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

Prostatitis isa purely male disease. It is one of the most common injuries to the genitourinary system and occurs in approximately 80% of men, with 4 of them occurring before the age of 40.

Disease is not an isolated process: it isexposes 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 is a very elastic organ, as 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 presses on the urethra, interrupting the process of urine excretion.

Prostateperforms such functions for the body:

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

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.

Furthermore, the enlarged prostate "invades" the bladder, compressing it. Because of this, the evacuation of urine is interrupted, it stagnates, causing inflammation now in the bladder. Prolonged stagnation of urinary fluid in its "reservoir" leads to intoxication of the entire body with metabolic products in its composition.

Contributing Factors

The main reason for the development of prostatitis isinfection. These can be staphylococci, enterococci, 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 from other systems: flu, tuberculosis, tonsillitis and others. Bacteria and viruses enter the prostate gland through lymph and blood flow, as well as through sexual contact. Often, pathogenic flora is introduced into the gland via the ascending urethra or descending from the bladder with infected urine.

Other factorsthat provoke inflammation of the gland include:

• circulatory disorders in the pelvis. This can be caused by a sedentary lifestyle, being overweight and pelvic injuries. A special risk group is represented by drivers who are constantly sitting and experience vibrations and pressure in the perineal area. Reduced blood circulation in the pelvis causes congestion and lack of oxygen in the prostate, which also causes the development of infection,
• hypothermia,
• Hormonal imbalance,
• problems with the passage of urine,
• irregular sexual activity – very "violent" sexual life, abstinence, interruption of sexual relations,
• chronic constipation,
• inflammation of the rectum,
• decreased immunity, as a result of which the body becomes susceptible to infectious agents.

There is an opinion that the risk of developing the disease increases with regular use of alcohol and drugs.

Typification 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. It isbased on clinical data, as well as the presence of leukocytes and pathogenic flora in seminal fluid, prostate 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 prostatitisis infectious in nature. There are several steps:

• 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 drops. Hyperthermia up to 38°,
• parenchymal.Characterized by acute urinary retention and bowel movement problems. Severe pain in the perineum, lower back and above the pubis. 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 examination performed by a urologist, a dense, enlarged prostate is palpated, warm and painful to the touch. 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 captures the nerve fibers in the small pelvis, where there are many of them. It is of a different nature. It can be insignificant or sharp and strong, disturbing even at night, decreasing and returning again. It is located in the sacrum, scrotum, lower back and perineum.
• dysuric.The urge to urinate becomes more frequent. It becomes sluggish and there is a feeling of the bladder being heavy and not completely empty. Then the process may improve due to a compensatory increase in the bladder muscles, but it soon starts again. Discharge appears in the urethra during bowel movements.
• sexual disorders– increase or decrease in nocturnal erections, blurred orgasm, pain during ejaculation and its acceleration. Worsening of sexual disorders, which ultimately lead to impotence. There is a concept of psychogenic dyspotence, when a man is convinced that in his condition violations in the intimate sphere are inevitable. And they are really developing. With the development of sexual dysfunction, the man's mood also changes: he becomes irritable and depressed.

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

CPPS Diagnosisis placed if there are clinical manifestations of prostatitis, but the pathogens of the disease are not detected in biological fluids (urine, ejaculate and prostate secretions). Leukocytes are determined at the same time.

The main criterion for diagnosis is pain that does not subside 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 prostate inflammation. It is discovered incidentally during prostate tissue histology if the patient has received a prostate biopsy. A similar procedure is prescribed, for example, when PSA levels rise.

The disease, regardless of the type (except the asymptomatic form), manifests itself, first of all, urinary disorders:

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

If these symptoms appear, do not delay in visiting a urologist. This will help stop the process at its first stage.

How to recognize the disease

The main criterion for diagnosis is the patient's clinical picture and complaints.

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

1. Examination by a urologist.The doctor should perform a rectal examination of the prostate. It is passed with a finger through the rectum. It is advisable to evacuate before the exam. Through 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. Digital examination allows prostate secretions to be collected.
2. Urine analysis.Two portions are examined: urine collected at the beginning of urination and urine collected at the end of the process. 1 portion indicates the condition of the urethra, 2 – the kidneys and bladder. The presence of leukocytes in the urine above normal (15 per field of view) indicates inflammation.
3. After collecting the urine, a prostate massage is performed, with which its secretion is obtained.If there is very little of it and it does not come out of the urethra, but remains on the walls, urine is collected after massage. It is as informative as the prostate secretion itself. Leukocytes are also determined here (there should be no more than 10 of them), and additionally lecithin grains and amyloid bodies. If the first analysis of glandular secretion showed no abnormalities, this does not mean the absence of a process. Prostate juice can be very viscous and obstruct 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 go through this analysis several times. Cultures of urine and prostate secretions are also performed to identify the causative agent of the disease and determine sensitivity to antibiotics.
4. General blood analysis.
5. Analysis for the presence of sexually transmitted diseases.
6. Ultrasound of the kidneys, bladder, TRUS,which allows you to fully assess the condition of the prostate,
7. Uroflowmetry.It is used to assess the rate and timing of urinary excretion. It is carried out using a special device consisting of sensors and a container. All the patient needs to do is urinate in the usual way.
8. blood PSA- Prostate specific antigen. It is an indicator of the presence of tumor formations in the prostate - adenoma or cancer,
9. Prostate biopsy.It is carried out if the presence of cancer is suspected.

It is necessary to take a spermogram, which will help confirm or refute infertility.

Therapy of acute and chronic prostatitis

Uncomplicated acute prostatitis is usually treated on an outpatient basis. Hospitalization is indicated for severe poisoning or the development of complications.

Treatment of acute prostatitisstart with antibiotics. If the condition is seriously disturbed, they are administered without waiting for the results of the analysis. They use groups of antibacterial drugs that are able to penetrate deep into the prostate tissues. They act on the types of bacteria that most often cause inflammation. These antibiotics include fluoroquinolones.

After receiving the testsantibiotic therapy can be adjusted differently. It all depends on the causative agent of the disease and its sensitivity to the medicine. Therapy is also changed if no effect is seen after 2 days.

In case of acute inflammation of the prostate, the administration of analgesics is indicated, as well as non-steroidal anti-inflammatory drugs. 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 poisoningcarry out detoxification therapy. To do this, use a glucose solution.

Prescription medications 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 for chronic prostatitis depends on the stage of the disease.

In the acute form, antibiotics are used. In the remission phase, therapy is aimed at maintaining normal functioning of the gland:

1. Medicines that normalize the microcirculation of organs.
2. Anti-inflammatory medications.
3. It is important to maintain the body's immune function, which decreases under the influence of antibiotics. For this, patients are given immunostimulants.
4. For sexual dysfunctions, 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.

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

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

Massage helps to strengthen the muscles of the gland and perineum. The procedure allows you to remove stagnant seminal fluid from the organ, due 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 a bougie instillation and massage method.

Instillation methodbegins with the introduction of a medicinal solution through the urethra. It is then pinched and the prostate is massaged using the finger method. In this case, the healing solution penetrates the gland, enhancing the effect of the procedure. At the end, the urethra is open, it is recommended to wait a while to urinate. The drug is reintroduced into the urethra.

Bougie Massagecarried out 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 the penis from top to bottom. The duration of the procedure is 1 minute, after which medications are administered intraurethral. This massage is supported by antibiotic therapy.

Prostate finger massage– medical manipulation, carried out by a specialist according to clear instructions.

A self-massage option 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 prostate organ.

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

Prostatitis and traditional medicine

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

There are many homemade recipes that help combat prostatitis. Here are some of them:

• Grind 500 grams of peeled raw pumpkin seeds in a meat grinder and mix with 200 grams of honey. Make balls with the resulting dough. Consume before meals twice a day, slowly, chewing and dissolving well. 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 fruit per day, you will support your man's health,
• Parsley, first of all, became famous as a culinary seasoning. But, in addition, it also contains many useful substances, including those that the male body needs. Take parsley juice 1 tbsp. I. 3 times a day 30 minutes before meals. This will help relieve inflammation and improve sex life,
• take the green skin of the chestnuts along with the thorns, chop them and pour boiling water over them. Use as tea
• Grind 300 grams of onion to a pasty consistency, add 100 grams of honey and 600 ml of dry wine. Store for 1 week in a dark, cool place, stirring occasionally. Variety. Use 2 tbsp. I. 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 region and, consequently, in the prostate.

1. Deep squat below knee level. The ideal number of times is 100. Do it 3 times a week. If you can't do this number at once, do squats in several approaches with pauses.
2. Scissors. Sit on the floor with your hands resting on the floor behind you. Stretch your legs in front of you and lift them off the floor. Cross them over each other. The movements resemble the work of scissors.
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 cancomplement this complex with other exercises, which activate and warm up the muscles.

Adolescent prostatitis

It's hard to believe, but prostatitis, which was considered a province of middle age 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.

That's whyIt is important to understand the reasonsthat lead to prostatitis in adolescence:

• early sexual activity and sexual illiteracy.Unprotected sexual intercourse contributes to the flourishing of sexually transmitted infections, which can cause bacterial inflammation of the prostate,
• hypothermia– a factor contributing to the development of prostatitis. Temperature imbalance reduces immunity and exposes the body to infectious attacks,
• fashion trends– wearing clothes and underwear that are too tight disrupts blood circulation in the pelvis and leads to stagnation in this area,
• sedentary lifestyle– computer work of modern young people 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 in its quality make it more susceptible to infections.

Prostatitis manifests itself in different ways in young people. Some are concerned about obvious symptoms: hyperthermia, severe pain in the groin radiating to neighboring organs and when urinating. For others, symptoms occur mildly. General weakness, decreased activity, low 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 treat it. Measures to prevent prostatitis are quite simple and not difficult to follow.

1. In the first place,reconsider your daily routine. If you have a sedentary job, 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 blood vessel spasms and impairs blood circulation, reducing oxygen supply to the prostate. Limit your intake of alcoholic beverages.
3. Avoid hypothermia and nervous tension.
4. It is worth eating marinated dishes, as well as seasonings and pickles, as well as hot sauces in doses.
5. The regularity of sexual activity and the adequacy of sexual intercourse must 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 for purulent foci – abscesses – to appear in the gland and become septic.

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