Inflammation of the prostate, or prostatitis, can be acute and chronic. Most often, organ damage is caused by specific or nonspecific infection, sometimes pathological changes develop as a result of congestion in the small pelvis. The main symptoms are urinary disturbances and decreased potency. Treatment should be comprehensive and include the use of drugs and the normalization of blood circulation in the pelvic organs in men.
Classification and characteristics of prostatitis
Inflammation of the prostate in men is a condition that significantly reduces the quality of life of patients and causes a number of serious complications in the urinary and genital areas.
Prostatitis can be acute and chronic along the way. The latter can occur on its own (this happens more often) or is the result of an acute untreated process.
Classify prostate inflammation as follows:
- The first category, or acute bacterial prostatitis.
- The second is chronic bacterial inflammation.
- The third, or chronic abacterial prostatitis (chronic pelvic pain syndrome). It is subdivided into 3A - inflammatory and 3B - non-inflammatory.
- The fourth is asymptomatic inflammation of the prostate.
The first and second categories are established for patients with a positive bacteriological study. The difference is that the first is diagnosed when the symptoms do not last more than 3 months. With a longer presence of clinical manifestations, chronic bacterial prostatitis is diagnosed.
The third category is also called chronic pelvic pain syndrome, because the main complaint of patients is pain for at least 3 months. When examining secretions (ejaculate, urine, glandular secretion after massage), pathological microflora is not detected. With an increase in the number of leukocytes in these analyzes, inflammatory prostatitis (category 3A) is established, with their normal - non-inflammatory content.
In most men, one of the above categories is identified, as patients seek help due to the presence of certain symptoms of pathology.
Recently, doctors have identified the fourth subtype of the disease - asymptomatic prostatitis. It is diagnosed by chance during medical examinations or when a man is examined for 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 there is a burning sensation in the urethra in men
Reasons
Acute inflammation of the prostate in men occurs in 70% of cases due to infection with E. coli.In other situations, the pathology is caused by Enterobacteriaceae such as pseudomonas, Klebsiella, Proteus. Staphylococci and streptococci are much less common.
Among specific infections, Neisseria gonorrheae and Trichomonas vaginalis can cause acute prostatitis.
The contributing factors are:
- Performing various surgical procedures on the male genitourinary organs.
- Narrowing of the urethra as a result of chronic and acute inflammatory processes in the urethra.
- Performance of diagnostic manipulations - cystoscopy, ureteroscopy, etc.
- Violation of urination as a result of benign prostatic hyperplasia.
- Activation of opportunistic microflora (Enterobacteriaceae) into a 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 appears as a continuation of an acute process, its cause will be the same. In the case of this form of the disease, the main predisposing factors are:
- Mycobacterium tuberculosis.
- Clostridium.
- Gonorrhea and trichomonads (can immediately cause a chronic form without an acute period).
- Salmonella.
- Different types of mushrooms.
In the mechanism of the onset of pathology, such a phenomenon as intraprostatic reflux plays an important role - the reflux of urine through the excretory ducts into 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);
- decreased lumen of the urethra;
- balanoposthitis (inflammation of the foreskin);
- obstruction of the urethra with tartar in urolithiasis.
Reflux and irregular sexual activity increase stagnant processes in the prostate, which leads to the active reproduction of microorganisms, intensification and spread of inflammationAs a result, areas of fibrosis (replacement of normal tissue with dense non-functioning connective tissue) may occur and form in prostate stones. All this improves the pathological process and leads to serious consequences.
Chronic bacterial prostatitis
Chronic pelvic pain syndrome (CPPS) is synonymous with this disease and occurs without the presence of microorganisms in the secretions detected by standard microbiological methods.
There are several theories about the appearance of the pathology:
infectious- ;
- chemical ignition;
- immune.
Confirmation of the infectious theory is that during the polymerase chain reaction (PCR), the DNA of pathogens is detected in the secretion of the prostate. However, the microorganisms themselves are not detected by other microbiological methods.
Usually with CPPS the genetic material of the following bacteria is found:
- Ureaplasma urealyticum (ureaplasma urealyticum).
- Mycoplasma hominis.
- Chlamydia trachomatis (Chlamidia trachomatis).
- Trichomonas vaginalis.
The chemical inflammation theory attributes CPPS to intraprostatic reflux, but in this case, the cause is not bacteria, but the urine itself. Once in 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 the immune response to the penetration of a foreign antigen into the organ.
In most cases, CPPS is caused not only by one, but by 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.
Severe pain in the suprapubic area and in the perineum, as well as urinary disorders until it stops completely, come first. Among the general symptoms of patients are concerned about muscle aches, sweating, chills, fever, weakness.
Sometimes the pain only occurs with bowel movements or when sitting. In some atypical cases, fever is the only sign of illness.
With severe edema of the prostate, acute urinary retention occurs. This is due to the fact that the organ with its enlarged size squeezes the urethra and forms a mechanical obstacle to the outflow of the contents of the bladder. At the same time, the general condition of the patient deteriorates significantly: signs of intoxication increase every hour, and in severe cases, impaired consciousness and even coma may occur.
With late diagnosis, complications such as abscess formation (suppuration) of the prostate with a new breakout of pus in the urethra or rectum may occur. As a result, fistulas form, which requires surgery and reconstruction operations.
Manifestations of chronic bacterial inflammation of the prostate
The manifestations of this form of the disease are varied and range from a complete absence of symptoms to a sharp exacerbation of the process.
In most cases, patients are concerned about pain in the perineum and rectum of varying intensity, which can spread to the scrotum, sacrum, penis and thighs. Sometimes the pain syndrome becomes paroxysmal, reminiscent of neuralgia.
Urethral discomfort and frequent urination are also observed. Sometimes discharge from the urethra is determined. They are worse during the day after walking, exercising, having a bowel movement, or massaging the prostate.
There is a feeling of heaviness, pressure, fullness in the rectum and perineum. These symptoms get 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 bacterial prostatitis
CPPS is characterized by a clinical picture of chronic bacterial inflammation of the prostate.
The patients have suffered from pelvic and perineal pain for more than 3 months, while the results of the bacteriological examination are negative.There are different types of urinary disorders:
- frequent urination;
- difficulty urinating (slow stream, need extra effort);
- pain when passing urine.
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 treatment. In a chronic process, drugs from the group of fluoroquinolones are indicated. For acute prostatitis, beta-lactam antibiotics and aminoglycosides are prescribed.The processing is carried out in 2 steps:
- At first, empiric therapy is prescribed (before receiving cultures). For this, third generation cephalosporins or fluoroquinolones are used.
- In the second stage, the treatment is corrected based on the bacteriological data obtained and the results of sensitivity to antibacterial agents.
These groups of antibiotics are chosen for the reason that they penetrate the hematoprostatic barrier and create a high concentration of the active substance in the prostate. This allows you to remove the focus of infection. For abacterial prostatitis, antimicrobial therapy is also prescribed, 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 or Doxycycline medication is prescribed for 2 weeks.
- A new examination of the secretion of the prostate is done, and with a decrease in symptoms, continue to take the funds for up to 4 weeks.
Treat patients with asymptomatic prostatitis in the following indications:
- infertility;
- before undergoing prophylactic prostate surgery;
- when identifying pathogenic microorganisms in secretions;
- with an increase in the level of antiprostatic antibodies in the blood and positive microbiological tests.
Other means
For prostatitis drugs from the group of alpha-blockers are prescribed. These funds increase the maximum and average urine output, reduce the tone of the wall of the urethra and eliminate the incomplete opening of the bladder neck during emptying. These effects eliminate phenomena such as:
- Frequent and painful urination;
- reducing the flow of the jet;
- the 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 for these drugs is at least 3 months.
Nonsteroidal anti-inflammatory drugs are prescribed as symptomatic treatment. They reduce inflammation, edema, and pain. Medicines such as diclofenac, ibuprofen, nimesulide and others are used. The duration of treatment with these agents should not exceed 4 weeks. These drugs are taken strictly after eating, as they irritate the lining of the stomach.
In addition to pills, local treatment is also used. For this purpose, patients are prescribed drugs in suppositories such as Vitaprost, Prostatilen, Uroprost, etc. They are also indicated for prostate adenoma.
Phytotherapy
Saw palmetto fruit extract is widely used in traditional medicine. The active substances reduce inflammation, edema and have a vasoprotective effect (strengthen the vascular wall).
The bark of the African plum tree has similar effects.
Prostatilen has a natural origin. It is made from the prostate of cattle. It has an anti-inflammatory effect and reduces the appearance of prostate adenoma.
Folk remedies
Prostatitis can be treated with folk remedies. In the first place in terms of effectiveness - the use of pumpkin seed oil. You can buy this product in pharmacies. Take it for 1 tbsp. l. 3 times a day, the course of treatment is 3-4 months.As a prophylaxis for prostate disease, all men can use 30 pumpkin seeds before meals once a day. You need to take them raw, because after roasting the healing properties are lost.
For processing, you can use pumpkin seeds prepared according to the following recipe:
- 0. 5 kg of peeled seeds are crushed in a meat grinder or blender.
- Add 200g of honey and mix everything until smooth.
- Shape balls of 2-3 cm.
Keep them in the refrigerator, take a piece 30 minutes before meals. This product should be chewed for 2-3 minutes and dissolve, not swallowed. The duration of treatment is 6 months.
An infusion of leaves or a decoction of hazel bark has a curative effect on prostatitis. To prepare the first remedy, you need to take 1 tbsp. l. dry the leaves and infuse in a glass of boiling water. You need to insist for 30 minutes and take 1/4 of the resulting solution 4 times a day. For a decoction of the bark, 1 tbsp. l. Pour 200 ml of crushed raw materials and cook in a water bath for 30 minutes. After that, the drug should be cooled and taken 1/4 cup 4 times a day.
Parsley greens have a healing effect on prostatitis. It has anti-inflammatory effects and helps restore sexual activity. In this case, parsley juice is used. To do this, the greens are crushed to a porridge state and squeeze out the liquid from it through a cheesecloth folded 3-4 times. Take it for 1 tbsp. l. 3 times a day.
Treat prostatitis at home and with herbal remedies. One of them is absinthe. It allows you to relieve inflammation and rid the body of the pathogen. It is taken dry in the first 3 days - it is absorbed in the mouth every 2-3 hours. The next four days reduce the number of parties to 5. Every day at night they make microclysters from the herb.
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 cooled to +40 degrees. After that, the solution should be filtered. It is necessary to make injections into the anus (100 ml), as well as into the urethra (50 ml). Procedures should be performed within one week. They are shown in a chronic process.During douching and microclysters, the release of pus is possible - this is normal, which indicates the effectiveness of the treatment.
Conclusion
In combination with the main methods of treating the disease, physiotherapy, prostate massage and organ acupuncture are used.
Living with chronic prostatitis means having a regular full examination and therapy, as there is a high likelihood of loss of reproductive function.