![inflammation of the prostate in men](/images/articles/2186/inflammation%20of%20the%20prostate%20in%20men.jpg)
Inflammation of the prostate today is the leader in the group of male diseases that are predominantly sexually transmitted. Its complications threaten infertility, decreased libido and impotence.
The symptoms of prostatitis are not only pain, urination disorders and inflammation of the spermatic cord. The most dangerous consequence of advanced inflammation can be cancerous degeneration of the prostate gland. While a timely diagnosed pathological process can be easily stopped.
Causes of inflammation
The risk of developing inflammation of the prostate increases due to several factors that predispose to the disease:
- Hypothermia, one-time or associated with the nature of work in the open air.
- A sedentary lifestyle leads to disruption of the functioning of the digestive system.
- Chronic somatic diseases (diabetes mellitus, hypertension).
- Foci of focal and perifocal infection (rhinitis, tonsillitis, stomatitis, gastritis).
- Persistent UGI (chlamydia, trichomoniasis, herpes virus).
- Stress, insomnia, chronic fatigue syndrome.
- Decreased immunity due to illness, surgery, emotional stress.
- Bad habits that lead to the development of intoxication: alcohol, smoking, strong coffee.
- Occupational injuries to the perineum of motorists, athletes, workers in dangerous industries.
- Promiscuous sexual life, interrupted sexual intercourse, unsensual intercourse with incomplete ejaculation, prolonged absence of intimacy (low need for sperm leads to stagnation in the gland).
- Venereal illnesses.
Despite a rather large number of provocative moments, the essence of prostatitis is the occurrence of stagnation inside the organ against the background of disorders of blood circulation and lymphatic outflow.
Symptoms of prostatitis
Prostatitis can be suspected based on the following disorders in the functioning of the genitourinary system:
- discomfort when urinating, uncontrolled urination;
- potency disorder, weak erection, decreased libido;
- difficulty urinating, sensation of incomplete emptying of the bladder;
- pain in the perineum when sitting for a long time, for example while driving;
- infertility.
The acute phase of the disease causes considerable discomfort. This phase is accompanied by the following symptoms:
- frequent and painful need to urinate;
- delay or inability to urinate;
- stabbing pain in the perineum, which transmits to the anus and intensifies during the act of defecation. As a result, difficulty in defecation;
- general intoxication of the body, feverish state.
The chronic form of prostatitis is accompanied by other symptoms:
- slight increase in body temperature;
- constant tiredness;
- slight pain in the perineum, burning in the urethra;
- discomfort during urination and defecation;
- weakening of sexual function and consequent psycho-emotional depression.
![healthy and diseased prostate](/images/articles/2186/healthy%20and%20diseased%20prostate.jpg)
Classification
In modern urology there is no uniform classification of the disease. However, practicing doctors prefer this option for classifying the inflammatory process in the prostate
According to the course of the disease:
- Acute prostatitis. It represents more than 50% of cases of the disease in people aged 30-35 years.
- Chronic option. It is considered a non-age category. It does not manifest itself for a long time, the impetus for its development is a cold or infection.
For the reason that caused the pathology:
- Bacterial inflammation of the prostate gland, predominates in men under 40 years of age, occurs on the background of ultrasound and does not extend beyond the boundaries of the organ.
- Non-bacterial pathological changes in the gland, predominantly chronic.
- Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.
According to the nature of structural changes in the prostate gland:
- Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention. Clinically it resembles prostatic adenoma.
- Calcium inflammation of the prostate gland occurs due to the formation of stones within the prostate. Considered a harbinger of cancer.
- Congestive prostatitis, a consequence of a sedentary lifestyle, is diagnosed in one in two patients.
Signs of the disease
If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:
- Micturition disorder with the presence of a weak, intermittent, unusually short stream of urine, causing splashing, difficulty and pain before urination. The frequent need to empty the bladder occurs mainly at night.
- The pain, which is localized in the lower abdomen, radiates to the scrotum, perineum and rectum.
- Sexual dysfunction.
- Problems with ejaculation, changes in semen (consistency, quantity).
Acute prostatitis
The disease begins with a sharp increase in temperature (up to 40 degrees), painful headache and fever. The symptoms that appear are accompanied by pain in the groin, perineum, back, discharge from the urethra, frequent urination and constant need to urinate.
Emptying of the bladder occurs with delay and burning sensation. The urine itself becomes cloudy and may contain blood. Irritability and fatigue occur.
The outcome of acute prostatitis can be complete resolution of the process (if treatment is started in a timely manner). Since changes occur in many pelvic organs, they cannot be left to chance, otherwise the corresponding complications will arise:
- Vesiculitis is an inflammation of the seminal vesicles, causing the appearance of pus in the spermatozoa, which not only reduces the quality of the ejaculate, but leads to the loss of reproductive function.
- Colliculitis - inflammatory changes in the seminal tubercle become the reason for the development of severe pain during sex, disruption of orgasm and impotence of a psychological nature.
- The formation of an abscess in the body of the prostate, its rupture and purulent damage to the rectum lead to an exacerbation of symptoms, severe intoxication of the body and even death.
- Stagnation in the tissues of the prostate leads to changes in their structure, disruption of innervation, blood supply, both to the gland itself and to organs located nearby, with disruption of their functions. The erection becomes insufficient for full sexual intercourse, premature ejaculation and prolonged sexual intercourse without orgasm are observed.
- Cicatricial changes in the gland and spermatic cord lead to infertility, decreased sperm quality and sperm motility. Narrowing of the urethra interferes with the normal urination process; Bladder obstruction can cause acute urinary retention, requiring emergency surgical care.
Chronic prostatitis
The main feature of the disease is the vagueness of clinical symptoms with a long and persistent course of the process. More often, the chronic form manifests itself independently, as a primary pathology against the background of stagnation of blood in the vessels (prostatosis), abacterial prostatitis.
The main symptoms of chronic prostatitis are:
- fever;
- pain occurs in the scrotum, perineum, anus, back;
- urinary disorder;
- mucous or mucopurulent discharge from the rectum, urethra, even in the absence of urination or defecation;
- erectile dysfunction, painful ejaculation, interrupted sexual intercourse, prolonged intercourse without feeling of satisfaction.
Inaction and improper treatment of chronic prostatitis can cause complications:
- Infertility is the result of chronic inflammation of the spermatic cord, vesicles, testes and their appendages.
- Cystitis, pyelonephritis (other diseases of the genitourinary system) are a consequence of hematogenous and mechanical spread of microbes.
- Sepsis.
- Persistent decrease in immunity.
- Untreated prostatitis can cause cancer in 35-40% of cases.
Diagnostics
The clinical picture of the disease is typical, so the diagnosis is not difficult. It is performed by a urologist on the basis of anamnesis, examination of the patient, a minimum of laboratory tests using the most modern medical devices:
- Rectal examination of the gland, sampling of secretions for examination (culture with determination of sensitivity to antibiotics).
- UAC, UAM, bacterial culture of urine.
- Pap test for sexually transmitted diseases, UGI examination.
- Daily monitoring of urinary rhythm, measurement of urination speed (uroflowmetry).
- Ultrasound or TRUS is performed for differential diagnosis.
- If it is necessary to exclude oncology, a biopsy is performed, urography is performed and PSA is determined: prostate specific antigen.
- To diagnose infertility, a spermogram is prescribed, an analysis of ejaculate to determine a man's fertility.
Based on the results of the patient's examination, an individual scheme for the complex treatment of prostatitis is drawn up. When prescribing drugs, the form of the pathology and the presence of concomitant diseases are taken into account. The decision on where to conduct therapy (inpatient or outpatient) lies with the doctor. The course of treatment is carried out with careful laboratory monitoring of the results.
![symptoms of acute prostatitis](/images/articles/2186/symptoms%20of%20acute%20prostatitis.jpg)
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.
Course treatment methods:
- The most effective treatment for prostatitis is etiotropic therapy. If the basis of prostatitis is an infection, the priority is a course of antimicrobial agents that relieve the manifestations of inflammation.
- Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers. NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
- Physiotherapeutic methods are possible only in the subacute stage of the disease. They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Massage is another effective method to influence the prostate. Opens the ducts, normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychological consultations.
Therapy for acute inflammation of the prostate is complex.
Effective treatment of acute prostatitis in men includes drugs from several pharmacological groups:
- Antibiotics.Drugs with a broad spectrum of activity are used that have a bactericidal effect on most pathogens. Most often, antimicrobial treatment is an etiotropic measure, since in most cases the cause of inflammation of the prostate is microbial pathogens. For a bacterial infection, antibiotics are prescribed, for a viral infection, antiviral drugs are prescribed, and if protozoa are detected, anti-trichomonas drugs are prescribed. The choice of antimicrobial agents is made empirically or based on the results of PCR, bacterioscopy and bacterial culture. The selection of antimicrobial agents, the determination of their dose, frequency and duration of administration can be carried out exclusively by the attending physician. Together with antibiotics, uroseptics can be prescribed, which have a disinfectant effect on the mucosa of the genitourinary tract.
- Anti-inflammatory drugs.It allows you to reduce the severity of swelling in the tissues and the intensity of pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually used.
- Vascular drugs– reduce tissue swelling, eliminate prostate congestion, thus helping to reduce pain, improve blood circulation and local metabolic processes in the tissues.
- Enzymes– fluidize prostatic secretion and promote pus drainage. Furthermore, enzymatic drugs increase the effectiveness of antimicrobial treatment by improving the absorption of their active ingredients by the affected tissues.
- Diuretics (diuretics).They increase urine production, which contributes to the mechanical "washing" of the infection.
- While taking antibiotics, patients are prescribed hepaprotectors that protect the liver parenchyma from toxic damage and improve its functional state.
- To eliminate and prevent the development of intestinal dysbiosis during antibiotic therapy, patients are prescribed probiotics.
- After the acute inflammatory phenomena in the prostate gland have subsided, patients are prescribed a course of physiotherapy treatment: medicinal electrophoresis, galvanization, magnetic therapy, laser, mud, etc. Such procedures improve local microcirculation and lymphatic drainage, metabolic processes and tissue nutrition, stimulate tissue repair, accelerate the final resolution of the inflammatory process, promote tissue restoration and normalization of the functional state of the prostate.
General activities must be carried out.
A diet for acute prostatitis in men is indicated, which includes a sufficient intake of easily digestible proteins and vitamins.
During the period of exacerbation of inflammation, spicy, fried, fatty, salty foods and marinades are excluded from the diet.
Alcohol consumption is excluded, smoking cessation, abstinence from sexual intercourse and intense physical activity, including sport, are recommended.
It is necessary to normalize sleep, work and rest and balance the emotional background.
During the period of illness, a person needs functional rest.
With timely and correct diagnosis and treatment of acute prostatitis in a medical institution, the prognosis is favorable: complete recovery occurs.
If acute prostatitis develops, consult a doctor immediately and do not self-medicate!
Treatment of chronic prostatitis
With a long-term effect (at least a month) on the prostate, there is no 100% cure guarantee. The priority goes to phytotherapy, immunocorrection, changing domestic habits:
- Herbal preparations are widely used in urological practice. They are able to accumulate at the site of the most active pathological process, protect cells from oxidation, remove free radicals and prevent the proliferation of glandular tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Drugs that improve immunity not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the function of the immune system.
- The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secretion of the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, hot sitz baths or herbal microenemas.
- In more severe cases, intravenous fluids with diuretics are indicated. This stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- For constipation, herbal laxatives are used.
- The urologist and psychologist, together with the patient, develop a long-term individual program including daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). Practiced in exceptional cases, it is fraught with impotence and urinary incontinence. Young people do not undergo surgery because it can cause infertility.
Treatment with drugs
Treatment of prostatitis with antibacterial therapy must begin with bacterial culture, the purpose of which is to evaluate the body's sensitivity to this type of antibiotic. If urination is impaired, the use of anti-inflammatory drugs gives a good result.
Medicines are taken in tablets, in acute cases - as a dropper or intramuscularly. Rectal suppositories are effective in the treatment of chronic forms of prostatitis: with their help, drugs reach their goals faster and have minimal effect on other organs.
Anticoagulant and anti-inflammatory drugs have also proven effective.
Antibacterial therapy
Antibiotics are an effective remedy in the fight against bacterial prostatitis. To achieve the desired effect and not harm the body, the choice of drug, dosage and treatment regimen should be made by a doctor. To correctly select the most effective drugs, he will have to find out what type of pathogen caused prostatitis, and also test the patient's tolerance to antibiotics of a particular group.
Antibiotics from the fluoroquinolone group have proven effective in the treatment of chronic prostatitis. Their action is aimed at suppressing bacterial infection and strengthening the body's immunity. In addition to this, the bacteriostatic antibiotic trimethoprim is recommended for the prevention and treatment of concomitant diseases of the genitourinary system.
The treatment of prostatitis caused by mycoplasma and chlamydia can also be carried out with drugs from the macrolide and tetracycline groups, which slow the spread of the infection.
The duration of taking antibacterial drugs is from 2 to 4 weeks. In case of positive dynamics the course may be extended.
Physiotherapy
Physiotherapeutic techniques in the treatment of prostatitis are aimed at activating blood circulation in the pelvic area, improving metabolic processes in the prostate gland and cleaning the ducts. If physiotherapy is combined with antibiotics, the effect of the latter is enhanced.
The main methods include:
- magnetotherapy;
- laser therapy;
- electrophoresis;
- heating;
- ultrasound;
- mud therapy;
- high frequency irradiation;
- Physiotherapy.
![prostatic massage](/images/articles/2186/prostatic%20massage.jpg)
One of the oldest methods, transrectal massage of the prostate gland, according to modern research, has no proven effectiveness.
Non-specific treatments
Nonspecific methods for treating prostatitis include:
- hirudotherapy;
- therapeutic fasting;
- acupuncture;
- diet according to the Ostrovsky method;
- alkalization of the body using the Neumyvakin method.
We strongly recommend that you discuss all non-traditional methods of treating prostatitis with your doctor.
Surgery
Surgical methods are used in complex and emergency cases:
- for drainage of purulent abscesses, which are removed by laparoscopic methods through a puncture;
- in case of difficulty urinating due to damage to the urinary tract;
- with a large volume of the affected area;
- with a significant number of stones in the body of the gland.
Stones and sclerotic tissue are removed using endoscopic methods. In case of a large affected area or multiple stones, resection of the prostate is used.
Transurethral resection is also effective for bacterial prostatitis. This way the risk of recurrence can be reduced.
Folk remedies
![treatment of prostatitis with traditional methods](/images/articles/2186/treatment%20of%20prostatitis%20with%20traditional%20methods.jpg)
Treatment of prostatitis with folk remedies is unlikely to be effective on its own, but it may be applicable in combination with drugs and physiotherapeutic methods. These include: beekeeping products, decoctions of herbs and seeds, tinctures of garlic, ginger, beaver brook, fresh greens, pumpkin seeds.
In acute cases of the disease it is necessary to consult a doctor and in no case self-medicate! If a purulent abscess ruptures, death is possible.
Suppositories for prostatitis
Treatment of prostatitis with rectal suppositories is much more effective than tablets, if only because the rectum is much closer to the prostate, which means the medicine will act faster.
The composition of drugs for the treatment of prostatitis can be completely different, they are prescribed to solve a particular problem.
- Antibacterial agents are especially effective for prostatitis caused by chlamydia.
- Painkillers are used for symptomatic treatment; They relieve pain well.
- Immunostimulants help improve blood circulation, relieve swelling and are used in complex therapy.
- Herbal medicines have a mild effect. They, like candles on bee products, are used as an addition to the main treatment.
- Compositions based on ichthyol promote blood flow in the area of the intestinal mucosa, which accelerates the attenuation of inflammatory processes and slightly improves immunity.
- Special enzyme products prevent the formation of scar tissue. It is recommended to take it as part of a complex therapy with antibiotics, anti-inflammatories and painkillers.
Accessory drugs
For the symptomatic treatment of prostatitis in men, for example, to relieve pain when urinating, you can also take antispasmodics, which relax the smooth muscles and thus quickly relieve pain.
General health is promoted by anticoagulant and anti-inflammatory dietary supplements based on bee products, pumpkin oil and palm fruit extracts.
Diet and lifestyle
A correct and balanced diet and a healthy lifestyle are very important for the treatment of prostatitis. Food should not contain spicy, fried, salted or pickled foods. In acute cases, alcohol is strictly prohibited.
Food should contain enough fiber to prevent constipation. The protein content should be reduced. It is recommended to supplement the diet with aromatic herbs, ginger and pumpkin seeds.
Consequences of untreated prostatitis
Even if the symptoms of prostatitis do not appear for a long time, it is necessary to regularly undergo examination by a urologist. Prostatitis that is not completely healed may be accompanied by the formation of calcifications, which will then need to be removed together with the gland. Experts are sure that there are no other ways to remove or dissolve stones.
Furthermore, pathogenic microorganisms can migrate to nearby organs, causing inflammation. Advanced prostatitis can cause the development of prostate adenoma and cancer.
Prevention
To prevent the occurrence of an unpleasant disease for men, it is necessary to eliminate provoking factors and follow simple rules:
- Lead a healthy lifestyle, abandon bad habits.
- Don't get too cold.
- Drink at least 1. 5-2 liters of water a day.
- Strengthen your immune system, walk a lot, strengthen yourself.
- Engage in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.