Prostatitis: symptoms, treatment

Prostatitis is an inflammation of the prostate gland in men, located just below the bladder and a small part of the genitals.

Every 7 men over 35 years old 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

Prostatitis can develop for many reasons, doctors identify the main ones:

1. Violation of blood circulation in the pelvic organs - this leads to stagnant processes and contributes to an increase in the size of the prostate.Obesity and a sedentary lifestyle contribute to stagnation.
2. If bacteria, viruses or protozoa enter the prostate tissue in the context of acute or chronic inflammatory processes occurring in other organs in the body, diseases such as tonsillitis, gonorrhea, urethritis, cystitis, influenza and pyelonephritis can cause prostatitis.Infectious agents can enter the prostate through the blood and lymph if there is infection in distant areas and organs.
3. Injuries and bruising to the soft tissues of the abdomen, perineum and external genitalia - this leads to swelling and poor circulation in the injured area;
4. Hypothermia of the body.
5. Chronic constipation.
6. Hormonal disorders.
7. Stormy sex life or, conversely, absent is harmful, both frequent sex (more than once a day) and rare intimate relationships (less than once a week), as this leads to hypogonadism or blockage in the prostate.

Symptoms of prostatitis

There are acute and chronic forms of the disease.

Acute prostatitis is characterized by sudden onset on the background of general health, clinically accompanied by the following symptoms:

• chills and weakness;
• general unrest;
• increased irritability and anxiety;
• increased body temperature (not higher than 37.5 degrees);
• pulling or cutting pain in the lower abdomen and perineum;
• frequent urge to urinate with persistent feeling of empty bladder;
• pain in the rectum and difficulty defecating.

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

Signs of chronic prostatitis

As the disease becomes chronic, clinical signs of prostatitis gradually subside and the patient feels recovered.A characteristic sign of a chronic inflammatory process in the prostate is a burning sensation along the urethra accompanied by irradiation to the perineum, which can be enhanced during urination and defecation.Gradually the disease progresses and causes impotence.Chronic prostatitis includes periods of remission and exacerbation, but even in times of exacerbation, the symptoms disappear, not as pronounced as in the acute form.The following symptoms appear clinically:

• difficulty getting an erection;
• inability to complete sexual intercourse upon ejaculation;
• decreased sexual desire;
• mucous discharge from the urethra mixed with white scales;
• feeling of incomplete bladder emptying;
• persistent pain in the lumbar region, pubic bone and groin;
• Weak urine flow - this is observed as a result of narrowing of the urethral lumen against the background of compression by an enlarged prostate.

Chronic, slow inflammation in the urethra irritates the nerve endings of the pelvis and causes a constant urge to urinate, especially at night.Many men feel embarrassed to consult a doctor about such a delicate matter, which increases the risk of developing 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 kidneys through the blood and lymph, causing acute inflammation, urinary retention 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, followed by stones - very often prostatitis in men occurs in parallel with urolithiasis.

Diagnostic method

A urologist is involved in the diagnosis, treatment and prevention of prostatitis.To diagnose and determine the form and cause of the inflammatory process in the prostate, the patient is prescribed a number of tests:

• palpation of the prostate - is performed through the rectum and allows you to detect an increase in size, pain, discharge of pus or mucus after palpation;
• a stain of discharge from the urethra - the material obtained will be sent for laboratory research;
• urinalysis - general, etc.;
• Ultrasound of pelvic organs and prostate.

If the spread of the pathological process to the bladder is suspected, the patient will undergo cystoscopy - 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

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

The acute nonbacterial form of prostatitis is treated comprehensively using herbal therapies and anti-inflammatory drugs.

Treatment of acute bacterial prostatitis

The principles of treatment of acute bacterial forms of prostatitis directly depend on the severity of the symptoms of the disease.

A distinctive feature of bacterial prostatitis is the acute onset and rapid increase in signs of intoxication of the body - nausea, vomiting, headache, high body temperature.The process of emptying the bladder is accompanied by a sharp pain in the lower abdomen and perineum, spreading to the lower back.Very often purulent processes and abscesses develop in the prostate.

Treatment for acute bacterial prostatitis is performed in a hospital because the patient's condition can be extremely serious.Therapy includes an integrated approach:

• The patient must stay in bed;
• prescribed antibiotics - macrolides, fluoroquinolones, cephalosporins;
• Selected drugs to improve blood microcirculation in the pelvic organs.They ensure the outflow of lymph and venous blood, reducing the severity of swelling and inflammation in the prostate;
• The drug belongs to the group of non-steroidal anti-inflammatory drugs that are prescribed orally.These drugs not only reduce the inflammatory process, but also eliminate pain;
• pain relievers - you can take pills or put rectal suppositories into your rectum;
• To eliminate intoxication of the body, a physiological solution of sodium with glucose is administered intravenously.

Important!Prostate massage is strictly prohibited because of the high risk of sepsis.

Surgical treatment

Surgical treatment of prostatitis is only required if the patient has acute urinary retention and has no way to empty the bladder.Surgery cannot be avoided if a prostatic abscess occurs.

The treatment process for prostatitis lasts 14 days, after which the patient is thoroughly examined to evaluate the effectiveness of treatment.If necessary, the course of treatment is prolonged and adjusted.

Treatment of chronic form

Treatment of chronic prostatitis varies and largely depends on the stage of the pathological process.In case of exacerbation of the inflammatory process, treatment is carried out in the same way as for acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. the use of non-steroidal anti-inflammatory drugs.The drug is prescribed 2 times a day for at least 3 days, sometimes up to 5 days.
2. The drug helps improve venous and lymphatic flow.
3. Immunomodulators.
4. Antidepressants and sedatives help normalize sleep and eliminate irritability.
5. Multivitamin complex rich in zinc, selenium, B vitamins.

During the remission phase of prostatitis, patients are prescribed physical therapy:

• prostate massage;
• supersonic;
• electrophoresis;
• magnetic therapy;
• Increase body temperature using microwave oven.

Surgical treatment of chronic prostatitis

With progressive chronic prostatitis, patients sometimes require surgical intervention.This can be done in two ways:

• transurethral resection;
• surgery to remove the prostate.

Transurethral resection

This surgical treatment is a minimally invasive procedure, although it is performed under general anesthesia.During the procedure, a segmentoscope is inserted under the urethra, through which electrical pulses are delivered.These electrical pulses act like an electric knife and remove part of the prostate tissue.The great advantage of this intervention method is that there is no blood loss, because the electric waves not only remove altered prostate tissue but also immediately treat blood vessels, preventing bleeding.

Transurethral resection significantly relieves the patient's condition - after surgery, urination is restored, the man no longer feels a burning sensation in the perineum and does not have to get up to go to the toilet at night.Normal erectile function and ejaculation are also restored.The entire surgical process is monitored by the doctor on a screen, so the risk of complications during or immediately after surgery is minimal.

Removal of the prostate

Prostatectomy is a major abdominal surgery and always carries many potential risks for the patient.During surgery, the doctor will remove all or most of the prostate.Recovery time is 4-6 weeks, there is a high risk of 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 treatments for chronic prostatitis

Other treatments for chronic prostatitis include:

1. hirud therapy - or treatment with leeches.Medical leeches are placed on the inflamed area. During their operation, they secrete a substance along with saliva that helps the blood function normally, removes congestion and quickly stops the inflammatory process.Leeches are for special, medical, individual use only for individual patients.After the procedure, the doctor places the used leech in a disinfectant solution to let it die.It is best to undergo at least 5 courses of hirud therapy.
2. Cold destruction method - liquid nitrogen is used.This treatment is indicated for patients who do not respond well to drug treatment and for whom surgery is contraindicated for some reason.
3. Microwave therapy is a special method – electromagnetic waves are applied to the prostate area.After 1 course, tissue swelling subsides, blood circulation returns to normal, and congestion is eliminated.After a course of electromagnetic therapy, the patient's urinary and erectile functions were completely restored.
4. Ultrasound treatment allows you to quickly stop the inflammatory process that occurs during the remission period;in the stage of exacerbation, ultrasound therapy is not performed.To improve treatment effectiveness, additional drugs can be used under the influence of ultrasound that will penetrate directly into prostate tissue.
5. Urethral stent placement - the essence of the procedure is to place a special stent into the urethra, which helps expand the urethral lumen and promote normal urine flow.Despite the effectiveness of the procedure, urethral stent placement only helps eliminate clinical symptoms of prostatitis and does not help the patient escape the chronic inflammatory process.

Consequences and complications

In the absence of qualified therapy, prostatitis will quickly progress, become chronic and threaten men's health with serious complications, including:

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

Sometimes prostatitis and long-term chronic hyperemic processes create the impetus for the disease to degenerate into adenoma and then prostate cancer.