Prostatitis is an inflammatory disease of the prostate gland. It manifests itself by frequent urination, pain in the penis, scrotum, rectum, sexual dysfunction (erectile dysfunction, early ejaculation, etc.), sometimes urinary retention, blood in the urine. The diagnosis of prostatitis is established by a urologist or andrologist according to a typical clinical picture, the results of a rectal examination. Additionally, ultrasound of the prostate, bacterial culture of prostatic secretions and urine are performed. Conservative treatment - antibiotic therapy, immunotherapy, prostate massage, lifestyle correction.
Causes of prostatitis Symptoms of prostatitis Acute prostatitis Chronic prostatitis Complications Diagnostics Treatment of prostatitis Treatment of acute prostatitis Treatment of chronic prostatitis Forecast and prevention Prices of treatment.
Prostatitis is an inflammation of the seminal (prostate) gland - the prostate. It is the most common disease of the genitourinary system in men. Most often it affects patients aged 25-50 years. According to various data, prostatitis affects 30-85% of men over the age of 30. Perhaps abscess formation of the prostate gland, inflammation of the testicles and appendages, which threatens infertility. The ascent of infection leads to inflammation of the upper parts of the genitourinary system (cystitis, pyelonephritis).
Staphylococcus aureus (Staphylococcus aureus), Enterococcus (Enterococcus), Enterobacter (Enterobacter), Pseudomonas aeruginosa (Pseudomonas), Proteus (Proteus), Klebsiella (Klebsiella) and Escherichia coli (E. Coli) can act as an infectious agent in an acute process. Most microorganisms belong to conditionally pathogenic flora and cause prostatitis only in the presence of other predisposing factors. Chronic inflammation is usually caused by polymicrobial associations. The risk of developing the disease increases with hypothermia, a history of specific infections and conditions accompanied by congestion in the tissues of the prostate.
General hypothermia (single or permanent, associated with working conditions). A sedentary lifestyle, a specialty that forces a person to be in a sitting position for a long time (computer operator, driver, etc.). Persistent constipation. Violations of the normal rhythm of sexual activity (excessive sexual activity, prolonged abstinence, incomplete ejaculation during a "habitual" sexual intercourse devoid of emotional coloring). The presence of chronic diseases (cholecystitis, bronchitis) or chronic infectious foci in the body (chronic osteomyelitis, untreated caries, tonsillitis, etc.). Postponed urological diseases (urethritis, cystitis, etc.) and sexually transmitted diseases (chlamydiasis, trichomoniasis, gonorrhea). Conditions that suppress the immune system (chronic stress, irregular and inadequate nutrition, regular lack of sleep, a state of overtraining in athletes).
It is assumed that the risk of developing pathology increases with chronic intoxication (alcohol, nicotine, morphine). Some studies in the field of modern andrology prove that chronic trauma to the perineum (vibration, concussion) in motorists, motorcyclists and cyclists is a provoking factor. However, the overwhelming number of experts believe that all of the above circumstances are not the real causes of the disease, but only contribute to the exacerbation of the latent inflammatory process in the tissues of the prostate.
Acute catarrhal. Patients complain of frequent, often painful urination, pain in the sacrum and perineum. Acute follicular. The pains become more intense, sometimes radiating to the anus, intensifying with bowel movements. Difficulty urinating; urine flows out in a thin stream. In some cases, urinary retention is noted. Subfebrile condition or moderate hyperthermia is typical. Acute parenchymal. Severe general intoxication, hyperthermia up to 38-40 ° C, chills. Dysuric disorders, often - acute retention of mofrom the emitting. Sharp, throbbing pain in the perineum. Difficulty in the act of defecation.
In rare cases, chronic prostatitis becomes the outcome of an acute process, however, as a rule, a primary chronic course is observed. The temperature occasionally rises to subfebrile values. The patient notes a slight pain in the perineum, discomfort during the act of urination and defecation. The most characteristic symptom is scanty discharge from the urethra during the act of defecation. The primary chronic form of the disease develops over a significant period of time. It is preceded by prostatosis (stagnation of blood in the capillaries), gradually turning into abacterial prostatitis.
Chronic prostatitis is often a complication of the inflammatory process caused by the causative agent of a specific infection (chlamydia, Trichomonas, ureaplasma, gonococcus). Symptoms of a specific inflammatory process in many cases mask manifestations of prostate involvement. There may be a slight increase in pain during urination, mild pain in the perineum, scanty discharge from the urethra during bowel movements. A slight change in the clinical picture often goes unnoticed by the patient.
Chronic inflammation of the prostate gland can manifest itself as a burning sensation in the urethra and perineum, dysuria, sexual dysfunction, increased general fatigue. The consequence of violations of potency (or fear of these violations) often becomes mental depression, anxiety and irritability. The clinical picture does not always include all of the listed groups of symptoms; it differs in different patients and changes over time. There are three main syndromes characteristic of chronic prostatitis: pain, dysuric, sexual disorders.
As a result of inflammation in chronic prostatitis, the volume of the prostate, which compresses the urethra, increases. The lumen of the ureter decreases. The patient has a frequent urge to urinate, a feeling of incomplete emptying of the bladder. As a rule, dysuric phenomena are expressed in the early stages. Then compensatory hypertrophy of the muscular layer of the bladder and ureters develops. Symptoms of dysuria during this period weaken, and then grow again with the decompensation of adaptive mechanisms.
There are no pain receptors in the prostate tissue. The cause of pain in chronic prostatitis becomes almost inevitable due to the abundant innervation of the pelvic organs, the involvement of the nervous pathways in the inflammatory process. Patients complain of pain of varying intensity - from weak, aching to intense, disturbing sleep. There is a change in the nature of pain (strengthening or weakening) with ejaculation, excessive sexual activity or sexual abstinence. Pain radiates to the scrotum, sacrum, perineum, and sometimes to the lumbar region.
In the initial stages, dispotency may develop, which manifests itself in different ways in different patients. Patients may complain of frequent nocturnal erections, a blurred orgasm, or erectile dysfunction. Accelerated ejaculation is associated with a decrease in the threshold level of excitation of the orgastic center. Painful sensations during ejaculation can cause refusal to have sex. In the future, sexual disorders become more pronounced. At an advanced stage, impotence develops.
The degree of sexual dysfunction is determined by many factors, including the sexual constitution and psychological mood of the patient. Violations of potency and dysuria can be caused both by changes in the prostate gland, and by the suggestibility of the patient, who, when diagnosed with chronic prostatitis, expects the inevitable development of sexual disorders and urinary disorders. Especially often psychogenic dispotency and dysuria develops in suggestible, anxious patients.
Impotence, and sometimes the very threat of possible sexual dysfunctions, is difficult for patients. Changes in character, irritability, grumpiness, excessive concern for their own health, and even "withdrawal into illness" are often noted.