The article will present the main causes of prostatitis.
The disease is an inflammatory process in the prostate gland, which is the most common pathology of the male genitourinary system. The disease can occur in acute or chronic form and most often occurs in patients 25-50 years old. According to statistics, prostatitis affects 35-80% of men after 30 years. Signs of the disease include pain, painful and difficult urination, sexual dysfunctions. The diagnosis is made by the andrologist or urologist according to the characteristic clinical picture. In addition, bacterial culture of urine and prostatic secretions, as well as ultrasound of the prostate, are performed.
Description of the disease
Prostatitis is manifested (according to ICD-10, the disease code is N41) in the form of frequent urination with an admixture of blood, purulent elements in the urine, pain in the scrotum, penis, rectum, sexual dysfunction (early ejaculation, lack of erection, etc.) d.), sometimes urinary retention. In some cases, abscess prostate, inflammation of the testicles, which threatens infertility for men. Climbing infection leads to inflammation of the upper urogenital organs (pyelonephritis, cystitis).
What are the causes of prostatitis? The disease develops when an infectious agent enters, which enters the prostate tissue from the urogenital organs (urethra, bladder) or from remote inflammatory foci (with pneumonia, tonsillitis, flu, furunculosis). There are also a number of risk factors that increase the likelihood of prostatitis.
Predisposing factors
The risk of this pathology increases with hypothermia, the presence in the history of certain specific infections and conditions that are accompanied by stagnation in the tissues of this organ. In this regard, the following factors contributing to the development of prostatitis can be distinguished:
- severe hypothermia (single or regular, associated with living or working conditions);
- a sedentary lifestyle or profession that forces a person to remain seated for a long time;
- frequent constipation;
- violations of the correct rhythm of sexual activity (increased sexual activity, prolonged abstinence, insufficient ejaculation during intercourse);
- the presence of chronic diseases (bronchitis, cholecystitis) or chronic foci of infection in the body (caries, chronic osteomyelitis, tonsillitis, etc.);
- a history of urological diseases (urethritis, cystitis, etc.) and sexually transmitted diseases (trichomoniasis, chlamydia, gonorrhea);
- conditions that cause depression of the immune system (chronic stress, malnutrition, lack of sleep, high physical exertion in athletes, etc.).
The causes of prostatitis are of interest to many. It is assumed that the likelihood of developing an ailment significantly increases with chronic intoxication (nicotine, alcohol, morphine, etc.). Studies in the field of urology prove that one of the common predisposing factors in the development of this pathology can be a chronic perineal injury (in motorists, cyclists, motorcyclists). However, many experts believe that all of the above factors cannot be considered real causes of prostatitis, but only contribute to the exacerbation of the inflammatory process in the tissues of this male organ.
The main role in the development of prostatitis is played by congestion in the prostate gland. Violations of capillary blood flow provokes an increase in lipid peroxidation processes, swelling, tissue exudation and creates favorable conditions for the occurrence of an infectious process.
The causes of prostatitis should be determined by the doctor.
Etiology
Staphylococcus aureus, enterococcus, enterobacter, Pseudomonas aeruginosa, Proteus, Klebsiella and Escherichia coli can be an infectious agent in the development of acute forms of the disease. The bulk of microorganisms is a conditionally pathogenic flora and causes inflammation of the prostate only in the presence of other predisposing factors. The chronic inflammatory process is usually caused by polymicrobial associations.
Symptoms of the disease in acute form
Three main stages of prostatitis in men in acute form can be distinguished, which are characterized by a certain clinical picture and morphological changes:
- Catarrhal acute prostatitis. At the same time, men complain of painful, rapid urination, pain in the sacrum and perineum. These are the main signs of prostatitis. The photo in the article reflects some of the symptoms.
- Follicular acute prostatitis. The pain becomes more intense, can radiate into the anus and intensify during bowel movements. In this case, urination is difficult, urine flows in a thin stream. In some cases, patients may observe urinary retention, low-grade fever, or a mild fever.
- Parenchymal acute prostatitis. At this stage, severe intoxication occurs, high fever, chills, dysuric disorders, urinary retention. The patient has pulsating sharp pains in the perineum and difficulty in bowel movement.
Signs of chronic prostatitis
In rare cases, chronic prostatitis (according to ICD-10 code - N41) is the result of acute processes, however, such an ailment initially develops with blurry symptoms. The temperature can rise to subfebrile values. A man notes discomfort or a weak pain in the perineum, discomfort during urination and defecation. The most characteristic symptom of chronic prostatitis is scanty discharge from the urethra during bowel movements.
Not everyone understands the causes of prostatitis in men. It must be remembered that primary chronic prostatitis develops over a long period of time. It is often preceded by a phenomenon such as prostatosis (stagnation of blood in the capillary vessels), which gradually turns into abacterial prostatitis (the initial stage of the inflammatory process).
Chronic prostatitis (according to ICD-10 - N41) can be a complication of chronic inflammatory processes caused by pathogens of specific infections (chlamydia, trichomonas, ureaplasma, gonococcus). Manifestations of specific inflammation in many cases mask the symptoms of chronic prostatitis. Perhaps a minor increase in pain during urination, slight pain in the perineum, slight discharge from the urethra. A similar change in the clinical picture and the onset of a chronic disease in most cases goes unnoticed for the patient.
Prostatitis in men of a chronic type can be manifested by a burning sensation in the perineum and urethra, dysuria, sexual disorders, excessive general fatigue. Potency disorders (or psychological discomfort, fear of such disorders) can result in depression, increased anxiety and irritability of the patient. The clinical picture of this disease does not always include all of the above groups of symptoms, without exception. They may differ in different patients and vary over time.
Let us consider in more detail the signs of chronic prostatitis in men. What to treat, we will tell below.
Clinicians distinguish three main syndromes that are most characteristic of chronic prostatitis:
- Painful. There are no pain receptors in the tissues of the prostate gland. The cause of this discomfort with prostatitis is the almost inevitable (as a result of abundant innervation of the pelvic organs) involvement in the process of inflammation of the nerve pathways. Men with chronic prostatitis often complain of pain of varying intensity - from aching, weak to intense, disturbing sleep. There is also a change in the nature of the pain syndrome (weakening or strengthening) with ejaculation, increased sexual activity, or, conversely, sexual abstinence. Pain can radiate into the scrotum, lower back, and perineum. It must be borne in mind that lower back pain occurs not only when prostatitis occurs. The cause of pain in this area may be osteochondrosis and a number of other pathological conditions. Symptoms of prostatitis and the causes of the disease are interrelated.
- Dysuric syndrome (violation of urination). Due to inflammation with chronic prostatitis, the prostate gland increases in volume, which contributes to compression of the ureter, the lumen of which gradually decreases. At the same time, the patient urges urination, there is a feeling of incomplete emptying. As a rule, dysuric conditions are expressed in the initial stages of chronic prostatitis. After this, compensatory hypertrophy of the muscles of the bladder develops. Signs of dysuria in this period are weakening, after which they reappear with decompensation of the adaptive mechanism.
- Violations of a sexual nature. In the early stages of the pathological process that occurs chronically, dyspotension may occur, which in different patients manifests itself in different ways. Patients may complain of frequent nocturnal erections, an insensitive orgasm, or decreased erection. Excessively fast ejaculation is due to a decrease in the threshold of excitation of the orgastic center. Soreness during ejaculation can cause a man with prostatitis to refuse a sexual life. Subsequently, sexual disorders become even more pronounced. In advanced stages of chronic prostatitis, impotence develops. The stage of sexual disorder in this disease is determined by many factors, including the psychological mood of the patient and the sexual constitution. Potency disorders and dysuric phenomena can be caused by changes in the tissues of the prostate gland, as well as by the suggestibility of the patient, who, when determining his chronic prostatitis, expects the inevitable occurrence of sexual and urination disorders. Most often, dysuria and psychogenic dyspotension develops in anxious, suggestible patients. Impotence, and in some cases the very threat of possible sexual dysfunctions, is tolerated by patients with prostatitis, as a rule, hard. Often there is a change in character, obese, irritability, increased health concern.
Complications of the pathological process
In the absence of timely treatment of prostatitis in acute course, there is a high probability of developing abscesses of the prostate gland. When a purulent lesion is formed in this organ, the patient's body temperature often rises to 39-40 ° C and in some cases acquires a hectic character.
Periods of hyperthermia can alternate with severe chills. A sharp pain in the perineum makes urination difficult and the act of defecation is impossible. The increase in swelling of the prostate gland leads to a delay in urination. In rare cases, an abscess can spontaneously open into the rectum or urethra. When opening in the area of the urethra, purulent muddy urine with a sharp unpleasant odor is observed, and when opening it into the rectum, feces contain mucus and pus.
For chronic prostatitis, the most characteristic wave-like course with prolonged remissions, during which the inflammatory process in the prostate proceeds latently or is accompanied by minimal symptoms. Patients who are not concerned about the manifestations of the disease often stop therapy and consult a doctor only if complications arise.
Prostatitis and prostate adenoma often accompany each other.
The spread of infectious agents along the urinary tract with chronic prostatitis causes the development of cystitis and pyelonephritis. The most common complication of this pathological process is inflammation of the testicles and their appendages (epididymorchitis), as well as seminal vesicles (vesiculitis). As a rule, the result of such diseases is infertility.
Diagnostic methods
A specific clinical picture often simplifies the diagnostic process for acute or chronic prostatitis. If you suspect the development of such a disease, a rectal examination of the prostate is mandatory, in which the urologist takes the secretion produced by this body. Sensitivity of flora is also carried out (inoculation of prostate secretion and bacterial urine culture).
To identify some structural changes (tumor, hand, adenoma, etc.) and to differentiate this pathology from other diseases of the prostate, an ultrasound examination is performed. To confirm or exclude the development of infertility helps spermogram.
So, signs of prostatitis were found. What to treat?
Acute treatment
Patients with uncomplicated acute prostatitis undergo outpatient treatment by a urologist or andrologist. With severe symptoms of intoxication, with suspected purulent processes, patients are shown hospitalization. Men with acute prostatitis are given antibiotic therapy. Medications are selected taking into account the sensitivity of the infection to a particular pharmacological substance. Widely used are drugs that treat prostatitis, such as antibiotics, which can penetrate well into the tissue of the prostate gland (Ciprofloxacin, etc.). When a prostate abscess occurs, an endoscopic transurethral or transrectal autopsy of the purulent focus is performed.
Acute prostatitis is a pathological process that has a pronounced tendency to chronicity. Even with timely adequate therapy, the outcome of acute processes in more than half of patients becomes chronic prostatitis.
Chronic treatment
Recovery with this form of pathology can not always be achieved, however, with consistent, adequate therapy and adherence to medical recommendations, it is possible to eliminate the unpleasant symptoms of prostatitis and achieve long periods of remission.
Treatment of chronic prostatitis is usually complex. The patient is prescribed long courses of taking antibacterial medicines (within 5-8 weeks), prostate massage, immunity correction, physiotherapy are performed. The man is also given recommendations for normalizing his lifestyle.
The selection of the variety and dosage of antibacterial drugs, as well as the determination of the duration of the course of treatment with these drugs, is carried out individually. The specialist selects medications, focusing on the sensitivity of microflora according to the results of inoculation of prostate secretion and urine.
Prostate massage can have a complex effect on the inflamed organ. During the massage, the pathological secretion that accumulates in the prostate gland begins to be squeezed out into the ducts, after which it enters the urethra and is naturally excreted from the body. This procedure improves blood circulation in the prostate, which helps to minimize the effects of stagnation and ensures maximum penetration of antibacterial substances into the tissues of the affected organ.
The recovery period after treatment, as a rule, is quite long, but it often happens that prostatitis cannot be completely cured. When recovering, the patient is prescribed funds to strengthen immunity, improve blood circulation, etc.
Home treatment
Treating prostatitis at home is not always effective, but as an adjunct therapy is very useful. Antibacterial drugs often replace natural antibiotics - garlic, honey, onions, viburnum, wild garlic, mustard, radish. Also used are infusions and decoctions of herbs - wormwood, calendula, coneflower, cinnamon, cloves, peony, marshmallow root, celandine, nettle, sage, chamomile, etc.
Alternative methods of stimulating blood circulation in the prostate are a variety of physical exercises, walking, running, as well as taking folk remedies - tincture of garlic with honey, garlic oil, peony infusion.
We examined the symptoms of prostatitis and the causes of the development of the disease.