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Prostatitis

pain in a man with prostatitis

Prostatitis is a disease in which the prostate becomes inflamed.Prostatitis, the most common symptom in men of reproductive age (20-40 years old), is diagnosed in an average of 35% of the population.

Depending on the origin, prostatitis can be bacterial or non-bacterial, depending on the nature of the course - acute or chronic.

When the first signs of prostatitis are detected, the choice of treatment depends on the form of the disease.As a rule, specific and symptomatic treatment is carried out.

Prostatitis is not a disease that can be diagnosed through imaging because it has no obvious symptoms.To promptly notice the first symptoms, you should listen to your own health.

General description

The prostate, affected by this disease, is a male-specific organ;Accordingly, prostatitis can develop only in men.If we look at a similar area in women and this is the distal third part of the urethra, or urethra, here they have Skene's glands.These glands are essentially similar to the prostate, and if inflammation of them develops, the symptoms may resemble those of prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.Thanks to this, the process of urination is controlled, moreover, it is thanks to the presence of the prostate that a certain secretion is secreted, causing the sperm to become liquid.

Quite often, prostatitis occurs in combination with diseases such as cystitis or urethritis, in elderly patients - in combination with benign prostatic hyperplasia.

Prostatitis: causes

Bacterial prostatitis, as the name suggests, develops upon exposure to related pathogens.Essentially, these are pathogens that frequently reside on the skin surface or in the gastrointestinal environment.In this case, a certain combination of factors can cause the development of prostatitis.

The causes of prostatitis include many different factors.So, this can be due to untimely emptying of the bladder, the presence of diseases of the genitourinary system, constant hypothermia, irregular sex life, sedentary lifestyle, bad habits, etc.The involvement of this type of factor either causes the possibility of bacterial agents entering the prostate, or causes disruption of blood supply to organs located in the pelvis, or leads to the development of stagnant processes.All this leads to an increase in microorganisms, as well as the development and progression of pathological inflammation.

If infectious pathogens are not detected in prostatitis, the diagnosis is a nonbacterial form of prostatitis.Many different reasons may explain this form of pathology, although none has been proven at this time.For example, some experts believe that in this form the disease can develop against the background of actual neurological disorders, while another part, on the contrary, focuses on the immunological nature of the disease in this form.These are only part of the existing theories about prostatitis.

Let's focus on acute and chronic forms of the disease.Acute prostatitis is based on the influence of bacterial factors.For chronic prostatitis, this factor is not the main factor here but only plays a secondary factor and only has an important effect at the beginning of the disease.Over time, the pathogenic mechanism can be supplemented by neurological factors, autoimmune factors or allergic factors, due to whose influence a chronic form of inflammation is maintained even in the absence of bacterial invasion.

Prostatitis: symptoms

Inflammation is accompanied by pain in prostatitis, in particular, the cause is damage to the excretory ducts of the follicular glands, from which the epithelial wall peels off, gradually accumulating mucus in the ducts.In addition, microliths also form;they look like small pebbles.Mixed with epithelium and mucus, they cause the appearance of special plugs, which in turn lead to blockage of the excretory ducts.Over time, such plugs turn into pus (or micro-abscesses), the lobules are no longer able to drain, they simply stop working.

Meanwhile, before the onset of such a stage as blockage of the excretory ducts, as a rule, it takes a lot of time, in some cases this time is calculated in months, in others even years.The process progresses gradually, the patient may not notice anything special, especially when the prostate gland produces secretions continuously.Another thing is that when these micro-abscesses form, this is already accompanied by the appearance of not very pleasant symptoms, manifesting themselves in varying degrees.

As the first symptom, the patient feels difficulty urinating.Due to the enlargement of the prostate against the background of the inflammatory process, the urethra is compressed to a certain extent.Further progression of the inflammatory process causes the development of sclerosis of the bladder neck;In an even more severe form of the pathological process, complete closure of the ureter occurs.

The next symptom is sexual dysfunction.Due to the pathological processes that occur during the disease, the erection mechanism is disrupted, orgasm is impaired.

There are also other signs of prostatitis, especially including:

  • the appearance of a burning sensation in the urethra and perineum;
  • persistent and frequent urination;
  • the appearance of discomfort during bowel movements;
  • “floating fibers” in urine;
  • the appearance of prolonged urethral discharge during defecation;
  • the appearance of persistent nocturnal erections;
  • Intermittent and difficult urination;
  • ejaculating too quickly;
  • increased general fatigue;
  • decreased potency;
  • orgasmic expression in erased form;
  • The expectation of the development of other forms of complications in the area under consideration, against the background of the appearance of anxiety and general mental weakness.

I would like to add separately that the listed signs (symptoms) do not necessarily appear overnight.The disease is characterized by a very variable pattern of presentation, which applies to different variations in each patient and different time periods during treatment.

When looking at the symptoms, it is helpful to go back to the cause.Naturally, the inflammatory process will not appear "unexpectedly".We are mainly talking about the pathogens mentioned above.Meanwhile, this factor has formed a misconception about the presence of some agents that cause prostatitis, which is still supported by many experts today.However, there is no specific pathogen for this disease.At the same time, any chronic infectious disease can cause prostatitis;it can be of any type, be it sinusitis, tonsillitis, cholecystitis or any other disease.In this case, the pathogen can enter the prostate through the bloodstream, which is characterized by a fairly strong blood supply (otherwise its function would be in doubt).

There is a certain risk group for prostatitis, in particular the following people fall into this group:

  • people whose occupational activities fall under the criteria of "sedentary" work;
  • people with a sedentary lifestyle;
  • people who have previously been diagnosed with a specific genital tract infection;
  • those who are concerned with the problem of chronic constipation;
  • promiscuous people;
  • people whose family relationships do not fall within the standard of order;
  • alcohol abusers.

Most often, men are diagnosed with “bacterial prostatitis”, “prostatitis in the prostate stage”.If a man is diagnosed with prostate disease, we can say that at this stage there is nothing special to worry about.Meanwhile, you will have to make certain adjustments in your lifestyle.In other words, what we are talking about here is that the above stasis phenomenon has occurred but there has not been any inflammation, which is related to prostate enlargement.If an option such as bacterial prostatitis is considered, then here we are talking about the beginning of the development of the inflammatory process in a man, but so far there is no accompanying infection.

A distinctive feature of prostatitis is that it practically does not manifest itself in an acute form.In other words, when it manifests, it is already a chronic process, which is explained by its frequent and long-term development.Complete recovery due to treatment of the disease or due to spontaneous disappearance of the pathological process is estimated in individual cases during the initial acute phase.The disease is characterized, as already noted, by an extremely slow progression, the manifestation of symptoms often having a mild form.

Prostatitis: consequences

Acute prostatitis, if its manifestations are ignored and the search for medical help is excluded, can cause the development of an abscess in the prostate, that is, the cause of the development of localized inflammation with pus in it.This is accompanied by an increase in temperature (within 39-40 degrees), which at the same time becomes boiling, that is, its difference exceeds one degree.Patients also experience high fever, sometimes leading to chills.The pain in the perineum becomes so severe that it causes difficulty urinating, and defecation becomes almost impossible due to the pain.After a while, the prostate will swell, thereby causing acute urinary retention.Meanwhile, acute prostatitis, which manifests itself against the background of a chronic diffuse pathological process, is rare - unless, at his own risk and risk, a man “suffers and endures”.

Returning to chronic prostatitis, we can say that it is characterized by fluctuations of its own course, that is, periodically the symptoms of the chronic form of prostatitis appear more intense, and periodically they are practically not felt.Because of this type of change, many patients choose a wait-and-see approach.Meanwhile, as pointed out above, the inflammatory process can become more severe and spread more and more.As it spreads, pyelonephritis can even develop.Meanwhile, complications of prostatitis in most cases are caused by diseases such as seminal vesiculitis, in which the inflammatory process affects the seminal vesicles, as well as epididymitis, in which the testicles and appendages are inflamed.Due to the transfer of the disease in a similar form of spread, one can indicate the development of infertility in a man.Infertility treatment is a long and complicated process, and in some cases is completely impossible.The listed characteristics primarily belong to the development of a chronic form of prostatitis, to the specific cause of its occurrence (in particular, we are talking about STD).

Diagnose

Examining patients to determine their specific type of prostate pathology can be done in a variety of ways.Meanwhile, in each specific case, an individual approach to the problem at hand is very important, on the basis of which a diagnostic option can be determined to obtain enough information about the disease.

To begin with, the doctor conducts a survey of the patient's complaints, studies the medical history, if any, based on it, then draws preliminary conclusions and determines the principles of an individual diagnostic algorithm.We would like to add that the first consultation with a urologist (namely, this is the specialist you should visit if worrying symptoms of prostatitis appear) is not final and reliable in making a diagnosis, because the first examination is only an opportunity for the doctor to determine what further diagnostic measures are necessary.

Due to the sensitivity of the issue, men are interested in what questions a urologist will ask if they suspect prostatitis.In particular, he will ask about current problems related to urination, as well as how the patient himself evaluates his sexual function (i.e. has there been any change, what exactly has changed, since what period).In addition, the doctor will ask what diseases you currently have, etc.

This is followed by examination, especially external examination, rectal examination, laboratory and instrumental examination.During an external examination, the doctor will examine the man's genitals, determining whether they are accompanied by rashes, irritation, discharge, etc.or not.

Then, after the external examination, the doctor moves on to the next stage which is a rectal examination.Rectal examination helps determine the general outline of the prostate, its consistency, boundaries, etc.

After this, you will need to obtain results from instrumental and laboratory diagnostics.Diagnosis is by an instrument called TRUS, which in expanded form means transrectal ultrasound.This is the most accurate method of determining pathology in men compared to conventional ultrasound.

As for laboratory tests, this includes smear tests, urine tests, prostate secretion tests, PCR (laboratory test for sexually transmitted diseases).

Based on the current classification of diagnostic methods for prostatitis, only microscopic examination of secretions obtained from the prostate, as well as any local diagnostic methods that can detect the presence of an inflammatory process in the lower genital tract, can be considered a necessary option.Other types of diagnostic methods only serve as clarifying methods;they are essential for differential diagnosis and identification of existing complications of the underlying disease.In addition, it is important to remember that when overdiagnosed, the period will be prolonged and symptoms will only get worse.That is, here, as in any problem, the principle of the "golden mean" is appropriate.

Treatment of prostatitis

Treatment of prostatitis today is a serious matter, although this does not mean that the doctor cannot help and should leave this disease to chance.Indeed, it is not always possible to completely cure prostatitis, but it is possible to eliminate its symptoms and achieve long-term and sustainable remission.Depending on how seriously a man takes his doctor's recommendations, how long remission will last.

At its core, the treatment of prostatitis can include a number of measures, especially antibacterial therapies, prostate massage, immunotherapy, physical therapy and general adjustment of the patient's lifestyle.Only on the basis of a set of these measures can the desired result be achieved;In general, the disease is difficult to treat so it cannot be ignored.

Antibacterial therapy

This type of therapy is considered the basis of conservative treatment.The basis for the choice of antibacterial drugs is a number of factors, in particular:

  • the possibility of the components of the proposed drug entering the prostate secretions and tissues to produce concentrations exceeding the MIC value of the pathogen;
  • characteristics of the spectrum of antibacterial activity (for example, the use of macrolide antibiotics determines their good penetration into prostate tissue, while they do not have any activity against gram-negative bacteria, namely they are the main pathogens when considering the acute form of prostatitis).

It is worth noting that acute prostatitis, when compared with the chronic form of the disease, is characterized by the fact that it allows the possibility of accumulation of aminoglycoside and beta-lactam antibiotics in the tissues of the gland and in concentrations sufficient to suppress the activity of most types of pathogens.This is due to increased perfusion of the prostate, as well as an increased degree of permeability of the prostate hemostatic barrier.Another feature of the drugs in this group is that as inflammation decreases, their penetration into the prostate also decreases.For this reason, switching to another oral medication is recommended.

Prostate massage

Most experts consider this method of action to be quite an effective solution in the treatment of prostatitis.The basic principles to achieve effective treatment in this case are as follows:

  • restore duct patency;
  • improves muscle tone and blood circulation in the prostate;
  • increased penetration of used antibiotics into glandular tissue;
  • the ability to activate microorganisms in a dormant state, thereby improving the sales results of antibacterial drugs.

How is prostate massage performed?Of course, to begin with, it is important to establish a certain bond of trust between the doctor and the patient;This will ensure greater relaxation of the patient, which, in turn, will help perform the necessary manipulations with minimal pain and maximum effectiveness.When preparing for massage, the patient leans forward, spreads his legs about 60 cm wide and puts his elbows on the examination table.The doctor puts on gloves and applies gel to the index finger (sometimes this gel has a pain-relieving effect).Next, with his other hand, he spreads his buttocks so that he can palpate the anal sphincter with his index finger.The natural reaction to such contact is muscle contraction.Next, after relaxing them, the index finger is inserted into the rectal bulb.

In some cases, patients experience dizziness and even fainting when performing these manipulations (on average in 10% of cases).These manifestations are mainly due to fear, shame and excessive anxiety, and if the massage is performed properly they are not accompanied at all.Massage can be called successful when at least 4 drops of secretions secreted by the prostate gland are obtained.

The most commonly recognized method used in the treatment of chronic prostatitis is massage according to the Manila Protocol.In this case, massage is performed three times a week, a microbiological kinetic study is also performed, and antibiotics are used.

Immunotherapy

This approach in the treatment of prostatitis is often extremely necessary, because with prolonged inflammatory manifestations combined with previous incorrect antibacterial treatment, the possibility of a negative impact on the general condition of the immune system cannot be excluded.Treatment of prostatitis requires not only the removal of infection from the gland and, in fact, inflammation, but also the prevention of recurrence of inflammation in it.However, like other areas of treatment, immunotherapy should not be reduced to self-medication or treatment based on the recommendation of a pharmacist at a pharmacy;Here you will need to consult an immunologist, and most likely, take some tests.

Physical therapy

For prostatitis, this direction of treatment can be carried out according to various action options, however, regardless of the specific solution, the action is focused on improving blood circulation in the pelvic organs, thereby increasing the overall effectiveness of carrying out antibacterial therapeutic measures.Physical therapy can use ultrasound, electromagnetic waves, laser therapy, direct rectal heating, and more.If there is no opportunity for physical therapy, your doctor may recommend microenemas with warm water and certain medications.

Adjust your lifestyle

This type of effect is aimed at both treating prostatitis and preventing the disease.It should be treated in the same way as the main treatment, because if the factors that led to the development of prostatitis remain, then sooner or later the disease will relapse on its own.Taking this into account, you should make certain changes in your life, this applies to playing sports, normalizing your wake/sleep schedule, nutritionally balanced diet, walking, getting rid of bad habits.

If symptoms suggestive of prostatitis appear, you should consult a urologist.