Recommend
Official site Urosaf

Prostatitis

Prostatitis in men

Prostatitis is the inflammation of the tissue of the prostate gland in men, which is manifested by pain in the lower abdomen and urination disorders. The disease proceeds in acute and chronic forms, develops under the influence of infectious and non -infectious causes. Prostatitis is included in the five most frequent problems that men resort to the urologist.

The prostate gland is an organ of the male reproductive system that produces a liquid secret that is part of the sperm and improves the mobility of sperm. The prostate has the form of chestnut, dimensions 2x3x3. 5 cm, is in the middle of the pelvis cavity. A bladder neck and the initial department of the urethra pass through the center of the gland.

Acute prostatitis is quite rare (5-10 % of cases), but the procedure is difficult and is a serious danger to male health. Most young men are sick with an acute way of inflammation. Chronic prostatitis develops in men more frequently from 60 to 70 years. The disease proceeds with moderately pronounced symptoms, but over time it leads to the formation of erectile dysfunction and deteriorated urination.

The causes and risk factors of prostatitis in men

All causes of prostatitis in men can be divided into two large, infectious and non -infectious groups.

Acute inflammation of the prostate glandMost of the time it has an infectious origin, this form of disease is especially common among men under 40. In the vast majority of cases, it is caused by bacterial flora:

  • Enterococci;
  • E. coli;
  • Klebsiella and Proteas;
  • Gococcus;
  • pale treponema;
  • clamidia;
  • Tuberculosis mycobacteria.

However, genitourinary or intestinal infection leads to inflammation of the prostate gland in 100 % of cases. For the development of bacterial prostatitis, predisposing factors are required, the main one of which is the systematic microtrauma of the gland. This happens with prostate biopsy, cystoscopies or operations in the pelvis. Other risk factors for infectious prostatitis include:

  • immunodeficiency (HIV infection, congenital pathology of the immune system);
  • random sex life;
  • homosexual contacts;
  • chronic diarrhea or constipation;
  • obesity;
  • A sedentary lifestyle.

Pathogenic microorganisms penetrate the prostate gland of the urethra or the rectum. The weakening of immune protection and prostate microtrauma contribute to the development of acute inflammation. In this background, the tone of the smooth muscles of the prostate increases, which leads to the compression of the urethra and urine disorders.

Chronic prostatitisIt has a non -infectious origin and a more complex development mechanism. Inflammation is gradually formed and the exact cause of its occurrence has not been established. Non -bacterial chronic prostatitis risk factors:

  • greater pressure in the prostate gland (with benign hyperplasia or adenoma);
  • greater pressure in the pelvic cavity;
  • chronic pelvic pain;
  • autoimmune diseases;
  • rare sexual contacts;
  • heavy physical activity;
  • Chronic stress

The pathogenesis of chronic prostatitis is based on the stagnation of the secret of the gland, the deterioration of its blood supply, which leads to constant inflammation.

In approximately 6 % of cases, chronic bacterial prostatitis develops in men. The reason for this is an insufficient or incomplete treatment of the acute form of the disease.

Types of prostatitis

Depending on the cause and development mechanism, four cliniciansProstatitis forms:

  • acute bacterial;
  • chronic bacterial;
  • non -chronic bacterial (chronic pelvic pain syndrome);
  • Asymptomatic inflammation.

The National Institute of Health distinguishes 4 types of prostatitis depending onOf the development stage and the clinic:

  • I Type - Acute bacterial inflammation with general and local manifestations;
  • II Type - Chronic bacterial inflammation with periods of remissions and exacerbations;
  • Type IIIA - Chronic non -bacterial inflammation has not been detected (pathogenic microorganisms have not been detected) confirmed by the presence of leukocytes in the secret of the prostate or ejaculated;
  • Type IIIV - Non -inflammatory prostatitis, in which there are no pathogenic microorganisms and leukocytes in the secret of the gland;
  • Type IV - Asymptomatic inflammation, which can only be confirmed histologically.

DependentOf the nature of the pathological processIn the prostate gland, they distinguish:

  • Catarral prostatitis - Acute inflammation not complicated;
  • Stagnant or congested prostatitis - chronic inflammation associated with the obstruction of the gland ducts and the accumulation of a prostate secret in them;
  • Calculation prostatitis: a complication in a chronic form of the disease, accompanied by the formation of stones in the conduits of the gland;
  • Granumatous prostatitis is an extremely rare form, which is accompanied by a thickening of the mucous membrane of the gland ducts.

Prostatitis symptoms in men

The clinical image of prostatitis in men consists of signs of inflammation of the prostate gland, compression of the bladder neck and urethra, as well as the general manifestations of the disease. The severity and combinations of the symptoms differ according to the form and stage of development of prostatitis.

Common manifestationsDiseases, regardless of form, serve:

  • pain in the lower abdomen, the lower back, coccyx and sacrum;
  • Urine violation in rapid impulse, discomfort and burning, intermittent current;
  • Violation of power and ejaculation.

The acute form of prostatitis begins suddenly, proceeds with pronounced symptoms, it is often accompanied by several complications. Chronic inflammation develops gradually, is characterized by periods of exacerbations and remissions. With bacterial prostatitis, the first symptoms are signs of general intoxication (fever, nausea), and with a non -infectious form of the disease, the local inflammation of the prostate is of the main importance.

Acute prostatitis signs

With acute bacterial inflammation of the prostate, the following symptoms appear in men:

  • general discomfort;
  • fever of more than 38 ° C;
  • nausea and vomiting;
  • severe pain at the bottom of the abdomen with rectum radiation;
  • Frequent, but at the same time, a difficult urination;
  • itching and burning in the urethra;
  • urine cloud, the appearance of blood or pus in it.

In the future, a complete recovery occurs in the context of treatment, or the chronic form of bacterial prostatitis with various consequences is developed.

Chronic prostatitis symptoms

By forming chronic bacterial prostatitis after acute inflammation, a man is concerned about periodic pain at the bottom of the abdomen, the urination of difficulty, sometimes burning in the urethra. Pain can also extend to the lower back and coccyx, rectum, penis and scrotum. Symptoms generally occur during the period of exacerbation of prostatitis, and during remission, the well of a man remains normal.

Non -infectious prostatitis in men is also called chronic pelvic pain, which includes pain and urination signs and sexual disorders. It is difficult for an urinating man, since a current of urine is slow and intermittent, there is a sensation of burning and a feeling of pressure in the urethra. With a prolonged course of the disease, there is a power violation, ejaculation becomes lower and painful. Ultimately, the quality of life of a man suffers significantly, psychological problems develop.

Pain with prostatitis

Pain syndrome with prostatitis is a constant and more pronounced symptom, which is present in all forms of the disease. The pain mechanism in prostatitis is due to the inflammation and edema of the gland, the compression of the recipients in the bladder neck and the initial section of the urethra.

The acute form of the disease is accompanied by the most severe pain, since inflammation is infectious, leads to a massive edema of the gland. The pain is located in the prostate itself, but the man feels that not only at the bottom of the abdomen, but also in the lower back, the nucleus, the rectum and the scrotum.

With the chronic inflammation of the prostate, the painful pain, but they are longer, they may not disappear even during the referral period. Chronic pelvic pain syndrome is accompanied by unpleasant sensations mainly in the prostate gland itself, as well as in the coxis, around the anus, at the base of the penis and the scrotum. Dismissary bother man daily for at least three months.

That the inflammation of the prostate is dangerous

Complications develop both with acute and chronic forms of prostatitis:

  • Vesiculite (inflammation of seed bubbles);
  • coliculite (inflammation of seed tubers);
  • Prostate abscess (abscess in the capsule);
  • Prostate fibrosis (the formation of scars in the tissue of the gland);
  • cysts in the prostate;
  • Prostate stones;
  • infertility due to deterioration in the quality of sperm;
  • erectile dysfunction caused by chronic pelvic pain and psychological disorders;
  • depression.

Inflammation diagnosis of the prostate gland

When the first signs of prostatitis appear, you must contact a urologist. First, the doctor speaks with the patient to determine the nature of the complaints and collect an anamnesis. For this, the doctor asks the following questions:

  • How long the symptoms of the disease have appeared;
  • Where pain is located, its character and conditions of occurrence;
  • Is there any problem with urination and ejaculation?
  • Are there chronic diseases, including genitourinary infections?

To diagnose prostatitis, the doctor uses the following methods:

  • Rectal finger of the prostate gland;
  • General Clinical Blood Analysis;
  • Bacteriological examination of ejaculated or prostatic secretion;
  • Ultrasound examination of pelvic organs;
  • Uroofloometry;
  • radiography or computerized tomography of the prostate;
  • In rare cases, a biopsy of the prostate gland may be required, followed by a histological exam.

Prostatitis treatment methods in men

For the treatment of prostatitis in men, conservative methods are mainly used, tactics depend on the cause and stage of disease development. With asymptomatic inflammation (type IV), active treatment is not required. In other forms of the disease, a complex treatment is indicated, the acute form of prostatitis requires hospitalization in the hospital, chronic inflammation can be treated in an outpatient basis.

First, the doctor gives recommendations about Lifestyle corrections:

  • rejection of smoking and drinking alcohol;
  • regular sex life;
  • exclusion of stress;
  • adequate physical activity;
  • balanced diet;
  • Exception of hypothermia and overheating.

A previous requirement for successful prostatitis treatment is Related diseases, especially urogenital infections.

Drug therapy  With prostatitis, it aims to suppress the inflammatory process, improve urination and pain relief. The following drug groups are used:

  • AntibioticsShown by acute bacterial inflammation, the doctor prescribes medications taking into account the results of the microbiological examination of the prostate secret. Medications can be taken orally in the form of tablets, or in the form of intramuscular injections. The treatment course is usually 4 to 6 weeks with an acute form of the disease. In chronic bacterial prostatitis, the duration of therapy is determined individually.
  • ALFA BLOCATORS. Drugs are designed to improve urine, as they relax the smooth muscles of the gland and eliminate the compression of the urethra's prostate. In the chronic form of the disease, they must be taken for a long time and, sometimes, for life.
  • Musorelaxant and non -steroidal anti -inflammatory drugs. It is shown that they eliminate the pain syndrome caused by the inflammation of the gland and the spasm of their muscles.
  • In chronic inflammation, medications are indicated to improve microcirculation, immunomodulators, antidepressants, drugs to stimulate erection.

The acute inflammation of the prostate gland responsible for drug treatment, in most cases, a complete recovery occurs within 1. 5-2 months. In the chronic form of the disease, therapy is carried out for a long time, for several years or for life.

An important way to treat congestive prostatitis is the massage of the prostate gland through the rectum. The procedure is carried out by a urologist, on an outpatient basis. Massage helps eliminate muscle spasm, stimulates the release of a prostate secret.

Physiotherapeutic procedures  It is shown in the chronic course of prostatitis:

  • laser therapy;
  • electrophoresis and ultra -ophoresis;
  • microwave therapy;
  • electrical stimulation;
  • acupuncture.

Surgical intervention  It is shown only with the development of complications: an abscess or prostate stones.

Forecast and prevention

The prognosis for the recovery of acute bacterial prostatitis is subject to timely and complex treatment. The transition to a chronic form is observed in 6-10 % of cases. Chronic non -bacterial prostatitis, as a rule, cannot be completely cured. Complex therapy allows you to slow down the progression of the disease, preserve the quality of man's life and reduce the risk of complications.

The prevention of the development of prostatitis in men includes the following recommendations:

  • healthy lifestyle;
  • regulation of the work and rest regime;
  • Balanced diet and mode of consumption;
  • adequate physical activity;
  • regular sex life (ejaculation);
  • prevention of genitourinary infections;
  • Restriction of invasive manipulations (cystoscopy, urethra catheterization, prostate biopsy);
  • Prevention of genital lesions.