According to statistics, one in three men of working age suffers from prostatitis at different stages of life. Constant pain, impotence, infertility - this is not a complete list of the problems that threaten patients in the absence of treatment. Due to the high urgency and danger of the disease, all men need to know about its symptoms and initial manifestations. In this article, you will learn about all the signs and diagnostic methods that allow you to recognize prostatitis.
The clinical picture in the early stages of development
Prostatitis is an inflammatory lesion of the male prostate. The following forms of the disease are distinguished: acute and chronic bacterial prostatitis, chronic pelvic pain syndrome, asymptomatic prostatitis. Each form manifests itself in different ways, has signs and characteristics that are characteristic of the course.
It is difficult to say how the disease will progress in each individual man. The presence of certain signs depends on a number of external and internal factors. To facilitate the characterization of the pathology, it is customary to divide all the symptoms of prostatitis into 3 large groups: those associated with urination disorders, sexual dysfunction, mental problems. The first and most important symptoms of prostatitis (except the asymptomatic form) may be the following signs in a man:
- Pain in the pelvis, back, groin area.
- Pain and burning during the act of urination.
- Difficulty urinating.
- Sensation of incomplete emptying of the bladder and false urge to urinate.
Pain in the pelvis, back, groin, a feeling of incomplete emptying of the bladder and a false urge to urinate are signs of prostatitis.
The symptoms listed are due to impaired urinary function, due to the anatomical features of the structure and the location of the bladder and prostate. Signs of prostatitis associated with sexual dysfunction are also prominent and pronounced. Men most often make the following complaints:
- Weak erection.
- Rapid onset of ejaculation during intercourse.
- Lack of orgasm or decreased sensitivity.
- Pain in the urethra and rectum during ejaculation.
Problems with urination and difficulties in intimate life due to inflammation of the prostate greatly disturb the man. Patients with prostatitis are forced to change their way of life, to deprive themselves of their habits, family relations become complicated. Obsession with your problem causes increased nervousness, anxiety, decreased libido, which can be called indirect signs of prostatitis, belonging to the third group of symptoms above (mental disorders).
Prostatitis in men can often be confused with prostate adenoma or cancer, a pathology of the bladder. All of these diseases appear in the same way, especially in the initial stages. It is very difficult to distinguish them for an unprepared person, therefore, the differential diagnosis is made by analyzing all the existing objective symptoms, laboratory and instrumental research data. Since each form of prostatitis has specific signs and characteristics, it is prudent to consider them separately.
Features of some forms of the disease
Acute prostatitis is inflammation of the male prostate caused by the entry of an infectious agent into the organ through the blood, lymph or urethra. The disease begins suddenly and is characterized by the severity of all clinical signs. The main symptoms of acute prostatitis:
- The increase in body temperature to 39-40 degrees.
- Symptoms of general intoxication (headache, weakness, fatigue, reduced performance, etc. ).
- Severe pain in the perineum, sacrum, above the pubic joint of a man.
- Frequent and painful urination.
- Sometimes men have urinary retention.
The temperature of 39-40 is a clear sign of inflammation of the prostate.
Acute inflammation of the prostate usually ends with a recovery or chronization of the process (symptoms may bother for several months). But most often this form of prostatitis is primary and results from the presence of bad habits (alcohol abuse, smoking, etc. ), a sedentary lifestyle, a deficiency in vitamins and minerals, prolonged sexual abstinence, or results from an aggressive non-sexually transmitted infection or ingestion of microflora of normal agents. The clinical picture of chronic prostatitis seems thinner compared to the acute form, the symptoms of the disease are inconsistent, which greatly complicates the diagnosis. For the chronic form of prostatitis, the following symptoms are most typical:
- Increased need to urinate, including at night.
- Pain during urine and also during ejaculation.
- Dull, aching pain in lower back, pelvis, above chest, etc.
Chronic pelvic pain syndrome (CPPS) in a man combines recurrent pain in the prostate area, temporary disorders of the urinary and reproductive systems. CPPS in medicine is a broader concept, since pathogenetically the pathology may be based on tumor or ischemic process, nervous system disorders and not just inflammation. The inconsistency in the presence of signs of prostatitis in chronic pelvic pain syndrome significantly complicates the diagnosis, but it is much more difficult to do in the asymptomatic form. In these cases, the main and decisive role is played by the data of laboratory and instrumental research methods.
Diagnostic techniques
Based on the symptoms of prostatitis alone, a definitive diagnosis cannot be made. In addition, doctors should collect the anamnesis: information about the time of onset of symptoms, their connection with main and significant life events, physical and mental shocks, all possible predisposing factors are clarified, etc. . A physiological examination is always performed - a digital rectal examination in the knee-elbow position of a sick man, lying on his side with his legs bent or standing with the body bent forward. During this study, you can find characteristic signs of prostatitis (the presence of everything is not necessary):
- Enlargement of the size of the male sex gland.
- The shape of the organ is correct or flattened with a depression.
- Dressed or pasty consistency.
- Softness of the edges of the prostate.
- Increased pain with pressure.
Further examination of a patient with symptoms of prostatitis is supplemented by laboratory methods. General and biochemical blood tests are prescribed - there are no specific changes in the indicators, only indirect signs by which to judge the presence of an inflammatory process in the body of a man (increased number of leukocytes, acute phase proteins, accelerated ESR). The results of urine analysis will be valuable, which will allow to judge the presence of an infectious process in the genital tract, will help to determine the pathogen to begin etiological treatment. In addition, urologists may order an analysis of the secretion of the prostate, a spermogram.
Among the instrumental methods of diagnosing diseases of the prostate, the most informative is TRUS - transrectal ultrasound. In this case, a special sensor is used, which the doctor inserts into the rectum. This causes discomfort for a sick man, but is compensated by the informative content of this method. With the help of TRUS, it is possible to assess the structure of the organ, judge the presence of tissue inflammation, the degree of narrowing of the urinary tract, and exclude the presence of stones. The main echo signs of prostatitis: increased organ size, edema, fibrosis, changes in sclera tissue, coarse-grained and heterogeneous structure.
Additionally, patients with symptoms of prostatitis undergo uroflowmetry - a special diagnostic manipulation in which a man's urination rate is measured. Based on the data from this study, conclusions can be drawn about the degree of urethral stricture, detrusor activity. Uroflowmetry should not replace TRUS, but rather confirm its findings and signs of existing prostatitis.
The diagnostic examination plan for prostatitis can be expanded if indicated in a man. To clarify individual points regarding the diagnosis, a cystoscopy, CT scan of the pelvis can be performed. In unclear cases, a biopsy is performed for differentiation with tumor processes.
What to do when the first symptoms appear
The most serious and common mistake many men make when showing signs and symptoms of prostatitis is waiting. Each patient hopes that the unpleasant symptoms are temporary and will go away soon. Untreated prostatitis is dangerous to health, leads to irreversible changes in the body, which are fraught with impaired erection mechanism, infertility or, even worse, malignancy of the process (transition to cancer).
In order to avoid serious complications, any man at the first signs of prostatitis should consult a urologist who will prescribe treatment. First of all, men are given etiotropic therapy - anti-inflammatory drugs, antibiotics are used, measures are taken to strengthen the immune system. No operation is necessary in the absence of complications. Men who have had prostatitis in the past are at risk and there is a high likelihood of recurrence. Therefore, after healing, an important role is given to prevention.