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Prostatitis in men

Prostatitis is an inflammatory process affecting the tissues of the prostate.This is one of the most common diseases in the practice of a urologist.The disease is diagnosed mainly in men aged 25-30 years, but at older ages the risk of developing pathology increases significantly.

The form distinguishes between acute and chronic prostatitis.In the latter case, the inflammation is characterized by a long course with periodic relapses.This condition is much more common than acute.

Causes of prostatitis

Many prostate diseases, for example benign hyperplasia or oncopathologies, are problems that affect older people.However, prostatitis does not fall into this category.Its symptoms generally appear in men between 30 and 50 years old.Most often, the cause is an infectious lesion due to the penetration of pathogenic flora from the urogenital canal or glands of the genitourinary system.This is explained by the proximity of the urethra and the anus.

Among the most common causative agents of bacterial (infectious) prostatitis, it is worth noting gram-negative organisms: pseudomonas, Escherichia coli, Serration, Enterobacter and Proteus.Often, the inflammatory process develops against the background of infection with STIs: chlamydia, gonococci, trichomonas, herpes viruses, etc.As a rule, these forms of the disease are diagnosed in men under 35 years old.Cases of treatment of pathology against the background of infection with Mycobacterium tuberculosis are extremely rare.

There are also nonbacterial types of prostatitis.Among their main reasons:

  • increased pressure in the prostate;
  • autoimmune diseases (destruction of prostate cells by antibodies);
  • muscle pain syndrome in the pelvic region;
  • psychoemotional disorders;
  • deficit of motor activity;
  • excessive physical stress.

Primary signs of prostatitis

a man showing signs of prostatitis

The disease is accompanied by a set of disorders that affect the functioning of the entire urinary system.Among the main symptoms:

  • uncontrolled urination;
  • discomfort, pain when emptying the bladder;
  • potency disorder in men of childbearing age;
  • pain in the perineum during prolonged sitting;
  • frequent and strong urge to urinate;
  • difficulty emptying the bladder;
  • decreased libido and erection problems;
  • reproductive dysfunction (infertility);
  • sensation of incomplete emptying of the bladder after going to the toilet;
  • inability to achieve a long-lasting, high-quality erection, even with strong arousal.

Signs of acute prostatitis

Symptoms of the disease in acute form and the general clinical picture differ depending on the stage of the pathological process:

  • Catarrhal.The patient complains of frequent urges, pain when urinating, pain in the perineum and sacrum.
  • Follicular.The pain syndrome becomes intense, can radiate to the anus and intensify during defecation.Urine is released in a thin stream.In some cases there is a delay.There is an increase in body temperature up to 38 degrees over a long period (mild fever) or moderate hyperthermia.
  • Parenchymal.The man begins to feel general intoxication of the body with chills and a temperature of up to 38-40°C.The pain in the perineum becomes sharp and throbbing.The act of defecation is difficult and normal emptying of the bladder is impossible, leading to acute urinary retention (dysuria).

Symptoms of chronic prostatitis

The chronic form of prostate inflammation can be a consequence of the absence or untimely treatment of the acute phase.However, in many men it develops immediately and is characterized by “blurred” symptoms.Among the main signs are:

  • mild fever (occasionally);
  • slight pain in the perineum;
  • discomfort when urinating;
  • scanty discharge from the urogenital canal during defecation.

In general, the clinical picture evolves over time, differs in intensity between patients and can become masked when self-medication is attempted.Symptoms of a chronic disorder may include a burning sensation in the urethra, pressure in the perineum, dysuria, impaired sexual function, and increased general fatigue.Against the background of potency problems, mental depression, irritability and anxiety arise.Fear of impotence leads to the development of complexes, but most men tend to delay visiting a urologist due to a feeling of shame.

Primary chronic prostatitis develops over a long period of time.Stagnation of blood in the capillaries (prostatosis) causes the initial stage of non-bacterial inflammation, which leads to the onset of the disease.

With an infectious etiology, the cause of the disease is a chronic inflammatory process due to infection with trichomonas, ureaplasma, chlamydia or gonococci.The primary infection masks the signs of prostatitis and its treatment does not eliminate the inflammation of the prostate.Often the addition of a concomitant problem remains unnoticed by a man.

Let's take a detailed look at the three main symptoms of chronic prostatitis:

  • Urinary disorder (dysuria).The inflammation increases the size of the prostate, which causes compression of the ureter.As its lumen decreases, a frequent urge to urinate and a feeling of incompletely empty bladder appear.Dysuric disorders in many men occur in the early stages of prostatitis.The compensatory mechanism during this period is manifested by hypertrophy of the muscles of the bladder and ureters, which reduces the symptoms of dysuria, but with the development of inflammation they increase again.
  • Pain syndrome.There are no pain receptors in prostate tissue.Pain occurs when the inflammatory process spreads to other pelvic organs and their nerve pathways.The sensations range from mild and painful to very intense, which disrupts nighttime rest.Increased discomfort occurs with ejaculation, sexual abstinence or excessive sexual activity.The pain radiates to the perineum, sacrum, scrotum and sometimes to the lumbar region.
  • Power violation.Lack of treatment in the early stages of prostatitis can lead to dyspotency, when a man experiences frequent nocturnal erections, deterioration in the quality of orgasm and accelerated ejaculation.In different patients, these signs manifest themselves with different intensity.Premature ejaculation occurs due to a decrease in the threshold of excitability of the orgasmic center.In this case, the patient feels pain, which leads to the development of pain anticipation syndrome and a gradual renunciation of sexual activity.In the absence of comprehensive treatment that takes into account the mental factor of the disorder, sexual disorders become more and more serious.Ignoring the need to see a doctor in case of prostatitis often results in impotence.

The degree of sexual dysfunction varies depending on individual factors.Some men are so afraid of erectile dysfunction that their problems are due to suggestions rather than objective physiological factors.In particular, psychogenic dyspotency is observed precisely with increased anxiety and obsessive complexes.The very idea of possible male health problems is difficult for these patients to bear.This greatly affects their character and communication with others.Irritability, hypochondria, bad mood and depression appear.

Complications of prostatitis

Lack of adequate treatment of prostate inflammation leads to concomitant diseases.The fact is that the prostate is closely related to other organs of the male genitourinary system.It is located around the bladder neck and urinary canal.Therefore, when the prostate enlarges, the urethra is compressed and the normal flow of urine is disrupted.Taking into account the peculiarities of physiology, if acute or chronic prostatitis is not treated in time, a number of serious pathologies and complications arise.

Related issues:

  • formation of cysts, prostate stones;
  • decreased amount of male hormones produced;
  • decreased sexual desire (libido);
  • erectile dysfunction (erectile dysfunction);
  • infertility (in 40% of patients with chronic prostatitis);
  • prostate adenoma (benign tumor);
  • prostate cancer.

Certain consequences of prostate inflammation, which are not subject to rapid and comprehensive treatment, pose a threat not only to health, but also to the life of the patient (oncological pathologies in particular can develop).Therefore, at the first symptoms of prostatitis, you should consult a urologist.Also, do not forget about regular preventive examinations after 40 years, when the risk of pathological processes in the prostate increases significantly.

Diagnosis of prostatitis

Many urological problems have similar symptoms, therefore the specialist works separately with each clinical case and uses all available diagnostic tools.A consultation with a urologist always begins with an investigation of symptoms, medical history and a general examination.Then the doctor prescribes a series of tests, based on the results of which a diagnosis is made and adequate treatment is selected.Typically, the exam package includes:

  • digital rectal examination of the prostate to determine the size, structure of the prostate, and level of compression of the urethra;
  • Ultrasound of the urinary system (prostate, bladder, kidneys);
  • laboratory tests of urine, prostate secretion, ejaculate;
  • tests for urogenital infections;
  • urodynamic study.

To ensure an accurate diagnosis of prostatitis in men and related disorders, you should refrain from urinating for 2-3 hours before visiting a urologist.Otherwise, the test results may not be entirely correct, because when the bladder is emptied, the pathogenic microflora is eliminated.In accordance with the characteristics of the clinical picture, the method of performing ultrasound is chosen: transrectal or abdominal (through the abdominal wall).After determining the cause and stage of the disease, a therapeutic strategy is developed.

Methods for treating prostatitis

The main treatment is antibiotics.The use of modern pharmacological developments gives high results, although it is impossible to completely eliminate the risk of relapse.The doctor prescribes an antibacterial medication after culturing urine and/or prostate secretions depending on the type of pathogen.If acute prostatitis is diagnosed, oral antibiotic therapy takes approximately 4 to 6 weeks.In chronic or recurrent forms of the disease, treatment will be longer (depending on the clinical picture).In severe cases (usually acute bacterial prostatitis), hospitalization and intravenous antibiotic treatment are necessary.

In case of difficulty urinating, the urologist prescribes drugs that relieve hypertonicity of the muscles of the bladder and prostate, which normalizes the flow of urine and prevents stagnation.Some patients are treated with medications that reduce sex hormone levels.This results in a decrease in the size of the prostate and, consequently, a feeling of discomfort during urination, defecation and ejaculation.In case of severe swelling of the prostate, muscle relaxants help relieve overstrain of the bladder sphincter and adjacent muscles.Nonsteroidal anti-inflammatory drugs effectively combat pain.In addition, chronic prostatitis responds well to auxiliary physiotherapy.Effective methods of such treatment are:

  • instillation of drugs into the urethra;
  • prostate massage;
  • shock wave therapy (SWT);
  • magnetic laser therapy (MLT);
  • electrophoresis;
  • ozone therapy;
  • intravenous laser blood irradiation (ILBI);
  • ultraviolet blood irradiation (UFOI).

Prostate massage is a frequently used urological technique.The doctor uses the method of digital stimulation of the prostate through the rectum to improve the flow of secretions and restore the permeability of the organ's ducts.An additional effect is improved blood circulation and accelerated penetration of antibiotics into inflamed tissues.In addition to prostate massage with fingers, hardware methods are also possible.Shock wave therapy gives good results in the treatment of prostatitis.The basis of this medical technology is short-term exposure to low-frequency sound waves on the inflamed area.The procedure helps to:

  • activate local blood circulation and new vessel growth;
  • stimulate the body’s own regenerative capabilities;
  • destroy fibrous foci and calcifications that cause pain and inflammatory processes.

After shock wave therapy, the symptoms of prostatitis are relieved and a good preventive effect is observed.Pronounced results can only be achieved with an integrated approach to the problem.In addition, the patient's responsible attitude towards medical prescriptions is important.

For their part, the clinic's urologists ensure the development of an individual treatment regimen, taking into account the cause, form, stage of the disease, general well-being and the presence of concomitant pathologies.

Prostatitis prevention

To minimize the risk of relapse, it is necessary to reduce the negative effects on the body.Among the provoking factors are:

  • Smoking.The anatomical features of the location of the prostate lead to a constant lack of oxygen, and inhalation of tobacco smoke causes vasospasm, which further slows down local microcirculation processes.All experienced smokers have a problem with high blood pressure.
  • Motor activity deficit.“Sedentary” work and a sedentary lifestyle lead to congestion of the pelvic organs.
  • Alcohol abuse.Exceeding the daily alcohol limit affects overall health and makes the body more vulnerable to various infectious diseases.
  • Stressful conditions.It is necessary to avoid situations that lead to anxiety, irritant and depressive disorders as much as possible.If necessary, you should contact a specialized specialist.
  • Hypothermia.Exposure to low temperatures reduces immunity, making the body “open” to colds and inflammation.
  • Fatigue, excessive physical activity.You should not forget the work and rest schedule, or lift heavy weights.

Preventive measures will help prevent the development of acute prostatitis and relapses of chronic prostatitis.For questions regarding the diagnosis and treatment of prostate inflammation, you can always contact the urology department of our clinic.