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 due to 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 disease that significantly reduces the quality of life of patients and causes a series of serious complications from both the urinary and genital areas.
Prostatitis can be acute and chronic during the course. The latter can occur on its own (this happens more often) or is the result of an acute untreated process.
Classify the inflammation of the prostate as follows:
- The first category, or acute bacterial prostatitis.
- The second is chronic bacterial inflammation.
- The third chronic bacterial prostatitis (chronic pelvic pain syndrome). It is divided 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 former is diagnosed when the symptoms don't last more 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, glandular secretions after massage), the pathological microflora is not detected. In case of an increase in the number of leukocytes in these analyzes, inflammatory prostatitis (category 3A) is established, with their normal - non-inflammatory content.
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 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 subjective signs. This condition often leads to the development of infertility.
Because there is a burning sensation in the urethra in men
Reasons
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 enterobacteria such as pseudomonas, Klebsiella, Proteus. Staphylococci and streptococci are much less common.
Among specific infections, neisseria gonorrheae and trichomonas vaginalis can cause acute prostatitis.
The contributing factors are:
- Performing various surgeries on the male genitourinary organs.
- Narrowing of the urethra as a result of chronic and acute inflammatory processes in the urethra.
- Carrying out diagnostic manipulations - cystoscopy, ureteroscopy, etc.
- Violation of urination due to benign prostatic hyperplasia.
- Activation of opportunistic microflora (enterobacteria) in pathogens under the influence of reduced immunity and other diseases of the body.
- Irregular sexual life, leading to stagnation of secretions in the prostate gland.
Chronic inflammation
If chronic prostatitis appears as the continuation of an acute process, its cause will be the same. In 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.
- Various types of mushrooms.
In the mechanism of the onset of the pathology, an important role is played by a phenomenon such 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 tartar in urolithiasis.
Reflux and irregular sexual activity increase stagnant processes in the prostate, which leads to the active reproduction of microorganisms, intensification and spread of inflammationAs a result, areas can occur and formof fibrosis (replacement of normal tissue with non-functional dense connective tissue) prostate stones. All this improves the pathological process and leads to serious consequences.
Chronic bacterial prostatitis
Chronic pelvic pain syndrome (CPPS) is synonymous with this disease and occurs without the presence of microorganisms in the secretions detected by standard microbiological methods.
There are several theories on the appearance of the disease:
- infectious;
- chemical inflammation;
- immune.
The confirmation of the infectious theory is that during the polymerase chain reaction (PCR), the DNA of the pathogens is detected in the secretion of the prostate gland. However, the 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 (chlamidia trachomatis).
- Trichomonas vaginalis.
The chemical inflammation theory explains CPPS as intraprostatic reflux, but in this case the cause is not bacteria, but the urine itself. Once in the prostate, it causes damage to cell 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 entry of a foreign antigen into an organ.
In most cases, CPPS is caused not only by one, but by their complex effect.
The trigger 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 pains in the suprapubic region and perineum, as well as reduced urination up to its complete cessation, come first. Among the general symptoms of patients, they are concerned about muscle aches, sweating, chills, fever, weakness.
Sometimes the 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 enlarged 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 is deteriorating significantly: signs of intoxication increase every hour, and in severe cases, disturbances of consciousness and even coma can 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 can occur. As a result, fistulas are formed that require surgical intervention and reconstructive operations.
Manifestations of chronic bacterial inflammation of the prostate
The manifestations of this form of the disease are diverse 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. Sometimes discharge from the urethra is determined. They get worse during the day after walking, exercising, bowel movements, or a 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 have been suffering from pelvic and perineal pain for more than 3 months, while the bacteriological examination results are negative.Various types of urinary disorders are characteristic:
- frequent urination;
- difficulty urinating (slow flow, need for extra effort);
- pain when urinating.
Sometimes there are sexual dysfunctions - decreased libido, impotence.General symptoms often come in the form of weakness, headache.
Drug treatment
Antibiotics are the cornerstone of therapy. In a chronic process, drugs from the group of fluoroquinolones are indicated. For acute prostatitis, beta-lactam and aminoglycoside antibiotics are prescribed.The treatment is performed in 2 phases:
- Initially empirical therapy is prescribed (before receiving cultures). For this, third generation cephalosporins or fluoroquinolones are used.
- In the second stage, the treatment is corrected based on the bacteriological data obtained and the results of sensitivity to antibacterial agents.
These groups of antibiotics are chosen because they penetrate the hematoprostatic barrier and create a high concentration of the active ingredient in the prostate gland. This allows you to eliminate the focus of the infection.Antimicrobial therapy is also prescribed for bacterial prostatitis, which is necessary for 2 reasons:
- Antibiotics significantly alleviate the condition of patients.
- There is a high probability of the 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 or doxycycline drug is prescribed for 2 weeks.
- A re-examination of the secretion of the prostate gland is performed and, with a decrease in symptoms, the funds are continued for up to 4 weeks.
Treat patients with asymptomatic prostatitis for the following indications:
- infertility;
- before undergoing prostate surgery as prophylaxis;
- when identifying pathogenic microorganisms in secretions;
- with an increase in the level of antiprostatic antibodies in the blood and positive microbiological tests.
Other means
For prostatitis, drugs from the group of alpha-blockers are prescribed. These agents increase the maximum and average rate of urinary 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;
- reduction of the jet flow;
- the need for extra effort to pass urine.
Typical representatives are Alfuzosin, Tamsulosin and Doxazosin, they are particularly 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 drugs in suppositories such as Vitaprost, Prostatilen, Uroprost, etc. They are also indicated for prostate adenoma.
Herbal Medicine
Dwarf palm fruit extract is widely used in traditional medicine. The active ingredients 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 produced by the prostate gland of cattle. It has an anti-inflammatory effect and reduces the appearance of prostate adenoma.
Folk remedies
Prostatitis can be treated with folk remedies. First in terms of effectiveness: the use of pumpkin seed oil. You can buy this product at the pharmacy. Take it for 1 tbsp. L. 3 times a day, the course of treatment is 3-4 months.As a prophylaxis of prostate disease, 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.
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 and mix everything until smooth.
- Form 2-3 cm balls.
Store them in the refrigerator, take a piece 30 minutes before meals. This product should be chewed for 2-3 minutes and dissolved, not swallowed. The course of treatment is 6 months.
An infusion of leaves or a decoction of hazelnut 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 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 chopped 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 seeds have a healing effect on prostatitis. It has anti-inflammatory effects and helps restore sexual activity. In this case, parsley juice is used. To do this, the vegetables are crushed to a state of gruel and squeeze the liquid from them through gauze 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 absinthe. 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 into the mouth every 2-3 hours. The next four days reduce the number of receptions to 5. Every day, at night, they produce microenemas from the herb.
For this it is necessary to prepare an infusion: 1 tbsp. L. you need to take 1 liter of water. The composition should be boiled and left to cool to +40 degrees. Next, the solution must be filtered. It is necessary to make injections into the anus (100 ml) and the urethra (50 ml). The procedures should be done within a week. They are indicated in a chronic process.During irrigation and microclimate, the release of pus is possible - this is normal, which indicates the effectiveness of the treatment.
Conclusion
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 a full examination and therapy, as there is a high probability of loss of reproductive function.