Inflammation of the prostateDoes urological disease accompany inflammation of the tissues of the prostate gland. Damage to the prostate can be caused by an infection transmitted through the blood, lymph, or unprotected intercourse. The development of prostatitis in men is facilitated by injuries and impaired blood supply to the pelvic organs, persistent hypothermia, low physical activity, hormonal imbalances, and other factors. Prostatitis can be accompanied by vesiculitis, urethritis, and other infectious and inflammatory diseases of the reproductive and urinary organs.
Incidence statistics
Prostatitis is one of the most common diseases of the male urogenital system in the world. According to various sources, it is observed in 60-80% of mature men. According to official medical statistics, more than 30% of young people of reproductive age suffer from chronic prostatitis. It occurs in about a third of cases in men over the age of 20 and under the age of 40. According to the WHO, urologists diagnose chronic prostatitis in every tenth patient.
Causes of prostatitis
Infections.Pathogenic and opportunistic bacteria enter the prostate through the lymph and blood vessels. Secondary infection of the prostate is often a complication of inflammatory diseases of the rectum and urethra.
Types of infection:
- ascending- microbes rise into the gland from the opening of the outer urethra;
- down- the microbes enter the prostate together with the flow of infected urine.
Conditionally pathogenic microorganisms that provoke the disease (according to data from the Urological Research Institute 1997-1999)
| Microorganisms | Number of tests | |
|---|---|---|
| % | abs | |
| Staphylococcus epidermidis | 42. 3 | 55 |
| S. saprophyticus | 17. 6 | 23 |
| S. aureus | 4. 6 | 6. |
| S. haemolyticus | 3. 1 | four |
| S. hominis | 0. 8 | one |
| S. warneri | 1. 5 | 2 |
| Staphylococcus spp. | 3. 1 | four |
| Enterococcus faecalis | 11. 6 | fifteen |
| Streptococcus spp. | 3. 1 | four |
| TOTAL (gr. +) | 87. 6 | 114. |
| P. aeruginosa | 3. 7 | five |
| E. coli | 4. 7 | 6. |
| Enterobacter spp. | 2, 3 | 3 |
| Proteus spp. | 1. 5 | 2 |
| TOTAL (gr. -) | 12. 3 | sixteen |
Weakening of immunity.One of the causes of inflammation of the prostate is a weakening of the body’s immune system. This can be facilitated by frequent stress, an unbalanced diet, overload, smoking, alcohol consumption. With reduced immunity, the body is most vulnerable to infections leading to prostate disease.
Blood supply disorders.The development of chronic prostatitis can be the result of a sedentary, sedentary lifestyle. With a constant lack of physical activity, the work of the endocrine, cardiovascular and nervous systems, as well as the blood circulation in the pelvic organs is interrupted. This results in oxygen starvation in the prostate tissue.
Irregular sexual activity.Both prolonged sexual abstinence and excessive sexual activity can contribute to the onset of prostatitis. Many sexually active men have nervous exhaustion, hormonal imbalances, impaired gonadal secretion, and gradual fading of potency. Interrupted intercourse has a negative effect on the health of the prostate gland.
Chronic prostate injury. . . Chronic prostatitis can develop as a result of frequent trauma to the soft parts of the prostate gland. This is most common in patients whose professional activities are related to driving. The cause of prostatitis in this case is constant tremor, vibration and excessive stress on the muscles of the perineum.
The main syndromes of prostatitis
Pain.With prostatitis in men, painful and cutting pains occur in the lower abdomen and lower back, as well as throughout the body. This symptom may be exacerbated by ejaculation, especially during intercourse after prolonged abstinence.
Dysuria.Typical signs of prostatitis in men are frequent urination, burning and stinging of the bladder, and pain in the perineum after urination. Another symptom of inflammation of the prostate is difficulty urinating. Acute urinary retention may occur if the disease is not treated.
Sexual dysfunctions.In the case of uncomplicated prostatitis, accelerated ejaculation, wearing orgasmic sensations, pain during ejaculation, partial or complete decrease in libido. Prolonged erections at night are also a symptom of chronic prostatitis.
External manifestations.In prostatitis, some patients have purulent or clear discharge from the urethra, which is most common in the morning. Patients may also experience symptoms such as the presence of white flakes or filaments in the urine.
Types of prostatitis
Acute bacteria.Acute prostatitis develops as a result of infection of the prostate gland by Staphylococcus aureus, Escherichia coli, enterococcus, and other pathogenic bacteria. If left untreated, this disease can cause sepsis. In this case, the man should be taken to hospital urgently.
Symptoms of this type of prostatitis include:
- chills and fever (38 ° C and higher);
- sharp or pulling pains in the groin, lower back and perineum;
- frequent urination;
- painful urination;
- difficulty urinating and acute urinary retention;
- white or colorless discharge from the urethra.
Chronic bacterium.The recurrent form of the disease is the result of the penetration of the infection into the gland. Chronic hypothermia, prolonged sexual abstinence, and premature urination contribute to the development of prostatitis. Chronic prostatitis, if left untreated, can provoke cystitis, as prostatitis is a reservoir of bacteria that affect the urogenital tract.
Symptoms of chronic prostatitis:
- pain in the scrotum, lower abdomen, perineum;
- dysuria;
- violation of potency.
Chronic, not bacterial.Causes of the disease include the penetration of viruses or bacteria into the prostate (tubercle bacillus, Trichomonas, chlamydia), autoimmune processes, urinary incontinence. Chronic prostatitis accounts for 95% of all prostatitis.
Signs of prostatitis include:
- chronic pain in the pelvic area (disturbing the man for at least 3 months);
- recurrent lumbar pain;
- lack of inflammatory symptoms of urine, sperm, and prostate secretions.
Chronic asymptomatic.Asymptomatic chronic prostatitis is not associated with bacterial infection and symptomatic prostate syndromes. It is hypothesized that this disease is an age-related physiological feature.
Symptoms of this type of chronic prostatitis:
- lack of major syndromes of the disease;
- increased leukocytes and bacteria in urine.
The main symptom of the disease - the presence of an infection in the gland - can be detected only by biopsy or during surgeries in the treatment of various pathologies of the prostate (adenoma, cancer).
Pangó.Prostatitis does not only develop underlying anatomical and physiological changes in the venous and other body systems. The main cause of the disease is irregular sex life.
Signs of prostatitis:
- painful pain in the perineum, radiating to the sacrum;
- increased urination in the morning;
- mild difficulty urinating (the symptom is observed in the chronic form of the disease);
- weakening of the erection;
- decreased libido;
- The "pallor" of orgasmic feelings during ejaculation.
Diagnosis of acute and chronic prostatitis
To select the right method of treatment, your doctor will prescribe a comprehensive diagnosis of the condition of the urogenital system, including the following methods.
Digital rectal examination.If prostatitis is suspected, the urologist will perform a digital examination. The back surface of the prostate is adjacent to the rectum, so when the finger is inserted through the anus, the doctor can determine the condition of the gland. During the examination, their size, consistency and shape, surface condition and pain are determined.
Signs of prostatitis in men:
- the soft, inelastic consistency of the prostate;
- tactile pain;
- enlarged gland;
- immobility of the rectal mucosa above the prostate.
Ultrasound procedure.Prostate ultrasound is prescribed prior to initiating treatment for acute prostatitis to identify / rule out an abscess of the gland and during the chronic course of the disease to identify prostate cysts and stones and the degree of prostate. compression of the urethra. The most effective method is rectal ultrasound.
Uroflometry.This method of diagnosing prostatitis is used to study the indicators of the urinary process: the duration of this physiological act and the rate of urine outflow. If the speed is 15 ml / s or more, this indicates normal urethral patency. A sign of prostatitis is a decrease in this value below 10 ml / s. This speed is due to poor urinary tract patency.
Interpretation of uroflowmetry results
| Urine flow rate | Interpretation |
|---|---|
| >15 ml / sec | Urinary tract obstruction is unlikely |
| <10ml / sec | Significant narrowing of the urethra or weakness of the detrusor is likely |
| 10-15 ml / sec | Indefinite result |
Cystoscopy.An endoscopic imaging system is placed in the bladder for examination. This method for diagnosing acute and chronic prostatitis is used when diseases such as cancer, cystitis, or bladder trauma are suspected.
Laboratory research.Urinary and prostate secretions are examined in the presence of symptoms of chronic prostatitis or acute inflammation to diagnose and determine the disease-causing microorganism. An indication of the presence of the pathogenic microflora is the increased number of leukocytes in the biological material. To establish an efficient treatment process, bacterial types are determined by inoculation into PCR, RIF, and medium.
Interpretation of laboratory results
| Prostate secret | Third urine sample (after prostate massage) | |||
|---|---|---|---|---|
| HP form | Leukocyte count, uv. x 400 | Sowing results | Leukocyte count, uv. x 400 | Sowing results |
| Bacterial | >10 | + | The difference in leukocyte count between the third part of the urine and the second part of the urine is ≥10 | + |
| Chronic pelvic pain is an inflammatory syndrome | >10 | - | The difference in leukocyte count between the third part of the urine and the second part of the urine is ≥10 | - |
| Non-inflammatory chronic pelvic pain syndrome | <10 | - | - | - |
Prevention of prostatitis
Physical activity.To prevent and treat prostate disease, a person must avoid physical inactivity. Recommended:
- walking (4 km or more per day);
- practice (squatting, jumping, bending);
- training the muscles of the perineum and buttocks (10 tension and relaxation).
Proper nutrition.To prevent acute and chronic prostatitis, men should include foods containing zinc and vitamin B in their diet. Recommended to eat:
- seafood (oysters, algae);
- meat;
- pumpkin seeds;
- walnut;
- bran;
- kefir;
- Rye bread.
Regular sex life. In preventing and treating the disease, people need:
- pursue a rhythmic sex life;
- avoid interrupted sexual intercourse;
- avoid casual relationships.
Treatment of acute and chronic prostatitis
Inflammation of the prostate is treated by the following methods.
Antibacterial therapy.If the prostatitis is bacterial, antibiotics are needed for treatment. The physician selects a group of drugs from the type of microbes that cause the disease, from the susceptibility of the pathogen to different drugs, and from the presence of contraindications in the patient.
Characteristics of drugs
| Drug | Advantages | disadvantages |
|---|---|---|
| Fluoroquinolones |
|
|
| Macrolides |
|
Not active enough against gram-negative bacteria |
| Tetracyclines | Active against atypical pathogens |
|
Hormone therapy.Hormone therapy is required to restore normal hormonal balance between androgens and estrogens. Antiandrogenic drugs reduce inflammation of the glandular tissues and prevent the disease from progressing to a more severe stage.
Prostate massage.This method can only be used to treat chronic prostatitis outside of exacerbations. The person should be in an oblique position, resting his palms on a couch or table, spreading his legs to shoulder width. The treating doctor puts on sterile gloves, applies an ointment or gel (in some cases a medicine containing an anesthetic component) to the index finger of his right hand, and injects it into the rectum through the anus. The massage is performed with gentle pressure until the secretions of the prostate are separated through the opening of the urethra. The treatment includes at least 10 massages.
Physiotherapy.Methods are used to treat the symptoms of prostatitis in the pelvis to normalize and increase blood circulation. This makes it possible to rule out stagnation and increase the effectiveness of drug therapy. The treatment is performed by exposing the gland to ultrasound waves, electromagnetic vibrations, and high temperatures (microcrystalline with warm water).
Surgical intervention.Surgical procedures for prostate disease are rarely used. Such treatment is mandatory for the development of complications of acute or chronic prostatitis.
Indications for prostate surgery:
- acute urinary retention due to severe narrowing of the urethra;
- abscess (appearance of lethargy on the surface of the gland);
- glandular sclerosis;
- adenoma that does not respond to conservative treatment.
Complications of prostatitis
Vesiculitis.Untreated prostatitis can cause inflammation in the nuclei. Symptoms of the disease include deep pelvic pain radiating to the sacrum, exacerbated by erection and ejaculation, frequent urination, and blood and / or pus in the semen and urine.
Colliculitis and urethritis.Due to its proximity to the drainage current of the prostate, the genital tubule often becomes inflamed as a result of infection of the infected gland. Without treatment, the symptoms of prostatitis are accompanied by a characteristic symptom of urethritis - burning or tickling in the urethra when urinating. Ejaculation also causes pain due to spasmodic constriction of the urethra.
Abscess of the prostate.The appearance of purulent cavities on the surface of the gland is due to the pathogenic bacteria that cause prostatitis. The characteristic symptoms of the disease are general weakness, confusion, delirium, sudden rise in temperature, increased sweating, chills. Prostate abscess is a severe septic disease that should be treated in a hospital setting.
Prostate sclerosis.Prostate sclerosis develops in the background of regular exacerbations of chronic prostatitis due to non-adherence to treatment prescribed by a urologist. This disease can develop over several years, however, if the human body is upset with hormonal imbalance, rapid development is possible. With prostate sclerosis, pain is observed during bladder emptying, intermittent and slow urine flow.
Formation of cysts and stones. . . The appearance of cysts in the gland is one possible possibility for the progression of chronic prostatitis. Infection with neoplasms can cause abscesses and greatly complicate the treatment of the disease. Single and multiple stones can form in the prostate. In this disease, in addition to the usual symptoms of chronic prostatitis, the outflow of urine, frequent urination, and pain in the perineum are violated.
Infertility.In chronic prostatitis, sperm production and motor function are impaired. If left untreated, the disease also affects iron deferents and nuclei, making them impassable to sperm and not being thrown into the urethra during ejaculation. As a result, men with chronic prostatitis often suffer from infertility.