Every second man of childbearing age (up to fifty) is subject to such a delicate disease as acute prostatitis, in which, under the influence of certain factors, the prostate (prostate gland) becomes inflamed, causing variousforms of disorders of sexuality functions, fertility and psycho-emotional states. Pay attention to what your body is saying and don't neglect prompt treatment.
What is acute prostatitis
If a man feels discomfort and even pain during urination, you should immediately consult a doctor, since acute prostatitis is a disease of infectious etiology that causes inflammation of the prostate gland, followed by the formation of edema of the tissueglandular, from the formation of purulent foci on it. If you do not pay attention to the signs of acute inflammation of the prostate, the pathological process can turn into a chronic form that is difficult to treat, and the time for reflection is very short - the transformation occurs within a few days.
However, more serious complications are possible than its transition to a chronic form. There is a risk of sepsis - a general blood infection and ascending urinary tract infection with the development of pyelonephritis and cystitis. In these cases, the patient is urgently hospitalized, the condition may be critical. Although sepsis as a complication is rare, it can occur in patients with immunosuppressive conditions - intoxication, fever, severe symptoms, weakness. Therefore, blood cultures are needed to detect microorganisms.
Symptoms of acute prostatitis
Every man should know and remember the symptoms of acute prostatitis. General signs of the disease are manifested:
- Sharp pain when urinating.
- Body poisoning.
- Disorders of urination (intermittent jet, weak, tense).
- Frequent urge to go to the toilet at night.
These are external symptoms of prostatitis, but with further study, leukocytes, traces of mucus and pus in the secretory fluid of the prostate are found in the urine. On palpation, a dense and enlarged organ is felt, the pressure will be painful. The further development of the inflammatory process is characterized by heaviness and pain in the perineum, radiating to the penis, sacrum and rectum. As a result, it becomes difficult for the patient to empty the bladder and defecate due to severe pain. Body temperature can rise to 38°C.
Causes of acute prostatitis
Since this disease is bacterial inflammatory in nature, the following infectious agents cause acute prostatitis:
- Gram negative - Klebsiella, E. coli, Proteus.
- Gram positive - enterococci, staphylococci, streptococci.
- Urogenital - trichomoniasis, chlamydia, ureaplasmosis, gonorrhea, candidiasis, mycoplasmosis.
The microbial microflora enters the glandular tissue of the prostate, as a rule, through the transcanalicular route (through the urethra and the excretory ducts of the prostate). In cystitis, the infection migrates to the prostate from the bladder. Other possible routes of bacterial penetration are open during endourethral manipulations (catheter placement, urethral candlening, cystoscopy, urethroscopy). Pathogenic microorganisms migrate into the prostate from distant pathogenic foci in caries, sinusitis, tonsillitis, cholecystitis, pyoderma, bronchitis.
There is a high probability of infection of the intestines with proctitis, hemorrhoidal fissures, colitis. Non-infectious factors that can provoke an attack of prostatitis are congestive (congestive) venous phenomena in the pelvic region and impaired drainage of the acini of the gland. Congestion can be caused by irregular or, conversely, excessive sexual activity, interruption of sexual intercourse, sedentary lifestyle, frequent constipation, frequent alcohol intoxication, varicose veins of the small pelvis, hypothermia.
Forms of acute prostatitis
The clinical development of this disease is considered in three stages, which are at the same time forms of acute pancreatitis. It is:
- The first stage is the catarrhal form.
- The second stage is the follicular form.
- The third stage is the parenchymal form.
Acute prostatitis in men begins with catarrhal inflammation, which is characterized by the expansion of acini, the occurrence of edema of glandular tissue and, as a result, an increase in the size of the organ. The excretory ducts of the prostate glands, which open into the posterior urethra, are actively involved in the inflammatory process. The lobules and ducts of the prostate become inflamed, their contractility is disturbed, they narrow and clog, which can make it difficult to secrete the secret of the prostate.
In the catarrhal stage, the pathological process stops at the mucous layers and goes no further. In the process of progression, the disease spreads to the entire prostate. Acute bacterial follicular prostatitis develops. On the analysis in urine pus comes to light. The tissues of the gland change destructively, the swelling continues to increase. The follicular form still lends itself to relatively easy treatment.
Also, a parenchymal form of the disease develops, the result of which can be an abscess of the prostate, that is, chronic prostatitis. Consequently, symptoms such as:
- An increase in body temperature to 39 ° C and above.
- Manifestations of intoxication: weakness, chills, thirst, lack of appetite.
- Frequent urges to go to the toilet for small needs are accompanied by sharp, stabbing pains.
- Inability to empty the bladder.
- Flatulence.
- Tenesmus.
- Constipation.
- Discharge of mucus from the anus.
Diagnosis of acute prostatitis
At the first suspicion of inflammation of the prostate, hurry to the doctor. A correct and complete diagnosis of acute prostatitis is very important for prompt and effective treatment. The doctor will first analyze the history, specify when pain sensations appear in the perineum, whether they increase or decrease during ejaculation, urination, defecation. Be sure that the doctor should study the patient's medical history: what diseases were transferred, whether there were sexually transmitted infections.
The urologist will palpate the external genitalia to determine developmental pathologies, visible signs of prostatitis, and rectal examination - palpation of the prostate through the anus. To create a complete clinical picture, it will be necessary to undergo the following examinations:
- Urinalysis to determine the level of leukocytes and the presence of purulent threads.
- Blood test.
- Culture smear - the contents and scraping from the urethra are taken to determine the growth of bacteria and their susceptibility to antibiotics.
- Determination of urine velocity (urine flowmetry).
- Ultrasound of the prostate to detect diffuse changes in the gland and its abscess formation.
- A blood test to determine the presence of pathogens of diseases such as syphilis, gonorrhea, mycoplasmosis, chlamydia.
- PCR diagnosis.
Treatment of acute prostatitis
After a thorough diagnosis, they begin treatment of acute prostatitis. It is based on antibiotic therapy, the purpose of which is to suppress infectious pathogens. Additionally, conservative treatment of prostatitis includes the use of:
- Anti-inflammatory drugs.
- Means that improve blood circulation.
- Analgesics and antispasmodics.
- Drugs that support metabolic processes in the prostate.
- Multivitamins.
- Phytotherapeutic agents.
- Immunomodulators.
Advanced forms of inflammation of the prostate with the appearance of purulent foci require surgical intervention. Transurethral (through the wall of the urethra) or transrectal (through the wall of the anus) drainage of abscessed areas is performed. Surgery may be necessary in case of pathological urinary retention. A puncture epicystostomy is performed - an incision is made in the abdominal cavity, into which a tube is inserted to divert urine.
medications
Treatment of acute prostatitis in men with drugs (tablets, injections) is the basis of successful treatment. With properly prescribed antibiotic therapy, the infection can be overcome within a few days. However, it is recommended to continue treatment for four weeks in order to achieve complete eradication of pathogenic microflora. The drugs used in the disease are:
- Etiotropic (antibiotics) - destroy pathogens.
- Pathogenetic (NSAIDs) - eliminates prostate congestion.
- Symptomatic (analgesics, antipyretics) - relieves pain, muscle spasms of the organ and other symptoms.
To treat inflammation of the prostate, the doctor may prescribe a complex of drugs, which will include:
- Injections - contribute to the penetration of the drug into the tissues of the body in a short time.
- Candles (rectal) - analgesic, antibacterial effect.
- Instillations - administration of the drug to the prostate through the opening of the urethra.
- Microclysters with herbal decoctions.
- Broad-spectrum antibacterial drugs, if a specific causative agent of the disease is not identified.
Antibiotics for acute prostatitis
The main causative agents of prostatitis are pathogenic bacteria that cause inflammation of the tissues of the prostate. Therefore, antibiotics for acute prostatitis are the mainstay of treatment and are prescribed only after testing the sensitivity of microflora. Antimicrobials used for inflammation are divided into the following groups:
- Fluoroquinolones.
- Penicillins.
- Cephalosporins.
- Macrolides.
- Tetracyclines.
- Aminoglycosides.
Prevention of acute prostatitis
In order for a man to always be healthy and full of strength, the prevention of acute prostatitis is important, including:
- Regular sex life with a regular partner, excluding casual relationships.
- Use of condoms.
- Stop smoking, drugs, alcohol.
- Adequate nutrition.
- personal hygiene.
- Annual preventive examinations at the urologist.
- Take vitamins and zinc preparations.
It is important to completely cure diseases of the genitourinary organs (urethritis, cystitis, pyelonephritis, balanoposthitis). Undertreated diseases can provoke the development of an inflammatory process in the prostate. Among other things, one should not forget to increase physical activity. In the cold season, hypothermia should be avoided. Prostate massage is very useful for men's health. However, if the disease has already made itself felt, massage is contraindicated and even impossible due to the pain of the organ.