Many doctors jokingly call prostatitis male menopause. Such a disease is diagnosed in 20% of cases in men after forty years, in 70% - after sixty years and in 90% of cases after the age of seventy years. The disease can occur in two forms: acute and chronic prostatitis. This disease must be treated, especially since it lends itself well to therapy. But many men ignore unpleasant symptoms, which leads to the development of many complications that become more difficult to cure.
Acute prostatitis is an acute pathology of the prostate that develops as a result of an inflammatory and infectious process in an organ due to the penetration of pathogens into its tissues. The disease is characterized by the appearance of swelling of the gland, purulent contents in its tissues.This leads to the appearance of many unpleasant symptoms, a violation of the functionality of the organs of the genitourinary system.
There are many causes of acute prostatitis. In most cases, it is provoked by pathogenic microbes.Some of the microbes can exist in the body of a healthy person in a passive form on the skin or in the intestines. Under the influence of some factors, they are activated, penetrate into the tissues of the gland and actively multiply there. Often the ailment appears due to STDs, for example,chlamydia, ureaplasmosis, gonorrhea, etc.
Also, an acute form of prostatitis occurs as a complication ofurethritis. Germs enter through ducts that open into the urethra. Also, often the cause of prostatitis is the spread of bacteria from other organs of the genitourinary system. Often, the gland can be affectedduring surgical procedures, catheterization, diagnostic measures.
Since there are a large number of blood vessels in the prostate gland, infection can get here with the blood flow in the presence of chronic pathologies in the body, for example,tonsillitis, bronchitis, etc.In the presence ofanal fissures, microbes may enter the prostate with lymph flow.
But infections do not always lead to the development of disease. Congestion in the vessels of the pelvic region, which developswith prolonged abstinence from sexual intercourse or a huge number of them.
Congestion is also associated withlack of physical activity, constant constipation, alcoholism, varicose veins in the pelvic region, hypothermia.
In urology, several forms of pathology are distinguished, which are also its stages of development:
- Catarrhal formis characterized by the appearance of inflammation in the organ, a change in its mucous epithelium. Over time, the swelling of the gland occurs, a mucopurulent secret is collected in it, contributing to the progression of the disease.
- Then focal suppuration appears. The disease enters the second stage (form) -follicular form. The urinary ducts are narrowed or blocked, the secret ceases to be normally secreted from the organ. Pus can be secreted into the urinary tract, forming purulent foci there. The cells of the gland change, the prostate continues to swell and grow in size.
- Parenchymal formdevelops when the organ is completely inflamed, a purulent infection develops in it. In the absence of therapy, small purulent foci merge into one huge one, an abscess develops, which often opens into the urethra, intestines and bladder. In some cases, the development of this form of pathology at once is possible when the infection penetrates into the interstitial tissue of an organ with blood or lymph flow.
Shows symptoms of acute prostatitis. How strongly the signs will be visible and felt will depend on the form (stage) of the disease. Common signs of the disease include the following:
- pain syndrome during urine excretion;
- symptoms of intoxication;
- pain in the genital area;
- frequent urge to use the toilet, especially at night;
- possible discharge from the urethra.
As a man's prostatitis progresses, the pain syndrome will spread to other areas. This is due to the transmission of impulses along the nerve endings. The excretion of urine becomes very painful. Often at this stage, an acute delay develops, which is considered a dangerous condition, since it can lead to rupture of the bladder.
The symptoms of acute prostatitis continue to increase. There is severe pain during bowel movements, body temperature increases. The prostate becomes enlarged, tight, and painful. The urine will be cloudy due to the content of pus and mucus.
At the last stage, the disease manifests itself strongly.
The body temperature increases greatly, it is joined by fever and chills, loss of appetite, severe weakness, exhaustion of the body as a whole. Urination may stop completely, and the man will experience acute severe pain when trying to go to the toilet. This condition is excruciating, pain syndrome begins to spread throughout the pelvic region. A man cannot find a place for himself, he is forced to lie with tucked limbs. If the inflammation has spread to the rectum, then mucus will come out of the anus. Yellow-green mucus mixed with blood is released from the urinary tract.
This condition can causesepsis, cystitis, pyelonephritis, chronic prostatitis, abscess. In this case, urgent hospitalization of the patient and emergency treatment are required.
Since the symptoms of acute prostatitis in men are quite pronounced, the doctor may immediately suspect a pathology. But he needs a thorough examination. Rectal examination in this case is strictly contraindicated.
The urologist must determine the stage (form) of the disease using laboratory and instrumental techniques. The doctor takes aprostate secretfor examination. The concentration of leukocytes will be increased in it, which indicates acute inflammation.
Thenlaboratory tests of blood and urine are performed. The urine is sent for bacteriological culture for examination, as well as determination of the causative agent of the infection and its sensitivity to antibacterial drugs. It is also possible to conduct:
- PCR for STD detection;
- uroflowmetry to identify the severity of organ disorders;
- Ultrasound of the prostate in order to determine the shape and size of the organ, changes in it, the stage of the disease;
- dopplerometry helps to distinguish acute prostatitis from other pathologies;
- MRI of the pelvic organs is often prescribed when planning a surgical intervention;
- analysis of the concentration of SPA in the blood;
- examination of smears of urethral discharge;
- puncture of parts of the organ in case of suspected purulent infection and abscess.
A urologist will tell you in detail how to treat acute prostatitis. The main component of therapy is an antibacterial drug, which is selected in accordance with the results of bacterial culture. Within two or three days, the antibiotic begins to help, the person feels much better, the pain begins to subside. But with this form of the disease, such drugs need to be taken for one month, even if the symptoms have completely disappeared.
It is also necessary to prevent the disease from becoming chronic, which is quite common.
When choosing a drug, the doctor takes into account other factors:
- some agents do not penetrate well into the tissues of the gland;
- other agents accumulate in tissues in large quantities.
Treatment of acute prostatitis in men should be based on the use of powerful drugs, as in other cases that threaten a person's life. Usually doctors prescribe fluoroquinolones. When using macrolides, the dosage should be large. This is especially true in patients with immunosuppression.
Antibiotics are usually given with intravenous injections. At the initial stage, the disease can be treated at home or on an outpatient basis.In this case, bed rest is prescribed, since any power load can provoke the spread of infection and the development of sepsis.
In combination with antibiotics, the following drugs are also prescribed:
- antipyretic drugs;
- an opiate may be prescribed for severe pain;
- diuretics to reduce intoxication of the body;
- laxatives to facilitate bowel movements;
- antispasmodic drugs to facilitate urine excretion;
- alpha blockers.
If a man has acute urinary retention, urea catheterization is performed. Antiandrogens are often used in order to reduce swelling and inflammation in the organ, improve the outflow of secretions, normalize blood flow in the gland, and reduce the risk of infection spreading throughout the body.
Use of hormones such as estrogen, cold enemas to relieve swelling and pain. Massage and thermal procedures for this form of the disease are strictly prohibited. They can only be applied during the recovery period.
In the absence of pain, the doctor may suspect the development of an abscess. In this case, surgical intervention is performed to eliminate the areas in which it occurs. Puncture drainage of an abscess is often used. In severe and extreme cases, the organ is removed.
The operation is prescribed in the presence of an abscess, acute retention of urine, severe pain syndrome that cannot be eliminated by any drugs, the appearance of stones and neoplasms, as well as the ineffectiveness of drug treatment, frequent infections of the genitourinary system, paraproctitis.
The surgeon may use one of the following techniques:
- TRUP (transurethral resection)involves the removal of the inside of the organ. Most often used;
- Prostatectomyinvolves partial or complete removal of an organ through an incision in the lower abdomen;
- Laser surgery. In this case, the affected areas of the organ are removed using a laser;
- The abscess is drainedthrough the rectum. A drain is inserted into the incision, through which pus is pumped out;
- To facilitate urine removal, atransurethral incisionis performed in the organ.
When the structure of the tissues of the gland is restored, its functions are normalized, the secret of the prostate normalizes its composition, the causative agent of the pathology will be completely eliminated from the body, we can talk about the cure of prostatitis.
With therapy, the prognosis of the disease will be good. Sometimes negative consequences of acute prostatitis develop. The disease can become chronic, then it will be more difficult to eliminate. Dangerous consequences of an untreated disease are organ abscess, sepsis, acute urinary retention. In some cases, due to the appearance of complications, death can occur. But usually men do not allow such consequences to develop, since they come to the doctor and begin a course of therapy.
For the purpose of prevention, it is necessary to prevent the appearance of predisposing factors. This requires timely treatment of all infections in the body so that they do not become chronic and do not become potential foci of infection that will spread to the prostate gland.
When carrying out surgical procedures, the doctor should pay attention to the use of antiseptics. Otherwise, the risk of germs entering the patient's body increases. It is important that a man and his sexual partner treat STDs in a timely manner, and it is best to prevent their occurrence. Sex life should take place with one regular partner, it should be regular.
It is necessary to lead an active lifestyle, play sports or exercise, observe the rules of intimate hygiene.
Men usually seek medical advice in emergencies. But when negative signs appear, it is better to contact them immediately. This will help to avoid many health problems and even save life in some cases.