Inflammation of the prostate, or prostatitis, can be acute and chronic. Most often, organ damage is caused by a specific or nonspecific infection, sometimes pathological changes develop as a result of congestion in the small pelvis. The main symptoms are urinary disorders and decreased potency. Treatment should be comprehensive and include the use of drugs and the normalization of blood circulation in the pelvic organs in men.
Classification and characteristics of prostatitis
Inflammation of the prostate in men is a pathology that significantly reduces the quality of life of patients and provokes a number of severe complications from both the urinary and genital areas.
Prostatitis along the course is acute and chronic. The latter can occur on its own (this happens more often) or is a consequence of an untreated acute process.
Classify prostate inflammation as follows:
- The first category, or acute bacterial prostatitis.
- The second is chronic bacterial inflammation.
- The third, or chronic abacterial prostatitis (chronic pelvic pain syndrome). It is subdivided into 3A - inflammatory and 3B - non-inflammatory.
- The fourth is asymptomatic inflammation of the prostate gland.
The first and second categories are established for patients with a positive bacteriological study. The difference is that the first is diagnosed when the symptoms last no longer than 3 months. With a longer presence of clinical manifestations, chronic bacterial prostatitis is diagnosed.
The third category is also called chronic pelvic pain syndrome, as the main complaint of patients is pain for at least 3 months. When examining secretions (ejaculate, urine, gland secretion after massage), pathological microflora is not detected. In the case of an increase in the number of leukocytes in these analyzes, inflammatory prostatitis (category 3A) is established, with their normal content - non-inflammatory.
In most men, one of the above categories is identified, as patients seek help due to the presence of certain symptoms of pathology.
Recently, doctors have identified the fourth subtype of the disease - asymptomatic prostatitis. It is diagnosed by chance during medical examinations or when a man is being examined for other diseases of the genitourinary system. The danger of this form lies in the fact that there are pathological changes in the prostate gland, but the disease does not show any subjective signs. This condition often leads to the development of infertility.
Why there is a burning sensation in the urethra in men
Acute inflammation of the prostate in men occurs in 70% of cases due to E. coli infection.In other situations, the pathology is caused by enterobacteriaceae such as pseudomonas, Klebsiella, Proteus. Staphylococci and streptococci are much less common.
Of specific infections, neisseria gonorrheae and trichomonas vaginalis can cause acute prostatitis.
The contributing factors are:
- Conducting various surgical interventions on the male genitourinary organs.
- Narrowing of the urethra as a result of chronic and acute inflammatory processes in the urethra.
- Performing diagnostic manipulations - cystoscopy, ureteroscopy, etc.
- Violation of urination as a result of benign prostatic hyperplasia.
- Activation of opportunistic microflora (enterobacteria) into pathogenic under the influence of reduced immunity and other diseases of the body.
- Irregular sex life, which leads to stagnation of secretions in the prostate gland.
If chronic prostatitis appears as a continuation of an acute process, then its cause will be the same. In the event of this form of the disease, the main predisposing factors are primarily:
- Mycobacterium tuberculosis.
- Gonorrhea and Trichomonas (can immediately cause a chronic form without an acute period).
- Various types of fungi.
In the mechanism of the appearance of pathology, an important role is played by such a phenomenon as intraprostatic reflux - the reflux of urine through the excretory ducts into the prostate gland. As a result of this process, the infection can easily enter the organ, multiply and cause inflammation. Increase reflux:
- phimosis (narrowing of the foreskin);
- decrease in the lumen of the urethra;
- balanoposthitis (inflammation of the foreskin);
- obstruction of the urethra with calculus in urolithiasis.
Reflux and irregular sex life increase stagnant processes in the prostate, which leads to the active reproduction of microorganisms, intensification and spread of inflammationAs a result, areas of fibrosis (replacement of normal tissue with dense non-functional connective tissue) and the formation ofprostatic calculi. All this enhances the pathological process and leads to serious consequences.
Abacterial chronic prostatitis
Chronic Pelvic Pain Syndrome (CPPS) is synonymous with this disease and occurs without the presence of any microorganisms in the secretions detected by standard microbiological methods.
There are several theories of the appearance of pathology:
- chemical inflammation;
Confirmation of the infectious theory is that during polymerase chain reaction (PCR), DNA of pathogens is detected in the secretion of the prostate gland. However, microorganisms themselves are not detected by other microbiological methods.
Generally, with CPPS, the genetic material of the following bacteria is found:
- Ureaplasma urealyticum (ureaplasma urealyticum).
- Mycoplasma hominis.
- Chlamydia trachomatis.
- Trichomonas vaginalis.
The chemical inflammation theory explains CPPS as intraprostatic reflux, but in this case, the cause is not bacteria, but urine itself. Once in the prostate, it causes damage to cellular structures and an inflammatory response.
According to the immune theory, pathology occurs as a result of autoimmune processes or as a result of the immune response to the ingress of a foreign antigen into an organ.
In most cases, CPPS is caused not only by one, but by their complex effect.
The provoking factor of asymptomatic prostatitis can be anyone that can cause the above categories, the difference lies only in the course of this form of the disease.
Acute bacterial inflammation of the prostate gland is characterized by the appearance of general and local symptoms.
Severe pain in the suprapubic region and in the perineum, as well as impaired urination up to its complete stop, come first. Of the general symptoms of patients, they are concerned about body aches, sweating, chills, fever, weakness.
Sometimes pain occurs only during bowel movements or in a sitting position. In some atypical cases, fever is the only sign of illness.
With severe prostate edema, acute urinary retention occurs. This is due to the fact that the organ with its increased size squeezes the urethra and forms a mechanical obstacle for the outflow of the contents of the bladder. At the same time, the general condition of the patient is significantly deteriorating: signs of intoxication are increasing every hour, and in severe cases, a disturbance of consciousness and even a coma may occur.
In case of delayed diagnosis, complications such as abscess formation (suppuration) of the prostate with further breakthrough of pus into the urethra or rectum may occur. As a result, fistulas are formed, which require surgical intervention and reconstructive operations.
Manifestations of chronic bacterial inflammation of the prostate
The manifestations of this form of the disease are varied and range from a complete absence of symptoms to a sharp exacerbation of the process.
In most cases, patients are concerned about pain in the perineum and rectum of varying intensity, which can spread to the scrotum, sacrum, penis and thighs. Sometimes the pain syndrome becomes paroxysmal, reminiscent of neuralgia.
Urethral discomfort and frequent urination are also observed. Discharge from the urethra is sometimes determined. They get worse during the day after walking, exercise, bowel movements, or prostate massage.
There is a feeling of heaviness, pressure, fullness in the rectum and perineum. These symptoms are worse after prolonged sitting. 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.
Abacterial prostatitis symptoms
CPPS is characterized by a clinical picture of chronic bacterial inflammation of the prostate.
Patients suffer from pelvic and perineal pain for more than 3 months, and the results of bacteriological examination are negative.There are various types of urinary disorders:
- frequent urine output;
- difficulty urinating (sluggish stream, need for additional efforts);
- pain when passing urine.
Sometimes there are sexual dysfunctions - decreased libido, impotence.General symptoms often appear in the form of weakness, headache.
The mainstay of therapy is antibiotics. In a chronic process, drugs from the group of fluoroquinolones are indicated. For acute prostatitis, beta-lactam antibiotics and aminoglycosides are prescribed.Treatment is carried out in 2 stages:
- At the first, empiric therapy is prescribed (before receiving cultures). For this, third-generation cephalosporins or fluoroquinolones are used.
- At the second stage, the treatment is corrected according to the obtained bacteriological data and the results for sensitivity to antibacterial agents.
These groups of antibiotics are chosen for the reason that they penetrate the hematoprostatic barrier and create a high concentration of active substance in the prostate gland. This allows you to eliminate the focus of infection.For abacterial prostatitis, antimicrobial therapy is also prescribed, which is necessary for 2 reasons:
- Antibiotics significantly alleviate the condition of patients.
- There is a high probability of presence of microorganisms in the secretions that are difficult to detect by laboratory methods in the prostate.
The antibiotic regimen for chronic pelvic pain syndrome is as follows:
- A fluoroquinolone drug or Doxycycline is prescribed for 2 weeks.
- Re-examination of the secretion of the prostate gland is carried out and, with a decrease in symptoms, continue taking the funds for up to 4 weeks.
Treat patients with asymptomatic prostatitis for the following indications:
- before undergoing prostate surgery as a prophylaxis;
- when identifying pathogenic microorganisms in secretions;
- with an increased level of antiprostatic antibodies in the blood and positive microbiological tests.
For prostatitis, drugs from the group of alpha-blockers are prescribed. These funds increase the maximum and average urine flow rate, reduce the tone in the wall of the urethra and eliminate incomplete opening of the bladder neck during emptying. These effects eliminate phenomena such as:
- Frequent and painful urination;
- jet flow reduction;
- the need for extra effort to excrete urine.
Typical representatives are Alfuzosin, Tamsulosin and Doxazosin, they are especially relevant in chronic forms of the disease.The course of treatment for these drugs is at least 3 months.
Non-steroidal anti-inflammatory drugs are prescribed as symptomatic therapy. They reduce inflammation, edema, and reduce pain.Drugs such as 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, local treatment is also used. For this purpose, patients are prescribed such drugs in suppositories as Vitaprost, Prostatilen, Uroprost, etc. They are also indicated for prostate adenoma.
Dwarf palm fruit extract is widely used in traditional medicine. Active substances reduce inflammation, edema and have a vasoprotective effect (strengthen the vascular wall).
The bark of the African plum tree has similar effects.
Prostatilen has a natural origin. It is made from the prostate gland of cattle. It has an anti-inflammatory effect and reduces the phenomenon of prostate adenoma.
Prostatitis can be treated with folk remedies. In the first place in terms of effectiveness - the use of pumpkin seed oil. You can buy this product at pharmacies. Take it for 1 tbsp. l. 3 times a day, the course of treatment is 3-4 months.As a prophylaxis of prostate diseases, all men can take 30 pumpkin seeds before meals once a day. You need to take them raw, since after roasting, the healing properties are lost.
For treatment, you can use pumpkin seeds prepared according to the following recipe:
- 0. 5 kg of peeled seeds are ground in a meat grinder or blender.
- Add 200 g of honey to them and mix everything until smooth.
- Forms 2-3 cm balls.
Store them in the refrigerator, take one piece 30 minutes before meals. This product should be chewed for 2-3 minutes and dissolve, not swallowed. The course of treatment is 6 months.
An infusion of leaves or a decoction of hazel bark has a healing effect on prostatitis. To prepare the first remedy, you need to take 1 tbsp. l. dry leaves and brew in a glass of boiling water. You need to insist it for 30 minutes and take 1/4 of the resulting solution 4 times a day. For a decoction from the bark, 1 tbsp. l. Pour 200 ml of crushed raw materials and cook in a water bath for 30 minutes. After that, the medicine should be cooled and taken 1/4 cup 4 times a day.
Parsley greens have a healing effect on prostatitis. It has anti-inflammatory properties and helps to restore sexual activity. In this case, parsley juice is used. To do this, the greens are crushed to a state of gruel and squeezes out liquid from it through cheesecloth folded 3-4 times. Take it for 1 tbsp. l. 3 times a day.
Treat prostatitis at home and with medicinal herbs. One of them is wormwood. It allows you to relieve inflammation and rid the body of the pathogen. It is taken dry in the first 3 days - it is absorbed in the mouth every 2-3 hours. The next four days reduce the number of receptions to 5. Every day, at night, they make microclysters from the grass.
For this you need to prepare an infusion: 1 tbsp. l. you need to take 1 liter of water. The composition should be boiled and allowed to cool to +40 degrees. After that, the solution must be filtered. It is necessary to do injections into the anus (100 ml), as well as into the urethra (50 ml). The procedures should be carried out within a week. They are indicated in a chronic process.During douching and microclysters, the release of pus is possible - this is a normal phenomenon, which indicates the effectiveness of treatment.
In combination with the main methods of treating the disease, physiotherapy, prostate massage and organ acupuncture are used.
Living with chronic prostatitis means regularly undergoing comprehensive examination and therapy, since there is a high probability of loss of reproductive function.