Every second man of reproductive age (up to fifty years old) is prone to such a delicate disease as acute prostatitis, in which, under the influence of certain factors, the prostate (prostate gland) becomes inflamed, causing various forms of disorders of sexual functions, fertility, and psycho-emotional states. Be attentive to what your body says, and do not neglect timely treatment.
What is acute prostatitis
If during urination a man feels discomfort and even pain, 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 the glandular tissue, the formation of purulent foci on it. If you do not pay attention to the signs of acute inflammation of the prostate, then the pathological process can transform into a chronic form that is difficult to treat, and there is very little time for reflection - the transformation occurs in a matter of days.
However, more serious complications are possible than its transition to a chronic form. There is a risk of sepsis - a general infection of the blood and an ascending infection of the urinary tract with the development of pyelonephritis and cystitis. In these cases, the patient is urgently hospitalized, the condition may be critical. Although sepsis as a complication is rare, it can occur in patients in immunosuppressive conditions - intoxication, fever, severe symptoms, weakness. Therefore, blood cultures are needed to detect microorganisms.
Symptoms of acute prostatitis
Every man needs to know and remember the symptoms of acute prostatitis. General signs of the disease are manifested:
- Sharp pain when urinating.
- Body intoxication.
- Urination disorders (intermittent, weak, strained stream).
- Frequent urge to visit the toilet at night.
These are external symptoms of prostatitis, but with a deeper examination, leukocytes, traces of mucus and pus in the secretory fluid of the prostate gland are found in the urine. On palpation, a dense, enlarged organ is felt, pressing will be painful. Further development of the inflammatory process is characterized by heaviness and pain in the perineum, radiating to the penis, sacrum and rectum. As a result, it becomes difficult for the patient to empty the bladder and defecate due to severe pain. Body temperature can rise up to 38°C.
Causes of acute prostatitis
Since this disease is bacterial inflammatory in nature, the following infectious agents are the causes of acute prostatitis:
- Gram-negative - Klebsiella, E. coli, Proteus.
- Gram-positive - enterococci, staphylococci, streptococci.
- Urogenital - trichomoniasis, chlamydia, ureaplasmosis, gonorrhea, candidiasis, mycoplasmosis.
Microbial microflora penetrates into the glandular tissue of the prostate, as a rule, by the transcanalicular route (through the urethra and excretory ducts of the prostate gland). In cystitis, the infection migrates to the prostate from the bladder. Other possible pathways for bacterial penetration are opened during endourethral manipulations (catheter placement, urethral bougienage, cystoscopy, urethroscopy). Pathogenic microorganisms migrate into the prostate from distant pathogenic foci in caries, sinusitis, tonsillitis, cholecystitis, pyoderma, bronchitis.
There is a high probability of infection from the intestines with proctitis, hemorrhoidal fissures, colitis. Non-infectious factors that can cause an attack of prostatitis are congestive (congestive) venous phenomena in the pelvic area and impaired drainage of the acini of the gland. Congestion can be caused by irregular or, conversely, excessive sexual activity, interruption of sexual intercourse, a sedentary lifestyle, frequent constipation, frequent alcohol intoxication, varicose veins of the small 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 the acini, the occurrence of edema of the glandular tissue and, as a result, an increase in the size of the organ. 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 clog, this can make it difficult to secrete the secret of the prostate.
At the catarrhal stage, the pathological process stops at the mucous layers and does not go deeper. In the process of progression, the disease spreads to the entire prostate gland. Follicular acute bacterial prostatitis develops. At the analysis in urine pus comes to light. The tissues of the gland destructively change, swelling continues to increase. The follicular form is still amenable to relatively easy treatment.
Further, a parenchymal form of the disease develops, the outcome of which can be an abscess of the prostate, that is, 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 small needs are accompanied by throbbing sharp pains.
- Inability to empty the bladder.
- Flatulence.
- Tenesmus.
- Constipation.
- Discharge of mucus from the anus.
Diagnosis of acute prostatitis
At the first suspicion of inflammation of the prostate, hurry to the doctor. Correct and comprehensive diagnosis of acute prostatitis is very important for quick and successful treatment. The doctor will first analyze the history, clarify when pain sensations appear in the perineum, whether they increase or decrease during ejaculation, urination, defecation. Be sure the doctor must study the patient's medical history: what diseases were transferred, whether there were sexually transmitted infections.
The urologist will palpate the external genital organs 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 threads.
- Blood test.
- Culture smear - the contents and scraping from the urethra are taken to determine the growth of bacteria and their sensitivity to antibiotics.
- Determination of urine velocity (uroflowmetry).
- Ultrasound of the prostate 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 the treatment of acute prostatitis. It is based on antibiotic therapy, the purpose of which is to suppress infectious pathogens. Additionally, conservative treatment of prostatitis includes the use of:
- Anti-inflammatory drugs.
- Means that improve blood circulation.
- Painkillers and antispasmodics.
- Drugs that support metabolic processes in the prostate.
- Multivitamins.
- Phytotherapeutic agents.
- Immunomodulators.
Advanced forms of inflammation of the prostate with the appearance of purulent foci require surgical intervention. Transurethral (through the wall of the urethra) or transrectal (through the wall of the anus) drainage of abscessed areas is performed. Surgery may be required in case of pathological urinary retention. A puncture epicystostomy is performed - an incision is made in the abdominal cavity, into which a tube is inserted to divert urine.
drugs
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 in a few days. However, it is recommended to continue treatment for four weeks in order to achieve complete eradication of the pathogenic microflora. Medications used in the disease are:
- Etiotropic (antibiotics) - destroying pathogens.
- Pathogenetic (NSAIDs) - eliminating congestion in the prostate.
- Symptomatic (analgesics, antipyretics) - relieving pain, muscle spasms of the organ, and other symptoms.
To treat inflammation of the prostate, the doctor may prescribe a complex of drugs, 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.
- Instillations - delivery of the drug to the prostate through the urethral opening.
- Microclysters with decoctions of herbs.
- Antibacterial drugs with a wide spectrum of action, if a specific causative agent of the disease is not 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.
- Penicillins.
- Cephalosporins.
- Macrolides.
- Tetracyclines.
- Aminoglycosides.
Prevention of acute prostatitis
In order for a man to be always healthy, full of strength, the prevention of acute prostatitis is important, including:
- Regular sex life with a regular partner, excluding casual relationships.
- Use of condoms.
- Stop smoking, drugs, alcohol.
- Proper nutrition.
- personal hygiene.
- Preventive annual examinations at the urologist.
- Taking vitamins and zinc preparations.
It is important to completely cure diseases of the genitourinary organs (urethritis, cystitis, pyelonephritis, balanoposthitis). Undertreated diseases can cause the development of an inflammatory process in the prostate gland. Among other things, we must not forget about increasing physical activity. In the cold season, hypothermia should be avoided. Prostate massage is very useful for men's health. However, if the disease has already made itself felt, massage is contraindicated and even impossible due to the soreness of the organ.