Prostatitis: symptoms, treatment.

Prostatitis is an inflammatory disease of the male prostate, located directly below the bladder and a minor part of the genital organs.

Every 7 men over 35 years old suffer from prostatitis and with each goal the risk of developing an inflammatory process in the prostate increases under the influence of external and internal factors.

Reasons

Inflammation of the prostate can develop for various reasons, doctors identify the main ones:

1. Violation of blood microcirculation in the pelvic organs - this leads to stagnant processes and contributes to an increase in the size of the prostate gland.Obesity and a sedentary, sedentary lifestyle contribute to stagnation of processes.
2. If bacteria, viruses or protozoa enter the prostate tissue against the background of an acute or chronic inflammatory process occurring in other organs of the body, diseases such as tonsillitis, gonorrhea, urethritis, cystitis, influenza and pyelonephritis can lead to prostatitis.Infectious agents can enter the prostate through blood and lymph flow if there is infection in distant areas and organs.
3. Injuries and bruises received in the soft tissues of the abdomen, perineum and external genitalia;This causes swelling and poor circulation in the injury area;
4. Hypothermia of the body.
5. Chronic constipation.
6. Hormonal disorders.
7. A stormy or, on the contrary, absent sexual life is harmful, both frequent sexual relations (more than once a day) and infrequent intimate relations (less than once a week), since this causes depletion of the gonads or congestion of the prostate.

Prostatitis symptoms

There are acute and chronic forms of the disease.

Acute prostatitis is characterized by a sudden onset against the background of general well-being, which is clinically accompanied by the following symptoms:

• chills and weakness;
• general malaise;
• increased irritability and nervousness;
• increased body temperature (not exceeding 37.5 degrees);
• drawing or cutting pain in the lower abdomen and perineum;
• frequent urge to urinate with a persistent feeling of incomplete emptying of the bladder;
• pain in the rectum and difficulty defecating.

In the absence of timely diagnosis and treatment, acute prostatitis can be complicated by a purulent process and the release of pus from the urethra during urination.

Signs of chronic prostatitis

When the disease becomes chronic, the clinical signs of prostatitis disappear and the patient feels that he has recovered.Characteristic signs of a chronic inflammatory process in the prostate are a burning sensation along the urethra with irradiation to the perineum, which can intensify during urination and defecation.Little by little the disease progresses and causes impotence.Chronic prostatitis involves periods of remission and exacerbation, but even during times of exacerbation the symptoms will disappear and will not be as pronounced as in the acute form.The following symptoms appear clinically:

• difficulties with erection;
• inability to complete sexual intercourse with ejaculation;
• decreased sexual desire;
• mucus discharge from the urethra mixed with white flakes;
• feeling of incomplete emptying of the bladder;
• persistent pain in the lumbar region, pubis and groin;
• Weak urine stream - this is observed as a result of the narrowing of the lumen of the urethra against the background of its compression by the enlargement of the prostate.

A chronic, slow inflammatory process in the urethra irritates the nerve endings in the pelvis and causes a constant need to urinate, especially at night.Many men are embarrassed to consult a doctor with such a delicate problem, which increases the risk of developing such serious complications as complete erectile dysfunction, infertility and even prostate cancer.

Furthermore, from the origin of chronic infection in the prostate, pathogenic microorganisms enter the kidneys through blood and lymph, causing acute inflammation, urinary retention and increasing the risk of developing kidney failure.

The constant accumulation of urine in the bladder and urethra creates favorable conditions for the formation of salt crystals and then stones;Very often, prostatitis in men occurs in parallel with urolithiasis.

Diagnostic methods

A urologist is involved in the diagnosis, treatment and prevention of prostatitis.To make a diagnosis, determine the form and cause of the inflammatory process in the prostate gland, the patient is prescribed a series of examinations:

• palpation of the prostate - is carried out through the rectum and allows you to detect an increase in size, pain, discharge of pus or mucus after palpation;
• a smear of discharge from the urethra - the resulting material is sent for study to the laboratory;
• urinalysis - general, etc.;
• Ultrasound of the pelvic organs and prostate.

If the spread of the pathological process to the bladder is suspected, the patient additionally undergoes cystoscopy - an examination of the walls of the bladder using a flexible device equipped with an optical system at the end.

When diagnosing prostatitis, it is very important to differentiate the pathological process from prostate adenoma and other urological diseases with a similar clinical course.

Treatment

Treatment of acute and chronic forms of prostatitis is different, therefore patients are strongly recommended not to self-medicate.

The acute nonbacterial form of prostatitis is treated comprehensively with the use of herbal remedies and anti-inflammatory medications.

Treatment of acute bacterial prostatitis.

The principles of treatment of acute forms of bacterial prostatitis directly depend on how pronounced the symptoms of the disease are.

A distinctive feature of bacterial prostatitis is the acute onset and rapidly increasing signs of intoxication of the body: nausea, vomiting, headache, and high body temperature.The process of emptying the bladder is accompanied by cutting pain in the lower abdomen and perineum, which radiates to the lower back.Very often a purulent process occurs and an abscess develops in the prostate.

Treatment of acute bacterial prostatitis is carried out in a hospital, since the patient's condition can be extremely serious.The therapy consists of an integrated approach:

• the patient must remain in bed;
• antibiotics are prescribed: macrolides, fluoroquinolones, cephalosporins;
• Medicines are selected that improve blood microcirculation in the pelvic organs.They ensure the outflow of lymph and venous blood, which reduces the severity of swelling and inflammation of the prostate;
• Drugs from the group of non-steroidal anti-inflammatory drugs are indicated orally.These drugs not only reduce the inflammatory process, but also eliminate pain;
• pain relievers - you can take tablets orally or insert rectal suppositories into the rectum;
• To eliminate intoxication from the body, a physiological sodium solution with glucose is prescribed intravenously.

Important!Prostate massage is strictly prohibited, as there is a high risk of developing sepsis.

Surgical treatment

Surgery for prostatitis is only required if the patient develops acute urinary retention and there is no way to empty the bladder.Surgery cannot be avoided if a prostate abscess occurs.

The course of treatment for prostatitis lasts 14 days, after which the patient again undergoes a comprehensive examination to evaluate the effectiveness of the therapy.If necessary, the course of treatment is extended and adjusted.

Treatment of the chronic form.

Treatment of chronic prostatitis differs and largely depends on the stage of the pathological process.In case of exacerbation of the inflammatory process, therapy is carried out in the same way as with acute prostatitis.

Treatment of chronic prostatitis during remission is as follows:

1. course of intake of non-steroidal anti-inflammatory drugs.Medications are prescribed 2 times a day for at least 3 days, sometimes up to 5 days.
2. Medications that help improve venous and lymphatic flow.
3. Immunomodulators.
4. Antidepressants and sedatives help to normalize sleep and eliminate irritability.
5. Multivitamin complexes rich in zinc, selenium, vitamin B.

In the remission phase of the inflammatory process of the prostate, the patient is indicated for physiotherapy treatment:

• prostate massage;
• ultrasound;
• electrophoresis;
• magnetic therapy;
• Microwave hyperthermia.

Surgical treatment of chronic prostatitis.

With advanced chronic prostatitis, the patient sometimes requires surgical intervention.This can be done in two ways:

• transurethral resection;
• prostatectomy.

transurethral resection

This surgical treatment method is a minimally invasive procedure, although it is performed under general anesthesia.During the procedure, a resectoscope is inserted under the urethra, through which pulses of electrical current are applied.These electrical impulses act like an electric knife and partially remove the prostate tissue.A great advantage of this method of intervention is the absence of blood loss, since the electrical waves not only eliminate the modified prostate tissue, but also immediately treat the blood vessels, preventing bleeding.

Transurethral resection significantly alleviates the patient's condition: after the operation, urination is restored, the man no longer has a burning sensation in the perineum and does not jump up to go to the toilet at night.Erectile function and normal ejaculation are also restored.The entire operation process is monitored by a doctor on a monitor screen, so the risk of complications during or immediately after surgery is minimal.

Prostatectomy

Prostatectomy is a major abdominal surgery and always involves risks for the patient.During the operation, the doctor removes all or most of the prostate.The recovery period is 4-6 weeks, there is a high risk of developing postoperative complications, but sometimes this method of surgical intervention is the only way to alleviate the patient's condition and eliminate the consequences of severe prostatitis.

Other treatments for chronic prostatitis

Other methods of treating chronic prostatitis include:

1. hirudotherapy - or treatment with leeches.Medical leeches are placed on the area of inflammation, which during their action secrete with saliva a substance that tidies up the blood, eliminates congestion and quickly stops the inflammatory process.Leeches are used only in a special, medical and individual way for each individual patient.After the procedure, the doctor places the used leech in a disinfectant solution in which it dies.The optimal thing is to undergo at least 5 cycles of hirudotherapy.
2. Cryodestruction: liquid nitrogen is used.This method of treatment is indicated for patients who do not respond well to drug therapy and for some reason surgery is contraindicated for them.
3. Microwave therapy is a special method: electromagnetic waves are applied to the prostate area.Already after 1 procedure, tissue swelling is reduced, blood circulation is normalized and congestion is eliminated.After a course of electromagnetic therapy, the patient's urination and erectile function are completely restored.
4. Treatment with ultrasound waves allows you to quickly stop the inflammatory process that occurs in the remission phase;during the exacerbation period, ultrasound therapy is not performed.To enhance the therapeutic effect, drugs can also be used that, under the influence of ultrasound, directly penetrate the prostate tissue.
5. Urethral stenting: the essence of the procedure is to install a special stent in the urethra, which expands the lumen of the urethra and promotes the normal outflow of urine.Despite the effectiveness of the procedure, the placement of a urethral stent only eliminates the clinical symptoms of prostatitis, but does not relieve the patient of the chronic inflammatory process.

Consequences and complications.

In the absence of qualified therapy, prostatitis rapidly progresses, becomes chronic and threatens a man's health with its serious complications, including:

• urolithiasis;
• pyelonephritis;
• development of abscesses;
• spread of the inflammatory process to the testicles and spermatic cords, which leads to infertility;
• erectile dysfunction and impotence;
• necrotic changes in the prostate tissue.

Sometimes prostatitis and chronic congestive processes for a long time drive the degeneration of the disease into an adenoma and then into prostate cancer.