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 years and in 90% of cases after seventy years. The disease can occur in two forms: acute and chronic prostatitis. This disease must be treated, especially as it is well suited for therapy. But many men ignore the unpleasant symptoms, leading to the development of many complications that are harder 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 the 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, violation 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 of the microbes in a healthy person can passively exist on the skin or intestines. Under the influence of some factors, they are activated, penetrate into the tissues of the gland and actively multiply there. The disease often occurs due to sexually transmitted diseases, for example,chlamydia, ureaplasmosis, gonorrhea, etc.
Also, the acute form of prostatitis occurs as a complication ofurethritis. Germs enter through channels that open into the urethra. Also, prostatitis is often caused by the spread of bacteria from other organs of the genitourinary system. The gland can often be affectedduring surgical procedures, catheterization, diagnostic measures.
Since there are a large number of blood vessels in the prostate, the infection can pass through the bloodstream here in the presence of chronic pathologies in the body, for example,tonsillitis, bronchitisetc.In the presence ofanal fissures, microbes can enter the prostate through lymph flow.
But infections do not always lead to the development of the disease. Congestion in the vessels of the pelvic region, which develops withprolonged 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 area, hypothermia.
Classification
There are several forms of pathology in urology, which are also the stages of its development:
- Catarrhal formis characterized by the appearance of inflammation in the organ, changes in its mucous epithelium. Over time, the gland swells, a mucopurulent secretion collects in it, contributing to the progression of the disease.
- Focal suppuration then occurs. The disease progresses to the second stage (form) -follicular form. The urinary tract is narrowed or clogged, the secretion stops being excreted normally from the organs. Pus can be excreted in the urinary tract, creating purulent foci there. Glandular cells change, the prostate continues to swell and grow in size.
- Parenchymal formoccurs when the organ is completely inflamed and a purulent infection develops in it. In the absence of therapy, small purulent foci merge into one huge one, developing an abscess that often opens into the urethra, intestines, and bladder. In some cases, it is possible to immediately develop this form of pathology when the infection penetrates the interstitial tissue of an organ with blood or lymph flow.
Symptoms
Displays symptoms of acute prostatitis. How visible and sensitive the signs will be will depend on the form (stage) of the disease. Common signs of the disease include the following:
- pain syndrome during urination;
- symptoms of intoxication;
- pain in the genital area;
- frequent urges to go to the toilet, especially at night;
- possible discharge from 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. Urinary excretion becomes very painful. Acute delay often develops at this stage, which is considered a dangerous condition because it can lead to a ruptured bladder.
The symptoms of acute prostatitis continue to increase. The pain intensifies during bowel movements, the body temperature increases. The prostate becomes enlarged, taut and painful. Urine will be cloudy due to the content of pus and mucus.
In the last stage, the disease manifests itself strongly.
Body temperature rises greatly, accompanied by fever and chills, loss of appetite, severe weakness, exhaustion of the body as a whole. Urination can stop completely and the man will feel acute severe pain when he tries to go to the toilet. This condition is painful, the pain syndrome begins to spread to the pelvic region. A man cannot find a place for himself, he is forced to lie with his limbs folded. If the inflammation has spread to the rectum, then mucus will come out of the anus. 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 urgent treatment are required.
Diagnostics
Because the symptoms of acute prostatitis in men are quite pronounced, the doctor may immediately suspect pathology. But a thorough review is needed. Rectal examination in this case is strictly contraindicated.
The urologist must determine the stage (form) of the disease using laboratory and instrumental techniques. The doctor takes theprostate secretfor examination. It will increase the concentration of leukocytes, which indicates acute inflammation.
Laboratory blood and urine tests are then performed. Urine is sent to a bacteriological culture for examination, as well as to determine the cause of the infection and its sensitivity to antibacterial drugs. It is also possible to perform:
- 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 to distinguish acute prostatitis from other pathologies;
- MRI of the pelvic organs is often prescribed when surgery is planned;
- analysis of SPA concentration in the blood;
- examination of urethral smear;
- puncture of organ parts in case of suspected purulent infection and abscess.
Treatment
A urologist will tell you in detail how to treat acute prostatitis. The main component of therapy is an antibacterial drug, which is selected in accordance with the results of bacterial culture. Within two or three days the antibiotic starts to help, the person feels much better, the pain starts to subside. But with this form of the disease, such medications should 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 glandular tissues;
- other agents accumulate in tissues in large quantities.
The treatment of acute prostatitis in men should be based on the use of powerful drugs, as in other cases that threaten a man's life. Usually doctors prescribe fluoroquinolones. When macrolides are used, the dosage should be high. This is especially true for patients with immunosuppression.
Antibiotics are usually given by intravenous injection. In the initial stage, the disease can be treated at home or on an outpatient basis.In this case, bed rest is prescribed, because any load of strength can cause the spread of infection and the development of sepsis.
In combination with antibiotics, the following medications are also prescribed:
- analgesics;
- antipyretic drugs; NSAIL;
- opiate may be prescribed for severe pain;
- diuretics to reduce body intoxication;
- laxatives to relieve stool;
- antispasmodics to facilitate urinary excretion;
- 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 forbidden. They can be applied only 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 remove the areas in which it occurs. Puncture drainage of abscesses is often used. In severe and extreme cases, the organ is removed.
Surgery is prescribed in the presence of abscesses, acute urinary retention, severe pain syndrome that can not be eliminated by any drugs, the appearance of stones and tumors, as well as the ineffectiveness of drug treatment, frequent infections of the genitourinary system, paraproctitis.
The surgeon can use one of the following techniques:
- TRUP (transurethral resection)involves the removal of the inside of the organ. It is most commonly used;
- Prostactomyinvolves partial or complete removal of organs by incision in the lower abdomen;
- Laser surgery. In this case, the affected areas of the organ are removed with a laser;
- The abscess drainsthrough the rectum. A drain is inserted into the incision through which the manure is pumped out;
- To facilitate urinary excretion, atransurethral incisionis performed on the organ.
When the structure of the gland tissue is restored, its functions are normalized, the secretion of the prostate normalizes its composition, the cause of the pathology will be completely removed from the body, we can talk about the cure of prostatitis.
Forecast
With therapy, the prognosis will be good. Sometimes the negative consequences of acute prostatitis develop. The disease can become chronic, so it will be harder to eliminate. Dangerous consequences of untreated disease are organ abscess, sepsis, acute urinary retention. In some cases, due to complications, death can occur. But usually men do not allow the development of such consequences, because they come to the doctor and start a course of therapy.
Prevention
In order to prevent it, it is necessary to prevent the occurrence of predisposing factors. This requires timely treatment of all infections in the body so that they do not become chronic and become potential foci of infection that will spread to the prostate.
When performing surgical procedures, the doctor should pay attention to the use of antiseptics. Otherwise, the risk of germs entering the patient's body increases. It is important that a man and his sexual partner treat sexually transmitted diseases in a timely manner, and it is best to prevent their occurrence. Sex life should take place with one regular partner, it should be regular.
It is necessary to lead an active lifestyle, play sports or exercise, follow the rules of intimate hygiene.
Men usually seek medical advice in extreme cases. But when negative signs appear, it is better to contact them immediately. This will help avoid many health problems and even save lives in some cases.