According to BME, prostatitis is an inflammatory process that occurs in the prostate in men with damage to the parenchyma and interstitium. The treatment of prostatitis in men is a long and difficult event, most of the time due to complete ignorance of the disease at the beginning. What is prostatitis, what are its causes and early signs, what you need to know about the subject of "diagnosis" and what modern methods of treating prostatitis exist. All men need to know about prostatitis in this review article.
Ab ovo - from the egg
We are not talking about Horace's satyrs, in this case we are interested in everything related to prostatitis, from the beginning to the last "squeal" of the treatment. Symptoms of prostatitis are found in men during the period of active sexual activity, from 25 to 45 years old, in a thematic video you can study in detail everything related to the fundamentals of the disease, its causes and symptoms, the peculiarities of diagnosis and treatment.
The reasons for the development of prostatitis are extensive. With prostatitis, infectious factors have the greatest weight in the development of the disease:
- Acute form. The coccal flora acts as provocative motifs.
- Chronic form. The reasons for its development are more extensive, as the main factors of such prostatitis in men are: gonococci, Trichomonas, Gr + and Gr-bacteria, mycobacterium tuberculosis. In rare cases, the diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
It is worth noting that chronic prostatitis, caused by a pathogen that has penetrated the prostate, may later have a pathogenic factor and be abacterial in nature. The acute form is most often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, hypodynamia and, as a result, violation of blood and lymphatic circulation in the pelvis ( congestive prostatitis), hormonal disorders or autoimmune.
You can often hear about only one type of prostatitis - infectious, however, according to the WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is recorded in 90% of cases.
Table nº 1. Brief characteristics of the pathology
| Categories for prostatitis | acute infection | The presence of the pathogen in the secret of the prostate or in the 3rd portion of the urine | The level (increase) of leukocytes with m/s secretion or urine |
| 1 cat. acute bacteria | + | + | + |
| 2 cat. chronic bacteria | - | + | Uncertain (whether or not) |
| 3a. Chronic pelvic pain syndrome of an inflammatory, non-bacterial nature | - | - | + |
| 3b. Prostatodynia, non-inflammatory pelvic pain syndrome | - | - | - |
| 4 cat. Asymptomatic inflammatory process | - | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in both acute and chronic manifestations has been studied more thoroughly, in most cases the bacteria of the family become the cause of the disease. Enterobacteriaceae (E. coli bacillus). The role of atypical microorganisms as a cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered not fully proven. Symptoms of prostatitis in men with signs of weakened immunity, particularly with HIV, can be caused by yeast (Candida spp. ) or Mycobacterium tuberculosis.
Before the advent of the antibiotic era, gonococcal flora (Neisseria gonorrhoeae) played a significant role in the development of prostatitis, especially often becoming the cause of its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have carefully studied the list of possible pathogenic factors (prostatitis triggers) that play an important role in the occurrence of inflammation in the prostate without the presence of microorganisms. Thus, at the heart of the causes of nonbacterial prostatitis are stagnant processes in the small pelvis, circulatory disorders, intraprostatic reflux of urine, and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What is a man with prostatitis like? To a person far removed from medicine, and even more unfamiliar with the problems of urology, the masculine appearance of one individual is no different from the multitude of others. And only an experienced specialist, from the patient's first complaints, will understand where the root of the problem has matured and which paths to eliminate it will need to follow.
The symptoms of prostatitis are often described in several sentences, highlighting the brightest moments, and this makes a cruel joke on a man. Relying on such imprecise definitions, he ignores really important bells, believing that the disease does not exist, although in fact the clinical picture depends on the nature of the morphological changes in the prostate.
The first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis. Dull pain in the perineum, radiating to the sacrum, frequent nocturnal impulses.
- Follicular prostatitis. Difficulty and frequent urination, sometimes with delay. Pain when "peeing", aggravated at the end of the urination process, as well as bowel movements. low fever.
- Parenchymal prostatitis. There are symptoms of pronounced dysuria, often AUR, pain during natural recovery, general intoxication with temperature up to 40 C.
In the case of prostatitis with abscess formation, the symptoms are clearer with the possible opening of the abscess in the rectum or in the prostatic part of the urethra. With such advancement, the symptoms disappear. If the opening of an abscess occurs in the paraprostatic tissue or in the perineal region, visual symptoms can be observed: swelling, redness of the skin with pronounced fluctuation. At the same time, man's condition deteriorates dramatically.
Comprehensive treatment of prostatitis cannot be started without a thorough examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is customary to distinguish between the acute and chronic course of prostatitis; in a thematic video on the Internet, you can find out in detail which symptoms refer to one way or another. Let's consider 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, as there are many variations in symptoms. In general, the effective treatment of prostatitis depends on the prostatitis, or rather its type.
In the chronization phase, the following moments can be distinguished:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis disappears with unresolved symptoms.
- A characteristic symptom of chronicity is scanty secretion 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 (congestion in the capillaries), which gently transforms into an abacterial form of prostate inflammation.
- 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.
What does a man feel with chronic prostatitis? Patient reviews show that most often, at first, small pains in the perineum are felt, scanty discharge, which most men simply do not pay attention to. The next stage is the combination of the following symptoms: burning sensation in the urethra, sexual dysuria, general malaise. Frequent failures during sex make men depressed, irritable, or depressed.
It is important to understand that all these signs do not necessarily appear in each specific case of chronicity, this is what makes the diagnosis at an early stage of the disease difficult, in addition, the symptoms tend to change places, which is even more misleading.
long term syndromes
What can you expect from chronic prostatitis? If there is no timely diagnosis and treatment - no good, any specialist will confirm this. This type of prostatitis is characterized by 3 syndromes:
Ache
The prostate itself does not hurt, but many nerve endings pass through it and are nearby, which inevitably get involved in the inflammatory process. The pain can be of different intensity - from a little painful, creating discomfort, to severe, not allowing you to sleep peacefully. Radiation of pain occurs in all nearby areas (scrotum, sacrum, perineum), pain from prostatitis must be differentiated from similar symptoms of other diseases.
dysuria
Dysuric syndrome always indicates a malfunction in the urinary system, but what caused it is revealed during diagnosis. The enlargement of the prostate inevitably compresses the urethra, and the flow of urine is interrupted, followed by the development of a frequent urge to use the toilet, a sensation of incomplete emptying of the bladder. With advanced prostatitis, there is compensatory hypertrophy of the muscular layer of the bladder and ureters. At this time, the symptoms of dysuria subside, but come back again in an intensified form.
sex without pleasure
A declining intimate life - it is these first symptoms that men notice, and it is they, as the reviews show, that force them to see a doctor. Frequent nocturnal erections, a dull orgasm, bad erection and rapid ejaculation, pain during this - this is what worries the stronger sex the most. In the advanced stage of chronicity, nothing good can be expected from prostatitis; erectile dysfunction usually develops.
The degree of sexual disorder in men is not the same, someone initiates sexual intercourse and somehow completes it, eliminating the characteristic bells. For some, even the initial weak response of the penis to a charming stimulus becomes a breakdown and the beginning of strange experiences that turn into prolonged depression. The spectrum of impotence is difficult for patients with prostate problems, almost always specialists and relatives note that prostatitis spoils the character.
To learn more about the disease, you can study a thematic video, where experts explain many of the nuances of the pathology.
What to write on the card
Which record will appear in the patient's chart and which final diagnosis will be established depends on a series of primary studies, from the patient's arrival at the urologist and his/her complaints (history) to the last stage of diagnostic measures. What exactly is needed depends on the type of prostatitis, its negligence, and the patient's consent to specific diagnostic procedures.
In general, the diagnosis consists of:
- Anamnesis. The doctor will ask in detail about all complaints and symptoms, the prerequisites of the disease, etc.
- Urine analysis.
- Prostate massage (digital rectal exam + secretion collection).
- Prostate ultrasound.
- spermograms.
- Prostate biopsy (if indicated).
What does the diagnosis give and is it so important? If you read patient reviews, you can often understand that most men are trying to get away from many stages of the diagnosis, while their motivations are very different. The price of such indifference is your own health! It is important to remember that prostatitis can only be cured if it is "caught" in time and the diagnosis is made accurately by defining the form of the disease and its cause.
How to stay healthy forever
So, does the man understand that he has prostatitis, what awaits him in the future, and is it possible to restore lost health? It is important to understand that you will have to get rid of prostatitis 2 times more than it has developed. In addition, if the pathological process has almost gone beyond the attention of man, then the treatment of prostatitis will take place with his direct participation. Whether acute or chronic prostatitis can be cured - yes, if you follow all the doctor's recommendations, in advanced cases of the chronic form, during treatment, it is possible to achieve a stable remission.
The steps in the treatment of prostatitis will directly depend on what the doctor finally found during the examination, the type of disease, the patient's age and physical data.
The treatment regimen is always strictly individual, but the following points may be present in it:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Appointment of immunocorrectors.
- Urological Massage.
- Physiotherapy.
The price of each stage of treatment is different depending on the total cost of prescription drugs, additional methods and clinic. The preventive measures that follow treatment have an important reason - they prevent the disease from returning. Prevention has a direct and close contact with the treatment, the fundamentals of prevention are as important as the fulfillment of all the doctor's requirements during the course of therapy.
Treatment of the acute form
The period of exacerbation requires the use of antibiotics, which are drunk in a course. In the presence of chlamydial infection, drugs from the cephalosporin series are indicated.
The duration of the course is significant, on average, antibiotics are drunk for at least 3-4 weeks to prevent a relapse of the disease. Sometimes the doctor continues treatment for a longer period, antibiotics are combined with pain relievers to relieve pain.
Antibiotic treatment is carried out taking into account the following rules:
- Bacterial culture is necessary to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of drugs are taken into account.
- They take into account the previous course of treatment, when it was, what means were used and the result.
The need for additional methods of treatment is determined by the attending physician, it should be remembered that massage is contraindicated in the acute form of prostatitis, as it causes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the 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 it is beyond the power of even doctors in your area to destroy it in a few weeks, you do not need to take the word of who cured the disease in 2-3 days. Treatment is aimed at stopping the focus of infection, restoring immunity in men and the work of the prostate, as well as preventing exacerbation - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks, with low effectiveness of treatment, the drug continues to be taken. Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs. In advanced cases, surgery is performed with partial or complete excision of the prostate.
Free of bacteria and symptoms
A characteristic difference of therapy is the absence of antibiotics, without the presence of pathogenic microflora, they are simply not necessary. But sometimes experts prescribe a short course of drugs in 2-4 weeks.
The treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy to strengthen the patient's immune system.
Diet and lifestyle changes also underlie the treatment of non-bacterial prostatitis, baths, alpha-blockers are shown.
Prostatitis without symptoms is difficult to detect; in diagnosis, the PSA method is used, followed by the indication of a 2-week course of antibiotics as treatment. After that, individual symptomatic treatment is selected.
In general, the treatment of any type of prostatitis is a long-term phenomenon and not always pleasant for the patient himself. In addition to physical discomforts, a man suffers psychologically, because his most valuable part of the body is affected - the intimate. Reviews of people who have cured the disease show that only strict adherence to medical prescriptions, along with dietary and lifestyle changes, pays off. The price of a frivolous attitude to treatment is very high - a man loses not only his health, his whole life, character and relationships with others are changing. To avoid this, it is necessary to monitor the health of the prostate and eliminate the causes of the development of diseases.