Inflammation of the prostate or prostatitis can be acute or chronic. Organ damage is most often caused by a specific or non-specific infection, sometimes pathological changes develop as a result of congestion in the small pelvis. The main symptoms are urination disorders and decreased potency. Treatment should be comprehensive and include the use of drugs and normalization of blood circulation in the pelvic organs 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 numerous severe complications in 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 untreated acute process.
Classify prostate inflammation as follows:
- First category, or acute bacterial prostatitis.
- The second is chronic bacterial inflammation.
- Third, or chronic abacterial prostatitis (chronic pelvic pain syndrome). It is divided into 3A - inflammatory and 3B - non-inflammatory.
- The fourth is asymptomatic inflammation of the prostate.
The first and second categories were established for patients with a positive bacteriological study. The difference is that it is first diagnosed when the symptoms last no longer than 3 months. With a prolonged presence of clinical manifestations, chronic bacterial prostatitis is diagnosed.
The third category is also called chronic pelvic pain syndrome, because the main complaint of the patient is pain for at least 3 months. When examining secretions (ejaculate, urine, gland secretions after massage), pathological microflora is not detected. In the case of an increase in the number of leukocytes in these analyzes, inflammatory prostatitis (category 3A) is determined, the normal content of which is non-inflammatory.
In most men, one of the above categories has been identified because patients seek help due to the presence of certain symptoms of pathology.
Recently, doctors have identified a fourth subtype of the disease - asymptomatic prostatitis. It is diagnosed accidentally during medical examinations or when a man is examined due to other diseases of the genitourinary system. The danger of this form lies in the fact that there are pathological changes in the prostate, but the disease does not show any subjective signs. This condition often leads to the development of infertility.
Why men have a burning sensation in the urethra
Reasons
Acute prostatitis 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 rarer.
From specific infections, neisseria gonorrheae and trichomonas vaginalis can cause acute prostatitis.
Contributing factors are:
- Performing various surgical interventions on the male genitourinary organs.
- Narrowing of the urethra as a result of chronic and acute inflammatory processes in the urethra.
- Performing diagnostic manipulations - cystoscopy, ureteroscopy, etc.
- Violation of urination as a result of benign prostatic hyperplasia.
- Activation of opportunistic microflora (enterobacteria) in the pathogen under the influence of reduced immunity and other diseases of the body.
- Irregular sex life, which leads to stagnation of secretions in the prostate.
Chronic inflammation
If chronic prostatitis seems to be a continuation of an acute process, then its cause will be the same. In the case of this form of the disease, the primary 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.
An important role in the mechanism of pathology is played by such a phenomenon as intraprostatic reflux - reflux of urine through the excretory ducts in the prostate. As a result of this process, the infection can easily enter the organ, multiply and cause inflammation. Increase reflux:
- phimosis (narrowing of the foreskin);
- reduction of urethral lumen;
- balanoposthitis (inflammation of the foreskin);
- obstruction of the urethra with stones in urolithiasis.
Reflux and irregular sexual activity increase stagnant processes in the prostate, leading to active reproduction of microorganisms, intensification and spread of inflammationAs a result, areas of fibrosis (replacement of normal tissue with dense non-functional connective tissue) and the formation of prostate stones. 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 of pathology:
- contagious;
- chemical inflammation;
- immunological
Confirmation of the infectious theory is that during the polymerase chain reaction (PCR) the DNA of the pathogen is detected in the secretion of the prostate. However, microorganisms themselves have not been detected by other microbiological methods.
In general, the genetic material of the following bacteria is found in CPPS:
- Ureaplasma urealyticum (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. When it enters the prostate, it causes damage to cellular structures and an inflammatory response.
According to immune theory, pathology occurs as a result of autoimmune processes or as a result of an immune response to the penetration of a foreign antigen into an organ.
In most cases, CPPS causes not only one, but also their complex effect.
The provoking factor of asymptomatic prostatitis can be anyone who can cause the above categories, the difference is only during this form of the disease.
Symptoms
Acute bacterial inflammation of the prostate is characterized by the appearance of general and local symptoms.
In the first place are severe pain in the suprapubic region and perineum, as well as urination disorders until complete cessation. Of the general symptoms, patients are concerned about body aches, sweating, cold, fever, weakness.
Sometimes pain occurs only during bowel movements or in a sitting position. In some atypical cases, fever is the only sign of the disease.
In severe prostate edema, acute urinary retention occurs. This is due to the fact that an organ of increased size squeezes out the urethra and creates a mechanical barrier to the outflow of bladder contents. At the same time, the general condition of the patient significantly deteriorates: the signs of intoxication increase every hour, and in severe cases, there may be a disturbance of consciousness, and even coma.
In the case of a delayed diagnosis, complications such as the formation of an abscess (suppuration) of the prostate with further penetration of pus into the urethra or rectum may occur. As a result, fistulas are formed that require surgery and reconstructive surgery.
Manifestations of chronic bacterial inflammation of the prostate
Manifestations of this form of the disease are different and range from the complete absence of symptoms to a sudden worsening of the process.
In most cases, patients are concerned about pain in the perineum and rectum of varying intensity, which can extend to the scrotum, sacrum, penis and thighs. Sometimes the pain syndrome becomes paroxysmal, reminiscent of neuralgia.
Urethral discomfort and frequent urination are also noted. Sometimes urethral discharge is determined. They get worse during the day after walking, exercising, stool or prostate massage.
Feeling of heaviness, pressure, fullness in the rectum and perineum. These symptoms are worse 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 abacterial prostatitis
CPPS is characterized by the 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 urination disorders:
- frequent urination;
- difficulty urinating (slow flow, need for extra effort);
- pain when urinating.
Sometimes there are sexual dysfunctions - decreased libido, impotence.General symptoms often appear in the form of weakness, headache.
Drug treatment
Antibiotics are the mainstay of therapy. In the chronic process, drugs from the group of fluoroquinolones are indicated. Beta-lactam antibiotics and aminoglycosides are prescribed for acute prostatitis.Treatment is carried out in 2 stages:
- Empirical therapy is prescribed first (before receiving the crop). Third-generation cephalosporins or fluoroquinolones are used for this.
- In the second phase, the treatment is corrected according to the obtained bacteriological data and the results of sensitivity to antibacterial agents.
These groups of antibiotics were selected because they penetrate the blood-brain barrier and create a high concentration of the active substance in the prostate. This allows you to remove the focus of the infection.Antimicrobial therapy is also prescribed for abacterial 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 secretions that 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.
- Repeated examination of prostate secretion is performed and, with the reduction of symptoms, the drug is continued for up to 4 weeks.
Treat patients with asymptomatic prostatitis due to the following indications:
- infertility;
- before undergoing prostate surgery as prophylaxis;
- in identifying pathogenic microorganisms in secretions;
- with increased levels of antiprostatic antibodies in the blood and positive microbiological tests.
Other assets
Alpha-blockers are prescribed for prostatitis. These agents increase the maximum and average flow rate of urine, reduce the tone in the wall of the urethra and eliminate incomplete opening of the bladder door during emptying. These effects eliminate phenomena such as:
- Frequent and painful urination;
- reduction of jet flow;
- need for extra effort to excrete urine.
Typical representatives are Alfuzosin, Tamsulosin and Doxazosin, they are especially relevant in 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, edema and reduce pain.Drugs such as Diclofenac, Ibuprofen, Nimesulide and others are used. The duration of these funds should not exceed 4 weeks. These medications are taken strictly after meals as they irritate the stomach.
In addition to tablets, topical treatmentis used. For that purpose, patients are prescribed such 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 substances reduce inflammation, edema and have a vasoprotective effect (strengthen the vascular wall).
African plum peel has similar effects.
Prostatilen is of natural origin. It is made from the prostate of cattle. It has an anti-inflammatory effect and reduces the appearance of prostate adenomas.
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 for 1 tbsp. l. 3 times a day, the course is 3-4 months.As a prophylaxis of prostate disease, all men can take 30 pumpkin seeds before meals once a day. You have to take them raw, because after frying the healing properties are lost.
You can use pumpkin seeds prepared according to the following recipe 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.
- Shapes balls of 2-3 cm.
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 has a healing effect on prostatitis. To prepare the first medicine, you need to take 1 tbsp. l. dry leaves and boil in a glass of boiling water. You need to insist on this for 30 minutes and take 1/4 of the resulting solution 4 times a day. For bark decoction, 1 tbsp. l. pour 200 ml of crushed 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 greens have a healing effect on prostatitis. It has an anti-inflammatory effect and helps to restore sexual activity. In this case, parsley juice is used. To do this, the cabbage is crushed to a state of pulp and squeeze the liquid out of it through gauze folded 3-4 times. Take for 1 tbsp. l. 3 times a day.
Treat prostatitis at home and with herbs. One of them is wormwood. It allows you to alleviate inflammation and rid the body of pathogens. It is taken dry in the first 3 days - it is absorbed in the mouth every 2-3 hours. For the next four days, reduce the number of receptions to 5. Every day, at night, they make a microclyster of 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. After that, the solution must be filtered. It is necessary to make injections into the anus (100 ml), as well as into the urethra (50 ml). The procedures should be carried out within a week. They are prescribed in a chronic process.During rinsing and microclysters, pus may be released - this is a normal occurrence, indicating the effectiveness of the treatment.
Conclusion
Physiotherapy, prostate massage and organ acupuncture are used in combination with the main methods of treating the disease.
Living with chronic prostatitis involves regularly undergoing a comprehensive examination and therapy, as there is a high probability of loss of reproductive function.