Prostatitis is one of the most common urological diseases in men.It is generally accepted that after 30 years 30% of men suffer from prostatitis, after 40 - 40%, after 50 - 50%, etc.At the same time, the real frequency is much higher than the registered one, this is explained by the peculiarities of the diagnosis and the possibility that the disease occurs in a latent form.With prostatitis, there are many problems with urination, libido decreases and erectile function is impaired.
Prostatitis is one of the most common urological diseases in men.It is generally accepted that after 30 years 30% of men suffer from prostatitis, after 40 - 40%, after 50 - 50%, etc.At the same time, the real frequency is much higher than the registered one, this is explained by the peculiarities of the diagnosis and the possibility that the disease occurs in a latent form.
The prostate gland is a small glandular-muscular organ that is located in the small pelvis below the bladder, covering the initial department of the urethra (urethra).The prostate gland produces a secretion that, mixed with the seminal fluid, supports the activity of spermatozoa and their resistance to various adverse conditions.
With prostatitis, there are many problems with urination, libido decreases and erectile function is impaired.The saddest thing is that, in the absence of appropriate treatment, about 40% of patients face some form of infertility, because the prostate gland can no longer produce a sufficient amount of high-quality secretion to ensure sperm motility.It is important to remember that similar symptoms can occur not only with prostatitis, but also with prostate adenoma and cancer.
Forms of prostatitis
According to the 1995 NIH USA criteria, there are four categories of prostatitis:
- Category I - Acute prostatitis;
- Category II - Chronic bacterial prostatitis;
- Category III - Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS):
- Category IIIa - Chronic prostatitis/chronic pelvic pain syndrome with signs of inflammation;
- Category IIIb - Chronic prostatitis / chronic pelvic pain syndrome without signs of inflammation;
- Category IV - Asymptomatic (asymptomatic) chronic prostatitis.
Chronic granulomatous prostatitis, which is not mentioned in this classification, also occurs occasionally.
Most experts distinguish 4 main forms of prostatitis:
- acute bacterial prostatitis,
- chronic bacterial prostatitis,
- non-bacterial prostatitis
- Prostatodynia.
Causes of prostatitis in men
In persons under 35 years of age, the disease usually takes the form of acute bacterial prostatitis.Bacterial prostatitis is called when there is laboratory confirmation of the presence of an infection.Most often this turns out to be chlamydia, trichomoniasis, gardnerellosis or gonorrhea.The infection enters the prostate gland from the urethra, bladder, rectum and through the blood and lymphatic vessels of the pelvis.
But recent studies prove that in most cases the infection is superimposed on existing disorders in the structure of the prostate tissue and blood circulation in it.In non-bacterial prostatitis, bacteria cannot be isolated, although this does not exclude their presence.
Chronic forms of the disease are more often diagnosed in older patients.
Prostatodynia is the presence of a clinical picture of prostatitis, thickening of the prostate tissue without signs of inflammation.
Symptoms of prostatitis in men
Symptoms of prostatitis can be divided into 3 groups:
- disorders of the excretory system (frequent and painful urges to urinate, feeling of incomplete emptying of the bladder), pain in the lower abdomen;
- disorders of sexual function (pain in the urethra and rectum during ejaculation, weak erection, premature ejaculation, loss of orgasm, etc.);
- increased anxiety and nervousness of the man caused by the fixation of the patients' attention on their condition.
Acute prostatitis usually begins with an increase in body temperature to 39-40°C with fever and chills.Urination is difficult and painful.Swelling of the prostate gland develops, which can cause acute urinary retention.
Chronic prostatitis progresses more calmly, but at any time, under unfavorable factors, an exacerbation may occur.Probably asymptomatic.
Complications of prostatitis
In the absence of timely treatment, prostatitis can cause the following complications:
- transition of acute prostatitis into chronic,
- bladder obstruction with acute urinary retention requiring surgical treatment,
- development of male infertility,
- narrowing and scarring of the urethra,
- recurrent cystitis,
- pyelonephritis and other kidney damage,
- prostate abscess that requires surgery,
- sepsis is a life-threatening complication that often develops in people with reduced immunity (patients with diabetes, kidney failure).
Treatment of prostatitis in men
The modern arsenal for diagnosing prostate diseases is very wide.
The doctor will prescribe a bacteriological examination of the urine and prostate secretion.To clarify the location of a urinary tract infection, different portions of urine are examined.In addition, a mandatory diagnostic method is a digital examination of the prostate gland.This procedure is not very pleasant, but it is very informative.Your doctor may refer you for an ultrasound scan of the prostate and pelvic organs.If necessary, computerized or magnetic nuclear tomography, cystoscopy, urography and research of prostate enzymes are prescribed.
When making the diagnosis, your doctor must rule out the presence of benign prostatic hyperplasia and prostate cancer.Analgesics and warm baths may be recommended for quick pain relief in acute prostatitis.
Bacterial prostatitis requires the prescription of antibiotics, the choice of which is made based on the results of the bacteriological culture of secretions on food media and determining the sensitivity of the pathogen to chemotherapy.
Non-bacterial prostatitis is treated with anti-inflammatory drugs.
Prevention of prostatitis
Avoid hypothermia and do not sit on cold objects.Follow a gentle diet (excluding alcohol, spicy, fried and canned foods).Regular sex life is also a way to prevent prostatitis (since one of the provoking factors is sperm stagnation and frequent erections without subsequent ejaculation).Equally important is the prevention of sexually transmitted diseases.
In adulthood, every man should undergo regular (once a year) examinations by a urologist.After prostatitis, preventive courses of outpatient treatment are carried out at least 2 times a year for one month and one course of sanatorium treatment.