Prostatitis, or prostatitis, can be acute and chronic. Often, organ damage is caused by a specific or nonspecific infection, sometimes pathological changes develop due to an obstruction in the small pelvis. The main symptoms are urinary disturbances and decreased potency. Treatment should be comprehensive and include the use of drugs and normalization of blood circulation in the pelvic organs in men.
Classification and Characteristics of Prostatitis
Prostatitis in men is a pathology that significantly reduces the patient's quality of life and causes a number of serious complications for both the urinary and genitals.
Prostatitis can be acute and chronic according to the course. The latter can happen on its own (it happens more often) or as a result of an untreated acute course.
The classification of prostatitis is as follows:
- First type, or acute bacterial prostatitis.
- The second is chronic bacterial inflammation.
- Third, or chronic bacterial prostatitis (chronic pelvic pain syndrome). It is divided into 3A - inflammatory and 3B - non-inflammatory.
- Fourth is asymptomatic prostatitis.
The first and second types are established for patients with positive bacteriological studies. The difference is that the disease is first diagnosed when the symptoms last for no more than 3 months. With a longer presence of clinical manifestations, chronic bacterial prostatitis is diagnosed.
The third type is also known as chronic pelvic pain syndrome, as a patient's main complaint is pain for at least 3 months. When examining secretions (ejaculation, urine, secretions after massage), no pathological microflora was detected. In the case of an increase in the number of leukocytes in these analyzes, inflammatory prostatitis (type 3A) is established, with their normal content - no inflammation.
In most men, one of the above categories is identified, when the patient seeks help due to the presence of certain pathological symptoms.
Recently, doctors have identified the fourth subtype of the disease - asymptomatic prostatitis. It is diagnosed by chance during a physical exam or when a man is being examined for other diseases of the genitourinary system. The danger of this form is that, the prostate gland has pathological changes, but the disease does not have subjective manifestations. This condition often leads to the development of infertility.
Why is there a burning sensation in the urethra in men
Prostatitis in men occurs in 70% of cases due to E. coli infection.In other situations, diseases caused by intestinal bacteria such as pseudomonas, Klebsiella, Proteus. Staphylococci and streptococci are much less common.
In specific infections, neisseria gonorrheae and trichomonas vaginalis can cause acute prostatitis.
The contributing factors are:
- Perform various surgical interventions on male genitalia.
- Urethral stenosis due to acute and chronic inflammatory processes in the urethra.
- Carry out diagnostic procedures - cystoscopy, ureteroscopy, v. v.
- Violation of urination due to benign prostatic hyperplasia.
- Activates opportunistic microflora (gut bacteria) causing disease under the influence of reduced immunity and other diseases of the body.
- Inadequate sex life leads to a stagnant prostate secretion.
If chronic prostatitis appears as a continuation of an acute process, then its cause will be the same. In the case of this disease, the main factors that cause disease are:
- Mycobacterium tuberculosis.
- Gonorrhea and Trichomonas (can immediately cause the chronic form without an acute phase).
- Various types of mushrooms.
In the mechanism of pathological occurrence, an important phenomenon such as intravenous reflux - regurgitation of urine through the secretory tube into the prostate gland. As a result of this process, the infection can easily penetrate the organs, multiply and cause inflammation. Increase reflux:
- phimosis (foreskin stenosis);
- decreased urethral lumen;
- balanoposthitis (foreskin);
- obstruction of the urethra with stones in urolithiasis.
Reflux and irregular sexual activity increase stagnation in the prostate gland, which leads to an active reproduction of microorganisms, enhances and spreads inflammationConsequently, fibrosis areas (replacing normal tissue with nonfunctional dense connective tissue) can occur and prostate formation. All of this intensifies the pathological process and leads to serious consequences.
Chronic bacterial prostatitis
Chronic pelvic pain syndrome (CPPS) is synonymous with the disease and occurs without the presence of any microorganisms in exudate detected by standard microbiological methods.
There are several theories about the appearance of the pathology:
- infection; inflammation caused by chemicals
- ; Immune
Confirms infectious theory that during polymerase chain reaction (PCR), the pathogen's DNA is detected in prostate secretions. However, the microorganism itself was not detected by other microbiological methods.
In general, with CPPS, the genetic material of the following bacteria is found:
- Ureaplasma urealyticum (ureaplasma urealyticum).
- Mycoplasma hominis.
- Chlamydia trachomatis.
- Trichomonas vaginalis.
Chemical inflammation theory explains CPPS as intravenous reflux, but in this case, the cause is not bacteria, but the urine itself. Once in the prostate gland, it causes damage to the cellular structure and an inflammatory response.
According to immunological theory, pathology occurs as a result of an autoimmune process or the result of an immune response to penetration of a foreign antigen into an organ.
In most cases, CPPS is not just one cause, but its complex effect.
The provoking factor of asymptomatic prostatitis can be anyone can cause the above types, the only difference is in the course of this form of the disease.
Acute bacterial prostatitis is characterized by the appearance of general and local symptoms.
Severe pain in the upper spine and perineum, and difficulty urinating until completely stopped, come first. Among the patient's general symptoms, they are concerned with body aches, sweating, chills, fever, weakness.
Sometimes the pain occurs only while having a bowel movement or while sitting. In some atypical cases, fever is the only sign of illness.
When prostate swelling is severe, acute urinary retention occurs. This is because the organ, increasing in size, compresses the urethra and creates a mechanical obstacle to the outflow of substances in the bladder. At the same time, the patient's general condition worsens significantly: the signs of intoxication increase hour by hour, in severe cases, consciousness can be disturbed, even coma.
In the case of a late diagnosis, complications such as the formation of an abscess (compression) of the prostate gland with a deeper breakthrough of pus into the urethra or rectum may occur. As a result, the fistula is formed, requiring surgical intervention and reconstructive operations.
Manifestations of bacterial chronic prostatitis
The manifestations of this form of the disease range from completely asymptomatic to a severe exacerbation of the process.
In most cases, patients are concerned about pain in the anal and rectum of varying intensity, which can spread to the scrotum, sacrum, penis and thigh. Pain syndrome sometimes becomes paroxysmal reminiscent of neuralgia.
Urethral discomfort and frequent urination. Excretion from the urethra is sometimes determined. This condition gets worse during the day after walking, exercising, having a bowel movement or massaging the prostate gland.
There is a feeling of weight, pressure, fullness of the rectum and perineum. These symptoms get worse after sitting for a long time. This form of the disease is characterized by the appearance of inflammatory processes in the urinary system, caused by the same microflora - cystitis, urethritis, pyelonephritis.
Symptoms of bacterial prostatitis
CPPS is characterized by a clinical picture of chronic bacterial prostatitis.
The patient suffered from pelvic and episiotomy pain for more than 3 months, her bacterial test result was negative.There are many types of urinary disorders:
- the amount of regular urine;
- difficult urination (slow flow, more effort required); Pain
- when urinating.
Sometimes there is sexual dysfunction - decreased libido, impotence.General symptoms usually appear in the form of weakness, headache.
The main therapy is antibiotics. In the chronic course, drugs from the fluoroquinolone group are indicated. For acute prostatitis, antibiotics beta-lactam and aminoglycosides are prescribed.The treatment is done in 2 phases:
- At first, empiric therapy was prescribed (before receiving a crop). For this, third generation cephalosporin or fluoroquinolon is used.
- At the second stage, treatment is adjusted according to the obtained bacteriological data and the results for susceptibility to antimicrobial agents.
These groups of antibiotics are selected for the reason that they penetrate the hemostasis barrier and produce high concentrations of the active substance in the prostate gland. This allows you to eliminate the focus of the infection. For bacterial prostatitis, antibiotic therapy is also prescribed, which is necessary for 2 reasons:
- Antibiotics significantly reduce the patient's condition.
- There is a high probability that the presence of microorganisms in the secretions, which are difficult to detect by laboratory methods, in the prostate gland.
Antibiotic regimen for chronic pelvic pain is as follows:
- Fluoroquinolon or Doxycycline is prescribed for 2 weeks.
- A repeat examination of prostate secretion is performed and, with a decrease in symptoms, the drug is continued for up to 4 weeks.
Treat patients with asymptomatic prostatitis according to the following indications:
- before prostate surgery as a preventive measure;
- when identifying pathogenic microorganisms in exudate;
- with increased levels of antibody to blood antibodies and positive microbiological assays.
For prostatitis, drugs of the alpha blocker group are prescribed. These funds increase the average and maximum flow rate of urine, reduce the tonicity in the urethral wall and eliminate incomplete opening of the bladder neck during emptying. These effects eliminate phenomena like:
- Frequent and painful urination;
- reduced jet flow;
- takes more effort to excrete urine.
The typical representatives are Alfuzosin, Tamsulosin and Doxazosin, which are particularly relevant in chronic forms of the disease.The course of treatment for these drugs is at least 3 months.
Nonsteroidal anti-inflammatory drugs prescribed as symptomatic therapy. They reduce inflammation, reduce edema, relieve pain.Drugs like diclofenac, ibuprofen, nimesulide and others are used. The duration of treatment with these agents should not exceed 4 weeks. These drugs are taken strictly after eating, as they irritate the stomach wall.
In addition to pills, topical treatment is also used. For this purpose, patients are prescribed such drugs in the form of suppositories such as Vitaprost, Prostatilen, Uroprost, etc. They are also indicated for prostate adenomas.
Dwarf palm fruit extract widely used in traditional medicine. Active ingredients reduce inflammation, edema and have a protective effect on the vessels (strengthen the vessel wall).
The bark of the African plum tree has the same effect.
Prostatilen is of natural origin. It is produced from the prostate gland of cattle. It has anti-inflammatory effects and reduces the appearance of prostate adenomas.
Prostatitis can be treated with folk remedies. In the first place in terms of efficiency - the use of pumpkin seed oil. You can buy this product in pharmacies. Drink 1 tbsp. l. 3 times a day, 3-4 months course.For the prevention of prostate diseases, all men can drink 30 pumpkin seeds before meals once a day. You need to get them raw, as after roasting, the healing properties are lost.
For the treatment you can use pumpkin seeds which have been processed according to the following formula:
- 0. 5 kg of the hulled seeds are ground in a meat grinder or blender.
- Add 200 g honey to them and mix everything until smooth.
- Make balls 2-3 cm long.
Store them in the refrigerator, take one bite 30 minutes before meals. This product should be chewed for 2-3 minutes and dissolved, not swallowed. The course of treatment is 6 months.
Witch hazel is effective in treating prostatitis. To prepare the first remedy, you need to take 1 tablespoon. l. dry leaves and mix in a cup of boiling water. You need to insist it for 30 minutes and drink 1/4 of the resulting solution 4 times a day. For decoction from the bark, 1 tbsp. l. Pour 200 ml of the crushed ingredients into the water and cook for 30 minutes. After that, the drug should be cooled and taken 1/4 cup 4 times a day.
Parsley has a curative effect on prostatitis. It has anti-inflammatory effects and helps restore sexual activity. In this case, parsley juice is used. To do this, the greens are ground to a paste and squeezed the liquid from it through the cheesecloth 3-4 times. Drink 1 tbsp. l. 3 times a day.
Home treatment of prostatitis and with herbal medicine. One of them is wormwood. It allows you to reduce inflammation and eliminate pathogens from your body. It is taken dry orally for the first 3 days - it is absorbed in the mouth every 2-3 hours. The next four days, the number of receptions decreased to 5. Each day, at night, they produced bacteria from the grass.
To do this, you need to prepare an infusion: 1 tbsp. l. You need 1 liter of water. Preparations should be boiled and allowed to cool to +40 degrees. Then the solution must be filtered. It is necessary to carry out injections into the anus (100 ml), as well as into the urethra (50 ml). The procedure should be done within a week. They are indicated in a chronic process.During douching and dilation, pus may be present - which is a normal phenomenon, indicating the effectiveness of treatment.
Associated with the main disease treatments are physical therapy, prostate massage and visceral acupuncture.
Living with chronic prostatitis means regular exams and comprehensive treatment, as there is a high chance of loss of reproductive function.