index finger.The natural reaction to such contact is muscle contraction.After relaxing, the index finger is then inserted into the ampulla of the rectum.

In some cases, patients experience dizziness and even fainting during these manipulations (on average in 10% of cases).These manifestations are mainly caused by excessive fear, embarrassment and anxiety and are not accompanied by this at all if the massage is carried out correctly.A massage can be considered successful if it is possible to extract at least 4 drops of secretion from the prostate.

The most popular recognized method for treating chronic prostatitis is massage using the Manila Protocol.In this case, massage is carried out three times a week, a microbiological dynamics study is also carried out and antibiotics are taken.

Immunotherapy

This direction in the treatment of prostatitis is often extremely necessary, since with the prolonged occurrence of inflammation in combination with previously incorrect antibacterial treatment, a negative impact on the general condition of the immune system cannot be excluded.Treatment of prostatitis requires not only eliminating the infection of the gland and therefore inflammation, but also preventing the re-development of inflammation in the gland.However, like other areas of treatment, immunotherapy should not be reduced to self-medication or treatment according to the recommendations of a pharmacist in a pharmacy;Here you will need to consult an immunologist and, most likely, also take some tests.

Physiotherapy

In the case of prostatitis, this direction of treatment can be implemented in a variety of ways, but regardless of the specific solution, the focus of the effect is on improving blood circulation in the pelvic organs and thus increasing the overall effectiveness of the implementation of antibacterial therapeutic measures.Ultrasonic waves, electromagnetic waves, laser therapy, increasing the temperature directly in the rectum, etc. can be used for physiotherapy.If there are no options for physical therapy, the doctor may recommend microenemas with warm water and certain medications.

Correction of lifestyle

This type of effect is aimed at both the treatment of prostatitis and its prevention.Treatment should be carried out in the same way as the main treatment, because if the predisposing factors for the development of prostatitis persist, sooner or later the disease will make itself felt again.With this in mind, you should make certain changes in your life.This applies to exercise, normalizing your wake/sleep rhythm, a nutritious, balanced diet, walking and eliminating bad habits.

If symptoms appear that indicate prostatitis, you should consult a urologist.