According to 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 event, in most cases due to total ignorance of the disease from the very beginning. What is prostatitis, what are its causes and the first signs, what you need to know on the topic of "diagnosis" and what modern methods exist to treat prostatitis. All men should know about prostatitis in this review article.
Ab ovo - from the egg
We are not talking about Horacio's satyrs, in this case we are interested in everything related to prostatitis, from the beginning to the last "screech" 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 the diagnosis and treatment.
The reasons for the development of prostatitis are extensive. In prostatitis, infectious factors have the greatest weight in the development of the disease:
- Acute form. The coccal flora acts as provocative reasons.
- Chronic form. The reasons for its development are more extensive, since the primary 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 noteworthy that chronic prostatitis, caused by a pathogen that has penetrated the prostate gland, may later have a pathogenic factor and be non-bacterial 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, a violation of blood and lymphatic circulation in the pelvis ( congestive prostatitis), hormonal or autoimmune disorders.
Often, you can only hear about 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 non-bacterial chronic 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 the third portion of urine. | The level (increase) of leukocytes with discharge m / s or urine |
| 1 acute catobacterial | + | + | + |
| 2 chronic catobacterial | - | + | Uncertain (whether or not) |
| 3 a. Chronic pelvic pain syndrome of an inflammatory, non-bacterial nature | - | - | + |
| 3b. Prostatedynia, non-inflammatory pelvic pain syndrome | - | - | - |
| 4 cat Asymptomatic inflammatory process | - | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been further studied, in most cases bacteria from 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 age of antibiotics, the gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, especially often it became 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 pathogenic (causing prostatitis) factors that play an important role in the development of inflammation in the prostate without it. presence of microorganisms. So at the heart of the causes of non-bacterial prostatitis are stagnant processes in the small pelvis, circulatory disorders, intraprostatic urine reflux, and an autoimmune aseptic inflammatory process.
Sick or not, that's the question
What does a man with prostatitis look like? For a person far removed from medicine, and even more not versed in 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 first complaints of the patient, will understand where the root of the problem has matured and what ways to eliminate it they will have to follow.
The symptoms of prostatitis are often described in several sentences, highlighting the brightest moments, and this plays 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 reality 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 when defecating. Low-grade fever
- Parenchymal prostatitis. There are symptoms of pronounced dysuria, often AUR, pain during natural recovery, general intoxication with a temperature up to 40 C.
In the case of prostatitis with abscess formation, the symptoms are clearer with the possible opening of the abscess towards the rectum or towards the prostatic part of the urethra. With such a breakthrough, 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, the man's condition sharply deteriorates.
Comprehensive treatment of prostatitis cannot be started without a complete examination of the man, diagnosis and analysis of symptoms that may 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 what symptoms refer to one form or another. Let us consider this problem 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 on its type.
In the chronization stage the following moments can be distinguished:
- Chronic prostatitis is rarely the result of an acute process.
- Primary prostatitis disappears with erased symptoms.
- A characteristic symptom of chronicity is scant 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 (congestion in the capillaries), which smoothly turns into a non-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.
What does a man with chronic prostatitis feel? Patient reviews show that more often at first minor pains in the perineum, scanty discharge, which most men simply do not pay attention to, are felt. The next stage is the union of the following symptoms: burning sensation in the urethra, sexual dysuria, general malaise. Frequent misfires during sex make men feel 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 complicates the diagnosis at an early stage of the disease, in addition, the symptoms tend to change places, which is even more misleading.
Long-term syndromes
What can be expected from chronic prostatitis? If there is no timely diagnosis and treatment, nothing good, any specialist will confirm. This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself does not hurt, but many nerve endings run through it and are close by, which inevitably becomes involved in the inflammatory process. The pain can be of different intensity, from a little pain, which creates discomfort, to severe, which does not allow you to sleep peacefully. Irradiation of pain occurs in all nearby areas (scrotum, sacrum, perineum), the pain of prostatitis should be differentiated from similar symptoms of other diseases.
dysuria
Dysuric syndrome always indicates a malfunction in the urinary system, but the cause 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 need to go to the bathroom, 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 disappear, but again return in intensified form.
sex without pleasure
An intimate life on the decline - it is these first symptoms that men notice, and it is they, as reviews show, that force them to see a doctor. Frequent nocturnal erections, a erased orgasm, poor erection and rapid ejaculation, pain during this - that's what the stronger sex worries the most. In the advanced stage of chronicity, nothing good can be expected from prostatitis, erectile dysfunction often develops.
The degree of sexual disorder in men is not the same, someone initiates the sexual relationship and somehow completes it, eliminating the characteristic bells. For some, even the initial weak response of the penis to a charming stimulus turns into a collapse and the beginning of spooky experiences that turn into a prolonged depression. The spectrum of impotence is difficult for patients with problems with the prostate, almost always experts 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 pathology.
What to write on the card
Which record will appear in the patient's medical record and which final diagnosis will be established depends on a series of primary studies, from the patient's arrival at the urologist and his complaints (antecedents) to the last stage of diagnostic measures. What exactly is required depends on the type of prostatitis, its negligence, and the patient's consent for specific diagnostic procedures.
In general, the diagnosis consists of:
- Anamnesis. The doctor will ask you in detail about all the complaints and symptoms, the prerequisites of the disease, etc.
- Urine analysis.
- Prostate massage (rectal examination + collection of secretions).
- Ultrasound of the prostate.
- 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 try to evade many stages of diagnosis, while the motivations are very different. The price of such indifference is your own health! It is important to remember that prostatitis is curable only if it is "caught" early and the diagnosis is made accurately with the definition of the form of the disease and its cause.
How to be healthy forever
So, the man understands that he has prostatitis, what awaits him in the future and is it possible to restore his lost health? It is important to understand that he will have to get rid of prostatitis 2 times more than it developed. Also, if the pathological process was almost beyond the attention of the man, then the treatment of prostatitis will be carried out with the direct participation of him. 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 stages of treatment of prostatitis will depend directly on what the doctor finally finds during the examination, the type of disease, the age of the patient and the 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 for each stage of treatment is different, depending on the total cost of prescription drugs, additional methods, and the clinic. The preventive measures that follow the treatment have an important foundation: they prevent the return of the disease. Prevention has a direct and close contact with treatment, the fundamentals of prevention are as important as meeting all the doctor's requirements during the course of therapy.
Treatment of the acute form.
The period of exacerbation requires taking 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 taken for at least 3-4 weeks to prevent a relapse of the disease. Sometimes the doctor continues the 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 required to determine the sensitivity of the 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 attending physician determines the need for additional treatment methods, it should be remembered that massage is contraindicated in the acute form of prostatitis, as it provokes 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 even of doctors in their field to destroy it in a couple of weeks. It is not necessary to take the word of those who cured the disease in 2-3 days. The goal of treatment is to stop the focus of infection, restore immunity in men and the work of the prostate gland, as well as prevent exacerbation; this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks, with low effectiveness of treatment, the drug is continued to be taken. Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs. In advanced cases, surgery is provided with partial or complete excision of the prostate gland.
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.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with the strengthening of the patient's immune system.
Changes in diet and lifestyle are also the basis of 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 appointment 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 discomfort, man suffers psychologically, because the most valuable part of his body is affected: the intimate. Reviews of those who have cured the disease show that it is only worth strictly following the doctor's prescriptions, along with changes in diet and lifestyle. The price of a frivolous attitude towards treatment is very high: a man loses not only his health, but his whole life, his character and his relationships with others are changing. To prevent this, it is necessary to monitor the health of the prostate gland and eliminate the causes of the development of diseases.