Every second man of reproductive age (up to fifty years) is prone to such a delicate disease as acute prostatitis, in which under certain factors the prostate (prostate gland) becomes inflamed, causing various forms of sexual disorders. functions, fertility and psychoemotional states. Be careful what your body says and do not neglect timely treatment.
What is acute prostatitis
If a man feels discomfort and even pain during urination, you should immediately consult a doctor, as acute prostatitis is a disease of infectious etiology, which causes inflammation of the prostate, followed by swelling of glandular tissue, the formation of purulent foci onhim. If you do not pay attention to the signs of acute inflammation of the prostate, then the pathological process can transform into a chronic form that is difficult to treat, and there is very little time to think - the transformation occurs in a few days.
However, more serious complications are possible than its transition to a chronic form. There is a risk of sepsis - a general infection of the blood and ascending urinary tract infection with the development of pyelonephritis and cystitis. In these cases the patient is urgently hospitalized, the condition can be critical. Although sepsis as a complication is rare, it can occur in patients with immunosuppressive conditions - intoxication, fever, severe symptoms, weakness. Therefore, blood cultures are needed to detect microorganisms.
Symptoms of acute prostatitis
Every man should know and remember the symptoms of acute prostatitis. The general signs of the disease are:
- Acute pain when urinating.
- Intoxication of the body.
- Disorders of urination (intermittent, weak, tense flow).
- Often a desire to visit the toilet at night.
These are external symptoms of prostatitis, but a more thorough examination of the urine reveals white blood cells, traces of mucus and pus in the secretory fluid of the prostate gland. On palpation, a dense, enlarged organ is felt, the pressure will be painful. The further development of the inflammatory process is characterized by heaviness and pain in the perineum, radiating to the penis, sacrum and rectum. As a result, the patient finds it difficult to empty the bladder and defecate due to severe pain. Body temperature may rise to 38 ° C.
Causes of acute prostatitis
Because this disease is bacterially inflammatory in nature, the following infectious agents are the causes of acute prostatitis:
- Gram-negative - Klebsiella, E. coli, Proteus.
- Gram-positive - enterococci, staphylococci, streptococci.
- Urogenital - trichomoniasis, chlamydia, ureaplasmosis, gonorrhea, candidiasis, mycoplasmosis.
The microbial microflora penetrates the glandular tissue of the prostate, usually via the transcanalicular route (through the urethra and secretory ducts of the prostate gland). In cystitis, the infection migrates to the prostate from the bladder. Other possible routes of bacterial penetration are opened during endourethral manipulations (catheter placement, urethral bougainvillea, cystoscopy, urethroscopy). Pathogenic microorganisms migrate to the prostate from distant pathogens in caries, sinusitis, tonsillitis, cholecystitis, pyoderma, bronchitis.
There is a high probability of intestinal infection with proctitis, hemorrhoidal fissures, colitis. Non-infectious factors that can cause an attack of prostatitis are congestive (congestive) venous phenomena in the pelvic area and impaired drainage of the acinus of the gland. Congestion can be caused by irregular or, conversely, excessive sexual activity, interruption of sexual intercourse, sedentary lifestyle, frequent constipation, frequent alcohol intoxication, varicose veins of the pelvis, hypothermia.
Forms of acute prostatitis
The clinical development of this disease is considered in three stages, which at the same time are forms of acute pancreatitis. It is:
- The first stage is the catarrhal form.
- The second stage is the follicular form.
- The third stage is the parenchymal form.
Acute prostatitis in men begins with catarrhal inflammation, which is characterized by enlargement of the acini, swelling of the glandular tissue and, as a result, an increase in the size of the organ. The secretory ducts of the prostate glands, which open into the posterior urethra, are actively involved in the inflammatory process. The lobules and ducts of the prostate gland become inflamed, their contractility is disturbed, they become narrow and clogged, which can make it difficult to secrete prostate secretions.
In the catarrhal stage, the pathological process stops in the layers of the mucosa and does not deepen. As the disease progresses, it spreads to the entire prostate gland. Follicular acute bacterial prostatitis develops. The analysis reveals pus in the urine. The tissues of the gland change destructively, the swelling continues to increase. The follicular form is still relatively easy to treat.
In addition, a parenchymal form of the disease develops, which can result in a prostate abscess, ie chronic prostatitis. Therefore, symptoms such as:
- Increase in body temperature to 39 ° C and more.
- Manifestations of intoxication: weakness, chills, thirst, loss of appetite.
- Frequent urges to the toilet for small needs are accompanied by throbbing sharp pain.
- Impossibility to empty the bladder.
- Flatulence.
- Tenesmus.
- constipation.
- Discharge of mucus from the anus.
Diagnosis of acute prostatitis
At the first suspicion of inflammation of the prostate, hurry to the doctor. Proper and comprehensive diagnosis of acute prostatitis is very important for rapid and successful treatment. The doctor will first analyze the history, will clarify when pain sensations appear in the perineum, whether they increase or decrease during ejaculation, urination, defecation. Make sure that the doctor should examine the patient's medical history: what diseases have been transmitted, whether there have been sexually transmitted infections.
The urologist will palpate the external genitalia to identify developmental pathologies, visible signs of prostatitis and rectal examination - palpation of the prostate gland through the anus. In order to create a complete clinical picture, it will be necessary to undergo the following tests:
- Urine analysis to determine the level of leukocytes and the presence of purulent fibers.
- Blood test.
- Culture smear - the contents and scrapings from the urethra are taken to determine the growth of bacteria and their sensitivity to antibiotics.
- Determination of urine velocity (uroflowmetry).
- Ultrasound of the prostate to detect diffuse changes in the gland and its abscess formation.
- Blood test to determine the presence of pathogens of diseases such as syphilis, gonorrhea, mycoplasmosis, chlamydia.
- PCR diagnostics.
Treatment of acute prostatitis
After a thorough diagnosis, treatment for acute prostatitis is started. It is based on antibiotic therapy aimed at suppressing infectious pathogens. In addition, conservative treatment of prostatitis involves the use of:
- Anti-inflammatory drugs.
- Means that improve blood circulation.
- Painkillers and antispasmodics.
- Drugs that support metabolic processes in the prostate.
- Multivitamins.
- Phytotherapeutic agents.
- Immunomodulators.
Advanced forms of inflammation of the prostate with the appearance of purulent foci require surgery. Transurethral (through the wall of the urethra) or transrectal (through the wall of the anus) drainage of abscesses is performed. Surgery may be required in case of abnormal urinary retention. A puncture epicystostomy is performed - an incision is made in the abdominal cavity, into which a tube is inserted to divert urine.
drugs
The treatment of acute prostatitis in men with drugs (tablets, injections) is the basis of successful therapy. With well-prescribed antibiotic therapy, the infection can be overcome in a few days. However, it is recommended to continue the treatment for four weeks in order to achieve complete destruction of the pathogenic microflora. The drugs used in the disease are:
- Etiotropic (antibiotics) - destruction of pathogens.
- Pathogenetic (NSAIDs) - removal of congestion in the prostate.
- Symptomatic (analgesics, antipyretics) - relief of pain, muscle spasms and other symptoms.
For the treatment of inflammation of the prostate, the doctor may prescribe a set of drugs, which will include:
- Injections - contribute to the penetration of the drug into body tissues in a short time.
- Candles (rectal) - analgesic, antibacterial effect.
- Instillations - delivery of the drug to the prostate through the opening of the urethra.
- Microenemas with decoctions of herbs.
- Antibacterial drugs with a broad spectrum of action, if no specific cause of the disease is identified.
Antibiotics for acute prostatitis
The main causes of prostatitis are pathogenic bacteria that cause inflammation in the tissues of the prostate gland. Therefore, antibiotics for acute prostatitis are the basis of treatment and are prescribed only after testing for sensitivity of the microflora. The antimicrobials used for inflammation are divided into the following groups:
- Fluoroquinolones.
- Penicillins.
- Cephalosporins.
- Macrolides.
- Tetracyclines.
- Aminoglycosides.
Prevention of acute prostatitis
To keep a man always healthy, full of strength, it is important to prevent acute prostatitis, including:
- Regular sex life with a regular partner, except for casual relationships.
- Use of condoms.
- Stop cigarettes, drugs, alcohol.
- Healthy diet.
- personal hygiene.
- Annual preventive examinations by a urologist.
- Intake of vitamins and zinc preparations.
It is important to completely cure diseases of the genitourinary system (urethritis, cystitis, pyelonephritis, balanoposthitis). Insufficiently treated diseases can lead to the development of an inflammatory process in the prostate gland. Among other things, we must not forget the increase in physical activity. Hypothermia should be avoided during the cold season. Prostate massage is very good for men's health. However, if the disease has already been felt, massage is contraindicated and even impossible due to pain in the body.