Prostatitis

Prostate inflammation today is the leader in the group of predominantly sexually transmitted male diseases. Its complications threaten infertility, decreased libido and impotence.

The symptoms of prostatitis are not just pain, urinary disorders and inflammation of the spermatic cord. The most dangerous consequence of advanced inflammation may be cancerous degeneration of the prostate. Whereas a pathological process diagnosed in a timely manner is easily stopped.

Causes of inflammation

The risk of developing prostate inflammation increases due to several factors that predispose to the disease:

• Hypothermia, unique or associated with the nature of outdoor work.
• A sedentary lifestyle leads to disruption of the functioning of the digestive system.
• Chronic somatic diseases (diabetes mellitus, hypertension).
• Foci of focal and perifocal infection (rhinitis, tonsillitis, stomatitis, gastritis).
• Persistent UGI (chlamydia, trichomoniasis, herpes virus).
• Stress, insomnia, chronic fatigue syndrome.
• Decreased immunity due to illness, surgery, emotional stress.
• Bad habits that lead to the development of intoxication: alcohol, smoking, strong coffee.
• Occupational injuries to the perineum of car drivers, athletes, workers in hazardous industries.
• Promiscuous sexual life, interrupted sexual relations, sexual relations devoid of sensuality with incomplete ejaculation, prolonged absence of intimacy (low need for sperm leads to stagnation of the gland).
• Venereal diseases.

Despite a large number of provocative moments, the essence of prostatitis is the occurrence of stagnation inside the organ against the background of impaired blood circulation and lymph flow.

Classification

In modern urology there is no uniform classification of the disease. However, practicing doctors prefer this option to classify the inflammatory process in the prostate:

According to the course of the disease:

• Acute prostatitis. It accounts for more than 50% of cases of the disease in people aged no more than 30-35 years.
• Chronic option. It is considered an ageless category. It does not manifest itself for a long time; the impetus for its development is a cold or infection.

For the reason that caused the pathology:

• Bacterial inflammation of the prostate predominates in men under 40 years of age, occurs against the background of ultrasound and does not extend beyond the limits of the organ.
• Non-bacterial pathological changes in the gland, predominantly chronic.
• Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.

According to the nature of structural changes in the prostate:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention. Clinically it resembles prostate adenoma.
• Calculus inflammation of the prostate occurs due to the formation of stones within the prostate. Considered a harbinger of cancer.
• Congestive prostatitis, the result of a sedentary lifestyle, is diagnosed in every second patient.

Signs of the disease

If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:

• Urination disorder with the occurrence of a weak and intermittent stream of urine, abnormally short, causing splashing, difficulty and pain before urinating. The frequent need to empty the bladder occurs mainly at night.
• The pain, located in the lower abdomen, radiates to the scrotum, perineum and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in sperm (consistency, quantity).

Acute prostatitis

The disease begins with a sharp rise in temperature (up to 40 degrees), painful headache and fever. The symptoms that appear are accompanied by pain in the groin, perineum, back, discharge from the urethra, frequent urination and a constant urge to urinate.

Bladder emptying occurs with a delay and a burning sensation. The urine itself becomes cloudy and may contain blood. Irritability and fatigue occur.

The result of acute prostatitis can be a complete resolution of the process (if treatment is started in a timely manner). Since changes occur in many pelvic organs, they cannot be left to chance, otherwise corresponding complications will arise:

• Vesiculitis is an inflammation of the seminal vesicles, causing the appearance of pus in the semen, which not only reduces the quality of ejaculation, but leads to the loss of reproductive function.
• Coliculitis - inflammatory changes in the seminal tubercle become the cause of the development of severe pain during sex, interruption of orgasm and impotence of a psychological nature.
• The formation of an abscess in the prostate body, its rupture and purulent damage to the rectum lead to an exacerbation of symptoms, severe intoxication of the body and even death.
• Stagnation of prostate tissues leads to changes in its structure, disruption of innervation, blood supply, both to the gland itself and to organs located nearby, with disruption of their functions. The erection becomes insufficient for full sexual intercourse, premature ejaculation and prolonged sexual intercourse without orgasm are observed.
• Cicatricial changes in the gland and spermatic cord lead to infertility, decreased sperm quality and motility. The narrowing of the urethra interferes with the normal urination process; Bladder obstruction can cause acute urinary retention, requiring emergency surgery.

Chronic prostatitis

The main feature of the disease is the vagueness of clinical symptoms with a long and persistent course of the process. More often, the chronic form occurs independently, as a primary pathology against the background of stagnation of blood in the vessels (prostatosis), non-bacterial prostatitis.

The main symptoms of chronic prostatitis are:

• fever;
• pain occurs in the scrotum, perineum, anus, back;
• urinary disorder;
• mucous or mucopurulent discharge from the rectum, urethra, even in the absence of urination or defecation;
• erectile dysfunction, painful ejaculation, interrupted sexual intercourse, prolonged sexual intercourse without a feeling of satisfaction.

Inaction and inadequate treatment of chronic prostatitis can cause complications:

• Infertility is the result of chronic inflammation in the spermatic cord, vesicles, testicles and their appendages.
• Cystitis, pyelonephritis (other diseases of the genitourinary system) are a consequence of the hematogenous and mechanical spread of microbes.
• Sepsis.
• Persistent decrease in immunity.
• Untreated prostatitis can cause cancer in 35–40% of cases.

Diagnosis

The clinical picture of the disease is typical, so the diagnosis is not difficult. It is carried out by a urologist based on medical history, patient examination, laboratory minimum using the most modern medical devices:

• Rectal examination of the gland, collection of secretions for examination (culture with determination of sensitivity to antibiotics).
• UAC, UAM, urine bacterial culture.
• Swab test for STDs, UGI exam.
• Daily monitoring of urinary rhythm, measurement of urination rate (uroflowmetry).
• For differential diagnosis, ultrasound or TRUS is performed.
• If it is necessary to exclude oncology, a biopsy is taken, urography is performed and PSA - prostate specific antigen is determined.
• To diagnose infertility, a spermogram is prescribed - an analysis of ejaculate to determine a man's fertility.

Based on the results of the patient's examination, an individual scheme for the complex treatment of prostatitis is drawn up. When prescribing medications, the form of the pathology and the presence of concomitant diseases are taken into account. The decision about where to carry out the therapy (inpatient or outpatient) is up to the doctor. The course of treatment is carried out with careful laboratory monitoring of the results.

One of the most modern prostatitis treatment centers is a specialized clinic. Because the problem of infertility is closely related to inflammatory urological diseases, medical professionals pay great attention to this problem.

In the clinics, each patient has the opportunity to undergo a full cycle of special examinations, receive psychological support, be treated with the latest generation medicines used in this area and learn about the latest methods of treating prostate inflammation. No less important in the complex therapy of prostatitis is the issue of effective rehabilitation of patients, clinical observation and prevention.

Treatment of acute prostatitis

Acute prostatitis requires bed rest, a special salt-free diet, and sexual rest.

Clear treatment methods:

• The most effective treatment for prostatitis is etiotropic therapy. If the basis of prostatitis is an infection, a series of antimicrobial agents are a priority, which alleviate the manifestations of inflammation.
• Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm analgesic solutions. NSAIDs can be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
• Physiotherapeutic methods are only possible in the subacute phase of the disease. Improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
• Massage is another effective method of influencing the prostate. Opens the ducts, normalizes blood circulation in the scrotum and pelvis.
• Acute renal filtrate retention can be corrected by catheterization and cystostomy with a trocar.
• The purulent process involves surgical intervention.
• Consultations with a psychologist.

Treatment of chronic prostatitis

With a long-term (at least a month) effect on the prostate, there is no 100% guarantee of a cure. Priority goes to herbal medicines, immunocorrection, changing domestic habits:

• Herbal preparations are widely used in urological practice. They are able to accumulate at the site of the most active pathological process, protect cells from oxidation, remove free radicals and prevent the proliferation of glandular tissue.
• Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
• Immunity-enhancing drugs not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the functioning of the immune system.
• The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
• Prostate massage allows you to mechanically remove "extra" secretion from the gland through the urethra, improve blood circulation and minimize congestion.
• Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or microenemas with herbs.
• In severe cases, intravenous fluids with diuretics are indicated. This stimulates abundant urine production, prevents symptoms of intoxication, development of ascending cystitis and pyelonephritis.
• For constipation, herbal laxatives are used.
• The urologist and psychologist, together with the patient, develop an individual long-term program of daily routine, necessary rest, diet, dosed physical activity and sexual activity.
• If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). Practiced in exceptional cases, it is fraught with impotence and urinary incontinence. Young people do not undergo surgery because it can cause infertility.

Prevention

To prevent the occurrence of a disease unpleasant for humans, it is necessary to eliminate provoking factors and follow simple rules:

• Lead a healthy lifestyle, give up bad habits.
• Don't get too cold.
• Drink at least 1. 5-2 liters of water per day.
• Strengthen your immune system, walk a lot, strengthen yourself.
• Do physical education and sports, visit fitness centers.
• Avoid stressful situations.
• Have a regular sex life with a regular partner.
• See a urologist regularly.

Questions and answers on the topic

What is prostatitis and how to recognize it?

Prostatitis is an inflammation of the prostate gland that can cause pain in the lower abdomen and problems urinating. Feeling frequent urges to go to the bathroom, especially at night, or pain when urinating may be signs of prostatitis.

Why does prostatitis appear?

Prostatitis can occur due to infection, cold, stress or even a sedentary lifestyle. Sometimes it develops after a disease of the genitourinary system.

Is it possible to completely cure prostatitis?

Acute prostatitis can be completely cured with proper treatment. Chronic forms take longer to treat, but the right approach will help reduce symptoms and prevent exacerbations.

How is prostatitis treated?

Treatment includes antibiotics (if the cause is infection), anti-inflammatories, prostate massage and physical therapy. The doctor will choose the best treatment method depending on your situation.

Can I exercise with prostatitis?

Light exercise, such as walking or swimming, is beneficial. Intense exercise can worsen the condition, so it is important to consult a doctor.

How to prevent prostatitis?

For prevention, it is necessary to lead an active lifestyle, avoid hypothermia, monitor the health of the genitourinary system and promptly treat infections. It is also important to avoid stress and follow a healthy diet.

Should I see a doctor if the symptoms go away on their own?

Yes, even if symptoms temporarily subside, it is important to see a doctor. Untreated prostatitis can lead to complications that could worsen your health in the future.

Questions and answers on the topic

Is it possible to completely cure prostatitis?

Acute prostatitis can be completely cured with timely treatment. Chronic prostatitis may require long-term therapy to control symptoms, but with the right approach, symptoms can be minimized and the patient's quality of life improves significantly.

Can I exercise if I have prostatitis?

Gentle exercise, such as walking, swimming, or yoga, may be helpful for prostatitis. However, it is best to avoid intense exercise and strength training, especially during an exacerbation. Be sure to consult your doctor before starting to exercise.

Does prostatitis affect fertility?

Prostatitis can temporarily reduce fertility, as prostate inflammation can affect sperm quality. After successful treatment of prostatitis, fertility is usually restored.

Do I need to follow a special diet for prostatitis?

Yes, if you have prostatitis, it is recommended to avoid spicy foods, alcohol, caffeine and fatty foods as they can increase inflammation. It is beneficial to eat more vegetables, fruits, whole grains and drink plenty of water.

Can prostatitis go away on its own?

Prostatitis does not go away on its own and requires treatment. Without proper treatment, symptoms can worsen, leading to complications. If symptoms appear, you should consult a doctor.

How long does prostatitis treatment take?

The duration of treatment depends on the form of prostatitis. Acute prostatitis is usually treated within a few weeks, while chronic prostatitis may require longer treatment, which can take months.

How to prevent prostatitis from recurring?

To prevent relapses, it is important to follow your doctor's recommendations, lead an active lifestyle, avoid hypothermia, eat well and have regular medical checkups.