Every second man of reproductive age (up to fifty years) is prone to such a delicate disease as acute prostatitis, in which, under the influence of several factors, the prostate (prostate gland) becomes inflamed, causing various forms of disorderssexual. functions, fertility and psycho-emotional states. Be attentive to what your body says and do not neglect timely treatment.
What is acute prostatitis
If a man feels discomfort and even pain when urinating, you should immediately consult a doctor, because acute prostatitis is a disease of infectious etiology that causes inflammation of the prostate, followed by the formation of edema of glandular tissue, the formation of purulent foci. in it. If you do not pay attention to the signs of acute inflammation of the prostate, then the pathological process can turn into a chronic form that is difficult to treat and has very little time for reflection - the transformation occurs within a few days.
However, more serious complications are possible than its transition to a chronic form. There is a risk of sepsis - a general bloodstream infection and a growing urinary tract infection with the development of pyelonephritis and cystitis. In these cases, the patient is urgently hospitalized, the condition can be critical. Although sepsis as a complication is rare, it can occur in patients with immunosuppressive conditions - intoxication, fever, severe symptoms, weakness. Therefore, blood cultures are needed to detect microorganisms.
Symptoms of acute prostatitis
Everyone should know and remember the symptoms of acute prostatitis. General signs of the disease are manifested:
- Severe pain when urinating.
- Intoxication of the body.
- Urinary disorders (intermittent, weak, tense current).
- Frequent desire to visit the toilet at night.
These are external symptoms of prostatitis, but with a deeper study, leukocytes, traces of mucus and pus in the secretory fluid of the prostate gland are found in the urine. On palpation, a dense and enlarged organ is felt, the pressure will be painful. Further development of the inflammatory process is characterized by aggravation and pain in the perineum, which radiates to the penis, sacrum and rectum. As a result, the patient becomes difficult to empty the bladder and stool due to severe pain. Body temperature can rise up to 38 ° C.
Causes of acute prostatitis
Since this disease has a bacterial inflammatory nature, the causes of acute prostatitis are the following infectious agents:
- Gram-negative - Klebsiella, E. coli, Proteus.
- Gram-positive - enterococci, staphylococci, streptococci.
- Urogenital - trichomoniasis, chlamydia, ureaplasmosis, gonorrhea, candidiasis, mycoplasmosis.
The microbial microflora penetrates the tissue of the prostate glands, as a rule, through the transcanalicular pathway (through the urethra and excretory ducts of the prostate gland). In cystitis, the infection migrates to the prostate from the bladder. Other possible routes for bacterial penetration are opened during enduretural manipulations (catheter placement, urethral bougienation, cystoscopy, urethroscopy). Pathogenic microorganisms migrate to the prostate from distant pathogenic foci in caries, sinusitis, tonsillitis, cholecystitis, pyoderma, bronchitis.
There is a high probability of intestinal infection with proctitis, hemorrhoid fissures, colitis. Non-infectious factors that can cause prostate attack are congestive venous phenomena (congestive) in the pelvic area and impaired drainage of glandular acids. Closure can be caused by irregular or, conversely, excessive sexual activity, cessation of sexual intercourse, a sedentary lifestyle, frequent constipation, frequent alcohol intoxication, varicose veins of the pelvis, hypothermia.
Forms of acute prostatitis
The clinical development of this disease is considered in three stages, which at the same time are forms of acute pancreatitis. This is:
- The first stage is the catarrhal form.
- The second stage is the follicular form.
- The third stage is the parenchymal form.
Acute prostatitis in men begins with catarrhal inflammation, which is characterized by the expansion of acids, the appearance of edema of glandular tissue and, as a result, an increase in organ size. The excretory ducts of the prostate glands, which open into the posterior urethra, are actively involved in the inflammatory process. The lobules and ducts of the prostate gland become inflamed, their contractility is disturbed, they narrow and block, this can make it difficult for the prostate to secrete.
In the catarrhal phase, the pathological process stops in the mucous layers and does not go deeper. In the process of progression, the disease spreads throughout the prostate gland. Acute follicular bacterial prostatitis develops. In the urine analysis pus comes to light. Glandular tissue changes destructively, swelling continues to increase. The follicular form is still suitable for relatively easy treatment.
Further, a parenchymal form of the disease develops, the result of which may be a prostate abscess, i. e. chronic prostatitis. Therefore, symptoms such as:
- An increase in body temperature to 39 ° C and above.
- Manifestations of intoxication: weakness, chills, thirst, lack of appetite.
- Frequent urges to the toilet for minor needs are accompanied by sharp throbbing pains.
- Inability to empty the bladder.
- bounce.
- Tenesmus.
- Constipation.
- Discharge of mucus from the anus.
Diagnosis of acute prostatitis
At the first suspicion of prostate inflammation, rush to the doctor. Accurate and comprehensive diagnosis of acute prostatitis is very important for prompt and successful treatment. The doctor will first analyze the history, will clarify when the sensations of pain appear in the perineum, whether they increase or decrease during ejaculation, urination, defecation. Make sure the doctor should study the patient's medical history: which diseases have been transferred, if there have been sexually transmitted infections.
The urologist will palpate the external genitalia to determine developmental pathologies, visible signs of prostatitis, and rectal examination - palpation of the prostate gland through the anus. To create a complete clinical picture, it will be necessary to undergo the following examinations:
- Urinalysis to determine the level of leukocytes and the presence of purulent fibers.
- Blood test.
- Cultural smear - contents and scratches from the urethra are taken to determine the growth of bacteria and their susceptibility to antibiotics.
- Determination of urine velocity (uroflowmetry).
- Prostate ultrasound to detect diffuse changes in the gland and its abscess formation.
- A blood test to determine the presence of pathogens of diseases such as syphilis, gonorrhea, mycoplasmosis, chlamydia.
- PCR diagnostics.
Treatment of acute prostatitis
After a thorough diagnosis, they begin treatment of acute prostatitis. It is based on antibiotic therapy, the purpose of which is to suppress infectious pathogens. Furthermore, conservative treatment of prostatitis involves the use of:
- Anti-inflammatory drugs.
- Tools that improve blood circulation.
- Painkillers and antispasmodics.
- Drugs that support metabolic processes in the prostate.
- Multivitamins.
- Phytotherapeutic agents.
- Immunomodulators.
Advanced forms of prostate inflammation with the appearance of purulent foci require surgical intervention. Transurethral drainage (through the urethral wall) or transrectal (through the anus wall) of the abscessed areas is performed. Surgery may be required in case of abnormal urine retention. Puncture epicistostomy is performed - an incision is made in the abdominal cavity, into which a tube is inserted to divert urine.
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Treatment of acute prostatitis in men with drugs (tablets, injections) is the basis of successful therapy. With well-prescribed antibiotic therapy, the infection can be overcome within a few days. However, it is recommended to continue treatment for four weeks in order to achieve complete eradication of pathogenic microflora. Medications used for this disease are:
- Etiotropic (antibiotics) - destroy pathogens.
- Pathogenetic (NSAIDs) - eliminate prostate overload.
- Symptomatic (analgesic, antipyretic) - relief of pain, muscle spasms of the organ and other symptoms.
To treat inflammation of the prostate, your doctor may prescribe a complex of medications, which will include:
- Injections - contribute to the penetration of the drug into the tissues of the body in a short time.
- Candles (rectal) - analgesic, antibacterial effect.
- Instructions - delivery of the drug to the prostate through the opening of the urethra.
- Microclysters with decoction of herbs.
- Antibacterial drugs with a broad spectrum of action, unless a specific cause of the disease is identified.
Antibiotics for acute prostatitis
The main causative agents of prostatitis are pathogenic bacteria that cause inflammation in the tissues of the prostate gland. Therefore, antibiotics for acute prostatitis are the basis of treatment and are prescribed only after testing for microflora sensitivity. Antimicrobials used for inflammation are divided into the following groups:
- Fluoroquinolones.
- Penicillin.
- Cephalosporins.
- Macrolides.
- Tetracyclines.
- Aminoglycosides.
Prevention of acute prostatitis
In order for a man to always be healthy, full of strength, prevention of acute prostatitis is important, including:
- Regular sex life with a regular partner, excluding casual intercourse.
- Use of condoms.
- Stop smoking, drugs, alcohol.
- Proper nutrition.
- personal hygiene.
- Annual preventive examinations by a urologist.
- Taking vitamin and zinc preparations.
It is important to completely cure diseases of the genitourinary organs (urethritis, cystitis, pyelonephritis, balanoposthitis). Untreated diseases can cause the development of an inflammatory process in the prostate gland. Among other things, we should not forget to increase physical activity. In the cold season, hypothermia should be avoided. Prostate massage is very beneficial for men's health. However, if the disease has already been felt, massage is contraindicated and even impossible due to organ pain.