ProstatitisIs a urological disease associated with inflammation of the prostate gland tissue. Prostate damage can be caused by an infection transmitted through blood, lymph or through unprotected intercourse. The development of prostatitis in men is facilitated by damage and impaired blood supply to the pelvic organs, persistent hypothermia, low physical activity, hormonal imbalance and other factors. Prostatitis can be associated with vesicles, urethra and other infectious and inflammatory diseases of the reproductive and urinary organs.
Incidence statistics
Prostatitis is one of the most prevalent diseases of the male genitourinary system in the world. According to various sources, it is observed in 60-80% of sexually mature men. According to official medical statistics, over 30% of young people of reproductive age suffer from chronic prostatitis. In about a third of cases, it occurs in men over 20 and under 40 years. According to the WHO, urologists diagnose chronic prostatitis in every tenth patient.
Causes of prostatitis
Infections.Pathogenic and opportunistic bacteria enter the prostate through lymphatic and blood vessels. Secondary prostate infection is often a complication of inflammatory diseases of the rectum and urethra.
Types of infection:
- in climbing- germs rise into the gland from the outer opening of the urethra;
- DOWN- germs enter the prostate along with the stream of infected urine.
Disease-causing pathogenic microorganisms that provoke the disease (according to the Urology Research Institute 1997-1999)
| ORGANISMS | Number of studies | |
|---|---|---|
| % | abs | |
| Staphylococcus epidermidis | 42. 3 | 55 |
| S. saprophyticus | 17. 6 | 23 |
| S. aureus | 4. 6 | 6 |
| S. haemolyticus | 3. 1 | four |
| S. hominis | 0. 8 | A |
| S. warning | 1. 5 | 2 |
| Staphylococcus spp. | 3. 1 | four |
| Enterococcus faecalis | 11. 6 | fifteen |
| Streptococcus spp. | 3. 1 | four |
| TOTAL (gr. +) | 87. 6 | 114 |
| P. aeruginosa | 3. 7 | five |
| E. coli | 4. 7 | 6 |
| Enterobacter spp. | 2, 3 | 3 |
| Proteus spp. | 1. 5 | 2 |
| TOTAL (gr. -) | 12. 3 | sixteen |
Weakening of immunity.One of the causes of prostate inflammation is the weakening of the body's immune defenses. This can be alleviated by frequent stress, unbalanced diet, overload, smoking, alcohol consumption. With reduced immunity, the body is more vulnerable to infections leading to the development of prostate disease.
Blood supply disorders.The development of chronic prostatitis can be the result of a sedentary, sedentary lifestyle. With a constant lack of physical activity, the work of the endocrine, cardiovascular and nervous system, as well as blood circulation to the pelvic organs, is disrupted. The result is oxygen starvation of prostate tissue.
Irregular sexual activity.Both prolonged sexual abstinence and excessive sexual activity can contribute to the onset of prostatitis. Many men who are sexually active have nervous exhaustion, hormonal imbalance, impaired secretion of sex glands and gradual fading of potency. Interrupted intercourse has a negative impact on the health of the prostate gland.
Chronic prostate injury. . . Chronic prostatitis can develop as a result of frequent trauma to the soft tissues of the prostate gland. Most often this is observed in patients whose professional activities are related to driving. The cause of prostatitis in this case is constant shaking, tremors and excessive stress on the perineum muscles.
The main syndromes of prostatitis
PainWith prostate in men, there is excruciating pain in the lower abdomen and lower back as well as pain all over the body. This symptom can be aggravated by ejaculation, especially during sexual intercourse after prolonged abstinence.
Dysuria.Typical signs of prostatitis in men are the frequent urge to urinate, burning, and burning when emptying the bladder, causing pain after urinating in the perineum. Another symptom of prostate inflammation is difficulty urinating. In the absence of treatment for the disease, acute urinary retention may occur.
Sexual dysfunctions.With uncomplicated prostate, there is accelerated ejaculation, orgasmic sensation, pain during ejaculation, partial or complete reduction of libido. Prolonged nocturnal erection is also a symptom of chronic prostatitis.
External manifestations.With prostate, some patients have purulent or clear discharge from the urethra, which is more abundant in the morning. Patients may also notice a symptom such as the presence of white hair or filaments in the urine.
Types of prostatitis
Acute bacterial.Acute prostatitis develops as a result of infection of the prostate gland with Staphylococcus aureus, Escherichia coli, enterococcus and other pathogenic bacteria. If left untreated, this disease can provoke blood poisoning. In this case, the husband must be urgently hospitalized.
Symptoms observed with this type of prostatitis:
- chills and fever (38 ° C and above);
- sharp or aching pain in the groin, lower back and perineum;
- frequent desire to urinate;
- painful urination;
- difficulty urinating and acute urinary retention;
- white or colorless discharge from the urethra.
Chronic bacterial.Recurrent form of the disease occurs as a result of infection penetrating the gland. Chronic hypothermia, prolonged sexual abstinence and premature urination contribute to the development of prostatitis. Chronic prostatitis, if left untreated, can provoke cystitis, as inflammation in the prostate is a reservoir of bacteria affecting the genitourinary tract.
Symptoms of chronic prostatitis:
- pain in the scrotum, lower abdomen, perineum;
- dizuri;
- potency violations.
Not chronic bacterial.Causes of the disease include the entry of viruses or bacteria into the prostate (tubercle bacillus, Trichomonas, chlamydia), autoimmune processes, urine penetration into the gland. Chronic prostatitis accounts for up to 95% of all types of prostate inflammation.
The signs of prostatitis are:
- chronic pain in the pelvic area (concern of the husband for at least 3 months);
- recurrent pain in the groin;
- absence of symptoms of inflammation in urine, sperm and prostate secretions.
Chronic asymptomatic.Chronic asymptomatic prostatitis is not associated with bacterial infection and symptomatic prostate syndrome. There is an assumption that this disease is an age-related physiological feature.
Symptoms of this type of chronic prostatitis:
- lack of major disease syndromes;
- an increased content of leukocytes and bacteria in the urine.
The main symptom of the disease - the presence of an infection in the gland - can be detected only by biopsy or during surgical operations in the treatment of various pathologies of the prostate (adenoma, cancer).
Stagnant.Prostatitis develops not only against the background of anatomical and physiological changes in the veins and other systems of the body. The main cause of the disease is irregular sex life.
Signs of prostatitis:
- aching pain in the perineum, radiating to the sacrum;
- increased urination in the morning;
- slight difficulty in passing urine (symptoms are observed in the chronic form of the disease);
- weakening of the erection;
- ulur lust;
- "Fading" of orgasmic sensations during ejaculation.
Diagnosis of acute and chronic prostatitis
To choose the right method of treatment, the doctor prescribes a comprehensive diagnosis of the condition of the genitourinary system, including the following methods.
Digital examination of the colon.If you suspect a prostate disease, the urologist performs a digital examination. The posterior surface of the prostate is adjacent to the rectum, so that when a finger is inserted through the anus, the doctor can determine the condition of the gland. During the study, the size, consistency and shape, surface condition, bitterness are determined.
Signs of prostatitis in men include:
- soft, inelastic firmness of the prostate;
- pain on touch;
- enlarged gland;
- immobility of the rectal mucosa above the prostate.
Ultrasound procedure.Prostate ultrasound is prescribed before starting treatment of acute prostatitis in order to identify / rule out a glandular abscess and in the chronic course of the disease - to identify prostate cysts and stones, as well as the degree of urethral compression. The most effective method is rectal ultrasound.
Uroflowmetry.This method of diagnosing prostatitis is used to study the indicators of the urinary process: the duration of this physiological act and the degree of urination. If the velocity is 15 ml / s or more, this indicates a normal opening of the urethra. A sign of prostatitis is a drop in this value below 10 ml / s. This speed is due to poor opening of the urinary tract.
Interpretation of uroflowmetry results
| Urine flow rate | iNTERPRETATION |
|---|---|
| >15ml / sec | Urinary tract obstruction is unlikely |
| <10ml / sec | Significant narrowing of the urethra or detrusor weakness is possible |
| 10-15ml / sec | Unspecified result |
Cystoscopy.For examination, an endoscopic imaging system is inserted into the bladder. This method for diagnosing acute and chronic prostatitis is used when diseases such as cancer, cystitis or bladder trauma are suspected.
Laboratory research.To diagnose and determine the microorganism that caused the disease, in the presence of symptoms of chronic prostatitis or acute inflammation, urine and prostate secretions are examined. A sign of the presence of pathogenic microflora is an increased number of leukocytes in the biological material. In order to design an effective course of treatment, the type of bacteria is determined by PCR, RIF and inoculation in a nutrient medium.
Interpretation of laboratory results
| The secret of the prostate | Third urine sample (after prostate massage) | |||
|---|---|---|---|---|
| Form HP | Leukocyte count, uv. x 400 | Planting results | Leukocyte count, uv. x 400 | Planting results |
| Bacterial | >10 | + | The difference between the number of leukocytes in the third part of the urine and the second part of the urine is ≥10 | + |
| Inflammatory syndrome of chronic pelvic pain | >10 | - | The difference between the number of leukocytes in the third part of the urine and the second part of the urine is ≥10 | - |
| Chronic non-inflammatory pelvic pain syndrome | <10 | - | - | - |
Prevention of prostatitis
Physical activity.To prevent and treat prostate disease, a man should avoid physical inactivity. Recommended:
- walking (4 km per day or more);
- exercise (squats, jumps, bends);
- perineum and buttock muscle training (10 tensions and relaxations).
Proper nutrition.To prevent acute and chronic prostatitis, men should include in their diet foods high in zinc and vitamin B. It is recommended to eat:
- sea fruit (sea urchin, seaweed);
- Meat;
- pumpkin seeds;
- arra;
- bran;
- kefir;
- Rye bread.
Regular sex life.When preventing and treating an illness, a man needs:
- have a rhythmic sex life;
- avoid interrupted intercourse;
- avoid casual relationships.
Treatment of acute and chronic prostatitis
Inflammation of the prostate is treated using the following methods.
Antibacterial therapy.If prostatitis is bacterial, antibiotics are needed to treat it. The doctor selects a group of drugs depending on the type of microbes that caused the disease, the susceptibility of the pathogen to different drugs and the presence of contraindications in the patient.
Characteristics of drugs
| A medicine | benefit | disadvantages |
|---|---|---|
| Fluoroquinolones |
|
|
| Macrolides |
|
Actively insufficient against gram-negative bacteria |
| tetracycline | Active against atypical pathogens |
|
Hormone therapy.Hormonal treatment is needed to restore the normal hormonal balance between androgens and estrogens. Drugs with antiandrogenic activity reduce inflammation of glandular tissue and prevent the disease from progressing to more severe stages.
Prostate massage.This method of treating chronic prostatitis can be used only external exacerbations. A man needs to take a prone position, rest his palms on a sofa or table, spread his legs shoulder-width apart. The treating doctor places sterile gloves on his hands, places an oil or gel (in some cases, a medicine with an anesthetic ingredient) on the index finger of his right hand, and injects it through the anus into the rectum. The massage is performed by applying light pressure until the prostate secretions are separated through the opening of the urethra. The treatment includes at least 10 massage sessions.
Physiotherapy.To treat the symptoms of prostatitis, methods are used to normalize and increase blood circulation to the pelvic area. This allows you to rule out stagnation as well as increase the effectiveness of medication therapy. The treatment is performed by exposing the gland to ultrasonic waves, electromagnetic vibrations, as well as high temperatures (microclusters with warm water).
Surgical intervention.Surgical interventions for prostate disease are rarely used. Such treatment is mandatory for the development of complications of acute or chronic prostatitis.
Indications for prostate surgery:
- acute urinary retention as a result of severe narrowing of the urethra;
- abscess (appearance of suppuration on the surface of the gland);
- glandular sclerosis;
- adenoma that does not respond to conservative treatment.
Complications of prostatitis
Vesicles.Untreated prostatitis can cause inflammation in the seminal vesicles. Symptoms of the disease are pain deep in the pelvis, radiating to the sacrum, worsened by collection and ejaculation, frequent urination, the appearance of blood and / or pus in semen and urine.
Colliculitis and urethritis.Due to its proximity to the excretory streams of the prostate, the seminal tubercle is often inflamed as a result of infection by the infected gland. If left untreated, the symptoms of prostatitis are complemented by the characteristic symptoms of urethritis - burning or tingling in the urethra during urination. There is also pain during ejaculation as a result of convulsive contraction of the urethra.
Prostate abscess.The appearance of purulent cavities on the surface of the gland is due to pathogenic bacteria that caused the prostate. A characteristic symptom of the disease is general weakness, impaired consciousness, delirium, a sharp rise in temperature, increased sweating, chills. Prostate abscess is a serious septic disease that needs to be treated in a hospital setting.
Prostate sclerosis.Prostate sclerosis develops against the background of regular exacerbations of chronic prostatitis as a result of non-compliance with the treatment prescribed by the urologist. This disease can form over several years, however, if the hormonal balance in a man's body is disturbed, rapid development is possible. With prostate sclerosis, pain is noticed during emptying of the bladder, an interrupted and slow flow of urine.
Formation of cysts and stones. . . The appearance of cysts in the gland is one of the possible options for the progression of chronic prostatitis. Infection with neoplasms can cause an abscess and greatly complicate the treatment of the disease. Single and multiple stones can also form in the prostate. In this disease, in addition to the usual symptoms of chronic prostatitis, there are violations of urine output, frequent urination, pain in the perineum.
Sterility.In chronic prostatitis, sperm production and motor function is impaired. If left untreated, the disease also affects the vas deferens and seminal vesicles, making them impassable to sperm, so they do not enter the urethra during ejaculation. As a result, men who have chronic prostatitis often suffer from infertility.