According to statistics, every third man of working age suffers from prostatitis at different periods of life. Constant pain, impotence, infertility - this is not a complete list of problems that threaten patients in the absence of treatment. Due to the high urgency and danger of the disease, its symptoms and initial manifestations should be known to every man. In this article, you will learn about all the signs and diagnostic methods that allow you to recognize prostatitis.
The clinical picture at the initial stages of development
Prostatitis is an inflammatory lesion of the male prostate gland. The following forms of the disease are distinguished: acute and chronic bacterial prostatitis, chronic pelvic pain syndrome, asymptomatic prostatitis. Each form manifests itself in different ways, has characteristic signs and features of the course.
It is difficult to say how the disease will proceed in each particular man. The presence of certain signs depends on a number of external and internal factors. For the convenience of characterizing the pathology, it is customary to divide all symptoms of prostatitis into 3 large groups: those associated with urination disorders, sexual dysfunction, mental problems. The first and most significant symptoms of prostatitis (except for the asymptomatic form) may be the following signs in a man:
- Pain in the pelvis, back, groin area.
- Pain and burning during the act of urination.
- Difficulty passing urine.
- Feeling of incomplete emptying of the bladder and a false urge to urinate.
Pain in the pelvis, back, groin area, a feeling of incomplete emptying of the bladder and a false urge to urinate are signs of prostatitis.
The listed symptoms occur due to impaired urinary function, which is due to the anatomical features of the structure and location of the bladder and prostate gland. Signs of prostatitis associated with sexual dysfunction are also significant and pronounced. Men most often make the following complaints:
- Weak erection.
- Rapid onset of ejaculation during intercourse.
- Lack of orgasm or decreased sensitivity.
- Soreness in urethra and rectum on ejaculation.
Problems with urination and difficulties in intimate life due to inflammation of the prostate gland greatly disturb the man. Patients with prostatitis are forced to change their lifestyle, deny themselves habits, and family relationships become more complicated. Obsession with your problem provokes increased nervousness, anxiety, decreased libido, which can be called indirect signs of prostatitis, belonging to the third group of the above symptoms (mental disorders).
Prostatitis in men can often be confused with prostate adenoma or cancer, a pathology of the bladder. All these diseases appear similarly, especially in the initial stages. It is very difficult to distinguish them for an unprepared person, therefore differential diagnosis is made by analyzing all existing objective symptoms, laboratory and instrumental research data. Since each form of prostatitis has specific signs and characteristics, it is prudent to consider them separately.
Characteristics of certain forms of the disease
Acute prostatitis is an inflammation of the male prostate gland caused by the penetration of an infectious agent into the organ through the blood, lymph or urethra. The disease begins abruptly and is characterized by the severity of all clinical signs. The main symptoms of acute prostatitis:
- The rise in body temperature to 39-40 degrees.
- Symptoms of general intoxication (headache, weakness, fatigue, decreased performance, etc. ).
- Severe pain in the perineum, sacrum, above the pubic joint of a man.
- Frequent, painful urination.
- Sometimes men have urinary retention.
Temperature 39-40 is a clear sign of inflammation of the prostate gland.
Acute inflammation of the prostate gland ends, as a rule, with recovery or chronization of the process (symptoms may bother for several months). But more often this form of prostatitis is primary and is a consequence of the presence of bad habits (alcohol abuse, smoking, and so on), a sedentary lifestyle, a deficiency of vitamins and minerals, prolonged sexual abstinence, or arises from a non-aggressive sexually transmitted infection or ingestion of normal agentsmicroflora. The clinical picture of chronic prostatitis looks more meager in relation to the acute form, the symptoms of the disease are inconsistent, which greatly complicates the diagnosis. For the chronic form of prostatitis, the following symptoms are most typical:
- Increased urge to urinate, including at night.
- Soreness when passing urine, and also when ejaculating.
- Dull aching pain in the lower back, pelvis, above the bosom, etc.
The syndrome of chronic pelvic pain (CPPS) in a man combines recurrent soreness in the area of the prostate, temporary disorders of the urinary and reproductive systems. CPPS in medicine is a broader concept, since pathogenetically, pathology may be based on a tumor or ischemic process, disorders of the nervous system, and not just inflammation. The inconsistency of the presence of signs of prostatitis in chronic pelvic pain syndrome significantly complicates the diagnosis, but it is much more difficult to do in the asymptomatic form. In these cases, the main and decisive role is played by the data of laboratory and instrumental research methods.
Diagnostic techniques
Based on the symptoms of prostatitis alone, a definitive diagnosis cannot be made. In addition, doctors must collect anamnesis: information about the time of onset of symptoms, their connection with the main and significant events in life, physical and mental shocks, all possible predisposing factors are clarified, and so on. A physiological examination is always performed - a digital rectal examination in the knee-elbow position of a sick man, lying on his side with bent legs or standing with his body bent forward. During this study, you can find signs characteristic of prostatitis (the presence of all is not necessary):
- Enlargement of the male sex gland in size.
- The shape of the organ is correct or flattened with a depression.
- Dressed or doughy consistency.
- Smoothness of the borders of the prostate gland.
- Increased soreness with pressure.
Further examination of a patient with symptoms of prostatitis is complemented by laboratory methods. General and biochemical blood tests are prescribed - there are no specific changes in the indicators, only indirect signs that make it possible to judge the presence of an inflammatory process in a man's body (an increase in the number of leukocytes, acute phase proteins, acceleration of ESR). The results of urine tests will be valuable, which will make it possible to judge the presence of an infectious process in the genital tract, will help determine the pathogen for starting etiological treatment. Additionally, urologists can prescribe an analysis of prostate secretion, spermogram.
Among the instrumental methods for diagnosing prostate diseases, the most informative is TRUS - transrectal ultrasound. In this case, a special sensor is used, which the doctor inserts into the rectum. This causes discomfort to a sick man, but is compensated by the information content of this method. With the help of TRUS it is possible to assess the structure of the organ, to judge the presence of tissue inflammation, the degree of narrowing of the urinary tract, and to exclude the presence of calculi. The main echo signs of prostatitis: enlargement of the organ in size, edema, fibrosis, sclerotic tissue changes, coarse-grained and heterogeneous structure.
In addition, patients with symptoms of prostatitis undergo uroflowmetry - a special diagnostic manipulation in which a man's urination rate is measured. Based on the data of this study, conclusions can be drawn about the degree of narrowing of the urethra, the activity of the detrusor. Uroflowmetry should not replace TRUS, but rather confirm its findings and signs of existing prostatitis.
The plan for a diagnostic examination for prostatitis can be expanded if indicated in a man. To clarify individual points regarding the diagnosis, cystoscopy, CT scan of the pelvis can be performed. In unclear cases, a biopsy is performed for differentiation with tumor processes.
What to do when the first symptoms appear
The biggest and most common mistake many men make when they have signs and symptoms of prostatitis is waiting. Each patient hopes that the unpleasant symptoms are temporary and will soon disappear. Untreated prostatitis is dangerous to health, leads to irreversible changes in the body, which are fraught with impaired erection mechanism, infertility, or even worse - malignancy of the process (transition to cancer).
In order to prevent serious complications, every man at the first signs of prostatitis should consult a urologist who will prescribe treatment. First of all, men are given etiotropic therapy - anti-inflammatory drugs, antibiotics are used, measures are taken to strengthen the immune system. There is no need for an operation in the absence of complications. Men who have had prostatitis in the past are at risk, and there is a high likelihood of recurrence, therefore, after recovery, a large role is given to prevention.