Prostatitis

Prostatitis is a disease in which the prostate becomes inflamed.Prostatitis, the symptoms of which most often occur in men of reproductive age (20-40 years), is diagnosed in an average of 35% of the population.

Depending on the origin, prostatitis can be bacterial or non-bacterial, depending on the nature of the flow - 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, specific and symptomatic treatment is carried out.

Prostatitis is not a disease that can be diagnosed from a photo, because 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, which is affected by the disease in question, is an exclusively male organ;consequently, prostatitis can develop exclusively in men.If we consider a similar area in women, which is the distal third of the urethra, that is, the urethra, then here they have Skene's glands.These glands are essentially analogues of the prostate, and if their inflammation develops, the symptoms may resemble those of prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.Because of it, the process of urination is controlled, in addition, due to the presence of the prostate, a certain secret is released that makes sperm liquid.

Often, prostatitis occurs in combination with diseases such as vesiculitis or urethritis, in elderly patients - in combination with benign prostatic hyperplasia.

Prostatitis: causes

Bacterial prostatitis, as the name suggests, develops when exposed to relevant pathogens.Basically, these are pathological agents that are constantly on the surface of the skin or in the environment of the digestive tract.In this case, a certain combination of factors can cause the development of prostatitis.

The causes of prostatitis include a number of factors.So, it can be untimely emptying of the bladder, the presence of diseases of the genitourinary system, constant hypothermia, irregular sex life, sedentary lifestyle, bad habits, etc.The relevance of this type of factor either causes the possibility of entry of microbial agents into the prostate or causes disruption of blood flow to the organs that lead to the development of the penis.stagnant processes.All this leads to the proliferation of microorganisms, as well as to the development and progression of pathological inflammation.

If an infectious pathogen is not detected in prostatitis, then a non-bacterial form of prostatitis is diagnosed.Various reasons can explain this form of pathology, although none of them have been proven at the moment.For example, some experts believe that in this form the disease can develop against the background of real neurogenic disorders, while the other part, on the contrary, focuses on the immunological nature of the disease in this form.This is only part of the existing theories about prostatitis.

Let's focus on acute and chronic forms of the disease.Acute prostatitis is based on the influence of a bacterial factor.As for chronic prostatitis, here this factor is not the main one, but acts as a secondary factor and important in its influence only at the beginning of the disease.Over time, the pathogenetic mechanism can be supplemented by a neurogenic, autoimmune factor or an 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 is accompanied by pain in prostatitis, and this is especially caused by damage to the outlet ducts of the acinus, from whose walls the epithelium peels off and gradually accumulates with mucus in the tubules.In addition, microliths are also formed;they look like small pebbles.Mixing with the epithelium and mucus, they cause the appearance of unusual plugs, which in turn leads to blockage of the excretory channels.Over time, such plugs turn into suppuration (or microabscesses), the lobules are no longer subject to drainage, they simply stop functioning.

Meanwhile, before the appearance of such a stage as the clogging of the outlet channels, as a rule, a lot of time passes, in some cases this time is counted in months, in others even 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 when these microabscesses form, it is already accompanied by the appearance of not very pleasant symptoms, which manifest themselves in different degrees of intensity.

As the first of these symptoms, patients notice certain difficulties when urinating.Due to the fact that the prostate increases against the background of the inflammatory process, the urethra is compressed to a certain extent.Further progression of the inflammatory process causes the development of bladder neck sclerosis;in an even more severe form of the pathological process, the ureter is completely closed.

The next symptom is sexual dysfunction.Due to the pathological processes that occur in the disease, the mechanism of erection is subject to disruption, and the orgasm is weakened.

There are other signs of prostatitis, especially:

• the appearance of a burning sensation in the urethra and perineum;
• persistent and frequent urge to urinate;
• discomfort during bowel movements;
• "floating threads" in the urine;
• the appearance of stretching from the urethra during defecation;
• occurrence of prolonged nocturnal erection;
• occasional and difficult urination;
• premature ejaculation;
• increased general fatigue;
• reduced potency;
• manifestation of orgasm in a deleted form;
• the expectation of the development of other forms of complications in the considered area, against the background of which anxiety and general mental depression appear.

In particular, I would like to add that the mentioned signs (symptoms) do not necessarily appear overnight.The disease is characterized by a very variable pattern of its manifestation, this refers to different variants in each individual patient, and to different periods during its course.

When considering the symptoms, it would be useful to return to the causes.Of course, the inflammatory process will not appear "out of the blue".These are mainly pathogenic agents, which have already been mentioned.Meanwhile, this very factor caused the formation of a wrong idea about the presence of certain causative agents of prostatitis, which is still supported by many experts today.However, there is no specific type of causative agent of this disease.At the same time, any chronic infectious disease can cause the development of prostatitis;it can be of any kind, be it sinusitis, tonsillitis, cholecystitis or any other disease.In this case, the pathogen can enter the prostate through the bloodstream, which is characterized by a rather powerful blood supply (otherwise its functionality would be questionable).

There is a certain risk group for prostatitis, and in particular the following people belong to it:

• persons whose professional activity falls under the criterion of "sedentary" work;
• people with a sedentary lifestyle;
• persons previously diagnosed with a certain genitourinary infection;
• persons for whom the problem of chronic constipation is relevant;
• persons who are promiscuous;
• persons whose family relationships do not fall under the criterion of regularity;
• people who abuse alcohol.

Men are often diagnosed with "abacterial prostatitis", "prostatitis in the stage of prostatosis".If a man has been diagnosed with prostatosis, we can say that at this stage there is nothing to worry about.In the meantime, you will have to make certain adjustments in your lifestyle.In other words, here we are talking about the fact that the above-mentioned phenomena of stagnation are already happening, but there is no inflammation as such yet, it is prostatosis.If we take into account such an option as abacterial prostatitis, then here we are already talking about the stage of the beginning of the development of the inflammatory process in a man, but so far without accompanying infection.

The peculiarity of prostatitis is that it practically does not manifest itself in an acute form.In other words, when it manifests, it is already a chronic process, which is explained by its often long and gradual development.In isolated cases in the initial acute stage, full recovery is assessed as a result of the treatment of the given disease or due to the spontaneous disappearance of the pathological process.The disease is characterized, as already mentioned, by an extremely slow course, the manifestations of symptoms generally have a smooth form.

Prostatitis: consequences

Acute prostatitis, if its manifestations are ignored and medical help is excluded, can cause the development of an abscess in the prostate, that is, 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 have a high fever, which occasionally turns into chills.The pain in the perineum becomes so strong that it makes urination difficult, while defecation is almost impossible due to the pain.After some time, swelling develops in the prostate, which in turn causes acute urinary retention.Meanwhile, acute prostatitis rarely occurs, which manifests itself against the background of chronic expansion of the pathological process - unless, at his own peril and risk, a man "endures and endures".

Returning to chronic prostatitis, we can say that it is characterized by the undulation of its own flow, that is, periodically the symptoms of the chronic form of prostatitis appear more intensively, and periodically they are practically not felt.Because of this type of change, many patients choose a wait-and-see approach.Meanwhile, as mentioned above, the inflammatory process can worsen, spreading further and further.When it spreads, even pyelonephritis can develop.Meanwhile, the complications of prostatitis in most cases are reduced to diseases such as vesiculitis, in which the inflammatory process affects the seminal vesicles, as well as epididymo-orchitis, in which the testicles and appendages become inflamed.As a result of the transmission of the disease in a similar form of spread, the development of infertility in men can be indicated.Treatment of infertility is a long and complex process, and in some cases it is completely impossible.The mentioned characteristics mainly belong to the development of a chronic form of prostatitis, due to the specific etiology of its occurrence (in particular, we are talking about sexually transmitted diseases).

Diagnosis

Examination of patients to determine their specific type of prostate pathology can be carried out in different ways.Meanwhile, in each specific case, an individual approach to the problem is important, on the basis of which it is already possible to determine the diagnostic option for obtaining sufficient information about the disease.

To begin with, the doctor conducts a survey about the patient's complaints, studies the anamnesis, if any, on the basis of which a preliminary conclusion is subsequently made and the principles of an individual diagnostic algorithm are determined.Please note that the first consultation with a urologist (namely, this is the specialist you should contact if disturbing symptoms of prostatitis appear) is not final and reliable in establishing a diagnosis, because the first examination is only an opportunity for the doctor to determine what further diagnostic measures are needed.

Given the sensitivity of the problem, men are interested in what questions a urologist asks if they suspect prostatitis.In particular, they will ask about current problems related to urination, as well as how the patient himself evaluates his own sexual function (that is, are there any changes, what exactly has changed, since which period).Additionally, the doctor will ask you what diseases you currently have, etc.

This is followed by an examination, especially an external examination, rectal examination, laboratory and instrumental examination.During the external examination, the doctor examines the genitals of the man, determining whether there are accompanying rashes, irritation, discharge, etc.

Then, after the external examination, the doctor moves on to the next stage, which is the rectal examination.A rectal examination allows determining the general contours of the prostate, its consistency, boundaries, etc.

After that, you will have to receive the results of instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which in its expanded form means transrectal ultrasound.This is the most accurate method for identifying diseases in men compared to standard ultrasound.

As for laboratory tests, it includes smear, urine test, prostate secretion test, PCR (laboratory test for detection of sexually transmitted infections).

Based on the current classification of methods for diagnosing prostatitis, only a microscopic examination of secretions obtained from the prostate, as well as any of the topical diagnostic options that can reveal the presence of an inflammatory process in the lower genital tract, can be considered a necessary option.Other types of diagnostic methods act only as clarifying methods;they are necessary for differential diagnosis and for the identification of existing complications of the underlying disease.In addition, it is important to remember that with overdiagnosis, this phase prolongs itself, and the symptoms only worsen.That is, here, as in any case, the principle of the "golden mean" is appropriate.

Treatment of prostatitis

Treatment of prostatitis today is a serious problem, although this does not mean that the doctor cannot help and the disease should be left to chance.Indeed, it is not always possible to fully recover from prostatitis, but it is possible to remove the symptoms of the disease, as well as achieve long-term and sustainable remission.Depending on how seriously a man takes the doctor's recommendations, how long his periods of remission will last.

Basically, the treatment of prostatitis can include a number of measures, especially methods of antibacterial therapy, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.Only on the basis of a set of these measures can the desired result be achieved;in general, the disease is difficult to treat, so it cannot be ignored.

Antibacterial therapy

This type of therapy is considered the basis of conservative treatment.The basis for choosing antibacterial drugs is a number of factors, especially these:

• the ability of the components of the proposed drug to enter the secretion and tissue of the prostate to create a concentration that exceeds the MIC values of the pathogen;
• characteristics of the spectrum of antimicrobial action (eg, the use of macrolide antibiotics determines the possibility of their good penetration into the prostate tissue, while they have no activity against gram-negative bacteria, i.e. they are the main etiological agents in considering the acute form of prostatitis).

It is important to note that acute prostatitis, compared to the chronic form of the disease, is characterized by the fact that it allows the possibility of accumulation of aminoglycosides and beta-lactam antibiotics in the gland tissues, in concentrations that are sufficient to suppress the activity of most types of pathogens.This is due to the increased perfusion of the prostate, as well as the increased degree of permeability characteristic of hemoprostatic barriers.Another characteristic of the drugs of 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 type of oral medication.

Prostate massage

Experts generally consider this method of influence to be quite an effective solution in the treatment of prostatitis.The basic principles for achieving a therapeutic effect in this case are as follows:

• restoration of channel patency;
• improvement of muscle tone and blood circulation in the prostate;
• increased penetration of antibiotics used in the tissue of the gland;
• the possibility of activating microorganisms that are in an inactive state, which improves the results of the sale of antibacterial drugs.

How is prostate massage performed?To begin with, of course, it is important to establish a certain contact of trust between doctor and patient;this will ensure greater relaxation of the patient, which in turn will allow the necessary manipulations to be performed with minimal pain and maximum efficiency.When preparing for the massage, the patient leans forward, spreading his legs about 60 cm wide and resting his elbows on the examination table.The doctor puts on gloves and applies gel to the index finger (sometimes this gel has an analgesic effect).Then, with his free hand, he spreads the buttocks to such a width that he will be able to palpate the anal sphincter with his index finger.The natural reaction to such contact is muscle contraction.Then, after relaxation, the index finger is 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, shame and anxiety, and if the massage is performed correctly, they do not accompany it at all.The massage can be called successful when it is possible to get at least 4 drops of secretion secreted by the prostate.

The most popular recognized method used in the treatment of chronic prostatitis is massage according to the Manila Protocol.In this case, the massage is performed three times a week, a microbiological dynamic study is also carried out and antibiotics are taken.

Immunotherapy

This direction in the treatment of prostatitis is often extremely necessary, because with a prolonged manifestation of inflammation in combination with previous improper antibacterial treatment, the possibility of a negative impact on the general state of the immune system cannot be ruled out.Treatment of prostatitis requires not only the removal of the infection from the gland and, in fact, the inflammation, but also the prevention of the re-development of inflammation in it.However, like other areas of treatment, immunotherapy should not be reduced to self-medication or treatment based on the recommendations of the pharmacist in the pharmacy;here you will have to consult an immunologist, and also, most likely, conduct some tests.

Physiotherapy

In prostatitis, this line of treatment can be applied in a wide range of impact options, however, regardless of the specific solution, the impact is aimed at improving blood circulation in the pelvic organs, thereby increasing the overall effectiveness of the implementation of antibacterial therapy measures.Ultrasound waves, electromagnetic waves, laser therapy, temperature increase directly in the rectum, etc. can be used in physiotherapy.If physical therapy is not possible, the doctor may recommend microenemas with warm water and certain medications.

Lifestyle correction

This type of effect is aimed both at the treatment of prostatitis and at its prevention.It should be treated in the same way as the main treatment, because if the factors that predispose to the occurrence of prostatitis remain, then the disease will, sooner or later, be felt again.Taking this into account, you should make certain changes in your life, it refers to playing sports, normalizing the wake/sleep schedule, nutritionally balanced diet, walking, eliminating bad habits.

If symptoms suggestive of prostatitis appear, you should consult a urologist.