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Prostatitis in men

Prostatitis is an inflammatory process affecting the tissue of the prostate gland.This is one of the most common diseases in the practice of a urologist.The disease is diagnosed mainly in men from 25-30 years of age, but by older age the risk of developing pathology increases significantly.

The form distinguishes between acute and chronic prostatitis.In the latter case, the inflammation is characterized by a long course with periodic relapses.This condition is much more common compared to acute.

Causes of prostatitis

Many diseases of the prostate gland, for example, benign hyperplasia or oncopathologies, are problems of the older age group.However, prostatitis does not fall into this category.Its symptoms usually appear in men between 30 and 50 years of age.Most often, the cause is an infectious lesion due to the penetration of pathogenic flora from the urogenital canal or glands of the genitourinary system.This is explained by the proximity of the urethra and anus.

Among the most common causative agents of bacterial (infectious) prostatitis, gram-negative organisms should be noted: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often the inflammatory process develops against the background of infection with STIs: chlamydia, gonococci, trichomonas, herpes virus, etc. As a rule, such forms of the disease are diagnosed in men under the age of 35 years.Cases of treatment of pathology against the background of infection by Mycobacterium tuberculosis are extremely rare.

There are also non-bacterial types of prostatitis.Among their main reasons:

  • increased pressure in the prostate gland;
  • autoimmune disorders (destruction of prostate cells by antibodies);
  • muscle pain syndrome in the pelvic area;
  • psychoemotional disorders;
  • deficit of motor activity;
  • excessive physical stress.

Primary signs of prostatitis

a man with signs of prostatitis

The disease is accompanied by a complex of disorders that affects the functioning of the entire urinary system.Among the main symptoms:

  • uncontrolled urination;
  • discomfort, pain when emptying the bladder;
  • potency disorder in men of reproductive age;
  • pain in the perineum when sitting for a long time;
  • frequent and strong urge to urinate;
  • difficulty emptying the bladder;
  • decreased libido and erection problems;
  • reproductive dysfunction (infertility);
  • feeling of incomplete emptying of the bladder after going to the toilet;
  • inability to achieve a high-quality and lasting erection even with strong arousal.

Signs of acute prostatitis

Symptoms of the disease in acute form and the general clinical picture differ depending on the stage of the pathological process:

  • Catarrhal.The patient complains of frequent urges, pain when urinating, pain in the perineum and sacrum.
  • Follicular.The pain syndrome becomes intense, can radiate to the anus and intensify during defecation.Urine is released in a thin stream.In some cases there is a delay.There is an increase in body temperature up to 38 degrees over a long period (low-grade fever) or moderate hyperthermia.
  • Parenchymatous.The man begins to experience general intoxication of the body with chills and a temperature of up to 38-40°C.Pain in the perineum becomes sharp and throbbing.The act of defecation is difficult, and normal emptying of the bladder is impossible, resulting in acute urinary retention (dysuria).

Symptoms of chronic prostatitis

The chronic form of prostate inflammation may be a consequence of the absence or untimely treatment of the acute stage.However, in many men it develops immediately and is characterized by “blurred” symptoms.Among the main signs are:

  • low-grade fever (occasionally);
  • mild pain in the perineum;
  • discomfort when urinating;
  • scanty discharge from the urogenital canal during defecation.

In general, the clinical picture changes over time, differs in intensity in different patients and can become hidden when attempting self-medication.Symptoms of a chronic disorder may include a burning sensation in the urethra, pressure in the perineum, dysuria, impaired sexual function and increased general fatigue.Against the background of problems with potency, mental depression, irritability and anxiety arise.Fear of impotence leads to the development of complexes, but most men tend to put off visiting a urologist because of a feeling of shame.

Primary chronic prostatitis develops over a long period.Blood stagnation in the capillaries (prostatosis) provokes the initial stage of non-bacterial inflammation, which leads to the onset of the disease.

With an infectious etiology, the cause of the disease is a chronic inflammatory process due to infection with trichomonas, ureaplasma, chlamydia or gonococcus.Primary infection masks the signs of prostatitis, and its treatment does not eliminate inflammation of the prostate.Often the addition of a concomitant problem remains unnoticed by a man.

Let us consider in detail the three main symptoms of chronic prostatitis:

  • Urinary disorder (dysuria).Inflammation increases the volume of the prostate gland, which leads to compression of the ureter.As its lumen decreases, a frequent urge to urinate and a feeling of an incompletely empty bladder appear.Dysuric disorders in many men occur in the early stages of prostatitis.The compensatory mechanism during this period is manifested in hypertrophy of the muscles of the bladder and ureters, which reduces the symptoms of dysuria, but with the development of inflammation they increase again.
  • Pain syndrome.There are no pain receptors in the prostate tissue.Pain occurs when the inflammatory process spreads to other pelvic organs and their nerve pathways.The sensations range from mild and aching to very intense, which interfere with night's rest.Increased discomfort occurs with ejaculation, sexual abstinence, or excessive sexual activity.The pain radiates to the perineum, sacrum, scrotum and sometimes to the lumbar area.
  • Violation of potency.Lack of treatment in the early stages of prostatitis can lead to dyspotence, when a man experiences frequent nocturnal erections, deterioration in the quality of orgasm and accelerated ejaculation.In different patients, these signs manifest themselves with different intensity.Premature ejaculation occurs due to a decrease in the threshold of excitability of the orgasmic center.In this case, the patient experiences pain, which leads to the development of pain anticipation syndrome and a gradual renunciation of sexual activity.In the absence of comprehensive treatment that addresses the mental factor of the disorder, sexual disorders become increasingly worse.Ignoring the need to seek medical help for prostatitis often ends in impotence.

The degree of sexual dysfunction varies depending on individual factors.Some men are so afraid of erectile dysfunction that their problems arise due to suggestion rather than objective physiological factors.In particular, psychogenic dyspotence is observed precisely with increased anxiety and obsessive complexes.The very thought of possible disorders of male health is difficult for such patients to bear.This greatly affects their character and communication with others.Irritability, hypochondria, grumpiness and depression appear.

Complications of prostatitis

Lack of adequate treatment for prostate inflammation leads to concomitant diseases.The fact is that the prostate gland is closely connected with other organs of the male genitourinary system.It is located around the neck of the bladder and urinary canal.Therefore, when the prostate enlarges, the urethra is compressed and the normal outflow of urine is disrupted.Taking into account the peculiarities of physiology, if acute or chronic prostatitis is not treated in a timely manner, a number of serious pathologies and complications arise.

Related problems:

  • formation of cysts, prostate stones;
  • decrease in the amount of male hormones produced;
  • decreased sexual desire (libido);
  • erectile dysfunction (erectile dysfunction);
  • infertility (in 40% of patients with chronic prostatitis);
  • prostate adenoma (benign tumor);
  • prostate cancer.

Some consequences of prostate inflammation that does not receive timely and comprehensive treatment pose a threat not only to the health, but also to the life of the patient (in particular, oncological pathologies may develop).Therefore, at the first symptoms of prostatitis, you should consult a urologist.You should also remember about regular preventive examinations after 40 years, when the risk of pathological processes in the prostate gland greatly increases.

Diagnosis of prostatitis

Many urological problems have similar symptoms, so the specialist works with each clinical case separately and uses all available diagnostic tools.A consultation with a urologist always begins with a survey about symptoms, medical history and general examination.Then the doctor prescribes a series of tests, based on the results of which a diagnosis is made and adequate treatment is selected.As a rule, the examination package includes:

  • rectal digital examination of the prostate to determine the size, structure of the prostate gland and the level of compression of the urethra;
  • Ultrasound of the urinary system (prostate, bladder, kidneys);
  • laboratory tests of urine, prostate secretion, ejaculate;
  • testing for urogenital infections;
  • urodynamic study.

To ensure an accurate diagnosis of prostatitis in men and related disorders, you need to refrain from urinating for 2-3 hours before visiting a urologist.Otherwise, the test results may not be entirely correct, since when the bladder is emptied, the pathogenic microflora is washed out.In accordance with the characteristics of the clinical picture, the method of performing ultrasound is selected: transrectally or abdominally (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Treatment methods for prostatitis

The main therapy is antibiotics.The use of modern pharmacological developments gives high results, although it is impossible to completely eliminate the risk of relapse.The doctor prescribes an antibacterial drug after culture of urine and/or prostate secretion for the type of pathogen.If acute prostatitis is diagnosed, oral antibiotic therapy takes about 4-6 weeks.In chronic or recurrent forms of the disease, treatment will take longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis), hospitalization and an intravenous course of antibiotics are required.

If there is difficulty urinating, the urologist prescribes medications that relieve hypertonicity of the muscles of the bladder and prostate gland, which normalizes the outflow of urine and prevents stagnation.Some patients are treated with drugs that reduce sex hormone levels.As a result, there is a decrease in the size of the prostate and, accordingly, a feeling of discomfort during urination, defecation and ejaculation.With severe swelling of the prostate gland, muscle relaxants help relieve overstrain of the bladder sphincter and adjacent muscles.Anti-inflammatory non-steroidal medications effectively combat pain.Also, chronic prostatitis responds well to auxiliary physiotherapy.Effective methods of such treatment are:

  • instillation of medications into the urethra;
  • prostate massage;
  • shock wave therapy (SWT);
  • magnetic laser therapy (MLT);
  • electrophoresis;
  • ozone therapy;
  • intravenous laser blood irradiation (ILBI);
  • ultraviolet blood irradiation (UFOI).

Prostate massage is a frequently used urological technique.The doctor uses the method of digital stimulation of the prostate gland through the rectum to enhance the outflow of secretions and restore the patency of the organ’s ducts.An additional effect is improved blood circulation and accelerated penetration of antibiotics into inflamed tissues.In addition to finger massage of the prostate, hardware methods are also possible. Shock wave therapy shows good results in the treatment of prostatitis.The basis of this medical technology is short-term exposure to low-frequency sound waves on the inflamed area.The procedure helps:

  • activate local blood circulation and growth of new vessels;
  • stimulate the body’s own regenerative abilities;
  • destroy fibrous foci and calcifications that provoke pain and inflammatory processes.

After a course of shock wave therapy, prostatitis symptoms are relieved and a good preventive effect is observed.Pronounced results can only be achieved with an integrated approach to the problem.In addition, the patient’s responsible attitude towards medical prescriptions is important.

For their part, the clinic’s urologists ensure the preparation of an individual treatment regimen, taking into account the cause, form, stage of the disease, general well-being and the presence of concomitant pathologies.

Prevention of prostatitis

To minimize the risk of relapse, it is necessary to reduce the negative effects on the body.Among the provoking factors are:

  • Smoking.The anatomical features of the location of the prostate gland lead to constant oxygen starvation, and inhalation of tobacco smoke causes vasospasm, which further slows down local microcirculation processes.All experienced smokers have the problem of high blood pressure.
  • Deficit of motor activity.“Sedentary” work and a sedentary lifestyle lead to congestion in the pelvic organs.
  • Alcohol abuse.Exceeding the daily limit of alcohol affects overall health and makes the body more vulnerable to various infectious diseases.
  • Stressful conditions.It is necessary to avoid situations that lead to anxiety, irritation, and depressive disorders as much as possible.If necessary, you should contact a specialized specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, which makes the body “open” to colds and inflammation.
  • Fatigue, excessive physical activity.You should not forget about the work and rest schedule, as well as lift heavy weights.

Preventive measures will help prevent the development of acute prostatitis and relapses of chronic prostatitis.For questions regarding the diagnosis and treatment of prostate inflammation, you can always contact the urology department of our clinic.