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 and in 90% of cases after seventy years. The disease can manifest itself in two forms: acute and chronic prostatitis. This disease needs to be treated, especially as it lends itself well to therapy. But many men ignore the unpleasant symptoms, which leads to the development of many complications that become more difficult to cure.
Reasons for development
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, disruption of the functionality of the organs of the genitourinary system.
There are many causes of acute prostatitis. In most cases, it is caused by pathogenic microbes.Some microbes can exist in the body of a healthy person in passive form on the skin or in the intestine. Under the influence of some factors, they are activated, penetrate the tissues of the gland and actively multiply there. Often the disorder appears due to sexually transmitted diseases, for example,chlamydia, ureaplasmosis, gonorrhea, etc.
Furthermore, an acute form of prostatitis occurs as a complication ofurethritis. Germs enter through the ducts that open into the urethra. In addition, the spread of bacteria from other organs of the genitourinary system often becomes the cause of the appearance of prostatitis. Often the gland can be affectedduring surgical procedures, catheterization, diagnostic measures.
Since the prostate gland contains a large number of blood vessels, infection can enter here with the bloodstream in the presence of chronic pathologies in the body, for example,tonsillitis, bronchitis, etc.In the presence ofanal fissures, microbes can enter the prostate with lymphatic flow.
But infections don't always lead to 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.
Classification
In urology, different 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, 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 excreted normally from the organ. Pus can be secreted into the urinary tract, forming purulent foci there. The gland cells change, the prostate continues to swell and grow in size.
- Parenchymal formdevelops when an organ is completely inflamed, a purulent infection develops in it. In the absence of therapy, small purulent foci merge into a huge one, an abscess develops, which often opens into the urethra, intestines and bladder. In some cases, it is possible to develop this form of pathology immediately when the infection enters the interstitial tissue of an organ with blood or lymphatic flow.
Symptoms
Shows the symptoms of acute prostatitis. How much the signs will be visible and perceived will depend on the form (stage) of the disease. Common signs of the disease include the following:
- pain syndrome during urinary excretion;
- symptoms of intoxication;
- pain in the genital area;
- frequent need to use the bathroom, especially at night;
- possible discharge from the urethra.
As male 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. Acute retardation often develops at this stage, which is considered a dangerous condition, as it can lead to rupture of the bladder.
The symptoms of acute prostatitis continue to increase. There is severe pain during bowel movements, the body temperature rises. The prostate becomes enlarged, tight and painful. The urine will be cloudy due to the pus and mucus content.
In the last stage, the disease manifests itself strongly.
The body temperature rises sharply, it is accompanied by fever and chills, loss of appetite, severe weakness, exhaustion of the body as a whole. Urination can stop completely and when he tries to go to the toilet, the man will experience severe pain. This condition is excruciating, the pain syndrome begins to spread throughout the pelvic region. A man cannot find a place for himself, he is forced to lie with his limbs hidden. If the inflammation has spread to the rectum, mucus will come out of the anus. A 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.
Diagnostics
Since the symptoms of acute prostatitis in men are quite pronounced, the doctor can immediately suspect a pathology. But it needs a thorough examination. Rectal examination in this case is strictly contraindicated.
The urologist must determine the stage (form) of the disease using instrumental and laboratory techniques. The doctor takes aprostate secretfor examination. The concentration of leukocytes will be increased in it, which indicates acute inflammation.
Thenlaboratory blood and urine tests are performed. Urine is sent for bacteriological culture for examination, as well as for the determination of the causative agent of the infection and its sensitivity to antibacterial drugs. It is also possible to conduct:
- PCR for the detection of sexually transmitted diseases;
- uroflowmetry to identify the severity of organ disorders;
- Ultrasound of the prostate to determine the shape and size of the organ, changes in it, the stage of the disease;
- dopplerometry helps distinguish acute prostatitis from other pathologies;
- MRI of the pelvic organs is often prescribed when planning surgery;
- analysis of the concentration of SPA in the blood;
- examination of urethral secretion smears;
- puncture of parts of the organ in case of suspected purulent infection and abscess.
Treatment
A urologist will explain in detail how to treat acute prostatitis. The main component of therapy is an antibacterial drug, which is selected based on the results of bacterial culture. Within two to 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 must be taken for a 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. Doctors usually prescribe fluoroquinolones. When using macrolides, the dosage should be high. This is especially true in patients with immunosuppression.
Antibiotics are usually given as intravenous injections. In the initial stage, the disease can be treated at home or on an outpatient basis.In this case, bed rest is prescribed, since any current load can provoke the spread of infection and the development of sepsis.
In combination with antibiotics, the following drugs are also prescribed:
- analgesics;
- antipyretic drugs;
- NSAIDs;
- for severe pain, an opioid may be prescribed;
- diuretics to reduce intoxication of the body;
- laxatives to facilitate bowel movements;
- antispasmodic drugs to facilitate the excretion of urine;
- alpha-blockers.
If a man has acute urinary retention, urea catheterization is performed. Antiandrogens are often used to reduce swelling and inflammation in the organ, improve the outflow of secretions, normalize blood flow in the gland, and reduce the risk of spreading the infection 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.
Surgery
In the absence of pain, the doctor may suspect the development of an abscess. In this case, surgery is performed to eliminate the areas where it occurs. Point drainage of an abscess is often used. In severe and extreme cases, the organ is removed.
The operation is prescribed in the presence of abscess, acute urinary retention, severe pain syndrome that cannot be eliminated by any drug, the appearance of stones and neoplasms, as well as 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 interior of the organ. Used most often;
- Prostatectomyinvolves the 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;
- To facilitate the removal of urine, atransurethral incisionis made in the organ.
When the tissue structure 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.
Forecast
With therapy, the prognosis of the disease will be good. Sometimes the negative consequences of acute prostatitis develop. The disease can become chronic, so it will be more difficult to get rid of it. The 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.
Prevention
For the purpose of prevention, it is necessary to prevent the appearance of predisposing factors. This requires prompt 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 performing surgical procedures, the physician should pay attention to the use of antiseptics. Otherwise, the risk of germs entering the patient's body increases. It is important for a man and his sexual partner to treat sexually transmitted diseases in a timely manner and it is best to prevent their occurrence. Sex life should be with a normal 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 an emergency. But when negative signs appear, it is best to contact them immediately. This will help avoid many health problems and even, in some cases, save lives.