Prostatitis: symptoms, treatment

Prostatitis is an inflammatory disease of the male prostate gland, which is located directly under the bladder and in a small part of the genitals.

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

Reasons

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

1. Disruption of blood microcirculation in the pelvic organs - this leads to stagnant processes and contributes to the increase in the size of the prostate gland.Obesity and a sedentary, sedentary lifestyle contribute to stagnant processes.
2. If bacteria, viruses or protozoa enter the prostate tissue against the background of acute or chronic inflammatory process occurring in other organs of the body, diseases such as tonsillitis, gonorrhea, urethritis, cystitis, influenza, pyelonephritis can cause prostatitis.If there is infection in distant areas and organs, infectious agents can enter the prostate through blood and lymph flow.
3. Injuries and bruises in the soft tissues of the abdominal cavity, perineum and external genitalia - this causes swelling and poor circulation in the damaged area;
4. Hypothermia of the body.
5. Chronic constipation.
6. Hormonal disorders.
7. A stormy or, on the contrary, a lack of sex life is harmful, both frequent intercourse (more than once a day) and infrequent intimate relations (less than once a week), because it leads to exhaustion of the gonads or congestion in the prostate.

Symptoms of prostatitis

There are acute and chronic forms of the disease.

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

• tremors and weakness;
• general disorder;
• increased irritability and irritability;
• increased body temperature (not more than 37.5 degrees);
• pulling or cutting pains in the lower abdomen and perineum;
• frequent urge to urinate with persistent feeling of incomplete emptying of the bladder;
• pain in the rectum and difficulty in bowel movements.

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

Symptoms of chronic prostatitis

When the disease becomes chronic, the clinical symptoms of prostatitis decrease and the patient feels that recovery is taking place.Characteristic symptoms of the chronic inflammatory process in the prostate gland are a burning sensation along the urethra with radiation to the perineum, which can be aggravated 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 disappear, not the same as in the acute form.The following symptoms appear clinically:

• difficulties with erection;
• inability to complete sexual intercourse with ejaculation;
• decreased sexual desire;
• discharge of mucus from the urethra mixed with white flakes;
• a feeling of incomplete emptying of the bladder;
• aching pain in the lower back, pubis and groin;
• weak urine flow - this is observed as a result of narrowing of the lumen of the urethra against the background of compression by an enlarged prostate.

A chronic, slow inflammatory process in the urethra irritates the nerve endings of the pelvic cavity and causes frequent urination, especially at night.Many men are embarrassed to consult a doctor with such a subtle problem, which increases the risk of developing serious complications such as complete erectile dysfunction, infertility and even prostate cancer.

In addition, pathogenic microorganisms from the source of chronic infection in the prostate gland enter the kidneys through blood and lymph, causing acute inflammation, urinary excretion and increasing the risk of developing kidney failure.

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

Diagnostic methods

A urologist deals with the diagnosis, treatment and prevention of prostatitis.To make a diagnosis, to determine the form and cause of the inflammatory process in the prostate gland, the patient is prescribed a series of examinations:

• palpation of the prostate - is carried out through the rectum, and after palpation, it is possible to detect an increase in size, pain, pus or mucous discharge;
• urethral discharge smear - the resulting material is sent to the laboratory for study;
• urinalysis - general, etc.;
• Ultrasound of the pelvic organs and prostate gland.

If it is suspected that the pathological process has spread to the bladder, the patient additionally undergoes a cystoscopy - an 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 differentiate 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 strongly advised not to self-medicate.

The acute non-bacterial form of prostatitis is thoroughly 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 the degree of manifestation of the symptoms of the disease.

A distinctive feature of bacterial prostatitis is the acute onset and rapidly increasing 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 spreads 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 a hospital setting, because the patient's condition can be extremely serious.Therapy consists of an integrated approach:

• the patient should stay in bed;
• antibiotics are prescribed - macrolides, fluoroquinolones, cephalosporins;
• drugs that improve blood microcirculation in the pelvic organs are selected.They ensure the outflow of lymph and venous blood, which reduces the severity of swelling and inflammation in the prostate;
• Medicines 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 intoxication of the body, physiological sodium solution with glucose is prescribed intravenously.

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

Surgical treatment

Surgery for prostatitis is required only if the patient develops acute urinary retention and there is no way to empty the bladder.If an abscess of the prostate gland occurs, surgical intervention cannot be avoided.

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

Treatment of the chronic form

Treatment of chronic prostatitis is different and mainly 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 acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. taking a course 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 help improve venous and lymphatic flow.
3. Immunomodulators.
4. Antidepressants and sedatives help normalize sleep and relieve irritability.
5. Multivitamin complexes rich in zinc, selenium, B vitamins.

In the remission stage of the inflammatory process of the prostate, the patient is given physiotherapeutic treatment:

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

Surgical treatment of chronic prostatitis

A patient with advanced chronic prostatitis sometimes requires surgical intervention.This can be done in two ways:

• transurethral resection;
• prostatectomy.

Transurethral resection

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

Transurethral resection significantly alleviates the patient's condition - urination is restored after the operation, the man no longer has a burning sensation in the perineum and does not get up at night to go to the toilet.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 the operation or immediately after the operation is minimal.

Prostatectomy

A prostatectomy is a major abdominal surgery and always carries 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 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 treatment of chronic prostatitis

Other methods of treatment of chronic prostatitis are:

1. hirudotherapy - or treatment with leeches.Medical leeches are placed on the inflamed area, which, during their actions, secrete a substance with saliva that regulates the blood, removes congestion and quickly stops the inflammatory process.Leeches are used exclusively, 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 method of treatment 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.After just 1 procedure, tissue swelling decreases, blood circulation normalizes, 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 to quickly stop the inflammatory process in the remission stage;ultrasound therapy is not performed during the exacerbation period.To increase the therapeutic effect, drugs that penetrate directly into the prostate tissue under the influence of ultrasound can be additionally used.
5. Stenting of the urethra - the essence of the procedure is to install a special stent that expands the lumen of the urethra and helps the normal flow of urine.Despite the effectiveness of the procedure, urethral stenting only relieves the clinical symptoms of prostatitis, but does not free the patient from the chronic inflammatory process.

Consequences and complications

In the absence of specialized therapy, prostatitis progresses rapidly, becomes chronic and threatens a man's health with serious complications, including:

• urolithiasis;
• pyelonephritis;
• abscess development;
• spread of the inflammatory process to the testicles and spermatic cords, causing infertility;
• erectile dysfunction and impotence;
• necrotic changes in prostate tissue.

Sometimes prostatitis and long-term chronic congestive processes trigger the disease to turn into adenoma and then into prostate cancer.