ProstatitisIt is a urological disease that is accompanied by inflammation of the prostate tissues. Prostate damage can be caused by an infection that is transmitted through the blood, lymph or through unprotected contact. The development of prostatitis in men is facilitated by injuries and reduced blood supply to the pelvic organs, constant hypothermia, low physical activity, hormonal imbalance and other factors. Prostatitis can be accompanied by cystitis, urethritis and other infectious and inflammatory diseases of the reproductive and urinary organs.
Statistical incidents
Prostatitis is one of the most common diseases of the male urinary system in the world. According to various sources, it is observed in 60-80% of sexually mature men. According to official medical statistics, over 30% of young people of reproductive age suffer from chronic prostatitis. About a third of cases occur in men over 20 and under 40 years. According to the WHO, urologists diagnose chronic prostatitis in every tenth patient.
Causes of prostatitis
Infections.Pathogens and opportunistic bacteria enter the prostate through the lymph and blood vessels. Secondary prostate infection is often a complication of inflammatory diseases of the rectum and urethra.
Types of infection:
- ascending- germs ascend to the gland from the external opening of the urethra.
- downwardsgerms enter the prostate with the stream of infected urine.
Conditionally pathogenic microorganisms that cause the disease (according to the Research Institute of Urology 1997-1999)
| Microorganisms | Number of studies | |
|---|---|---|
| % | ABS | |
| Staphylococcus epidermidis | 42. 3 | 55 |
| S. saprophyticus | 17. 6 | 23 |
| S. aureus | 4. 6 | 6 |
| S. haemolyticus | 3. 1 | four |
| S. Hominis | 0, 8 | a |
| S. warneri | 1. 5 | 2 |
| Staphylococcus spp. | 3. 1 | four |
| Enterococcus faecalis | 11. 6 | fifteen |
| Streptococcus spp. | 3. 1 | four |
| TOTAL (gr. +) | 87. 6 | 114 |
| P. aeruginosa | 3. 7 | five |
| E. Coli | 4. 7 | 6 |
| Enterobacter spp. | 2, 3 | 3 |
| Proteus spp. | 1. 5 | 2 |
| TOTAL (gr. -) | 12. 3 | sixteen |
Weakening of immunity.One of the causes of prostate inflammation is the weakening of the body's immune defenses. This can be facilitated by frequent stress, unbalanced diet, overwork, smoking, alcohol consumption. With reduced immunity, the body is more vulnerable to infections that lead to the development of prostate disease.
Blood supply disorders.The development of chronic prostatitis can be the result of a sedentary, sedentary lifestyle. With constant lack of physical activity, the work of the endocrine, cardiovascular and nervous systems, as well as the blood circulation in the pelvic organs, is interrupted. The result is oxygen starvation of the prostate.
Abnormal sexual activity.Both prolonged sexual abstinence and excessive sexual activity can contribute to the development of prostatitis. Many men who are sexually active have nervous exhaustion, hormonal imbalance, decreased secretion of sexual glands and a gradual weakening of power. Discontinuation of contact has a negative impact on prostate health.
Chronic prostate injury. . . Chronic prostatitis can develop as a result of frequent injuries to the soft tissues of the prostate. This is most often seen in patients whose driving activities are related to driving. The cause of prostatitis in this case is the constant shaking, vibrations and excessive pressure on the perineal muscles.
The main syndromes of prostatitis
Pain.With prostatitis in men, there are aches and pains in the lower abdomen and back, as well as aches all over the body. This symptom can be aggravated by ejaculation, especially during sexual intercourse after prolonged abstinence.
Dysuria.Typical signs of prostatitis in men are the frequent urge to urinate, burning and stinging when emptying the bladder, causing pain after urinating in the perineum. Another symptom of prostate inflammation is difficulty urinating. In the absence of treatment for the disease, acute urinary retention may occur.
Sexual dysfunction.With simple prostatitis, there is accelerated ejaculation, loss of orgasmic sensations, pain during ejaculation, partial or total reduction of libido. Prolonged erection at night is also a symptom of chronic prostatitis.
Outdoor events.With prostatitis, some patients have purulent or clear discharge from the urethra, which is more abundant in the morning. Patients may also notice a symptom such as the presence of white fringes or threads in the urine.
Types of prostatitis
Acute bacterial.Acute prostatitis develops as a result of infection of the prostate gland with Staphylococcus aureus, Escherichia coli, enterococcus and other pathogenic bacteria. If left untreated, this disease can cause blood poisoning. In this case, the man must be treated urgently.
Symptoms seen with this type of prostatitis:
- chills and fever (38 ° C and above)
- sharp or pulling pains in the groin, lower back and perineum.
- frequent urge to urinate
- painful urination
- difficulty urinating and acute urinary retention
- white or colorless discharge from the urethra.
Chronic bacterium.The recurrent form of the disease occurs as a result of the penetration of the infection into the gland. Chronic hypothermia, prolonged sexual abstinence and premature urination contribute to the development of prostatitis. Chronic prostatitis, if left untreated, can cause cystitis, as inflammation in the prostate is a reservoir of bacteria that affect the urogenital tract.
Chronic symptoms of prostatitis:
- pain in the scrotum, lower abdomen, perineum
- dysuria;
- power violations.
Non-bacterial years.Causes of the disease include the entry of viruses or bacteria into the prostate (tubercle bacillus, Trichomonas, chlamydia), autoimmune processes, urine penetration into the gland. Chronic prostatitis accounts for up to 95% of all types of prostate inflammation.
The signs of prostatitis are:
- chronic pelvic pain (bothers the man for at least 3 months)
- recurrent pain in the groin
- absence of symptoms of inflammation in urine, semen and prostate secretions.
Chronic asymptomatic.Asymptomatic chronic prostatitis is not associated with bacterial infection and symptomatic prostate syndromes. There is a hypothesis that this disease is a physiological feature associated with age.
Symptoms of this type of chronic prostatitis:
- absence of significant disease syndromes;
- increased content of leukocytes and bacteria in the urine.
The main symptom of the disease - the presence of infection in the gland - can be detected only by biopsy or during surgery to treat various pathologies of the prostate (adenoma, cancer).
Stationary.Prostatitis develops not only in the context of anatomical and physiological changes in the venous and other systems of the body. The main cause of the disease is irregular sex life.
Signs of prostatitis:
- pain in pain, radiating to the sanctuary
- increased urination in the morning.
- slight difficulty in passing urine (the symptom is observed in the chronic form of the disease).
- weakening of the erection
- decreased libido
- "Pale" orgasmic sensations during ejaculation.
Diagnosis of acute and chronic prostatitis
To choose the right treatment method, your doctor will prescribe a comprehensive diagnosis of the urinary tract condition, including the following methods.
Digital rectal examination.If you suspect a prostatitis disease, your urologist will perform a digital examination. The posterior surface of the prostate is next to the rectum, so when a finger is inserted through the anus, the doctor can determine the condition of the gland. During the study, the size, consistency and shape, surface condition, pain were found.
Signs of prostatitis in men include:
- soft, inelastic consequence of the prostate.
- pain on palpation
- enlarged gland
- immobility of the anal mucosa above the prostate.
Ultrasound procedure.Prostate ultrasound is prescribed before starting treatment for acute prostatitis to detect / rule out an abscess of the gland and during the course of the disease - to detect cysts and prostate stones, as well as the degree of compression of the urethra. The most effective method is anal ultrasound.
Uroflowmetry.This method of diagnosing prostatitis is used to study the indicators of the urinary process: the duration of this normal operation and the rate of urination. If the rate is 15 ml / s or higher, this indicates a normal sensation in the urethra. A sign of prostatitis is a decrease in this value below 10 ml / s. This speed is a consequence of the poor weakness of the urinary system.
Interpretation of uroflowmetry results
| Urine flow rate | Interpretation |
|---|---|
| >15ml / sec | Urinary tract obstruction is unlikely |
| <10 ml / sec | Significant narrowing of the urethra or weakness of the ejaculate is possible |
| 10-15 ml / sec | Unspecified result |
Cystoscopy.For examination, an endoscopic imaging system is inserted into the bladder. This method for diagnosing acute and chronic prostatitis is used when diseases such as cancer, cystitis or bladder trauma are suspected.
Laboratory research.Urine and prostate secretions are examined to diagnose and identify the microorganism that caused the disease, in the presence of symptoms of chronic prostatitis or acute inflammation. A sign of the presence of pathogenic microflora is an increased number of leukocytes in biological material. In order to synthesize an effective treatment regimen, the type of bacteria is determined by PCR, RIF and nutrient inoculation.
Interpretation of laboratory results
| Secret protector | Third urine sample (after prostate massage) | |||
|---|---|---|---|---|
| HP Form | The number of leukocytes, uv. x 400 | Sowing results | The number of leukocytes, uv. x 400 | Sowing results |
| Bacterial | >10 | + | The difference between the number of leukocytes in the third part of the urine and the second part of the urine is ≥10 | + |
| Inflammatory chronic pelvic pain syndrome | >10 | - | The difference between the number of leukocytes in the third part of the urine and the second part of the urine is ≥10 | - |
| Non-inflammatory chronic pelvic pain syndrome | <10 | - | - | - |
Prevention of prostatitis
Physical activity.To prevent and treat prostate disease, a man must avoid physical inactivity. Recommended:
- walking (4 km per day or more)
- exercise (squats, jumps, turns)
- training of the perineal and buttock muscles
Proper nutrition.To prevent acute and chronic prostatitis, men should include in their diet foods high in zinc and vitamin B. It is recommended to eat:
- seafood (oysters, seaweed)
- meat;
- Pumpkin seeds;
- walnuts;
- bran;
- kefir?
- Rye bread.
Regular sex life.When preventing and treating a disease, a man needs:
- live a rhythmic sex life.
- avoid interrupting sexual intercourse.
- avoid casual relationships.
Treatment of acute and chronic prostatitis
Inflammation of the prostate is treated using the following methods.
Antibacterial therapy.If prostatitis is bacterial, antibiotics are needed to treat it. The doctor selects a group of drugs depending on the type of microbes that caused the disease, the susceptibility of the pathogen to various drugs and the presence of contraindications in the patient.
Characteristics of drugs
| A medicine | Benefits | disadvantages |
|---|---|---|
| Fluoroquinolones |
|
|
| Macrolides |
|
Insufficiently active against gram-negative bacteria |
| Tetracyclines | Active against atypical pathogens |
|
Hormone therapy.Hormone therapy is necessary to restore the normal hormonal balance between androgens and estrogens. Antiandrogen drugs reduce the inflammation of the glandular tissues and prevent the disease from progressing to more severe stages.
Prostate massage.This method of treating chronic prostatitis can only be used without exacerbations. A man should take a reclining position, rest his palms on a couch or table, spread his legs shoulder width apart. The treating doctor puts sterile gloves on his hands, applies an ointment or gel (in some cases, a medicine with an anesthetic ingredient) to the index finger of his right hand and injects it through the anus into the rectum. The massage is performed with light pressure until the prostate secretions are separated through the opening of the urethra. The treatment includes at least 10 massage sessions.
Physiotherapy.To treat the symptoms of prostatitis, methods are used to normalize and increase blood circulation to the pelvic area. This allows you to rule out stagnation as well as increase the effectiveness of medication. The treatment is carried out by exposing the gland to ultrasonic waves, electromagnetic vibrations, as well as at high temperatures (microclusters with hot water).
Surgery.Surgery for prostate disease is rarely used. Such treatment is mandatory for the development of complications of acute or chronic prostatitis.
Indications for prostate surgery:
- acute urinary retention as a result of severe urethral stricture.
- abscess (the appearance of overflow on the surface of the gland).
- hardening of the gland.
- adenoma that does not respond to conservative treatment.
Complications of prostatitis
Cystitis.Unprotected prostatitis can cause inflammation of the seminal vesicles. The symptoms of the disease are pains deep in the pelvis, which radiate to the sanctuary, aggravated by erection and ejaculation, frequent urination, the appearance of blood and / or pus in the semen and urine.
Colitis and urethritis.Due to its proximity to the secretory currents of the prostate, sperm tuberculosis is often inflamed as a result of infection by the infected gland. If left untreated, the symptoms of prostatitis are complemented by the characteristic symptom of urethritis - burning or tickling in the urethra when urinating. There is also pain during ejaculation as a result of spastic contraction of the urethra.
Prostate abscess.The appearance of purulent cavities on the surface of the gland is due to the pathogenic bacteria that caused prostatitis. A characteristic symptom of the disease is general weakness, decreased consciousness, delirium, a sudden rise in temperature, increased sweating, chills. Prostate abscess is a serious septic disease that must be treated in a hospital.
Prostate sclerosis.Prostate sclerosis develops as part of regular signs of chronic prostatitis as a result of non-compliance with the treatment prescribed by the urologist. This disease can form over several years, however, if the hormonal balance in a man's body is disturbed, rapid growth is possible. With prostate sclerosis, there is pain when emptying the bladder, an intermittent and slow flow of urine.
Formation of cysts and stones. . . The appearance of cysts in the gland is one of the possible options for the development of chronic prostatitis. Infection with tumors can cause an abscess and greatly complicate the treatment of the disease. Single and multiple stones can also form in the prostate. In this disease, in addition to the usual symptoms of chronic prostatitis, there are violations of the outflow of urine, frequent urination, pain in the perineum.
Infertility.In chronic prostatitis, sperm production and motor function are reduced. If left untreated, the disease also affects the vas deferens and seminal vesicles, making them impermeable to sperm, so they are not thrown into the urethra during ejaculation. As a result, men with chronic prostatitis often suffer from infertility.