According to the BME, prostatitis is an inflammatory process that occurs in the prostate gland in men with damage to the parenchyma and interstitium.Treatment of prostatitis in men is a long and complex undertaking, most often due to complete ignorance of the disease at its very beginning.What is prostatitis, what are its causes and first signs, what you need to know about the subject of “diagnosis” and what modern methods of treating prostatitis exist.Everything about prostatitis that men need to know is in this review article.
Ab ovo – from the egg
We are not talking about Horace’s satires; in this case, we are interested in everything related to prostatitis, from the very beginning to the last “squeak” of treatment.Symptoms of prostatitis occur in men during the period of active sexual activity, from 25 to 45 years old. In the thematic video, you can study in detail everything related to the basics of the disease, its causes and symptoms, features of diagnosis and treatment.
The reasons for the development of prostatitis are extensive.In prostatitis, infectious factors play the greatest role in the development of the disease:
- Acute form.Coccal flora acts as provoking causes.
- Chronic form.The reasons for its development are more extensive; the primary factors of such prostatitis in men are: gonococci, trichomonas, Gr+ and Gr-bacteria, mycobacterium tuberculosis.In rare cases, diagnosis reveals mycoplasmas, viruses, fungi, chlamydia, etc.
It is noteworthy that chronic prostatitis, which is caused by a pathogen that has penetrated the prostate gland, can subsequently have an abacterial character without the participation of a pathogenic factor.The acute form is often provoked by external causes: hypothermia, trauma to the urethra or damage to the bladder as a result of endoscopic examinations or various manipulations, physical inactivity and, as a result, impaired blood and lymph circulation in the pelvis (congestive prostatitis), hormonal or autoimmune disorders.
You can often hear about only one type of prostatitis - infectious, but according to WHO, bacterial prostatitis accounts for no more than 10% of all cases of the disease, while chronic abacterial prostatitis is registered in 90% of cases.
Table No. 1. Brief characteristics of the pathology
| Categories for prostatitis | Acute infection | The presence of a pathogen in the prostate secretion or the 3rd portion of urine | Level (increase) of leukocytes in urine or secretions |
| 1 cat.Acute bacterial | + | + | + |
| 2 cat.Chronic bacterial | — | + | Uncertain (yes or not) |
| 3 a.Chronic pelvic pain syndrome of an inflammatory nature, non-bacterial | — | — | + |
| 3 b.Prostatodynia, non-inflammatory pelvic pain syndrome | — | — | — |
| 4 cat.Asymptomatic inflammatory process | — | Uncertain (yes or no) | Uncertain (yes or no) |
The etiology of bacterial prostatitis in acute and chronic manifestations has been studied more fully; in most cases, the cause of the disease is bacteria of the family.Enterobacteriaceae (E. coli bacillus).The role of atypical microorganisms as the cause of prostatitis (ureplasma, chlamydia, mycoplasma) is currently considered not fully proven.Symptoms of prostatitis in men with signs of weakened immunity, in particular with HIV, the cause of the disease can be yeast fungi (Candida spp.) or Mycobacterium tuberculosis.
Before the era of antibiotics, the gonococcal flora (Neisseria gonorrhoeae) played a significant role in the development of prostatitis, especially often causing its abscess form.
The causes of the abacterial form of prostatitis have not been fully studied, although urologists have thoroughly learned a list of possible pathogenetic (provoking prostatitis) factors that play an important role in the occurrence of inflammation in the prostate without the presence of microorganisms.Thus, the causes of prostatitis, which is non-bacterial in nature, are congestive processes in the pelvis, poor circulation, intraprostatic reflux of urine and an autoimmune aseptic inflammatory process.
Sick or not - that is the question
What does a man look like with prostatitis?For a person far from medicine, and especially not understanding the problems of urology, the external male appearance of one individual is no different from the crowd of others.And only an experienced specialist, based on the patient’s first complaints, will understand where the root of the problem is and what ways to eliminate it will need to be taken.
Symptoms of prostatitis are often described in a few phrases, highlighting the most striking moments, and this plays a cruel joke on a man.Relying on such inaccurate definitions, he ignores really important signals, believing that the disease does not exist, although in fact the clinical picture depends on the nature of the morphological changes in the prostate.
The very first symptoms can be attributed to the following types of prostatitis:
- Catarrhal prostatitis.Dull pain in the perineum, radiating to the sacrum, frequent night urges.
- Follicular prostatitis.Difficulty and frequent urination, sometimes with delay.Pain during peeing, intensifying at the end of the process of urination, as well as defecation.Low-grade fever.
- Parenchymal prostatitis.There are symptoms of pronounced dysuria, often acute respiratory distress, pain during natural recovery, general intoxication with a temperature of up to 40 C.
With prostatitis with abscess formation, the symptoms are more vivid with possible opening of the abscess into the rectum or into the prostatic part of the urethra.With such a breakthrough, the symptoms subside.If the opening of the abscess occurs in the paraprostatic tissue or in the perineal area, visual symptoms can be observed: swelling, redness of the skin with pronounced fluctuation.The man's condition deteriorates sharply.
Comprehensive treatment of prostatitis cannot be started without a thorough examination of the man, diagnosis and analysis of symptoms that can directly indicate the type of disease.
In general, it is customary to distinguish between acute and chronic prostatitis; on a thematic video on the Internet, you can find out in detail which symptoms relate to one form or another.Let's consider this issue in more detail.
Acute - its typical symptoms are characterized by the manifestation of three stages: catarrhal, follicular and parenchymal.They are described in detail above.
The most interesting in terms of symptoms is the chronic form of prostatitis, since it has a lot of variations in symptoms.In general, effective treatment of prostatitis depends on prostatitis, or rather on its type.
In the chronicization stage, the following points can be distinguished:
- Chronic prostatitis rarely results from an acute process.
- Primary prostatitis passes with erased symptoms.
- A characteristic symptom of chronicity is scanty discharge from the urethra during defecation.
- The first symptoms, as a rule, are not pronounced; the pathological process itself develops over the years.It is preceded by prostatosis (congestion in the capillaries), which gradually turns into an abacterial form of inflammation of the prostate gland.
- Specific pathogenic microflora is not the cause of chronic prostatitis, but the chronic process itself is a complication of the inflammatory process due to the effects of ureaplasma, trichomonas, chlamydia and gonococci.
How does a man feel with prostatitis in the chronic stage?Reviews from patients show that most often, at first, minor pain in the perineum and scanty discharge are felt, which most men simply do not pay attention to.The next stage is the addition of the following symptoms: burning in the urethra, sexual dysfunction, dysuria, general malaise.Frequent misfires during sex lead men to depression, they become irritable or depressed.
It is important to understand that all these signs do not necessarily appear in each specific case of chronicity, this is what complicates the diagnosis at an early stage of the disease, in addition, the symptoms tend to change places, which is even more misleading.
Long-term syndromes
What can you expect from chronic prostatitis?If there is no timely diagnosis and treatment, there is nothing good, any specialist will confirm this.This type of prostatitis is characterized by 3 syndromes:
Pain
The prostate itself does not hurt, but many nerve endings pass through it and are nearby, which inevitably become involved in the inflammatory process.The pain can be of varying intensity - from slightly aching, creating discomfort, to severe, preventing you from falling asleep peacefully.Irradiation of pain occurs in all nearby areas (scrotum, sacrum, perineum); pain from prostatitis must be differentiated from similar symptoms of other diseases.
Dysuria
Dysuric syndrome always indicates a problem in the urinary system, but what caused this is clarified during diagnosis.The increased volume of the prostate inevitably compresses the urethra, and the flow of urine is disrupted, followed by the development of frequent urge to go to the toilet, and a feeling of incomplete emptying of the bladder.With advanced prostatitis, there is compensatory hypertrophy of the muscular layer of the bladder and ureters.At this time, the symptoms of dysuria weaken, but return again in an intensified form.
Sex without pleasure
An intimate life that is on the decline - these are the first symptoms that men notice, and it is they, as reviews show, that force them to see a doctor.Frequent night erections, orgasm in an erased form, poor erection and rapid ejaculation, pain during it - this is what worries the stronger sex most of all.In the advanced stage of chronicity, nothing good can be expected from prostatitis; erectile dysfunction often develops.
The degree of sexual dysfunction in men is not the same; some begin sexual intercourse and somehow complete it, brushing aside the characteristic warning signs.For some, even the initial weak reaction of the penis to a charming stimulus becomes a collapse and the beginning of terrible experiences that turn into prolonged depression.The specter of impotence is difficult for patients with problems with the prostate gland; specialists and relatives almost always notice that prostatitis deteriorates the character.
To learn more about the disease, you can study a thematic video where experts explain many of the nuances of the pathology.
What to write on the card
What entry will appear in the patient’s medical record and what final diagnosis will be established depends on a series of primary studies, starting from the patient’s arrival to the urologist and his complaints (history) to the very last stage of diagnostic measures.What exactly is required depends on the type of prostatitis, its severity and the patient’s consent to specific diagnostic procedures.
In general, diagnostics consists of:
- History.The doctor will ask in detail about all complaints and symptoms, prerequisites for the disease, etc.
- Urinalysis.
- Prostate massage (digital rectal examination + taking secretions).
- Ultrasound of the prostate.
- Spermograms.
- Prostate biopsy (if indicated).
What does diagnostics provide and is it so important?If you read the reviews of patients, you can often understand that most men try to avoid many stages of diagnosis, the motivations are very different.The price of such indifference is your own health!It is important to remember that prostatitis is curable only if it is “caught” on time and the diagnosis is made accurately, determining the form of the disease and its cause.
How to become healthy forever
So, a man understands that he has prostatitis, what awaits him in the future and is it possible to regain lost health?It is important to understand that it will take 2 times longer to get rid of prostatitis than it took to develop.Moreover, if the pathological process proceeded practically without the attention of the man, then the treatment of prostatitis will take place with his direct participation.Is acute or chronic prostatitis curable? Yes, if you follow all the doctor’s recommendations, in advanced cases of the chronic form, treatment can achieve stable remission.
The stages of treatment for prostatitis will directly depend on what the doctor ultimately discovered during the examination, on the type of disease, the patient’s age and physical characteristics.
The treatment regimen is always strictly individual, but the following points may be present in it:
- Antibacterial therapy.
- Physiotherapeutic methods.
- Phytotherapy.
- Prescription of immunocorrectors.
- Urological massage.
- Therapeutic gymnastics.
The price of each stage of treatment is different and depends on the total cost of the prescribed medications, additional methods and the clinic.Preventive measures following treatment have an important rationale - they prevent the return of the disease.Prevention has direct and close contact with treatment; the basics of prevention are as important as compliance with all the doctor’s requirements during the course of therapy.
Treatment of acute form
The period of exacerbation requires taking antibiotics, which are taken in a course.In the presence of chlamydial infection, cephalosporin drugs are indicated.
The duration of the course of use is significant; on average, antibiotics are taken for at least 3-4 weeks to prevent relapse of the disease.Sometimes the doctor continues treatment for a longer period, combining antibiotics with analgesics to relieve pain.
Treatment with antibiotics is carried out taking into account the following rules:
- A bacterial culture is required to determine the sensitivity of microorganisms to the drug.
- Side effects and contraindications of medications are taken into account.
- They take into account the previous course of treatment, when it took place, what means were used and the result.
The need for additional treatment methods is determined by the attending physician; it should be remembered that in acute forms of prostatitis, massage is contraindicated, as it provokes the spread of bacterial infection throughout the body, followed by bacteremia and sepsis.
Treatment of the chronic form
It is important to remember that it is impossible to get rid of chronicity quickly in principle, the disease has developed over the years and even doctors in their field cannot destroy it in a couple of weeks; you do not need to take the word of those who cured the disease in 2-3 days.Treatment is aimed at stopping the source of infection, restoring immunity in men and the functioning of the prostate gland, as well as preventing exacerbations - this takes time.
The course of antibiotic therapy lasts from 4 to 12 weeks; if the treatment is low, the medication is continued further.Most often, antibacterial drugs are prescribed in combination with other anti-inflammatory drugs.In advanced cases, surgical intervention with partial or complete excision of the prostate gland is provided.
No bacteria or symptoms
A characteristic difference between therapy is the absence of antibiotics; without the presence of pathogenic microflora, they are simply not needed.But sometimes experts prescribe a short course of drugs of 2-4 weeks.
The treatment of abacterial prostatitis is based on the use of physiotherapeutic methods: iontophoresis, ultrasound, laser therapy, electromagnetic radiation and symptomatic therapy with strengthening of the patient’s immune system.
Diet and lifestyle changes also form the basis of the treatment of non-bacterial prostatitis; baths and alpha-blockers are indicated.
Prostatitis without symptoms is difficult to identify; the PSA method is used for diagnosis, followed by a 2-week course of antibiotics as treatment.After this, symptomatic treatment is selected individually.
In general, treatment of any type of prostatitis is a long-term phenomenon and not always pleasant for the patient.In addition to physical inconvenience, a man suffers psychologically, because his most valuable part of the body is affected - the intimate part.Reviews from those who have cured the disease show that only strict adherence to the doctor’s instructions, coupled with diet and lifestyle changes, bears fruit.The price of a frivolous attitude to treatment is very high - a man loses not only his health, his whole life, character and relationships with others change.To prevent this, it is necessary to monitor the health of the prostate gland and eliminate the causes of disease development.