According to the BME, prostatitis is an inflammatory process that occurs in the prostate gland in men, with damage to the parenchyma and interstitium. Treatment of prostatitis in men is a long and difficult process, often due to complete ignorance at the onset of the disease. What is prostatitis, what are their causes and first symptoms, what you need to know about the subject of "diagnosis" and what modern methods of treatment of prostatitis are available. All men should know about prostatitis in this article.
Ab ovo - from the egg
We are not talking about Horace satirists, in which case we are interested in everything related to prostatitis, from the beginning of treatment to the last "squeak". Symptoms of prostatitis are found during active sexual activity in men aged 25 to 45 years, in the thematic video you can learn in detail about the basics, causes and symptoms of the disease, the features and characteristics of the diagnosis. treatment.
The reasons for the development of prostatitis are wide. Infectious factors with prostatitis have the greatest weight in the development of the disease:
- Acute form. Coccal flora acts as provocative causes.
- Chronic form. The reasons for its development are broader, because the main factors of such prostatitis in men are: gonococci, Trichomonas, Gr + and Gr-bacteria, mycobacterium tuberculosis. Rarely, the diagnosis includes mycoplasmas, viruses, fungi, chlamydia, etc.
Interestingly, chronic prostatitis caused by a pathogen that has invaded the prostate gland may subsequently have a pathogenic factor and be abacterial in nature. The acute form is caused by more external causes: hypothermia, damage to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, hypodynamics and, consequently, impaired blood and lymphatic circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You can often hear about only one type of prostatitis - infectious, but according to the WHO, bacterial prostatitis does not account for more than 10% of all cases of the disease, and chronic abacterial prostatitis is noted in 90% of cases.
Table No 1. Brief features of pathology
| Categories for prostatitis | Acute infection | Presence of the pathogen in the secretion of the prostate gland or in the 3rd part of the urine | m / s secretion or level of leukocytes in the urine (increase). |
| 1 cat. Acute bacterial | + | + | + |
| 2 cats. Chronic bacterial | - | + | Indefinite (or not) |
| 3 a. Non-bacterial chronic pelvic pain syndrome of inflammatory nature | - | - | + |
| 3 b. Prostatodinia, non-inflammatory pelvic pain syndrome | - | - | - |
| 4 cats. Asymptomatic inflammatory process | - | Indefinite (yes or no) | Indefinite (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied in more detail, and in most cases, the bacteria of the family are the cause of the disease. Enterobacteriaceae (E. coli bacillus). The role of atypical microorganisms as the cause of prostatitis (ureplasm, chlamydia, mycoplasma) is currently considered unproven. In men with signs of weakened immunity, symptoms of prostatitis, especially HIV-infected prostatitis, can be caused by yeast (Candida spp. ) Or mycobacterial tuberculosis.
Before the advent of the antibiotic period, gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, especially as it was often the cause of its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have thoroughly studied the list of possible pathogenetic (causing prostatitis) factors that play an important role in the development of inflammation in the prostate gland without the presence of microorganisms. Thus, the causes of non-bacterial prostatitis are stagnant processes in the small pelvis, circulatory disorders, prostatic reflux and autoimmune aseptic inflammation.
Sick or not - that's the question
What does a man with prostatitis look like? For a person who is far from medicine and is not more knowledgeable about urological problems, the male appearance of an individual is no different from the crowd of others. And only an experienced specialist will understand from the first complaints of the patient, where the root of the problem has grown and what ways to address it.
The symptoms of prostatitis are often described in a few expressions, emphasizing the brightest moments, and it plays a cruel joke with a man. Relying on such inaccurate definitions, he ignores the calls that are really important, believing that the disease does not exist, although in fact the clinical picture depends on the nature of morphological changes in the prostate.
The earliest symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis. Dull pain in the perineum, spreading to the sacrum, often nocturnal calls.
- Follicular prostatitis. Difficulty and frequent urination, sometimes delayed. Pain during "peing" is aggravated at the end of the process of urination, as well as during bowel movements. Low fever.
- Parenchymal prostatitis. There are obvious signs of dysuria, often AUR, pain during natural recovery, general intoxication with a temperature of up to 40 C.
In the case of prostatitis with abscess formation, the symptoms become more pronounced with the possible opening of the abscess into the rectum or the prostate part of the urethra. With such a jump, the symptoms decrease. If the opening of an abscess occurs in the paraprostatic tissue or in the perineal region, visual symptoms may be observed: swelling, redness of the skin with a clear ripple. At the same time, the man's condition deteriorates sharply.
It is impossible to begin a comprehensive treatment of prostatitis without a thorough examination of the man, the diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is common to distinguish between acute and chronic prostatitis, you can learn more about what symptoms belong to this or that form in a thematic video on the Internet. Let's look at this issue in more detail.
Acute - its typical symptoms are characterized by the manifestation of three stages: catarrhal, follicular and parenchymal. They are described in detail above.
The most interesting in terms of symptoms is the chronic form of prostatitis, because there are many variations in symptoms. In general, the effective treatment of prostatitis depends on the prostatitis, or rather its type.
The following points can be distinguished at the stage of chronization:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis disappears with deleted symptoms.
- A characteristic feature of chronicity is a small amount of discharge from the urethra during bowel movements.
- The first symptoms, as a rule, are not expressed, the pathological process itself develops over the years. It is preceded by prostatosis (blockage of the capillaries), which smoothly turns into a bacterial form of inflammation of the prostate gland.
- The specific pathogenic microflora is not the cause of chronic prostatitis, but the chronic process itself is a complication of the inflammatory process due to the effects of ureaplasma, trichomonas, chlamydia and gonococcus.
How does a man with chronic prostatitis feel? Feedback from patients shows that at first there is a slight pain in the perineum, most men simply do not pay attention. The next stage is a combination of the following symptoms: burning sensation in the urethra, sexual dysuria, general malaise. Frequent mistakes during sex can make men depressed, irritable, or depressed.
It is important to understand that all of these symptoms do not necessarily appear in every particular case of chronicity, which complicates the diagnosis in the early stages of the disease, in addition, the symptoms tend to change places, which is even more incorrect.
Long-term syndromes
What to expect from chronic prostatitis? If there is no timely diagnosis and treatment - nothing good, any specialist will confirm it. This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself is not damaged, but many nerve endings pass through and are close to it, which inevitably contributes to the inflammatory process. The pain can be of varying intensity - a little painful, disturbing, strong, not allowing you to sleep peacefully. Radiation of pain occurs in all nearby areas (scrotum, sacrum, perineum), pain from prostatitis should be distinguished from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a malfunction of the urinary system, but what causes it occurs at the time of diagnosis. The increased volume of the prostate inevitably compresses the urethra and disrupts the flow of urine, followed by the desire to use the toilet more often, the feeling of complete emptying of the bladder. With advanced prostatitis there is a compensatory hypertrophy of the muscular layer of the bladder and ureters. At this time, the symptoms of dysuria decrease, but return to an intensified form.
Tasteless sex
Decreased intimate life is one of the first symptoms that men notice, and reviews show that it forces them to see a doctor. Frequent nocturnal erections, deleted orgasms, weak erections and rapid ejaculation, pain at this time - this is what worries the strongest sex the most. In the advanced stages of chronicity, nothing good can be expected from prostatitis, often erectile dysfunction develops.
The degree of sexual dysfunction in men is not the same, someone starts having sex and somehow completes it, brushing the characteristic calls. For some, even the initial weak reaction of the penis to an attractive stimulus becomes the beginning of terrible experiences that lead to depression and long-term depression. Impotence is difficult for patients with prostate problems, and almost always experts and relatives say that it violates the nature of prostatitis.
To learn more about the disease, you can watch a thematic video, where experts explain many nuances of the pathology.
What to write on the card
Which entry will appear in the patient's medical record and which will be the final diagnosis will depend on a number of preliminary studies, from the patient's visit to the urologist and complaints (history) to the final stage of diagnostic procedures. Exactly what is required depends on the type of prostatitis, its negligence and the patient's willingness to special diagnostic procedures.
In general, the diagnosis consists of:
- Anamnesis. The doctor examines all the complaints and symptoms, the initial conditions of the disease, etc. will ask details about.
- Urine analysis.
- Prostate massage (digital rectal examination + secretion collection).
- Ultrasound of the prostate gland.
- Spermograms.
- Prostate biopsy (if indicated).
What is the diagnosis and is it so important? If you read the reviews of patients, you can often understand that most men try to avoid many stages of diagnosis, and the motivation is very different. The price of such indifference is your own health! It should be borne in mind that the treatment of prostatitis is possible only if it is "caught" in time and diagnosed with a clear definition of the form and cause of the disease.
How to be healthy forever
So, a man understands that he has prostatitis, what awaits him in the future, and is it possible to regain lost health? It is important to understand that you will have to get rid of prostatitis twice as long as it develops. Moreover, if the pathological process is almost beyond the attention of the man, the treatment of prostatitis will take place with his direct participation. Regardless of whether acute or chronic prostatitis can be treated - yes, if you follow all the doctor's recommendations, in advanced cases of chronic form, it is possible to achieve stable remission during treatment.
The stages of treatment of prostatitis will directly depend on what the doctor finds during the examination, the type of disease, the patient's age and physical data.
The treatment regimen is always strictly individual, but there may be the following points:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Assignment of immunocorrectors.
- Urology massage.
- Physiotherapy.
The cost of each stage of treatment varies depending on the total cost of the prescribed drugs, additional methods and clinic. Preventive measures after treatment have an important logic - they prevent the recurrence of the disease. Prevention is in direct and close contact with treatment, the basics of prevention are as important as following all the requirements of the doctor during therapy.
Treatment of acute form
The exacerbation period requires a course of intoxicated antibiotics. In case of chlamydial infection, drugs of the cephalosporin series are indicated.
The duration of the course is important, on average, antibiotics are drunk for at least 3-4 weeks to prevent recurrence of the disease. Sometimes the doctor continues the treatment for a longer period of time, and antibiotics are combined with analgesics to relieve the pain.
Treatment with antibiotics is carried out taking into account the following rules:
- Bacterial culture is required to determine the susceptibility of microorganisms to the drug.
- Side effects and contraindications of the drug are taken into account.
- They take into account the previous course of treatment, when, what tools were used and the outcome.
The need for additional treatment is determined by the attending physician, it should be remembered that massage is contraindicated in acute forms of prostatitis, as it causes the spread of bacterial infections throughout the body, followed by bacteremia and sepsis.
Treatment of chronic form
It is important to remember that it is impossible to get rid of chronicity quickly, in principle, the disease has developed over the years, and to destroy it in a few weeks is beyond the power of even doctors in their field, you do. It is not necessary to take the word of those who cure the disease for 2-3 days. Treatment is aimed at stopping the focus of infection, restoring immunity and prostate function in men, as well as preventing exacerbation - it takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks, with low efficacy of treatment. Antibacterial drugs are often prescribed in combination with other anti-inflammatory drugs. In advanced cases, surgery is performed with partial or complete removal of the prostate gland.
Free of bacteria & symptoms
A characteristic difference of therapy is the absence of antibiotics without the presence of pathogenic microflora, they are simply not needed. However, sometimes specialists prescribe a short course of medication for 2-4 weeks.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening the patient's immune system.
The basis of treatment of non-bacterial prostatitis are diet and lifestyle changes, baths, alpha-blockers.
Asymptomatic prostatitis is difficult to detect, the diagnosis is made using the PSA method, and then a 2-week course of antibiotics is prescribed for treatment. After that, individual symptomatic treatment is selected.
In general, the treatment of any prostatitis is a long-term phenomenon and is not always pleasant for the patient himself. In addition to physical discomfort, a man suffers psychologically, because the most valuable part of his body - the intimate part - is affected. Opinions of those who have cured the disease show that only strict adherence to doctor's prescriptions, changes in diet and lifestyle will bear fruit. The cost of a careless approach to treatment is very high - a person not only loses his health, but changes his whole life, character and relationships with others. To prevent this, it is necessary to monitor the health of the prostate gland and eliminate the causes of the development of diseases.