Inflammation of the prostate or prostatitis can be acute or chronic. Most often the damage to the organs is caused by a specific or non-specific infection, sometimes pathological changes develop as a result of congestion in the pelvis. The main symptoms are urinary incontinence and decreased potency. Treatment should be comprehensive and include the use of drugs and normalization of pelvic circulation 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 can be acute or chronic in course. 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 were established for patients with a positive bacteriological examination. The difference is that the first is diagnosed when the symptoms last no more than 3 months. With prolonged 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. Examination of secretions (ejaculate, urine, glandular secretions after massage) does not reveal pathological microflora. In case of increase in the number of leukocytes in these analyzes, inflammatory prostatitis (category 3A) is found, with their normal content - non-inflammatory.
One of the above categories is identified in most men, as patients seek help due to the presence of certain symptoms of pathology.
Doctors have recently identified a fourth subtype of the disease - asymptomatic prostatitis. It is diagnosed accidentally during medical examinations or when the man is 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
Causes
Acute inflammation of the prostate in men occurs in 70% of cases due to infection with E. coli.In other situations the pathology is caused by enterobacteria such as pseudomonas, Klebsiella, Proteus. Staphylococci and streptococci are much less common.
From specific infections neisseria gonorrheae and trichomonas vaginalis can cause acute prostatitis.
Contributing factors are:
- Carrying out various surgical interventions on the urogenital organs of men.
- Narrowing of the urethra as a result of chronic and acute inflammatory processes in the urethra.
- Performing diagnostic procedures - cystoscopy, ureteroscopy, etc.
- Impaired urination as a result of benign prostatic hyperplasia.
- Activation of opportunistic microflora (enterobacteria) in 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.
Chronic inflammation
If chronic prostatitis seems to be a continuation of an acute process, then the cause will be the same. In the case of this form of the disease, the main primary predisposing factors are:
- Mycobacterium tuberculosis.
- Clostridium.
- Gonorrhea and Trichomonas (can immediately cause a chronic form without an acute period).
- salmonella.
- Different types of fungi.
An important role in the mechanism of pathology is played by such a phenomenon as intraprostatic reflux - the reflux of urine through the secretory ducts in the prostate gland. As a result of this process, the infection can easily enter the body, multiply and cause inflammation. Increased reflux:
- phimosis (narrowing of the foreskin);
- reduction of the lumen of the urethra;
- balanoposthitis (inflammation of the foreskin);
- obstruction of the urethra with a stone in urolithiasis.
Reflux and irregular sexual activity increase stagnant processes in the prostate, which leads to active reproduction of microorganisms, intensification and spread of inflammationAs a result, areas of fibrosis may appear and form (replacement ofnormal tissue with dense non-functional connective tissue) prostate calculi. All this intensifies 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 about the appearance of pathology:
- infectious;
- chemical inflammation;
- immune.
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, the microorganisms themselves are not detected by other microbiological methods.
In general, CPPS detects the genetic material of the following bacteria:
- Ureaplasma urealyticum. Mycoplasma hominis.
- Chlamydia trachomatis. Trichomonas vaginalis.
The theory of chemical inflammation attributes CPPS to 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 reaction.
According to the immune theory, the pathology arises as a result of autoimmune processes or as a result of the immune response to the penetration of a foreign antigen into the organ.
In most cases, CPPS is caused not by one but by their complex effect.
The provoking factor of asymptomatic prostatitis can be anyone who can cause the above categories, the difference is only in the course of this form of the disease.
Symptoms
Acute bacterial inflammation of the prostate gland is characterized by the appearance of general and local symptoms.
Severe pain in the suprapubic region and perineum, as well as impaired urination until it stops completely, are in the first place. Of the common symptoms of patients are concerned about body aches, sweating, chills, fever, weakness.
Sometimes the pain appears only during defecation or in a sitting position. In some atypical cases, fever is the only sign of illness.
Severe prostate edema results in acute urinary retention. This is due to the fact that the organ with its increased size squeezes the urethra and forms a mechanical obstacle to the outflow of the contents of the bladder. At the same time, the general condition of the patient deteriorates significantly: the signs of intoxication increase every hour, and in severe cases, disturbance of consciousness and even coma may occur.
In case of delayed diagnosis, complications such as the formation of an abscess (suppuration) of the prostate may occur with further penetration of pus into the urethra or rectum. As a result, fistulas form that require surgery and reconstructive surgery.
Manifestations of chronic bacterial inflammation of the prostate
The manifestations of this form of the disease are diverse and range from the 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. Urethral discharge is sometimes determined. They are worse during the day after walking, exercising, defecating or prostate massage.
There is a feeling of heaviness, pressure, fullness in the rectum and perineum. These symptoms worsen 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.
Symptoms of bacterial prostatitis
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 the bacteriological examination are negative.There are different types of urinary disorders:
- frequent urination;
- difficulty urinating (slow flow, need for extra effort);
- pain when passing urine.
Sometimes sexual dysfunctions occur - decreased libido, impotence.General symptoms often appear in the form of weakness, headache.
Drug treatment
The basis of therapy is antibiotics. In a chronic process, drugs from the group of fluoroquinolones are indicated. In acute prostatitis, beta-lactam antibiotics and aminoglycosides are prescribed.The treatment is performed in 2 stages:
- Empirical therapy is initially prescribed (before receiving cultures). Third-generation cephalosporins or fluoroquinolones are used for this.
- In the second stage, the treatment is adjusted according to the obtained bacteriological data and the results for sensitivity to antibacterial agents.
These groups of antibiotics are chosen because they penetrate the blood-brain barrier and create a high concentration of active substance in the prostate gland. This allows you to remove the focus of the infection. Abacterial prostatitis also prescribes antimicrobial therapy, which is needed for two reasons:
- Antibiotics significantly alleviate the condition of patients.
- There is a high probability of the presence of microorganisms in the secretions, which are difficult to detect by laboratory methods in the prostate.
The antibiotic regimen for chronic pelvic pain syndrome is as follows:
- Fluoroquinolone drug or doxycycline is prescribed for 2 weeks.
- A re-examination of the secretion of the prostate gland is performed and with the reduction of symptoms the intake of the funds is continued for up to 4 weeks.
Treat patients with asymptomatic prostatitis according to the following indications:
- infertility;
- before undergoing prostate surgery as a prophylaxis;
- in identifying pathogenic microorganisms in secretions;
- with elevated levels of antiprostatic antibodies in the blood and positive microbiological tests.
Other tools
Alpha-blockers are prescribed for prostatitis. These agents increase the maximum and average urine flow, reduce the tone in the wall of the urethra and eliminate the incomplete opening of the bladder neck during emptying. These effects eliminate phenomena such as:
- Frequent and painful urination;
- reduce jet flow;
- the need for extra effort to pass urine.
Typical representatives are Alfuzosin, Tamsulosin and Doxazosin, they are especially suitable for chronic forms of the disease.The course of treatment with these drugs is at least 3 months.
Nonsteroidal anti-inflammatory drugs are prescribed as symptomatic therapy. They reduce inflammation, swelling and reduce pain.Drugs such as diclofenac, ibuprofen, nimesulide and others are used. The duration of treatment with these drugs should not exceed 4 weeks. These drugs are taken strictly after meals, as they irritate the stomach wall.
In addition to pills, topical treatment is used. For this purpose, patients are prescribed such drugs in suppositories as Vitaprost, Prostatilen, Uroprost and others. They are also indicated for prostate adenoma.
Herbal medicines
Dwarf palm fruit extract is widely used in traditional medicine. The active substances reduce inflammation, swelling and have a vasoprotective effect (strengthen the vessel wall).
African plum peel 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.
Folk remedies
Prostatitis can be treated with folk remedies. In the first place in terms of efficiency - the use of pumpkin oil. You can buy this product in pharmacies. Take it for 1 tbsp. l. 3 times a day, the course of treatment is 3-4 months.As a prevention of prostate disease, all men can take 30 pumpkin seeds before meals once a day. You should take them raw, because after baking the healing properties are lost.
Pumpkin seeds prepared according to the following recipe can be used for treatment:
- 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 eating. This product should be chewed for 2-3 minutes and dissolved, not swallowed. The course of treatment is 6 months.
Infusion of leaves or decoction of hazelnut bark cures prostatitis. To prepare the first medicine, you need to take 1 tbsp. l. dry leaves and boil in a glass of boiling water. You should insist for 30 minutes and take 1/4 of the resulting solution 4 times a day. For a decoction of the bark 1 tbsp pour 200 ml of crushed raw materials and cook in a water bath for 30 minutes. Then the drug should be cooled and taken 1/4 cup 4 times a day.
Parsley vegetables have a healing effect on prostatitis. It has anti-inflammatory action and helps to restore sexual activity. In this case, parsley juice is used. For this purpose, the greens are crushed to a pulp and squeeze the 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 herbs. One of them is wormwood. It allows you to relieve inflammation and rid the body of the pathogen. Take dry for the first 3 days - absorbed in the mouth every 2-3 hours. The next four days reduce the number of intakes 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. The solution should then be filtered. Injections should be given into the anus (100 ml) as well as into the urethra (50 ml). The procedures should be performed within a week. They are shown in a chronic process.During syringes and microclysters, pus may be released - this is normal, which shows the effectiveness of the treatment.
Conclusion
Physiotherapy, prostate massage and organ acupuncture are used in combination with the main methods of treatment of the disease.
Living with chronic prostatitis means undergoing regular check-ups and therapy, as there is a high probability of loss of reproductive function.