prostatitis

Prostatitis is an inflammation of the prostate.Symptoms of prostatitis are most common in men of childbearing age (20-40 years), with an average of 35% of the population being diagnosed.

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 depends on the form of the disease.Usually, specific and symptomatic treatment is performed.

Prostatitis is not a disease that can be diagnosed from photographs because the disease has no obvious symptoms.In order to detect the first symptoms in time, you should listen to your health.

General instructions

The prostate affected by this disease is an organ unique to men.Therefore, prostatitis can only occur in men.If we think about a similar area in women, which is the urethra or the distal third of the urethra, then here you have Skene's glands.These glands are similar in nature to the prostate, and if they become inflamed, symptoms may resemble prostatitis.

The prostate itself looks like an adenomyotic organ located near the bladder.Therefore, the urination process is controlled, and in addition, thanks to the presence of the prostate, a certain secret is released that keeps the sperm in a liquid state.

In elderly patients, prostatitis often occurs simultaneously with diseases such as seminal vesiculitis or urethritis, and is accompanied by benign prostatic hyperplasia.

Prostatitis: causes

As the name suggests, bacterial prostatitis occurs upon exposure to associated pathogens.Basically, these are pathological agents that persist on the surface of the skin or in the environment of the digestive tract.In this case, a combination of factors may contribute to the development of prostatitis.

The causes of prostatitis include many factors.Therefore, it could be delayed bladder emptying, genitourinary disorders, persistent hypothermia, irregular sex life, sedentary lifestyle, bad habits, etc.The relevance of such factors leads either to the possibility of entry of microbial agents into the prostate, to the interruption of the blood supply to the pelvic organs, or to the development of stagnant processes.All of this leads to the proliferation of microorganisms and the onset and progression of pathological inflammation.

If no infectious pathogen is detected in prostatitis, nonbacterial prostatitis is diagnosed.There are several reasons that may explain this form of pathology, although none have yet been proven.For example, some experts believe that this form of the disease can develop in the context of actual neurogenic diseases, while others, on the contrary, focus on the immune nature of this form of the disease.These are just some of the existing theories about prostatitis.

Let us discuss the acute and chronic forms of the disease in detail.Acute prostatitis is based on the influence of bacterial factors.With chronic prostatitis, this factor is not a primary but a secondary factor and has an important impact only at the beginning of the disease.Over time, the pathogenesis may be supplemented by neurogenic, autoimmune, or allergic factors, due to the influence of which a chronic inflammatory form is maintained even when bacterial invasion is not a problem.

Prostatitis: Symptoms

Inflammation accompanies the pain of prostatitis, in particular, this is caused by damage to the excretory ducts of the acinus, the epithelium falls off the walls, and mucus gradually accumulates in the canaliculi.Additionally, fine stones form; they look like small pebbles.They mix with the epithelium and mucus, leading to the development of special embolic structures that lead to blockage of the excretory ducts.Over time, these blockages become suppurative (or microabscesses) and the lobules no longer drain, they simply stop functioning.

At the same time, a lot of time usually passes before the stage of blockage of the excretory duct begins, in some cases this time is measured in months, in other cases even in years.The process occurs gradually and the patient may not notice anything special, especially since the production of prostate secretions does not stop.Another thing is that when these microabscesses form, they are already accompanied by the appearance of less pleasant symptoms that manifest themselves with varying degrees of intensity.

As the first of these symptoms, patients will notice difficulty urinating.As the prostate enlarges during inflammation, the urethra is compressed to a certain extent.Further progression of the inflammatory process leads to sclerosis of the bladder neck; in more severe pathological processes, complete closure of the ureter.

The next symptom is sexual dysfunction.Due to the pathological processes that occur in the disease, the erectile mechanism is destroyed and orgasm is weakened.

There are other signs of prostatitis, specifically including:

• Burning sensation in urethra and perineum;
• persistent and frequent urge to urinate;
• Discomfort during bowel movements;
• "Floating threads" appear in urine;
• Urethral stretching discharge during defecation;
• Prolonged nocturnal erections;
• intermittent difficulty urinating;
• Ejaculation too quickly;
• Increased general fatigue;
• decreased effectiveness;
• Representation of orgasm as erasure;
• Other forms of comorbidity are expected in the area under consideration, with anxiety and general mental depression occurring in this context.

I would also like to add that the signs (symptoms) listed do not necessarily all appear overnight.The disease is characterized by a very variable pattern of presentation, which applies to different variants in each patient, as well as at different stages in its course.

When considering symptoms, it is useful to return to the causes.Of course, inflammatory processes don’t “just pop up.”We are mainly talking about pathogens, which have been mentioned above.At the same time, it was this factor that led to the erroneous belief in the existence of certain prostatitis pathogens, a view that is still supported by many experts today.However, there is no specific type of causative agent for this disease.At the same time, any chronic infectious disease can lead to the occurrence of prostatitis; it can be any type, sinusitis, tonsillitis, cholecystitis or any other disease.In this case, pathogens can enter the prostate through the blood stream, which is characterized by a rather strong blood supply (otherwise its functionality would be questioned).

Prostatitis has certain risk groups, especially the following groups:

• Persons whose professional activities fall within the “sedentary” work criteria;
• People with sedentary lifestyles;
• People who have been previously diagnosed with certain urogenital infections;
• People with chronic constipation issues;
• promiscuous person;
• People whose family relationships do not meet the standards of order;
• Alcoholics.

Men are often diagnosed with "non-bacterial prostatitis" and "prostatitis in the prostatic disease stage".If a man is diagnosed with prostatic disease, we can say that there is nothing special to worry about at this stage.In the meantime, you'll have to make some adjustments to your lifestyle.In other words, what we are talking about here is that the stagnation phenomenon discussed above has occurred, but inflammation has not yet occurred. This is prostate disease.If you consider the option of non-bacterial prostatitis, then here we have discussed the stage at which the inflammatory process in men begins to develop, but so far there is no accompanying infection.

One of the distinguishing features of prostatitis is that it does not actually manifest in an acute form.In other words, by the time it manifests, it is already a chronic process, which can be explained by its often long-term and gradual development.In individual cases, complete recovery is estimated during the initial acute phase due to treatment of the disease or due to the natural disappearance of the pathological process.As already stated, the disease is characterized by an extremely slow course and the presentation of symptoms usually has a smooth pattern.

Prostatitis: consequences

Acute prostatitis, if its manifestations are ignored and seeking medical help is excluded, may lead to prostatic abscess, a cause of purulent inflammation of the prostate.This is accompanied by an increase in temperature (within 39-40 degrees) and at the same time it becomes busy, that is, the difference is more than 1 degree.Patients also develop high fever and sometimes chills.Perineal pain becomes so severe that it becomes difficult to urinate and defecation becomes almost impossible due to pain.Over time, the prostate becomes swollen, leading to acute urinary retention.At the same time, it rarely concerns acute prostatitis, which manifests itself against the background of the chronic spread of the pathological process - unless a person "bears it and endures it" at his own risk and risk.

Returning to chronic prostatitis, we can say that it is characterized by the fluctuating nature of its own course, that is, the symptoms of chronic prostatitis appear periodically more intensely, and periodically barely felt.Because of this change, many patients are choosing to wait and see.At the same time, as mentioned above, the inflammatory process may worsen, spreading further and further.When it spreads, it can even develop into pyelonephritis.At the same time, complications of prostatitis in most cases can be attributed to conditions such as seminal vesiculitis, in which the inflammatory process affects the seminal vesicles, and epididymo-orchitis, in which the testicles and appendages become inflamed.Since the disease spreads in a similar form to its spread, it can indicate male infertility.Treatment of infertility is a long and complex process, and in some cases, even completely impossible.The listed features mainly belong to the development of chronic prostatitis due to the specific causes of its occurrence (in particular, we are talking about sexually transmitted diseases).

diagnosis

Patients can be examined in a variety of ways to determine their specific type of prostate pathology.At the same time, in each specific case, an individualized approach to the problem at hand is very important, on the basis of which diagnostic options can already be determined to obtain sufficient information about the disease.

First, the doctor investigates the patient's chief complaint, studies the medical history (if any), draws preliminary conclusions on this basis and determines the principles of the individual diagnostic algorithm.We would like to add that the first consultation with a urologist (that is, the specialist you should see if disturbing symptoms of prostatitis appear) is not a final and reliable diagnosis, since the first examination is only an opportunity for the doctor to determine what further diagnostic measures are needed.

Given the sensitivity of this issue, men are interested in what questions their urologist asks when prostatitis is suspected.In particular, he will ask about current problems related to urination and how the patient himself evaluates his sexual function (i.e., whether there have been any changes, what changes have occurred, and since what period).In addition, the doctor will also ask you what diseases you are currently suffering from.

This is followed by examination, particularly external, rectal, laboratory and instrumental examinations.During an external exam, the doctor will examine the male genitals to determine if there are any accompanying rashes, irritations, discharge, etc.

Then, after the external examination, the doctor proceeds to the next stage, which is the rectal examination.A rectal examination can determine the overall contour, consistency, borders, etc. of the prostate.

Thereafter, you will need to obtain results from instruments and laboratory diagnostics.The instrumental diagnosis is called TRUS, which in its expanded form refers to transrectal ultrasound.Compared to standard ultrasound, this is the most accurate way to identify disease in men.

As for laboratory tests, these include smear tests, urine tests, prostate secretion tests, and PCR (laboratory tests that detect sexually transmitted infections).

According to the current classification of methods for diagnosing prostatitis, only microscopic examination of prostatic secretions, as well as any local diagnostic protocol that can detect the presence of inflammatory processes in the lower genital tract, can be considered necessary options.Other types of diagnostic methods serve only as clarifying methods; they are necessary for differential diagnosis and identification of existing complications of the underlying disease.Additionally, it is important to remember that if overdiagnosed, the phase itself will be prolonged and symptoms will only get worse.That is, here, as in everything, the principle of "golden mean" is appropriate.

Treatment of prostatitis

Today, the treatment of prostatitis is a serious problem, but this does not mean that doctors cannot help and the disease should be left alone.The reality is that complete recovery from prostatitis is not always possible, but it is possible to eliminate symptoms of the disease and achieve long-term, sustainable remission.The duration of remission depends on how seriously the patient takes the doctor's advice.

In essence, the treatment of prostatitis may consist of a variety of measures, in particular antimicrobial therapy, prostate massage, immunotherapy, physical therapy and general correction of the patient's lifestyle.Only on the basis of a series of these measures can the desired results be achieved; in general, the disease is very difficult to treat, so it cannot be ignored.

antibacterial treatment

This type of treatment is considered the basis of conservative treatment.Antimicrobial selection is based on a variety of factors, in particular:

• The ability of the components of the proposed drug to enter prostatic secretions and tissues to produce concentrations that exceed the MIC value of the pathogen;
• Characterization of the spectrum of antimicrobial activity (for example, the use of macrolide antibiotics determines the possibility of good penetration into the prostate tissue, while they do not have any activity against Gram-negative bacteria, i.e. they are the main pathogens considered in acute prostatitis).

It is worth noting that, in contrast to chronic diseases, acute prostatitis is characterized by the potential for accumulation of aminoglycosides and β-lactam antibiotics in glandular tissue in concentrations sufficient to inhibit the activity of most types of pathogens.This is due to increased prostate perfusion and increased permeability characteristics of the blood-prostatic barrier.Another characteristic of this group of drugs is that as inflammation subsides, their penetration into the prostate decreases.Therefore, it is recommended to switch to other types of oral medications.

prostate massage

In most cases, experts consider this method of influence to be a fairly effective solution for the treatment of prostatitis.The basic principles for achieving therapeutic effects in this case are as follows:

• Restore ductal patency;
• Improve prostate muscle tone and blood circulation;
• Increased penetration of antibiotics into glandular tissue;
• The possibility of activating microorganisms in an inactive state, thereby increasing the sales effectiveness of antibacterial drugs.

How is prostate massage performed?Of course, first of all, it is important to establish a certain trusting relationship between doctor and patient.This will ensure that the patient is more relaxed, allowing the necessary procedures to be performed with minimal pain and maximum efficiency.When preparing for massage, the patient leans forward, legs about 60 cm wide apart, and rests her elbows on the examination table.The doctor puts on gloves and applies gel to the index finger (sometimes the gel has pain-relieving properties).Next, use your other hand to spread your buttocks wide enough so that you can palpate the anal sphincter with your index finger.The natural response to this contact is muscle contraction.Next, after relaxing, insert your index finger into the ampulla of the rectum.

In some cases, patients experience dizziness or even fainting during these procedures (average 10%).These manifestations are mainly caused by excessive fear, shame and anxiety and will not be accompanied at all if the massage is performed correctly.When a massage can obtain at least 4 drops of prostate secretion, it can be called a success.

According to the Manila Agreement, the most popular and accepted method of treating chronic prostatitis is the use of massage.In this case, massages are performed three times a week, microbiological dynamics are also studied, and antibiotics are taken.

Immunotherapy

This direction in the treatment of prostatitis is often extremely necessary, since with the long-term manifestations of inflammation coupled with previous incorrect antimicrobial treatment, the possibility of a negative impact on the overall condition of the immune system cannot be ruled out.Treatment of prostatitis requires not only the elimination of infection and inflammation of the gland, but also the prevention of the redevelopment of inflammation in the gland.However, as with other areas of treatment, immunotherapy should not be reduced to self-medication or treatment based on the advice of a pharmacy pharmacist; here, you will need to consult an immunologist and most likely also undergo some tests.

physical therapy

In the case of prostatitis, this therapeutic direction can be implemented through various influencing options, but, regardless of the specific solution, the influencing is focused on improving blood circulation in the pelvic organs and thus increasing the overall effectiveness of the implemented antimicrobial therapeutic measures.Physical therapy can use ultrasound, electromagnetic waves, laser therapy, directly increase rectal temperature, etc.If there is no opportunity for physical therapy, your doctor may recommend a microenema with warm water and certain medications.

lifestyle modification

This effect is intended to treat and prevent prostatitis.It should be treated in the same way as the main treatment, since if the factors that precipitated the development of prostatitis remain, sooner or later the disease will reappear.With this in mind, you should make some changes in your life, this applies to exercise, regularizing your waking/sleeping schedule, eating a nutritionally balanced diet, walking, eliminating bad habits.

If symptoms of prostatitis occur, you should consult a urologist.