What is prostatitis? The first signs and symptoms, as well as the treatment of acute and chronic phases

Prostatitis yesa predominantly male disease. It is one of the most common lesions of the genitourinary system and occurs in approximately 80% of men, of which 4 occur before the age of 40.

Illness is not an isolated process: itit exposes nearby organs to trauma and also poisons the entire body.

How does prostatitis develop?

The essence of the process is inflammation of the prostate or prostate gland.

The prostate is located in the pelvis, adjacent to the bottom of the bladder. This is an unpaired organ that looks like a chestnut. The urethra passes through it. Behind the gland is the rectum, and in front of it is the pubis.

The prostate gland is a fairly elastic organ, because its base is made up of muscle fibers and glandular cells. It consists of 2 lobes connected by an isthmus. It is the main source of problems associated with urination. Densifying and increasing in size with age, the isthmus puts pressure on the urethra, interrupting the process of urine excretion.

Prostateperforms these functions for the body:

Function	The essence
Secretary	It produces a secretion that is part of the sperm. It dilutes it, sets the required pH level and increases sperm motility.
The engine	The muscle fibers of the gland form the urinary sphincter, which helps hold urine.
Barrier	Contains a zinc-peptide complex, lysozyme, cellular immunity factors, spermine, which prevent the development of the infection in an ascending manner.

Prostatitis develops when an inflammatory process begins in the gland. At the same time it increases in size, compressing the urinary canal. This causes difficulty urinating.

Additionally, the enlarged prostate "intrudes" into the bladder, compressing it. Because of this, the evacuation of urine from it is interrupted, stagnates, causing inflammation in the bladder. Long-term stagnation of urinary fluid in its "tank" leads to intoxication of the entire body with metabolic products in its composition.

Contributing factors

The main reason for the development of prostatitis isinfection. This can be staphylococcus, enterococcus, Klebsiella, Pseudomonas aeruginosa and Escherichia coli, Proteus. Most often, prostatitis isa consequence of sexually transmitted diseases: syphilis or gonorrhea, chlamydia, trichomoniasis.

Less commonly, the cause of the disease isinfectious processes of other systems: influenza, tuberculosis, tonsillitis and others. Bacteria and viruses enter the prostate through lymphatic and blood flow, as well as through sexual contact. Very often the pathogenic flora is introduced into the gland via the ascending route from the urethra or descending from the bladder with infected urine.

Other factorsthat cause inflammation of the gland include:

• circulatory disorders in the pelvis. This can be caused by a sedentary lifestyle, excess weight and pelvic injuries. A group particularly at risk are drivers who are constantly in a sitting position and feel vibrations and pressure on the perineal area. Reduced blood circulation in the pelvis causes congestion and lack of oxygen in the prostate gland, which also causes the development of infections,
• hypothermia,
• hormonal imbalance,
• problems with passing urine,
• irregular sexual activity – too "violent" sexual life, abstinence, interruption of sexual intercourse,
• chronic constipation,
• inflammation of the rectum,
• decreased immunity, as a result of which the body becomes susceptible to infectious agents.

The risk of developing the disease is believed to increase with regular use of alcohol and drugs.

Typology and symptoms of the disease

In the modern world, the division of prostatitis into types is carried out according to the classification of the US National Institutes of Health in 1995.based on clinical data, as well as the presence of leukocytes and pathogenic flora in seminal fluid, prostatic secretion and urine:

1. Acute bacterial prostatitis.
2. Chronic bacterial prostatitis.
3. CPPS – chronic pelvic pain syndrome or chronic non-bacterial prostatitis.
4. Asymptomatic prostatitis.

Acute prostatitisIt is infectious in nature. There are several phases:

• catarrhalAccompanied by frequent and painful urination. The pain radiates to the sacrum and perineum,
• follicular.The intensity of the pain increases. It also appears during defecation. Urination becomes difficult: urine comes out in a thin stream or in drops. Hyperthermia up to 38°,
• parenchymatous.Characterized by acute urinary retention and problems with bowel movements. Severe pain in the perineum, lower back and above the pubis. The body temperature rises to 38-40°. Intoxication of the body develops, the symptoms of which are general weakness, nausea and increased heart rate.

During a digital exam performed by a urologist, an enlarged and dense prostate gland that is warm and painful to the touch is palpated. A large number of leukocytes and bacteria are detected in the urine.

Chronic prostatitisit can develop as a consequence of an acute illness or as a separate illness. The diagnosis is made if the process lasts 3 months or more.

Chronic prostatitis manifests itself in 3 main syndromes:

• painful. Interestingly, the prostate itself does not contain pain receptors. Pain appears when the inflammatory process grabs the nerve fibers of the small pelvis, in which there are many of them. It is of a different nature. It can be insignificant or sharp and strong, disturbing even at night, fading and resuming. It is located in the sacrum, scrotum, lower back and perineum.
• dysuric.The urge to urinate becomes more frequent. It becomes sluggish and feels like a heavy, not completely empty bladder. The process may subsequently improve due to a compensatory increase in bladder muscles, but it soon resumes. Discharge appears from the urethra during bowel movements.
• sexual disorders– increased or decreased nocturnal erections, blurred orgasm, pain during ejaculation and its acceleration. Worsening of sexual disorders, ultimately leading to impotence. There is a concept of psychogenic depotism, when a man convinces himself that in his conditions violations in the intimate sphere are inevitable. And they are actually developing. With the development of sexual dysfunction, a man's mood also changes: he becomes irritable and depressed.

Often the chronic form of prostatitis becomes a manifestation of hidden sexually transmitted infections.

Diagnosis of CPPSis placed if clinical manifestations of prostatitis are present, but no pathogens of the disease are detected in biological fluids (urine, ejaculate and prostatic secretions). At the same time, leukocytes are determined.

The main criterion for diagnosis is pain that does not disappear within 3 months.

Chronic pelvic pain syndrome is divided into 2 categories: inflammatory and non-inflammatory.

Inflammatory CPPSdetermined when a large number of leukocytes are found in biological fluids. Bacteria are not detected.

Non-inflammatory CPPScharacterized by the absence of leukocytes and pathogenic flora in biological fluids.

In both cases, the symptoms of prostatitis persist.

Asymptomatic formThe disease is characterized by the absence of signs of inflammation of the prostate. It is discovered accidentally during histology of prostate tissue if the patient has been prescribed a prostate biopsy. A similar procedure is prescribed, for example, when PSA levels increase.

The disease, regardless of its type (with the exception of the asymptomatic form), manifests itselffirst of all, urinary disorders:

• pain when passing urine,
• weak stream or dribbling of urine,
• feeling that the bladder is not completely empty.

If such symptoms appear, do not delay a visit to a urologist. This will help stop the process in its early stage.

How to recognize the disease

The main criterion for making a diagnosis is the clinical picture and complaints of the patient.

But to finally confirm it,it is necessary to undergo a series of tests and examinations:

1. Examination by a urologist.Your doctor should conduct a rectal exam of your prostate. It is passed with a finger through the rectum. It is advisable to evacuate before the exam. Using manipulation, the shape and size of the gland, as well as its consistency, are determined. The procedure helps determine the presence of tumors and inflammation in the prostate. The digital exam allows you to collect prostate secretions.
2. Urine analysis.Two portions are examined: the urine collected at the beginning of urination and the urine collected at the end of the process. 1 portion indicates the condition of the urethra, 2 – the kidneys and bladder. The presence of more than normal leukocytes in the urine (15 per visual field) indicates inflammation.
3. After collecting urine, a prostate massage is performed, as a result of which its secretion is obtained.If there is too little of it and it is not released from the urethra, but remains on its walls, urine is collected after massage. It is as informative as the prostatic secretion itself. Leukocytes (there should be no more than 10 of them) and, in addition, lecithin granules and amyloid bodies are also determined here. If the first analysis of the secretion of the gland did not show any abnormalities, this does not mean the absence of a process. Prostate juice may be too viscous and block the lumen of the ducts of the affected glands. Then the secretory secretion will be produced by healthy glandular cells. Therefore, it is necessary to pass such an analysis several times. Cultures of urine and prostatic secretions are also performed to identify the causative agent of the disease and determine sensitivity to antibiotics.
4. General blood tests.
5. Analysis for the presence of sexually transmitted diseases.
6. Ultrasound of the kidneys, bladder, TRUS,which allows you to thoroughly evaluate the condition of the prostate,
7. Uroflowmetry.It is used to evaluate the rate and time of urine excretion. It is carried out with a special apparatus consisting of sensors and a container. All the patient has to do is urinate in the usual way.
8. PSA in the blood- prostate specific antigen. It is an indicator of the presence of tumor formations in the prostate gland - adenoma or cancer,
9. Prostate biopsy.It is carried out if cancer is suspected.

It is necessary to do a spermogram which will help confirm or deny infertility.

Treatment of acute and chronic prostatitis

Acute prostatitis without complications is usually treated on an outpatient basis. Hospitalization is indicated in case of severe intoxication or development of complications.

Treatment of acute prostatitisLet's start with antibiotics. If the condition is severely disturbed, they are administered without waiting for the results of the analysis. They use groups of antibacterial drugs capable of penetrating deep into the tissues of the prostate gland. They act on those types of bacteria that very often cause inflammation inside. These antibiotics include fluoroquinolones.

Upon receipt of the testsantibiotic therapy can be adjusted differently. It all depends on the causative agent of the disease and its sensitivity to the drug. Therapy is also changed if no effect is observed after 2 days.

In case of acute inflammation of the prostate gland, the administration of painkillers and non-steroidal anti-inflammatory drugs is indicated. In addition to oral medications, suppositories are also used which also have an analgesic and anti-inflammatory effect: based on prostate extract, suppositories with propolis.

In case of severe intoxicationcarry out detox therapy. To do this, use a glucose solution.

Prescribed drugs that improve blood circulation in the prostate. They ensure the drainage of lymph from the gland, relieve swelling and promote the elimination of toxins.

In case of acute prostatitis, it is forbidden to massage the gland, as this can provoke the development of sepsis.

Treatment of chronic prostatitis depends on the stage of the disease.

In the acute form antibiotics are used. In the remission phase, therapy aims to maintain the normal functioning of the gland:

1. Drugs that normalize the microcirculation of organs.
2. Anti-inflammatory drugs.
3. It is important to maintain the body's immune function, which decreases under the influence of courses of antibiotics. For this, patients are prescribed immunostimulants.
4. For sexual dysfunction, antidepressants and sedatives can be prescribed.
5. Prostate massage.
6. Physiotherapy:
   • laser,
   • ultrasound,
   • rectal electrophoresis,
   • Transrectal microwave hyperthermia.
7. Physiotherapy.

Physiotherapy for prostatitis helps increase the tone of the pelvic floor muscles and reduce pain.

Prostate massage: purpose and technique

Finger massage of the prostate has several purposes.

It is used as a diagnosis, to obtain glandular secretions and also as a method of treating chronic prostatitis.

MostA common method for this procedure is transrectal. In this case the patient is positioned on the right side with knees bent. The doctor inserts the index finger into the anus, moving it along the rectum. Then a massage is performed: gentle strokes on each lobe of the gland around it and along the ducts. At the end of the procedure, the groove between the lobes is kneaded to release the secretory fluid.

It is necessary to focus on the patient's sensations: there should be no pain during manipulation. The procedure lasts 1 minute, the full course is 15 sessions.

An indicator of a high-quality massage is the release of a few drops of glandular secretion.

This manipulation, first of all,increases blood circulation in the prostate. This accelerates tissue repair and improves drug passage, clears congestion and relieves inflammation.

Massage helps strengthen the muscles of the gland and perineum. The procedure allows you to remove stagnant seminal fluid from the organ, thanks to which the prostate is cleansed of bacteria and toxins. Compression of the urethra is eliminated and urination improves. Massage increases potency by increasing the circulation of seminal fluid.

In addition to the transrectal method, there is an instillation method and a bougie massage.

Instillation methodbegins with the introduction of a medicinal solution through the urethra. Then it is clamped and the prostate is massaged with the finger method. In this case, the healing solution penetrates the gland, improving the effect of the procedure. Eventually, the urethra is open, it is recommended to wait a while with urination. The drug is reintroduced into the urethra.

Bougie massageperformed through the urethra using bougies - special instruments for dilation and examination of tubular organs. The patient is in the right lateral position. The bougie is inserted into the urethra and held with one hand. With the second hand, stroke and press on the penis from top to bottom. The duration of the procedure is 1 minute, after which the drugs are administered intraurethrally. This massage is supported by antibiotic therapy.

Finger massage of the prostate– medical manipulation, which is performed by a specialist according to clear indications.

An option for self-massage is possible: to do this, rhythmically tense and relax the muscles around the anus. This procedure will be invisible to others and will help strengthen the gland.

Like any manipulation,Prostate massage has its contraindications:

• acute inflammation of the prostate,
• cancer or adenoma of the gland,
• hemorrhoids,
• stones, cystic formations in the prostatic organ.

A professionally performed procedure will help restore the structure of the prostate and its function, and stimulation of sensitive points will eliminate sexual dysfunction.

Prostatitis and traditional medicine

Along with medications, traditional methods will also help to cope with inflammation of the prostate.Combining these 2 types of treatment, you will speed up the healing process and get rid of unpleasant sensations.

There are many home recipes that help in the fight against prostatitis. Here are some of them:

• Grind 500 grams of peeled raw pumpkin seeds through a meat grinder and mix with 200 grams of honey. Make small balls from the resulting mass. Consume before meals 2 times a day, slowly, chewing and dissolving thoroughly. Pumpkin seeds contain a large amount of zinc, which is essential for human health.
• blueberries have an anti-inflammatory effect. By eating 200 grams of this berry a day, you will support the health of your men,
• Parsley, first and foremost, became famous as a culinary spice. But besides this, it also contains many useful substances, including those that the male body needs. Take parsley juice 1 tbsp. L. 3 times a day 30 minutes before meals. This will help relieve inflammation and improve sex life,
• take the green peel of the chestnuts together with the thorns, chop them and pour boiling water over them. Use as a tea
• Grind 300 grams of onion until a paste-like consistency is obtained, add 100 grams of honey, 600 ml of dry wine. Store for 1 week in a dark, cool place, stirring occasionally. Subject to tension. Use 2 tbsp. L. 3 times a day before meals. Effective in the treatment of chronic prostatitis.

Some will help speed recoveryphysical exercise. They stimulate blood circulation in the pelvic area and, consequently, in the prostate.

1. Deep squats below knee level. The optimal number of times is 100. Perform 3 times a week. If you cannot perform such a number at the same time, perform squats in several approaches with pauses.
2. Scissors. Sit on the floor with your hands on the floor behind you. Extend your legs in front of you, lift them off the floor. Cross them over each other. The movements are reminiscent of scissor work.
3. Lying on your back, bend your knees and bring them to your chest. Wrap your arms around them. Hold the pose for up to 20 minutes.
4. Walking regularly is also a great way to relieve congestion.

You canintegrate this complex with other exercises, which activate and warm up the muscles.

Adolescent prostatitis

It's hard to believe, but prostatitis, which used to be considered the preserve of middle and old age, is now significantly younger and is found even among teenagers. It negatively affects the condition of the entire body, as well as the reproductive capacity of young people.

Here becauseit is important to understand the reasonsthat lead to adolescent prostatitis:

• early sexual activity and sexual illiteracy.Unprotected sexual intercourse contributes to the spread of sexually transmitted infections, which can cause bacterial inflammation of the prostate,
• hypothermia– a factor that contributes to the development of prostatitis. Thermal imbalance reduces immunity and exposes the body to infectious attacks,
• Fashion trends– wearing clothes and underwear that are too tight interrupts blood circulation in the pelvis and leads to stagnation in this area,
• sedentary lifestyle– computer work of modern youth replaces sports, walking and other active pastimes,
• excessive sexual activityit literally exhausts the gland. Its functions are reduced, and the small amount of secretion released and the deterioration of its quality make it more susceptible to infections.

Prostatitis manifests itself in young people in different ways. Some are concerned about the obvious symptoms: hyperthermia, severe pain in the groin with irradiation to nearby organs and during urination. For others, the symptoms manifest themselves in a mild form. General weakness, decreased activity, low-grade fever and urethral discharge appear.

VeryIt is important not to ignore the signs of the disease, but to start treatment on time. The neglected pathological process will leave its mark on the state of the organ and the life of young people.

Preventive actions

It is better to prevent any disease than to cure it. The measures to prevent prostatitis are quite simple and are not difficult to follow.

1. First of all,reconsider your daily routine. If you have a sedentary job, be sure to introduce five-minute sports exercises into your routine. Stretch your body, move more. This is necessary to make the blood "run" faster through the vessels. At the same time, avoid excessive physical activity, which exhausts the body.
2. Stop smoking. Tobacco smoke causes spasms in the blood vessels and impairs blood circulation, reducing the supply of oxygen to the prostate gland. Limit your intake of alcoholic beverages.
3. Avoid hypothermia and nervous tension.
4. It is worth eating marinated dishes, spices and pickles and hot sauces in doses.
5. The regularity of sexual activity and the appropriateness of sexual intercourse should be observed.

Untreated prostatitis threatens a number of complications: transition to a chronic form, development of infertility, spread of the process to the kidneys and bladder. More serious consequences include adenoma and prostate cancer. It is possible that purulent foci – abscesses – may appear in the gland and become septic.

As you can see, the disease is quite insidious. And, despite the sensitivity of the matter, you should not delay treatment. Stop the process in the early stages of its development: only in this case will you preserve your health and virility.