According to the BME, prostatitis is an inflammatory process that occurs in the prostate gland in men with damage to the parenchyma and interstitium. Treatment of prostatitis in men is a long and difficult event, most often due to complete ignorance of the disease at first. What is prostatitis, what are their causes and first signs, what you need to know about the subject of "diagnosis" and modern methods of treating prostatitis exist. All men need to know about prostatitis in this review article.
Ab ovo - from eggs
We are not talking about Horace's satire, in this case we are interested in everything related to prostatitis, from the beginning to the last "scream" of treatment. Symptoms of prostatitis are found in men during periods of active sexual activity, from 25 to 45 years, on thematic videos you can study in detail everything related to the basics of the disease, its causes and symptoms, the peculiarities of diagnosis and treatment.
The reasons for the development of prostatitis are wide. With prostatitis, infectious factors have the greatest weight in the development of the disease:
- Acute form. The coccal flora acts as a provocative cause.
- Chronic form. The reasons for its development are broader, because the main factors of such prostatitis in men are: gonococci, Trichomonas, Gr + and Gr-bacteria, mycobacterium tuberculosis. In rare cases, the diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
It should be noted that chronic prostatitis, which is caused by pathogens that have penetrated the prostate gland, can then have pathogenic and abacterial factors. The acute form is more often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder due to endoscopic examination or various manipulations, hypodynamia and, consequently, violations of blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
Often you can hear about only one type of prostatitis - infectious, however, according to the WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is recorded in 90% of cases.
Table No. 1. Brief characteristics of pathology
| Categories for prostatitis | Acute infection | The presence of pathogens in the secretions of the prostate or the 3rd part of the urine | Level (increase) of leukocytes with m / s secretion or urine |
| 1 cat. Acute bacteria | + | + | + |
| 2 cats. Chronic bacteria | - | + | Not sure (whether or not) |
| 3 a. Chronic pelvic pain syndrome that is inflammatory in nature, not bacterial | - | - | + |
| 3 b. Prostatodynia, a non -inflammatory pelvic pain syndrome | - | - | - |
| 4 cats. Asymptomatic inflammatory process | - | Not sure (yes or no) | Not sure (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more fully, in most cases familial bacteria being the cause of the disease. Enterobacteriaceae (E. coli bacillus). The role of atypical microorganisms as causes of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered not fully proven. Symptoms of prostatitis in men with signs of weakened immunity, particularly with HIV, can be caused by yeast (Candida spp. ) Or mycobacterium tuberculosis.
Before the advent of the antibiotic era, the gonococcal flora (Neisseria gonorrhoeae) played an important role in the development of prostatitis, especially often it was the cause of its abscess form.
The causes of abacterial forms of prostatitis have not been fully studied, although urologists have carefully studied the list of possible pathogenetic factors (provoking prostatitis) that play an important role in the occurrence of inflammation of the prostate in the absence of microorganisms. So, at the heart of the causes of non-bacterial prostatitis are the process of stagnation in the small pelvis, circulatory disorders, intraprostatic urine reflux and autoimmune aseptic inflammatory processes.
Sick or not - that's the question
What do men with prostatitis look like? For someone who is far from medicine, and even more so unskilled in urological problems, the male appearance of an individual is no different from that of the rest of the crowd. And only an experienced specialist, from the patient’s first complaint, will understand where the root cause of the problem has ripened and ways to eliminate it need to be done.
The symptoms of prostatitis are often described in a few phrases, highlighting the brightest moments, and this plays a cruel joke with a man. Relying on an inaccurate definition, he ignores a very important bell, believing that the disease does not exist, although in fact the clinical picture depends on the nature of the morphological changes in the prostate.
Early symptoms can be associated with the following types of prostatitis:
- Catarrhal prostatitis. Dull pain in the perineum, radiating to the sacrum, frequent nocturnal urges.
- Follicular prostatitis. Difficulty and frequent urination, sometimes with delay. Pain when "urinating", worsens at the end of the process of urination, as well as bowel movements. Low -grade fever.
- Prostatitis parenchyma. There are obvious symptoms of dysuria, often AUR, pain during natural recovery, general intoxication with temperatures up to 40 C.
In the case of prostatitis with the formation of abscesses, the symptoms are more pronounced with the possibility of the opening of the abscess into the rectum or into the prostate portion of the urethra. With such success, the symptoms diminish. If the opening of the abscess occurs in the paraprostatic tissue or in the perineal area, visual symptoms may be observed: swelling, redness of the skin with significant fluctuations. At the same time, the man's condition was deteriorating.
Comprehensive treatment of prostatitis should not be started without a thorough examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is customary to distinguish between acute and chronic prostatitis; on thematic videos on the Internet, you can find out in detail which symptoms refer to one form or another. Let us consider this issue in more detail.
Acute - the typical symptoms are characterized by manifestations of three stages: catarrhal, follicular and parenchymal. They are described in detail above.
The most interesting in terms of symptoms is the chronic form of prostatitis, as there are many variations in symptoms. In general, the effective treatment of prostatitis depends on the prostatitis, or more precisely on its type.
In the stage of chronization, the following moments can be distinguished:
- Chronic prostatitis is rare as a result of an acute process.
- Primary prostatitis disappears with symptoms cleared.
- A chronic characteristic symptom is a slight discharge from the urethra during defecation.
- The first symptoms, as a rule, are not expressed, the pathological process itself develops over many years. It is preceded by prostatosis (congestion in the capillaries), which smoothly turns into a form of abacterial inflammation of the prostate gland.
- Specific pathogenic microflora is not the cause of chronic prostatitis, but the chronic process itself is a complication of inflammatory processes due to the effects of ureaplasma, Trichomonas, chlamydia and gonococci.
How does a man with chronic prostatitis feel? Patient reviews show that most often at first, a small pain in the perineum is felt, a slight discharge, which most men do not pay attention to. The next stage is the consolidation of the following symptoms: burning sensation in the urethra, sexual dysuria, general malaise. Frequent offenses during sex make men depressed, irritable or depressed.
It is important to understand that all these symptoms do not necessarily appear in every chronic case, this is what complicates the diagnosis in the early stages of the disease, in addition, the symptoms tend to change places, which is more confusing.
Long -term syndrome
What can you expect from chronic prostatitis? If there is no timely diagnosis and treatment - nothing good, any specialist will confirm this. This type of prostatitis is characterized by 3 syndromes:
sick
The prostate itself is not painful, but many nerve endings pass through it and nearby, which are inevitably involved in the inflammatory process. The pain can be of different intensity - from slight pain, causing discomfort, to strong, not allowing you to sleep peacefully. Radiation of pain occurs in all nearby areas (scrotum, sacrum, perineum), pain due to prostatitis must be distinguished from similar symptoms of other diseases.
Disuria
Disurik syndrome always indicates damage in the urinary system, but what causes it is revealed at diagnosis. The increased volume of the prostate inevitably compresses the urethra, and the flow of urine is disrupted, followed by the development of a frequent desire to use the toilet, a feeling of incomplete emptying of the bladder. With advanced prostatitis, there is compensatory hypertrophy of the muscular layers of the bladder and ureter. During this time, the symptoms of dysuria diminished, but again returned in an intensified form.
Sex without pleasure
Deteriorating intimate life - these are the first symptoms that men notice, and they are, as the reviews show, forcing them to see a doctor. Frequent nocturnal erections, erased orgasms, weak erections and rapid ejaculation, current pain - that’s what worries the stronger sex the most. In the chronic stage, nothing good can be expected from prostatitis; Erectile dysfunction often develops.
The level of sexual harassment in men is not the same, a person initiates sexual intercourse and somehow resolves it, dismissing the characteristic bells. For some people, even a weak initial penile response to a captivating stimulus becomes a collapse and the beginning of a horrible experience that turns into prolonged depression. The specter of impotence is difficult for patients who have problems with the prostate gland, almost always specialists and relatives see that prostatitis spoils the character.
To learn more about the disease, you can study thematic videos, in which experts explain the many nuances of pathology.
What to write on the card
What records will appear in the patient’s medical record and the final diagnosis to be determined depends on a series of primary studies, starting from the patient’s arrival at the urologist and his or her complaints (history) to the final stage of diagnostic steps. What exactly is needed depends on the type of prostatitis, the patient’s neglect and consent to the particular diagnostic procedure.
In general, the diagnosis consists of:
- Anamnesis. The doctor will ask in detail about all the complaints and symptoms, prerequisites of the disease, etc.
- Urine analysis.
- Prostate sequence (digital rectal examination + collection of secretions).
- Ultrasound of the prostate.
- Spermogram.
- Prostate biopsy (if indicated).
What does diagnostics provide and is it so important? If you read patient reviews, you can often understand that most men try to avoid many stages of diagnosis, while their motivations vary greatly. The price of such indifference is your own health! It is important to remember that prostatitis can be cured only if it is "caught" in a timely manner and a diagnosis is made accurately with a definition of the form of the disease and its causes.
How to be healthy forever
So, the man understands that he has prostatitis, what awaits him in the future and is it possible to restore lost health? It is important to understand that you need to get rid of prostatitis 2 times longer than it develops. Moreover, if the pathological process is almost beyond the attention of the man, then the treatment of prostatitis will take place with his direct participation. Whether acute or chronic prostatitis can be cured - yes, if you follow all the recommendations of the doctor, in cases of advanced chronic form, during treatment, it is possible to achieve a stable remission.
The stage of prostatitis treatment will directly depend on what the doctor finally discovers during the examination, on the type of disease, the patient’s age and physical data.
Treatment regimens are always individual, but the following may be present in them:
- Antibacterial therapy.
- Physiotherapy methods.
- Phytotherapy.
- Appointment of immunocorrector.
- Urological massage.
- Physiotherapy.
The price of each stage of treatment is different, depending on the total cost of the prescribed medication, additional methods and the clinic. The preventive measures that follow treatment have an important rationale - they prevent the return of the disease. Prevention has a direct and close relationship with treatment, the basics of prevention are just as important as compliance with all the requirements of the doctor while undergoing therapy.
Treatment of the acute form
The period of exacerbation requires taking antibiotics, which are taken in course. In the presence of chlamydial infection, cephalosporin series drugs are indicated.
The duration of the course is important, on average, antibiotics are taken for at least 3-4 weeks to prevent recurrence of the disease. Sometimes doctors continue treatment for longer periods, antibiotics combined with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- Bacterial cultures are required to determine the sensitivity of microorganisms to drugs.
- Side effects and contraindications of the drug are taken into account.
- They take into account the previous course of treatment, when it was, what methods were used and the results.
The need for additional treatment methods is determined by the attending physician, it should be borne in mind that massage is contraindicated in the form of acute prostatitis, as it provokes the spread of bacterial infections throughout the body, followed by bacteremia and sepsis.
Treatment of chronic forms
It is important to remember that it is impossible to get rid of chronic quickly, in principle, the disease has developed over the years and it is beyond the power of doctors in their field to destroy it in a few weeks, you do not have to take their word for it. cure the disease in 2-3 days. Treatment aims to stop the focus of infection, restore immunity in men and the work of the prostate gland, as well as prevent deterioration - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks, with low treatment effectiveness, the drug continues to be taken. Often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs. In further cases, surgery is provided with partial or complete isolation of the prostate gland.
Free of bacteria and symptoms
The difference of therapeutic features is the absence of antibiotics, without the presence of pathogenic microflora, they are not needed. But sometimes specialists prescribe a short course of medication in 2-4 weeks.
Treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy by strengthening the patient's immune system.
Dietary and lifestyle changes also underlie the treatment of non -bacterial prostatitis, bathing, alpha blockers are indicated.
Symptomatic prostatitis is difficult to detect; in diagnosis, the PSA method was used, followed by the appointment of a 2 -week course of antibiotics as treatment. After that, individual symptomatic treatment is selected.
In general, the treatment of any type of prostatitis is a long-term phenomenon and not always pleasant for the patient himself. In addition to physical discomfort, a man suffers psychologically, because the most precious part of his body is affected - the intimate ones. Reviews of those who have cured the disease show that only strict adherence to doctor’s prescriptions, coupled with dietary and lifestyle changes, pays off. The price of a frivolous attitude towards treatment is very high - a man loses not only his health, his whole life, his character and his relationships with others change. To prevent this, it is necessary to monitor the health of the prostate gland and eliminate the causes of disease progression.