Prostatitis is one of the most common urological diseases in men.It is generally accepted that after 30 years, 30% of men suffer from prostatitis, after 40 - 40%, after 50 - 50%, etc.At the same time, the real incidence is much higher than the registered one, this is explained by the peculiarities of diagnosis and the possibility of the disease occurring in a latent form.With prostatitis, numerous problems with urination occur, libido decreases and erectile function is impaired.
Prostatitis is one of the most common urological diseases in men.It is generally accepted that after 30 years, 30% of men suffer from prostatitis, after 40 - 40%, after 50 - 50%, etc.At the same time, the real incidence is much higher than the registered one, this is explained by the peculiarities of diagnosis and the possibility of the disease occurring in a latent form.
The prostate gland is a small glandular-muscular organ that is located in the small pelvis under the bladder, covering the initial section of the urethra (urethra).The prostate gland produces a secretion that, when mixed with seminal fluid, maintains sperm activity and their resistance to various adverse conditions.
With prostatitis, numerous problems with urination occur, libido decreases and erectile function is impaired.The saddest thing is that in the absence of proper treatment, approximately 40% of patients face some form of infertility, since the prostate gland can no longer produce a sufficient amount of high-quality secretion to ensure sperm motility.It is important to remember that similar symptoms can occur not only with prostatitis, but also with prostate adenoma and cancer.
Forms of prostatitis
In accordance with the criteria of the American National Institute of Health (NIH USA) from 1995, there are four categories of prostatitis:
- Category I - Acute prostatitis;
- Category II - Chronic bacterial prostatitis;
- Category III - Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS):
- Category IIIa - Chronic prostatitis/chronic pelvic pain syndrome with signs of inflammation;
- Category IIIb - Chronic prostatitis / chronic pelvic pain syndrome without signs of inflammation;
- Category IV - Asymptomatic (asymptomatic) chronic prostatitis.
Occasionally, chronic granulomatous prostatitis, not mentioned in this classification, also occurs.
Most experts distinguish 4 main forms of prostatitis:
- acute bacterial prostatitis,
- chronic bacterial prostatitis,
- nonbacterial prostatitis
- Prostatodynia.
Causes of prostatitis in men
In persons under 35 years of age, the disease usually occurs in the form of acute bacterial prostatitis.Bacterial prostatitis is called when there is laboratory confirmation of the presence of infection.Most often it turns out to be chlamydia, trichomoniasis, gardnerellosis or gonorrhea.The infection enters the prostate gland from the urethra, bladder, rectum, and through the blood and lymphatic vessels of the pelvis.
However, recent studies prove that in most cases the infection is layered on existing disturbances in the structure of the prostate tissue and blood circulation in it.With non-bacterial prostatitis, bacteria cannot be isolated, although this does not exclude their presence.
In older patients, chronic forms of the disease are more often diagnosed.
Prostatodynia is the presence of a clinical picture of prostatitis, thickening of prostate tissue without signs of inflammation.
Symptoms of prostatitis in men
Symptoms of prostatitis can be divided into 3 groups:
- disorders of the urinary system (frequent and painful urge to urinate, feeling of incomplete emptying of the bladder), pain in the lower abdomen;
- sexual function disorders (pain along the urethra and in the rectum during ejaculation, weak erection, premature ejaculation, loss of orgasm, etc.);
- increased anxiety and nervousness of a man, caused by the patients’ attention fixation on their condition.
Acute prostatitis usually begins with an increase in body temperature to 39-40°C with fever and chills.Urination is difficult and painful.Swelling of the prostate gland develops, which can cause acute urinary retention.
Chronic prostatitis proceeds more calmly, but at any time, under unfavorable factors, an exacerbation can occur.Possibly asymptomatic.
Complications of prostatitis
In the absence of timely treatment, prostatitis can cause the following complications:
- transition of acute prostatitis to chronic,
- obstruction of the bladder with acute urinary retention, which requires surgical treatment,
- development of male infertility,
- narrowing and scarring of the urethra,
- recurrent cystitis,
- pyelonephritis and other kidney damage,
- abscess (suppuration) of the prostate, which requires surgical intervention,
- sepsis is a life-threatening complication that often develops in people with reduced immunity (patients with diabetes mellitus, renal failure).
Treatment of prostatitis in men
The modern arsenal for diagnosing prostate diseases is very wide.
The doctor will prescribe a bacteriological examination of your urine and prostate secretions.To clarify the location of a urinary tract infection, different portions of urine are examined.In addition, a mandatory diagnostic method is a digital examination of the prostate gland.This procedure is not very pleasant, but it is very informative.Your doctor may refer you for an ultrasound scan of your prostate and pelvic organs.If necessary, computed or magnetic nuclear tomography, cystoscopy, urography and prostate enzyme testing are prescribed.
When making a diagnosis, your doctor must rule out the presence of benign prostatic hyperplasia and prostate cancer.To quickly relieve pain in acute prostatitis, analgesics and warm baths can be recommended.
Bacterial prostatitis requires the prescription of antibiotics, the selection of which is carried out based on the results of bacteriological culture of secretions on nutrient media and determination of the sensitivity of the pathogen to chemotherapy.
Non-bacterial prostatitis is treated with anti-inflammatory drugs.
Prevention of prostatitis
Avoid hypothermia and do not sit on cold objects.Follow a gentle diet (excluding alcohol, spicy, fried and canned foods).Regular sex life is also a way to prevent prostatitis (since one of the provoking factors is stagnation of sperm and frequent erections without subsequent ejaculation).Equally important is the prevention of sexually transmitted diseases.
In adulthood, every man should undergo regular (once a year) examinations by a urologist.After prostatitis, preventive courses of outpatient treatment are carried out at least 2 times a year for a month and one course of sanatorium treatment.