Prostatitis

Today, inflammation of the prostate gland is the leader in the group of male diseases that are predominantly sexually transmitted. Its complications threaten infertility, reduced libido and impotence.

The symptoms of prostatitis are not only pain, urination disorders and inflammation of the spermatic cord. The most dangerous consequence of advanced inflammation can be cancerous degeneration of the prostate. While the pathological process diagnosed in time is easily stopped.

Causes of inflammation

The risk of developing prostate inflammation increases due to various factors that predispose to the onset of the disease:

• Hypothermia, one-time or associated with the nature of outdoor work.
• A sedentary lifestyle leads to disturbances in the functioning of the digestive system.
• Chronic somatic diseases (diabetes mellitus, hypertension).
• Foci of focal, perifocal infection (rhinitis, tonsillitis, stomatitis, gastritis).
• Persistent UGI (chlamydia, trichomoniasis, herpes virus).
• Stress, insomnia, chronic fatigue syndrome.
• Reduced immunity due to previous illness, surgery, emotional stress.
• Bad habits that lead to the development of intoxication: alcohol, smoking, strong coffee.
• Professional injuries of the perineum of car drivers, athletes, workers in hazardous industries.
• Promiscuous sex life, interrupted sexual intercourse, devoid of sensuality, intercourse with incomplete ejaculation, prolonged absence of intimacy (low need for sperm leads to stagnation in the gland).
• Venereal diseases.

Despite a rather large number of provocative moments, the essence of prostatitis is the occurrence of stagnation within the organ on the background of disturbed blood circulation and lymph outflow.

Classification

In modern urology, there is no single classification of diseases. However, practitioners prefer this option to classify the inflammatory process in the prostate:

According to the course of the disease:

• Acute prostatitis. This accounts for more than 50% of cases of the disease in people not older than 30-35 years.
• Chronic option. It is considered a non-age category. It does not manifest itself for a long time, the stimulus for its development is a cold or an infection.

For the reason that caused the pathology:

• Bacterial inflammation of the prostate, prevalent in men under 40 years of age, appears against the background of ultrasound and does not cross the boundaries of the organ.
• Non-bacterial pathological changes in the gland, mostly chronic.
• Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.

According to the nature of structural changes in the prostate:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention. Clinically, it resembles prostate adenoma.
• Calculous inflammation of the prostate is caused by the formation of stones inside the prostate. It is considered a sign of cancer.
• Congestive prostatitis, the result of a sedentary lifestyle, is diagnosed in every second patient.

Signs of illness

If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:

• Urinary disorder with intermittent, weak stream of urine, unusually short, causing splashing, difficulty and pain before urination. The frequent urge to empty the bladder occurs mostly at night.
• The pain, which is localized in the lower abdomen, radiates to the scrotum, perineum and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in sperm (consistency, quantity).

Acute prostatitis

The disease begins with a sudden rise in temperature (up to 40 degrees), painful headache and fever. The symptoms that appear are accompanied by pain in the groin, perineum, back, discharge from the urethra, frequent urination and a constant urge to urinate.

Bladder emptying occurs with a delay and a burning sensation. The urine itself becomes cloudy and may contain blood. Irritability and fatigue appear.

The outcome of acute prostatitis can be a complete resolution of the process (if treatment is started on time). Since changes occur in many pelvic organs, they cannot be left to chance, otherwise corresponding complications will arise:

• Vesiculitis is an inflammation of the seminal vesicles, the cause of the appearance of pus in the semen, which not only reduces the quality of the ejaculate, but also leads to the loss of reproductive function.
• Coliculitis - inflammatory changes in the seminal tubercle become the reason for the development of severe pain during sex, interruption of orgasm and impotence of a psychological nature.
• Abscess formation in the body of the prostate, its rupture and purulent damage to the rectum lead to worsening of symptoms, severe intoxication of the body, and even death.
• Stagnation in prostate tissues leads to changes in their structure, disruption of innervation, blood supply, both to the gland itself, and to the organs located nearby, along with disruption of their functions. Erection becomes insufficient for full sexual intercourse, premature ejaculation and prolonged sexual intercourse without orgasm are observed.
• Changes in scars on the gland and spermatic cord lead to infertility, reduction in sperm quality and sperm motility. Narrowing of the urethra interferes with the normal process of urination, can cause acute retention of urine, which requires urgent surgery.

Chronic prostatitis

The main feature of the disease is the vagueness of clinical symptoms with a long, persistent course of the process. More often, the chronic form occurs independently, as a primary pathology against the background of blood stagnation in the vessels (prostatosis), abacterial prostatitis.

The main symptoms of chronic prostatitis are:

• fever;
• pain occurs in the scrotum, perineum, anus, back;
• urination disorder;
• mucous or mucopurulent discharge from the rectum, urethra, even in the absence of urination or defecation;
• erectile dysfunction, painful ejaculation, interrupted sexual intercourse, prolonged intercourse without a feeling of pleasure.

Inaction and improper treatment of chronic prostatitis can cause complications:

• Infertility is the result of chronic inflammation in the spermatic cord, vesicles, testicles and their appendages.
• Cystitis, pyelonephritis (other diseases of the genitourinary system) are the result of hematogenous and mechanical spread of microbes.
• Sepsis.
• Constant decrease in immunity.
• Untreated prostatitis can cause cancer in 35-40% of cases.

Diagnostics

The clinical picture of the disease is typical, so the diagnosis is not difficult. It is performed by a urologist based on the anamnesis, examination of the patient, laboratory minimum using the most modern medical devices:

• Rectal examination of the gland, collection of secretions for examination (culture with determination of sensitivity to antibiotics).
• UAC, UAM, bacterial culture of urine.
• Smear test for sexually transmitted diseases, UGI review.
• Daily monitoring of urination rhythm, measurement of urination speed (uroflowmetry).
• Ultrasound or TRUS is used for differential diagnosis.
• If it is necessary to exclude oncology, a biopsy, urography is taken and PSA - prostate specific antigen is determined.
• To diagnose infertility, a spermogram is prescribed - an ejaculate analysis to determine a man's fertility.

Based on the results of the patient's examination, an individual scheme for the complex treatment of prostatitis is drawn up. When prescribing drugs, the form of the pathology and the presence of concomitant diseases are taken into account. The decision on where to carry out the therapy (inpatient or outpatient) is made by the doctor. The course of treatment is carried out with careful laboratory monitoring of the results.

One of the most modern centers for the treatment of prostatitis is a specialized clinic. Since the problem of infertility is closely related to inflammatory urological diseases, medical experts pay a lot of attention to this problem.

In the clinics, each patient has the opportunity to undergo a complete cycle of special examinations, receive psychological support, be treated with the latest generation drugs used in this field, and learn about the latest methods for treating prostate inflammation. No less important in the complex therapy of prostatitis is the issue of effective rehabilitation of patients, clinical observation and prevention.

Treatment of acute prostatitis

Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.

Treatment course methods:

• The most effective treatment for prostatitis is etiotropic therapy. If the underlying cause of prostatitis is an infection, the priority is a course of antimicrobial agents that alleviate the manifestations of inflammation.
• The pain syndrome is alleviated with analgesics, antispasmodics, rectal suppositories, microenemas and warm solutions of painkillers. NSAIDs may be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
• Physiotherapy methods are possible only in the subacute phase of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
• Massage is another effective method of influencing the prostate. It opens channels, normalizes blood circulation in the scrotum and pelvis.
• Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
• The purulent process involves surgical intervention.
• Psychologist consultations.

Treatment of chronic prostatitis

With long-term, course (at least one month) effect on the prostate, there is no 100% guarantee of cure. The priority is herbal medicines, immunocorrection, change of household habits:

• Herbal preparations are widely used in urological practice. They are able to accumulate at the site of the most active pathological process, protect cells from oxidation, remove free radicals and prevent the proliferation of gland tissue.
• Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
• Medicines that strengthen immunity not only help in the fight against prostatitis, but also correct the negative effects of antibiotics that disrupt the function of the immune system.
• The pain syndrome is alleviated by using alpha-blockers and muscle relaxants.
• Prostate massage allows you to mechanically remove the "extra" secretion of the gland through the urethra, improve blood circulation and reduce congestion.
• Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitting baths or microenemas with herbs.
• In severe cases, intravenous fluids with diuretics are indicated. It stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
• Herbal laxatives are used for constipation.
• Together with the patient, the urologist and psychologist create an individual long-term program of daily routine, necessary rest, nutrition, dosed physical activity and sexual activity.
• If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of the entire affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). Practiced in exceptional cases, it is full of impotence and urinary incontinence. Young people do not undergo surgery because it can cause infertility.

Prevention

To prevent the appearance of a disease that is unpleasant for men, you need to remove provoking factors and follow simple rules:

• Lead a healthy lifestyle, discard bad habits.
• Don't get too cold.
• Drink at least 1. 5-2 liters of water a day.
• Strengthen your immune system, walk a lot, get stronger.
• Do physical education and sports, visit fitness clubs.
• Avoid stressful situations.
• Practice a regular sex life with a regular partner.
• Visit a urologist regularly.

Questions and answers on the topic

What is prostatitis and how to recognize it?

Prostatitis is an inflammation of the prostate that can cause pain in the lower abdomen and problems with urination. A frequent urge to go to the toilet, especially at night, or pain when urinating can be signs of prostatitis.

Why does prostatitis appear?

Prostatitis can occur due to an infection, a cold, stress or even a sedentary lifestyle. Sometimes it develops after diseases of the genitourinary system.

Is it possible to completely cure prostatitis?

Acute prostatitis can be completely cured with proper treatment. Treatment of chronic forms takes longer, but the right approach will help reduce symptoms and prevent exacerbations.

How is prostatitis treated?

Treatment includes antibiotics (if the cause is infection), anti-inflammatory drugs, prostate massage and physical therapy. The doctor will choose the best method of treatment depending on your situation.

Can I exercise with prostatitis?

Light exercise such as walking or swimming is helpful. Strenuous exercise can worsen the condition, so it is important to consult a doctor.

How to prevent prostatitis?

For prevention, you must lead an active lifestyle, avoid hypothermia, monitor the health of the genitourinary system and treat infections in a timely manner. It is also important to avoid stress and eat healthy.

Should I see a doctor if the symptoms go away on their own?

Yes, even if the symptoms disappear temporarily, it is important to see a doctor. Untreated prostatitis can lead to complications that can worsen your health in the future.

Questions and answers on the topic

Is it possible to completely cure prostatitis?

Acute prostatitis can be completely cured with timely treatment. Chronic prostatitis may require long-term therapy to control symptoms, but with the right approach, symptoms can be minimized and significantly improve the patient's quality of life.

Can I exercise if I have prostatitis?

Light exercises such as walking, swimming or yoga can be helpful for prostatitis. However, it is best to avoid intense exercise and strength training, especially during an exacerbation. Be sure to consult your doctor before starting to exercise.

Does prostatitis affect fertility?

Prostatitis can temporarily reduce fertility, as prostate inflammation can affect sperm quality. After successful treatment of prostatitis, fertility usually returns.

Should I follow a special diet for prostatitis?

Yes, if you have prostatitis, it is recommended to avoid spicy foods, alcohol, caffeine and fatty foods, as they can increase inflammation. It is useful to eat more vegetables, fruits, whole grains and drink enough water.

Can prostatitis go away on its own?

Prostatitis does not go away on its own and requires treatment. Without proper treatment, symptoms can worsen, which can lead to complications. If symptoms appear, you should consult a doctor.

How long does prostatitis treatment take?

The duration of treatment depends on the form of prostatitis. Acute prostatitis is usually treated within a few weeks, while chronic prostatitis may require longer treatment that can last for months.

How to prevent recurrence of prostatitis?

To prevent relapses, it is important to follow the doctor's recommendations, lead an active lifestyle, avoid hypothermia, eat properly and undergo regular medical examinations.