According to BME, prostatitis is an inflammatory process that occurs in the male prostate in which its parenchyma and stroma are damaged.Treatment of prostatitis in men is a long and complicated endeavor, often due to complete ignorance about the disease at the outset.What is prostatitis, what are its causes and first symptoms, what you need to know about the topic of "diagnosis" and what are the modern methods of treating prostatitis.Everything men need to know about prostatitis is in this review article.
.jpg)
Ab ovo – from egg
We are not talking about the satires of Horace;In this case, we are interested in everything related to prostatitis, from the very beginning of treatment to the last "squeak".Symptoms of prostatitis occur when men are sexually active, between the ages of 25 and 45.In the thematic video you can learn more about the basics of the disease, its causes and symptoms, features of diagnosis and treatment.
The causes of prostatitis are widespread.In prostatitis, infectious factors play the greatest role in the development of the disease:
- acute form.The coccal flora is the predisposing factor.
- Chronic form.The reasons for its development are more extensive; the main causative factors of male prostatitis are: gonococcus, trichomonas, Gr+ and Gr- bacteria, and Mycobacterium tuberculosis.In rare cases, diagnosis will reveal mycoplasma, viruses, fungi, chlamydia, etc.
Of note, chronic prostatitis is caused by pathogens that invade the prostate and can subsequently take on non-bacterial characteristics without the involvement of causative agents.The acute form is usually caused by external causes: hypothermia, damage to the urethra or bladder due to endoscopy or various procedures, physical inactivity leading to impaired blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune diseases.
You often hear about only one type of prostatitis - infectious, but according to the World Health Organization, bacterial prostatitis accounts for only 10 percent of all cases, while chronic, non-bacterial prostatitis accounts for 90 percent.
Table 1. Brief pathological characteristics
| Classification of prostatitis | acute infection | Presence of pathogens in prostate secretions or third part of urine | Levels of white blood cells (increased) in urine or secretions |
| 1 cat.acute bacterial | + | + | + |
| 2 cats.chronic bacterial | — | + | Not sure (yes or no) |
| 3 a.Inflammatory nonbacterial chronic pelvic pain syndrome | — | — | + |
| 3 b. Prostatic pain, non-inflammatory pelvic pain syndrome | — | — | — |
| 4 cats.asymptomatic inflammatory process | — | Not sure (yes or no) | Not sure (yes or no) |
The causes of acute and chronic bacterial prostatitis are better studied; in most cases, the cause of the disease is household bacteria.Enterobacteriaceae (E. coli).It is currently believed that the role of atypical microorganisms (Ureaplasma, Chlamydia, Mycoplasma) as the cause of prostatitis has not been fully confirmed.Symptoms of prostatitis in men, especially those with HIV, are signs of weakened immunity, and the cause may be yeast (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, often leading to its abscess formation.
Although urologists have a thorough understanding of the range of possible causative (prostatitis-causing) factors that play an important role in the development of prostate inflammation in the absence of microorganisms, the causes of nonbacterial prostatitis have not been fully studied.Therefore, prostatitis is nonbacterial in nature and is caused by pelvic congestion processes, poor blood circulation, intraprostatic urinary reflux, and autoimmune sterile inflammatory processes.
Sick or not – that is the question
What does a man with prostatitis look like?To a person who is far away from medicine, especially urological issues, one's male appearance is no different than that of the rest of the population.Only an experienced specialist can understand, based on the patient's first complaint, where the source of the problem lies and what needs to be done to eliminate it.
The symptoms of prostatitis are often described in a few sentences, highlighting the most striking moments, which plays a cruel joke on men.Relying on this inaccurate definition, he ignored the truly important signals and concluded that the disease did not exist, even though in fact the clinical manifestations depended on the nature of the morphological changes in the prostate.
Initial symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.There is a dull pain in the perineum that radiates to the sacrum, and the urge to urinate frequently occurs at night.
- Follicular prostatitis.Difficulty urinating, frequent urination, and sometimes delayed urination.Pain during urination that worsens at the end of urination and during bowel movements.Low grade fever.
- Parenchymal prostatitis.Symptoms include obvious difficulty urinating, often acute respiratory distress, pain during natural recovery, systemic poisoning, and body temperature as high as 40°C.
Symptoms are more pronounced in prostatitis with abscess formation, which may open into the rectum or prostatic portion of the urethra.With such a breakthrough, symptoms subside.If the abscess opening occurs in the paraprostatic tissue or in the perineal area, visual symptoms can be observed: swelling, redness of the skin with noticeable fluctuations.The man's condition deteriorated rapidly.
Comprehensive treatment of prostatitis cannot be started without a thorough examination of the man, diagnosis and analysis of symptoms that directly indicate the type of disease.
In general, it is customary to distinguish between acute and chronic prostatitis; through thematic videos on the Internet you can learn in detail which symptoms are associated with one or the other form.Let's consider this question in more detail.
Acute - Its symptoms typically manifest in three stages: catarrhal, follicular and parenchymal.They are described in detail above.
In terms of symptoms, the most interesting is chronic prostatitis, since its symptoms have many variations.In general, effective treatment of prostatitis depends on the prostatitis, or rather on its type.
In the chronic phase, the following points can be distinguished:
- Chronic prostatitis rarely results from an acute process.
- Symptoms disappear after primary prostatitis disappears.
- A classic symptom of chronic disease is minimal urethral discharge during bowel movements.
- Often, the first symptoms are not noticeable.The pathological process itself evolves over the years.This is preceded by prostatopathy (capillary congestion), which gradually turns into non-bacterial inflammation of the prostate.
- Specific pathogenic flora are not the cause of chronic prostatitis, but the chronic process itself is a complication of the inflammatory process due to the influence of Ureaplasma, Trichomonas, Chlamydia and Neisseria gonorrhoeae.
How do men with chronic prostatitis feel?Patient reviews indicate that most commonly, mild perineal pain and light discharge are experienced initially, and most men do not notice this at all.The next stage is the addition of the following symptoms: burning sensation in the urethra, sexual dysfunction, difficulty urinating, general malaise.Frequent misfires during sex can cause depression in men, who become irritable or depressed.
It is important to understand that all of these symptoms are not necessarily present in every specific chronic case, which complicates diagnosis in the early stages of the disease. Furthermore, symptoms often change location, which is more likely to be misleading.
long term syndrome
What are the consequences of chronic prostatitis?There is little benefit if not promptly diagnosed and treated, as any specialist will attest.This type of prostatitis has 3 symptoms:
pain
The prostate itself is not injured, but many nerve endings pass through it and are nearby, and these nerve endings are inevitably involved in the inflammatory process.The intensity of the pain can vary - from mild pain that causes discomfort to severe pain that prevents you from sleeping peacefully.Radiation pain occurs in all nearby areas (scrotum, sacrum, perineum); pain due to prostatitis must be distinguished from similar symptoms of other diseases.
Difficulty urinating
Dysuria syndrome always indicates a problem with the urinary system, but the cause of the condition will be clarified during the diagnostic process.The increase in the size of the prostate inevitably puts pressure on the urethra, and the flow of urine is disrupted, followed by the urge to go to the toilet frequently and the feeling of incomplete emptying of the bladder.In advanced prostatitis, compensatory hypertrophy occurs in the muscular layers of the bladder and ureters.At this time, the symptoms of dysuria subside but reappear in an intensified form.
No pleasure in sex
Decline in intimacy – these are the first symptoms that men notice and, as reviews show, it is these symptoms that compel them to see a doctor.Frequent erections at night, missing orgasms, poor erections, too fast ejaculation, and pain during ejaculation - these are the biggest concerns for those with a strong sexual desire.In the advanced stages of chronic disease, prostatitis brings no benefits.Erectile dysfunction often occurs.
Male sexual dysfunction varies in degree; some initiate intercourse and complete it in a certain way, ignoring typical warning signs.For some, even the initial weak reaction of the penis to fascinating stimulation can turn into a meltdown and start a horrific experience that turns into long-term depression.For patients with prostate problems, the specter of impotence can be difficult.Experts and relatives almost always note that prostatitis worsens the character.
To learn more about this disease, you can watch thematic videos, in which experts explain the many nuances of the pathology.
what to write on the card
Which entries appear in the patient's medical record and the final diagnosis depends on a series of preliminary studies, starting from the arrival of the patient to the urologist and his chief complaint (history) to the final stage of diagnostic measures.Exactly what is needed depends on the type of prostatitis, its severity, and the patient's consent for specific diagnostic procedures.
Generally, diagnosis includes:
- history.The doctor will inquire in detail about all complaints and symptoms, prerequisites of the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + extraction of secretions).
- Prostate ultrasound.
- Sperm diagram.
- Prostate biopsy (if needed).
What does diagnosis provide?Is it so important?If you read patient reviews, you can often learn that most men try to avoid multiple stages of diagnosis, with very different motivations.The cost of this indifference is your own health!It is important to remember that prostatitis can be cured only if it is "detected" in time and an accurate diagnosis is made, which determines the form of the disease and its causes.
How to stay healthy forever
So, if a man knows that he has prostatitis, what awaits him in the future, and is it possible to regain the lost health?It is important to understand that it takes twice as long to eliminate prostatitis as it does to develop it.In addition, if the pathological process actually proceeds without the attention of the man, then the treatment of prostatitis will be carried out with his direct participation.Can acute or chronic prostatitis be cured?Yes, in advanced cases of the chronic form, treatment can lead to stable remission if you follow all your doctor's recommendations.
The stage of treatment for prostatitis will directly depend on what the doctor finally discovers during the examination, the type of disease, the age and physical characteristics of the patient.
Treatment options are always strictly individualized, but some of the following may be included:
- Antimicrobial treatment.
- Physical therapy methods.
- Phytotherapy.
- Prescription of immunocorrectors.
- Urology Massage.
- Therapeutic gymnastics.
The price for each stage of treatment varies and depends on the prescribed medications, additional methods and the total cost to the clinic.There is an important reason for post-treatment prophylaxis - they prevent the disease from returning.Prevention is directly and closely related to treatment; the basics of prevention are as important as complying with all the doctor's instructions during treatment.
acute form of treatment
Antibiotics need to be taken during the period of worsening of the condition, and should be taken according to a course of treatment.If chlamydial infection is present, cephalosporin medications are needed.
The duration of the course of use is important; on average, antibiotics are taken for at least 3-4 weeks to prevent recurrence of the disease.Sometimes, doctors will continue treatment for a longer period of time, using a combination of antibiotics and analgesics to relieve pain.
The following rules should be considered when using antibiotic therapy:
- Bacterial culture is required to determine the susceptibility of the microorganism to the drug.
- Consider the medication's side effects and contraindications.
- They will consider previous treatments, length of treatment, methods used, and results.
The need for additional treatments is left to the discretion of the attending physician; it should be remembered that in acute prostatitis, massage is contraindicated, as it can cause the spread of bacterial infection throughout the body, leading to bacteremia and sepsis.
Treatment of chronic forms
It is important to remember that in principle it is impossible to get rid of a chronic disease quickly, the disease has developed for many years, and even doctors in their field cannot eliminate it in a few weeks; you do not need to believe the words of those who cure the disease in 2-3 days.The goals of treatment are to stop the source of infection, restore a man's immunity and prostate function, and prevent the condition from getting worse -- which takes time.
Courses of antibiotic treatment last from 4 to 12 weeks; if treatment is less effective, the medication is continued further.Most commonly, antibacterial drugs are used in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete removal of the prostate is offered.
No bacteria or symptoms
A typical difference between treatments is the absence of antibiotics.If pathogenic microflora were not present, they would not be needed at all.But sometimes experts prescribe a short course of medication for 2-4 weeks.
Treatment of non-bacterial prostatitis is based on the use of physical therapy methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy to strengthen the patient's immune system.
Dietary and lifestyle changes are also fundamental in the treatment of nonbacterial prostatitis; bath solutions and alpha-blockers are indicated.
Asymptomatic prostatitis is difficult to recognize; diagnosis is made using the PSA method, followed by 2 weeks of antibiotic therapy.After that, symptomatic treatment is chosen individually.
In general, treatment of any type of prostatitis is a long-term phenomenon and is not always pleasant for the patient.Apart from the physical inconvenience, a man is also affected psychologically as the most valuable part of his body - the private part - is affected.Reviews of patients who were cured of the disease indicate that results can be achieved only by strict compliance with the doctor's instructions, coupled with changes in diet and lifestyle.The cost of a cavalier approach to treatment is very high - not only does a person lose his health, but his entire life, personality, and relationships with other people change.To prevent this, it is necessary to monitor the health of the prostate and eliminate the causes of the development of the disease.