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Prostatitis

pain in a man with prostatitis

Prostatitis is a disease in which the prostate gland is inflamed.Prostatitis, whose symptoms are most common in men of reproductive age (20-40 years), 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 method 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 from a photograph, because there are no visible manifestations of the disease.You should listen to your own health to see the first symptoms in time.

General description

The prostate gland affected by the said disease is a purely male organ;accordingly, prostatitis can develop only in men.If we consider a similar area in women and it is the urethra or the distal third of the urethra, then there are Skene's glands.These glands are actually analogues of the prostate, and if their inflammation develops, the symptoms are similar to prostatitis.

The prostate itself appears as a glandular-muscular organ located near the bladder.Thanks to this, the process of urination is controlled, in addition, due to the presence of the prostate, a certain secret is secreted that makes the sperm liquid.

Often, prostatitis occurs together with diseases such as vesiculitis or urethritis, and in elderly patients - benign hyperplasia of the prostate.

Prostatitis: causes

Bacterial prostatitis, as the name suggests, develops when exposed to relevant pathogens.Basically, these are pathological agents that constantly live on the surface of the skin or in the environment of the digestive system.In this case, a combination of certain factors can lead to the development of prostatitis.

The causes of prostatitis include various factors.So, it is not emptying the bladder on time, the presence of diseases of the genitourinary system, constant hypothermia, irregular sex life, sedentary lifestyle, bad habits, etc.can befrom stagnant processes.All this leads to the multiplication of microorganisms, as well as the development and progression of pathological inflammation.

If an infectious pathogen is not detected in prostatitis, a non-bacterial form of prostatitis is diagnosed.Various reasons can explain this form of pathology, although none of them has been proven at the moment.For example, some experts believe that this form of the disease can develop against the background of actual neurogenic disorders, while the other part, on the contrary, focuses on the immune nature of the disease in this form.This is only a part of the current theories about prostatitis.

Let's focus on acute and chronic forms of the disease.Acute prostatitis is caused by a bacterial factor.As for chronic prostatitis, here this factor is not the main one, but rather acts as a secondary factor, and its effect is important only at the beginning of the disease.Over time, the pathogenetic mechanism can be supplemented by a neurogenic, autoimmune factor or an allergic factor, as a result of which the chronic form of inflammation is maintained even if there is no question of bacterial invasion.

Prostatitis: symptoms

Inflammation is accompanied by pain in prostatitis, in particular, it is caused by damage to the excretory ducts of the acini, the epithelium is peeled off from its walls, and mucus gradually accumulates in the tubes.In addition, microliths are also formed;they look like small pebbles.Mixing with the epithelium and mucus, it causes the formation of special plugs, which in turn causes the blockage of the excretory ducts.Over time, such plugs turn into pus (or microabscesses), the lobules are no longer subject to drainage, they simply stop functioning.

Meanwhile, before the beginning of such a stage as the blockage of the excretory ducts, as a rule, a lot of time passes, in some cases, this period is calculated for months, and in others, even years.The process progresses gradually, the patient cannot feel anything special, especially the production of secretions by the prostate does not stop.Another thing is that when these microabscesses appear, it is accompanied by the appearance of very unpleasant symptoms that manifest themselves in varying degrees of intensity.

As the first of these symptoms, patients note some difficulties in urinating.Against the background of the inflammatory process, due to the growth of the prostate, the urethra is compressed to some extent.Further progression of the inflammatory process leads to the development of bladder neck sclerosis;In the more severe form of the pathological process, complete closure of the ureter occurs.

The next symptom is sexual dysfunction.Due to the pathological processes occurring in the disease, the mechanism of erection is disturbed, the orgasm is weakened.

Other symptoms of prostatitis include:

  • the appearance of a burning sensation in the urethra and perineum;
  • persistent and frequent urge to urinate;
  • the appearance of discomfort during bowel movements;
  • "floating threads" in the urine;
  • the appearance of urethral discharge during defecation;
  • the appearance of a long night erection;
  • intermittent and difficult urination;
  • too rapid ejaculation;
  • increased general fatigue;
  • decrease in capacity;
  • the manifestation of an orgasm in a deleted form;
  • waiting for the development of other forms of complications in the considered area against the background of anxiety and general mental depression.

I would like to add separately that the listed signs (symptoms) do not necessarily appear overnight.The disease is characterized by a very variable form of its manifestation, which refers to different variants and different periods of its course in each individual patient.

While considering the symptoms, it would be helpful to return to the causes.Of course, the inflammatory process will not appear "blue".We are mainly talking about the pathogenic agents mentioned above.Meanwhile, it was this factor that led to the formation of a wrong idea about the presence of certain causative agents of prostatitis, which is supported by many experts today.However, there is no specific causative agent for this disease.At the same time, any chronic infectious disease can cause the development of 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 blood flow characterized by a sufficiently strong blood supply (otherwise its functionality would be in question).

There is a certain risk group for prostatitis, especially the following people:

  • persons whose professional activity falls under the criterion of "sedentary" work;
  • people living a sedentary lifestyle;
  • persons previously diagnosed with a specific genitourinary infection;
  • people with chronic constipation problems;
  • immoral persons;
  • persons whose family relations do not belong to the disciplinary criterion;
  • persons who abuse alcohol.

Often, men are diagnosed with "bacterial prostatitis", "prostatitis in the stage of prostatitis".If a man is diagnosed with prostatosis, we can say that there is nothing to worry about at this stage.Meanwhile, you will have to make some adjustments in your lifestyle.In other words, what we are talking about here is that the stagnation phenomena discussed above are already happening, but there is no such inflammation yet, which is what prostatosis is all about.If an option such as abacterial prostatitis is considered, then we are already talking about the initial stage of the development of the inflammatory process in a man, but so far without an 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 itself, it is already a chronic process, which is often explained by its long and gradual development.Complete recovery due to the treatment given to the disease or the spontaneous disappearance of the pathological process is evaluated in isolated cases in the initial acute stage.The disease, as already mentioned, is characterized by a rather slow course, the manifestations of symptoms generally have a smoothed form.

Prostatitis: results

Acute prostatitis, if its manifestations are ignored and seeking medical help is excluded, can lead to the development of an abscess in the prostate gland, that is, it can be the cause of the development of purulent inflammation.This is accompanied by an increase in temperature (within 39-40 degrees), which is also exciting, that is, the difference is more than one degree.Patients also occasionally experience high fever, which gives way to chills.The pain in the perineum is so strong that it makes it difficult to urinate, defecation is almost impossible due to the pain.After a certain time, swelling occurs in the prostate gland, which in turn causes acute retention of urine.Meanwhile, acute prostatitis, which manifests itself against the background of chronic spread of the pathological process, rarely occurs - if a person "endures and endures" at his own peril and risk.

Returning to chronic prostatitis, we can say that it is characterized by fluctuations in its course, that is, from time to time the symptoms of the chronic form of prostatitis manifest themselves more intensively, and from time to time they are practically not felt.Because of this type of change, many patients choose a wait-and-see approach.At the same time, as indicated above, the inflammatory process may worsen, spread further.When spread, even pyelonephritis can develop.At the same time, complications of prostatitis in most cases fall into diseases such as vesiculitis, in which the inflammatory process affects the seminal vesicles, as well as epididymo-orchitis, in which the testicles and appendages are inflamed.As a result of a similar spread of the disease, you can show the development of infertility in a man.Treatment of infertility is a long and complicated process, and in some cases it is completely impossible.The listed features mainly refer to the development of the chronic form of prostatitis, due to the specific etiology of its occurrence (in particular, we are talking about STDs).

Diagnosis

In order to determine the specific type of prostate pathology, examination of patients can be carried out in different ways.Meanwhile, in each specific case, an individual approach to the existing problem is important, on the basis of which it is possible to determine the diagnostic option in order to obtain sufficient 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 which a preliminary conclusion is drawn and the principles of the individual diagnostic algorithm are determined.We would like to add that the first consultation of a urologist (this is the specialist you should consult when the disturbing symptoms of prostatitis appear) is not final and reliable for making a diagnosis, because the first examination is only an opportunity for the doctor to determine what additional diagnostic measures are needed.

Given the sensitivity of the problem, men are interested in what questions to ask a urologist if they suspect prostatitis.In particular, he will ask about current problems with urination, as well as how the patient assesses his sexual function (ie, has there been any change, exactly what has changed, and from what period).In addition, the doctor will tell you what diseases you currently have, etc.

This is followed by examination, especially external examination, rectal examination, laboratory and instrumental examination.During the external examination, the doctor examines the male's genitals, the accompanying rash, irritation, discharge, etc.

Then, after the external examination, the doctor proceeds to the next stage, which is the rectal examination.Rectal examination shows the general contours, consistency, boundaries, etc. of the prostate.allows to determine.

After that, you need to get the results of instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which means transrectal ultrasound in an expanded form.This is the most accurate method for identifying diseases in a man compared to standard ultrasound.

As for laboratory tests, it includes smear, urine test, prostate secretion test, PCR (laboratory test for detection of sexually transmitted infections).

According to the existing classification of prostatitis diagnosis methods, only the microscopic examination of the discharge from the prostate gland, as well as any of the current diagnostic options that can reveal the presence of an inflammatory process in the lower genital tract, can be considered as a necessary option.Other types of diagnostic methods act only as clarifying methods;they are necessary for differential diagnosis and to identify existing complications of the underlying disease.In addition, it should be remembered that with overdiagnosis, this stage itself is prolonged and the symptoms only worsen.That is, as in every issue, the "golden mean" principle is appropriate here.

Treatment of prostatitis

Today, the treatment of prostatitis is a serious problem, although this does not mean that the doctor cannot help, and the disease should be left to chance.Indeed, it is not always possible to completely recover from prostatitis, but it is possible to eliminate the symptoms of the disease, as well as to achieve long-term and stable remission.Depending on how seriously a man takes the doctor's recommendations, how long the periods of remission will be for him.

Basically, the treatment of prostatitis can include a number of measures, in particular, antibacterial therapy, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.Any result can be achieved only on the basis of this set of measures;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.A number of factors are important for the selection of antibacterial drugs, in particular:

  • the ability of the components of the proposed drug to enter the secretion and tissue of the prostate, to create a concentration exceeding the MIC values of pathogens;
  • characteristics of the spectrum of antimicrobial activity (for example, the use of macrolide antibiotics determines the possibility of their good penetration into the prostate tissue, while they have no activity against gram-negative bacteria, that is, they are the main etiological agents when considering the acute form of prostatitis).

It is noteworthy that acute prostatitis, compared to the chronic form of the disease, is characterized by the accumulation of aminoglycosides and beta-lactam antibiotics in the tissues of the gland, which are sufficient to suppress the activity of most types of pathogens.This is due to increased perfusion of the prostate, as well as increased permeability, which is characteristic of the hemoprostatic barrier.Another feature of drugs in this group is that as inflammation decreases, their rate of penetration into the prostate decreases.For this reason, switching to another type of oral medication is recommended.

Prostate massage

In most cases, experts consider this method of action to be a fairly effective solution in the treatment of prostatitis.In this case, the main principles for obtaining a therapeutic effect are as follows:

  • restoration of channel permeability;
  • improvement of muscle tone and blood circulation in the prostate gland;
  • increased penetration of used antibiotics into glandular tissue;
  • the ability to activate microorganisms in an inactive state and thereby increase the results obtained from the sale of antibacterial drugs.

How is prostate massage performed?To begin with, of course, it is important to establish a certain trusting relationship between the doctor and the patient;this will ensure greater relaxation of the patient, which in turn will allow the necessary manipulations to be carried out with minimal pain and maximum effectiveness.When preparing for the massage, the patient leans forward, leaning on the examination table with his elbows, spreading his legs about 60 cm wide.The doctor puts on gloves and applies a gel to the index finger (sometimes this gel has an analgesic effect).Then, with his free hand, he spreads the hips wide enough to allow palpation of the anal sphincter using the index finger.The natural response to such contact is muscle contraction.Then, after relaxing them, the index finger is inserted into the ampulla of the rectum.

In some cases, patients experience dizziness and even fainting during these manipulations (in 10% of cases on average).These manifestations are mainly caused by excessive fear, shame and anxiety and are not accompanied by any kind if the massage is done correctly.The massage can be called successful when it is possible to get at least 4 drops of secretion secreted by the prostate.

The most well-known method used in the treatment of chronic prostatitis is the use of massage according to the Manila Protocol.In this case, massage is performed three times a week, microbiological dynamic research is also carried out, and antibiotics are taken.

Immunotherapy

This direction is often extremely necessary in the treatment of prostatitis, because the possibility of a negative effect on the general condition of the immune system with the long-term manifestation of inflammation in combination with earlier incorrect antibacterial treatment cannot be excluded.Treatment of prostatitis requires not only to eliminate the infection and actually inflammation from the gland, but also to prevent the inflammation from developing again.However, like other areas of treatment, immunotherapy should not become a self-medication or a treatment based on a pharmacist's prescription;here you need to see an immunologist and probably do some tests.

Physiotherapy

This direction of treatment for prostatitis can be carried out in different ways, but regardless of the specific solution, the effect is aimed at improving blood circulation in the pelvic organs, thereby increasing the overall effectiveness of the implementation of antibacterial therapy measures.Physiotherapy uses ultrasound waves, electromagnetic waves, laser therapy, increasing the temperature directly in the rectum, etc.can use. If there are no possibilities for physiotherapy, the doctor can recommend micro-infusions with warm water and certain drugs.

Lifestyle correction

This effect is aimed both at the treatment of prostatitis and its prevention.It should be treated as the main treatment, because if the factors that lead to the development of prostatitis remain, then the disease will make itself felt again sooner or later.With this in mind, you need to make certain changes in your life, this applies to doing sports, normalizing your wake/sleep schedule, nutritious balanced diet, walking, eliminating bad habits.

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