Recommend
Official site Prostamin Forte

prostatitis

symptoms of prostatitis in men

Prostatitis is an inflammatory disease of the prostate gland (prostate) in men, which has a negative impact on both sexual function and the urination process. Pain in the perineum, groin, lower back and pelvic area, urodynamic disorders (urine outflow) may indicate the presence of prostatitis. Untreated prostatitis can cause male infertility and prostate cancer.

This is one of the most common male diseases that requires careful attention and competent systemic treatment. It is this approach to solving the problem of prostatitis that you will find in the urology department of a professional clinic. Highly qualified urologists-andrologists have been successfully treating acute and chronic prostatitis for many years. Complex therapy, careful attitude and individual approach to each case inevitably lead patients to recovery and stable long-term remission.

Distribution

Prostatitis is in 5th place among the 20 main urological diagnoses. It is estimated that at the age of 30, 30% of the male population suffers from prostatitis, at the age of 40 - 40%, and after the age of 50, almost all men in one way or another bear the burden of this disease. And if by the age of 35 mostly infectious prostatitis is registered, then at an older age the non-infectious form prevails and in general it is diagnosed several times more often than bacterial inflammation of the prostate.

Anatomy and physiology of the prostate gland

The prostate gland (prostate) is located in the front lower part of the pelvis below the bladder. It consists of glandular and smooth muscle tissue surrounded by a fibrous capsule. The urethra passes through the body of the prostate from the bladder into which the ejaculatory ducts open.

The prostate is a hormone-dependent organ. It is formed and functions under the influence of male hormones - androgens. Testosterone plays a key role in this process.

The prostate gland is connected to the seminal tubercle, which acts as a valve for the ejaculatory duct. As part of the male reproductive system, the prostate affects erection, ejaculation and orgasm. The nerves responsible for erection pass through the gland. In the chronic course of the disease, they are involved in the inflammatory process and erectile dysfunction develops.

The prostate produces a secretion that is part of the seminal fluid. Creates favorable conditions for sperm activity. Therefore, with chronic gland dysfunction, male infertility can be observed.

Pathogenesis

There are two main reasons for the development of prostatitis:

  • stagnation of prostate secretion against the background of blood circulation disorders and lymph leakage in the gland itself and neighboring organs;
  • pathogenic and conditionally pathogenic microflora.

Acute prostatitis is usually associated with an infection of the prostate tissue. But, as a rule, both factors are interconnected and together create a vicious circle that makes it difficult to treat prostatitis.

An inflamed prostate becomes painful. Pain can be felt in the perineum, groin, pelvis, lower back. Sharply increases on palpation during digital rectal examination or defecation.

The prostate increases in size, constricting the urethra. Thus, the outflow of urine from the bladder becomes difficult. The stream of urine becomes weak. The patient must tense the abdominal muscles in order for the act of urination to take place. In acute cases, there is sometimes obstruction of the urinary tract and acute retention of urine.

Inflammation leads to disruption of the outflow of prostatic juice and its stagnation. The resulting edema disrupts the processes of cell metabolism and respiration in the gland. This creates conditions for the process to chronize. In case of prolonged prostatitis, neighboring organs can also become inflamed: seminal tuberculosis, Cooper's glands, seminal vesicles. The chronic form of the disease is associated with a risk of developing male infertility, adenoma and prostate cancer.

In recent years, it has been established that in 70-80% of cases, prostatitis occurs due to stagnant processes in the gland. Venous disorders are less common, but they also cause prostatitis, especially if accompanied by hemorrhoids and varicocele on the left (enlargement of the testicular vein).

Classification

The US National Institutes of Health identify 4 categories of prostatitis:

  • Acute prostatitis (Category I)
  • Chronic bacterial prostatitis (Category II)
  • Chronic Prostatitis/Chronic Pelvic Pain Syndrome (Category III)
  • Asymptomatic chronic prostatitis (Category IV)

Due to the appearance of prostatitis, it is divided into two types:

  • non-infectious
  • Infectious

The inflammatory process can develop quickly, accompanied by bright symptoms (acute stage) or slowly with gradually increasing symptoms, erased.

Non-infectious prostatitisin most cases, it is associated with stagnation of the secretion of the prostate gland and impaired blood circulation and lymph flow in the gland itself and nearby organs.

Infectious prostatitisdevelops due to the penetration of pathogenic or conditionally pathogenic microflora into the tissues of the prostate gland: bacteria, viruses, fungi. There are different ways for an infection to enter the prostate:

  • Urinogenic (ascending): the entrance door is the urethra. It should be noted that the infection can also occur downstream, for example, with purulent pyelonephritis (kidney disease) and other inflammatory diseases of the urinary tract.
  • Lymphogenic: infection from adjacent pelvic organs can enter the prostate through the lymph due to inflammation of the rectum (proctitis) or bladder (cystitis), as well as from infected hemorrhoidal veins.
  • Hematogenous (through the blood): due to the presence in the body of foci of chronic infection (tonsillitis, carious teeth) or complications of acute infections (influenza, acute respiratory infections, tonsillitis, etc. ).

The most common causes of prostatitis are:

  • bacteria: E. coli, Proteus, gardnerella (gram-negative); staphylococci, streptococci (gram-positive);
  • viruses (influenza, herpes, cytomegalovirus, ARVI pathogens);
  • mycoplasma;
  • chlamydia;
  • specific flora (gonococci, trichomonads, Mycobacterium tuberculosis).

By the nature of the course, prostatitis happens:

  • Spicy
  • Chronic

Acute prostatitisusually occurs under the influence of pathogenic (conditionally pathogenic) microflora in the presence of predisposing factors. It has a rapid course and pronounced symptoms. If it is not cured in time, a purulent process can develop, leading to melting of the tissues of the prostate gland. With improper treatment, acute prostatitis often becomes chronic.

Chronic prostatitisthere is a lighter course, erased symptoms. However, it can worsen from time to time, and then the symptoms will correspond to an acute process. At the same time, complete remission does not always occur between exacerbations, and the patient may constantly feel discomfort. Chronic prostatitis can cause impotence, male infertility, prostate adenoma or cancer.

There is a chronic asymptomatic form of the disease, when the patient has no complaints, but there is an increased amount of purulent elements (leukocytes) in the prostate secretion.

Complications

Without proper therapy, the inflammatory process can lead to purulent fusion of prostate tissues. In addition, the inflammation can spread to nearby organs: seminal tubercle, Cooper's glands, seminal vesicles, urethra. Accordingly, the following complications may occur:

  • prostate abscess
  • Sclerosis/fibrosis of the prostate (functional tissue of the gland is replaced by connective tissue)
  • prostate cysts
  • stones in the prostate
  • Vesiculitis (inflammation of the seminal vesicles)
  • Coliculitis (inflammation of the seminal tubercle)
  • Epididymorchitis (inflammation of the testicles and their appendages)
  • Posterior urethritis
  • Erectile dysfunction / impotence
  • Ejaculation disorder
  • Infertility
  • Adenoma of the prostate
  • Prostate cancer

Symptoms

Different forms of prostatitis have their own characteristics of the course and severity of symptoms. In general, prostatitis is characterized by the following manifestations:

  • Pain in the groin, lower back, perineum (may radiate to the spermatic cord).
  • Pain increases with defecation, digital rectal examination.
  • Violation of urodynamics (frequent urination, retention of urine, difficulty urinating, weak stream, incomplete emptying of the bladder).
  • Prostatorrhea (involuntary discharge of prostate juice, especially in the morning and during bowel movements).
  • Disorders of sexual function (reduced libido, erectile dysfunction, infertility).

Symptoms of acute prostatitis

  • Increase in temperature to 39-40 degrees
  • Acute urinary retention
  • General intoxication
  • Leukocyturia, albumen and mucus in the urine
  • Blood in urine and semen
  • Leukocytosis in prostatic secretion
  • Hypoechogenicity and enlargement of the gland, increased blood flow according to ultrasound

Symptoms of chronic prostatitis

  • Body temperature usually does not exceed 37 ° C
  • Pain sensations are dulled and smoothed
  • Discharge from urethra during bowel movement
  • Urination disorders
  • Decreased libido
  • erectile dysfunction
  • Ejaculation disorders (premature or delayed ejaculation)

The reasons

The main reasons for the development of prostatitis are infections and stagnation of prostate secretion. The following factors contribute to the occurrence of prostatitis:

  • Infections and opportunistic flora with weakened immunity
  • Hypodynamia
  • "Sedentary work
  • Prolonged sexual abstinence
  • Interrupted intercourse (with delayed ejaculation)
  • Excessive sexual activity leading to exhaustion of the glands
  • Alcohol abuse
  • Reduced local immunity (hypothermia, use of immunosuppressants, immune deficiency, autoimmune diseases)
  • Pelvic organ injuries
  • Manipulations on the prostate and nearby organs (biopsy of the prostate, surgery, catheterization, cystoscopy, etc. )
  • Chronic diarrhea or constipation

Diagnosis

Many methods are used to detect prostatitis, which can be divided into 3 groups: digital rectal examination, laboratory tests and instrumental methods.

Digital rectal examinationis conducted by a urologist-andrologist after a conversation with the patient. This method allows you to evaluate the size, shape and some characteristics of the structure of the prostate gland. If the size of the prostate is increased and the procedure itself is painful for the patient, the doctor can pre-diagnose prostatitis.

If the case is not acute, the doctor can massage the prostate during the examination to obtain prostatic secretion, the examination of which is an important link in the diagnosis of prostatitis. If acute bacterial prostatitis is suspected, prostate massage is contraindicated: such manipulation can lead to the spread of the pathogen and blood poisoning.

To clarify the diagnosis, the patient will be asked to undergoinstrumental studies, such as:

  • transrectal ultrasound examination of the prostate and pelvic organs (reveals structural features, the presence of inflammation and purulent foci, stones, cysts and other neoplasms);
  • dopplerography (features of blood flow in the gland);
  • uroflowmetry (determining the speed and time of the act of urination);
  • nuclear magnetic resonance of the pelvic organs (a highly informative and safe study that allows differential diagnosis with other diseases).

If necessary, diagnostics of the nearby organs of the genitourinary system are carried out: ureteroscopy, urethrography and urethrocystography.

Laboratory researchesare a necessary component of the diagnosis of prostatitis:

  • Urinalysis (before and after prostate massage)
  • General blood analysis
  • Blood test for proteins from the acute phase of inflammation (C-reactive protein, etc. )
  • Microscopic examination of prostate discharge after her finger massage
  • Microscopic examination of urethral scrapings
  • Spermogram (cytology and biochemistry of sperm)
  • Culture of urine, prostatic secretion and semen
  • Determination of prostate specific antigen (PSA)
  • Puncture biopsy of the prostate and histological examination of the gland tissues

The latter two tests are necessary to rule out prostate cancer or adenoma.

The modern one has an excellent highly informative diagnostic base. Urologists have extensive experience in the diagnosis and successful treatment of various forms of prostatitis, and the status of a multidisciplinary clinic allows you to use the services of related specialists. The medical center has developed research packages that include all necessary types of diagnostics at a very attractive price.

Treatment

Treating prostatitis is not an easy task. It requires a thoughtful, integrated approach. The treatment protocol for this disease includes drug therapy and physical therapy, in some cases surgical intervention is necessary.

Medical therapy

This includes the use of the following medicines:

  • Antibiotics (after determining sensitivity to them)
  • Antiseptics (topical)
  • Vascular preparations (improving microcirculation in the prostate)
  • Nonsteroidal anti-inflammatory drugs
  • Alpha-1-adrenergic blockers (for urinary disorders)
  • Enzyme preparations (dilute prostate secretions, stimulate the immune system, relieve inflammation)
  • Immunomodulators
  • Antidepressants

Physiotherapy treatment

  • Electrical stimulation of the prostate (electrophoresis, galvanization, pulse impact)
  • Vibration massage
  • Rectal sensor laser therapy (for chronic prostatitis)

Prostate massage can be used as a treatment procedure for chronic prostatitis. In the acute stage of the disease, this manipulation is not performed to avoid the spread of infection and sepsis.

Surgical treatment

Surgery for prostatitis is rarely resorted to. Such a need arises in the case of severe suppuration of prostate tissues, lack of positive dynamics for drug treatment and pathological enlargement of the prostate gland, which blocks the urethra.

Forecast

With early diagnosis and adequate treatment, acute prostatitis can be defeated. However, quite often the chronicity of the process occurs even with correct and timely therapy.

In case of incorrect treatment and non-observance of treatment deadlines (this is several months), the disease usually turns into a chronic form. Chronic prostatitis significantly affects a man's quality of life, as it affects not only urinary but also sexual function. Erectile dysfunction, loss of orgasm, ejaculation problems and infertility are observed in 30% of cases. It is completely impossible to cure chronic prostatitis, but with the right approach you can achieve a stable remission.

The benefits of visiting a professional clinic

  • Successful treatment of various forms of prostatitis
  • Experienced urologists-andrologists with the highest qualifications
  • Multidisciplinary, allowing specialists in related fields to be involved in the treatment
  • High-precision modern equipment for diagnosis and treatment
  • Own clinical diagnostic laboratory of European class
  • Comfortable and high-tech hospitals
  • A package of urological diagnostic services at an attractive price

Prevention of prostatitis

  • Choose safe sex to avoid sexually transmitted infections (STIs)
  • Support of the immune system (vitamins, healthy nutrition, prevention of dysbacteriosis, reasonable antibiotic therapy, etc. )
  • Avoid hypothermia
  • Lead an active lifestyle
  • Have sex regularly, if possible, with one partner (to avoid prostate congestion and STIs)
  • Avoid interrupted coitus (this will remove sperm stasis)
  • Visit a urologist once a year for preventive purposes and twice a year if you are over 50 or have a history of prostate disease.

Frequently Asked Questions

How informative is the PSA test in diagnosing prostatitis?

Prostate-specific antigen (PSA) is a marker for prostate cancer. It is known that in some cases, prostate cancer has a clinical picture similar to the manifestations of prostatitis. Therefore, the PSA test is used for differential diagnosis between these two diseases. Don't bet on PSA, though. This antigen is also increased in prostate adenoma – a benign growth of gland tissue. In prostatitis, PSA levels may also rise during periods of active inflammation. In the remission phase, it decreases. Therefore, PSA cannot be used as absolute evidence of prostate cancer or prostatitis.

Why is prostatitis difficult to treat?

The capillaries of the prostate have a special structure that creates a hematoprostatic barrier. This makes it difficult for certain types of antibiotics to penetrate the gland's tissues. In addition, microorganisms tend to form biofilms that reliably protect them from the action of antibacterial agents. Therefore, modern prostatitis treatment protocols necessarily include proteolytic enzymes that can destroy biofilms. Bacteria become vulnerable and antibiotics work more effectively. The most stubbornly treated chronic prostatitis, the main feature of which is the wide variety of microflora in the crop. In about 50% of cases, Enterococcus faecalis, resistant to all aminoglycosides and cephalosporins, is cultured. This narrows the list of effective antimicrobial agents, which also complicates treatment.