Prostatitis

Prostatitis is an inflammatory disease of the prostate gland. It is manifested by frequent campaigns in the bathroom, pain in the penis, scrotum, rectum, sexual disorders (erection, premature ejaculation, etc. ), sometimes late urine and blood insurance in the urine. The diagnosis of prostatitis is established by a urologist or other specialist in a typical clinical picture, the results of a rectal study. In addition, prostate ultrasound are performed, sowing prostatic secretion bacteria and urine. Conservative treatment - Antibacterial therapy, immunotherapy, prostate massage, lifestyle correction.

general information

Prostatitis - inflammation of the seed (prostate) - prostate. It is the most common disease of the genitourinary system in men. Most of the time, it affects patients aged 25 to 50. According to several data, prostatitis suffers from 30 to 85% of men over 30. Perhaps the abscess of the prostate gland, the inflammation of the testicles and appendages, which threaten infertility. The rise of infection leads to inflammation of the upper parts of the genitourinary system (cystitis, pyelonephritis).

Pathology develops when an infectious agent is inserted, which enters the prostate tissue of the organic system organs (urethra, bladder) or remote inflammatory focus (with pneumonia, flu, tonsillitis, cornunculose).

The causes of prostatitis

A Golden Staphylococcus aureus (Enterococcus), Enterobacter (Enterobacter), Pseudomonas (Pseudomonas), Proteus (Proteus) and Klebcelllah and Klebcelllah can act as an infectious agent in an acute process. (Klebsiella) and E. coli (E. coli). Most microorganisms belong to conditionally pathogenic flora and cause prostatitis only if there are other predisposing factors. Chronic inflammation is usually caused by Paul with microbial associations.

The risk of developing the disease increases during hypothermia, the presence of specific infections and conditions in the history of congestion in prostate tissues. The following predisposing factors are distinguished:

• General hypothermia (unique or permanent, related to working conditions).
• A sedentary lifestyle, a specialty forcing a person to stay in a long time sitting (computer operator, driver, etc. ).
• Constant constant.
• Violations of the normal rhythm of sexual activity (excessive sexual activity, prolonged abstinence, incomplete ejaculation during the deprived of the emotional color of "usual" sexual intercourse).
• The presence of chronic diseases (cholecystitis, bronchitis) or chronic infectious foci in the body (chronic osteomyelitis, absurd caries, tonsillitis, etc. ).
• Transferred urological diseases (urethritis, cystitis, etc. ) and sexually transmitted diseases (trichomoniasis, gonorrhea).
• States that cause inhibition of the immune system (chronic tensions, irregular and inferior nutrition, lack of regular sleep, a state of excess training in athletes).

It is supposed that the risk of developing pathology increases with chronic poisoning (alcohol, nicotine, morphine). Some studies in the field of modern andrology prove that the provocative factor is a chronic groin injury (vibration, concussion) in drivers, motorcyclists and cyclists. However, the expert number of expert believes that all listed circumstances are not real causes of the disease, but contribute only to the exacerbation of the latent inflammatory process in prostate tissues.

The decisive role in the occurrence of prostatitis is played by stagnation in prostate tissues. Infringement of hair blood flow causes an increase in lipid peroxidation, edema, prostate tissue exudation and forms conditions for the development of the infectious process.

Prostatitis symptoms

Acute prostatitis

There are three stages of acute prostatitis, which are characterized by the presence of a certain clinical image and morphological changes:

• Clear phlegm. Patients complain of rapid, often painful urination, sacred and perineum pain.
• Sharp follicular. The pain becomes more intense, sometimes radiates to the anus, intensifies during defecation. Urination is difficult, urine flows with a thin flow. In some cases, the delay of urine is observed. Moderate subfebrililitity or hyperthermia is typical.
• Acute papayat. Pronounced general poisoning, hyperthermia up to 38-40 ° C, chills. Disturbances said, usually an acute delay in urination. Clear and pulsating pains in the perineum. Difficulty defecating.

Chronic prostatitis

In rare cases, chronic prostatitis becomes the result of an acute process, however, as a rule, a primary chronic course is observed. The temperature occasionally rises to small values. The patient observes the poor pain in the perineum, discomfort during the act of urination and defecation. The most characteristic symptom is the scarce discharge of the urethra during the act of defecation. The primary chronic form of the disease develops for a significant period of time. It is preceded by the stagnation of the blood in the capillaries, gradually becoming a slaughtering prostatitis.

Chronic prostatitis is often a complication of the inflammatory process caused by the causative agent of a specific infection (chlamydia, urea, gonococcus). The symptoms of a specific inflammatory process in many cases mask the manifestations of prostate injury. A slight increase in pain during urination is possible, poor pain in the perineum, scarce discharge from the urethra during defecation. A slight change in the clinical image usually goes unnoticed by the patient.

Chronic inflammation of the prostate gland may be manifested by a burning sensation in the urethra and perineum, dysuria, sexual disorders, increased general fatigue. The consequence of violations of power (or fear of these violations) usually becomes mental depression, anxiety and irritability. The clinical picture does not always include all listed symptom groups, differs in different patients and changes over time. There are three main syndrome characteristic of chronic prostatitis: pain, violations when going to the bathroom, sex disorders.

There are no pain receptors in prostate tissue. The cause of pain in chronic prostatitis becomes almost inevitable due to abundant innervation of pelvic organs involvement in the inflammatory process of nerve paths. Patients complain of pain of various intensity - weak, pain to intense and violating sleep. There is a change in the nature of pain (improvement or weakening) with ejaculation, excessive sexual activity or sexual abstinence. The pain radiates to a scrotum, sacred, groin, sometimes to the lower back.

As a result of inflammation of chronic prostatitis, the volume of the prostate that squeezes the urethra increases. The ureter lumen decreases. The patient has frequent urination, a feeling of incomplete emptying of the bladder. As a rule, dysurical phenomena are expressed in the early stages. Then compensatory hypertrophy of the muscle layer of the bladder and ureters develop. The symptoms of dysuria during this period are weakening and, again, increased during the decompensation of adaptive mechanisms.

In the early stages, power violations may develop, which manifest themselves differently in different patients. Patients may complain about frequent night erections, delete orgasm or deterioration of an erection. Accelerated ejaculation is associated with a decrease in the center's threshold level of the center, responsible for obtaining an orgasm. Ejaculation pain can cause a refusal of sexual activity. In the future, sexual disorders become more pronounced. At an advanced stage, impotence develops.

The degree of sexual disorder is determined by many factors, including the patient's sexual constitution and psychological mood. Power violations and dysuria can be due to both changes in the prostate gland and how easy the patient can inspire anything. If he has chronic prostatitis, he expects the inevitable development of sexual disorders and urination disorders. Especially often psychogenic disorders in power and problems with the toilet develops in suggestive and alarming patients.

Complications

In the absence of timely treatment of acute prostatitis, there is a significant risk of developing the prostate gland abscess. When purulent focus is formed, the patient's body temperature rises to 39-40 ° C and can acquire a hectic character. The heat periods alternate with pronounced chills. Acute pain in the perineum complicates urination and makes defecation impossible.

The growth of edema of edema leads to acute delay of urination. In rare cases, the abscess opens spontaneously on the urethra or rectum. When opening in the urethra, the muddy purulent urine appears with an unpleasant poignant smell, when opening in the rectum, the stools contain pus and mucus.

For chronic prostatitis, a wave course with periods of prolonged remissions is characteristic, during which inflammation in the prostate continues latent or manifests itself in extremely scarce symptoms. Patients, who bother nothing, usually interrupt treatment and convert only with the development of complications.

The most frequent complication of the chronic process is the inflammation of the testicles and appendages of the testicles and inflammation of the seed bubbles. The result of these diseases usually becomes infertility.

Diagnosis

A characteristic clinical image simplifies the process of diagnosis in acute and chronic prostatitis. Mandatory is made:

• Retal Study of the Prostate
• About prostate gland secretion to determine microflora sensitivity (sowing prostate secret and urine urine to bacteria).
• A prostate ultrasound to identify structural changes (tumors, cysts, adenoma) and the differentiation of prostatitis from other diseases is performed
• A sperm to exclude or confirm the development of infertility.

Prostatitis Treatment

Treatment of acute prostatitis

Patients with an acute process without complications undergo a course of treatment with an outpatient urologist. With severe poisoning, suspected of a purulent process, hospitalization is indicated. Antibacterial therapy is performed. Medicines are selected taking into account the sensitivity of an infectious agent. Antibiotics are widely used that can penetrate well on prostate tissue (ciprofloxacin, etc. ).

With the development of acute delay of urination, at the bottom of prostatitis, they use the installation of a special tube, not a urethral catheter, because there is a danger of forming a prostate abscess. With the development of the abscess, an endoscopic transrectal or urethral opening of the abscess is performed.

Treatment of chronic prostatitis

The treatment of chronic prostatitis should be complex, including ethiotropic therapy, physiotherapy, immunity correction:

• Antibiotic therapy. The patient receives long-term antibacterial courses (within 4-8 weeks). Type and dose selection of antibacterial medications, as well as determining the duration of the treatment course is performed individually. The drug is chosen based on the sensitivity of microflora based on the results of urine sowing and prostate secret.
• Prostate massage. The gland massage has a comprehensive effect on the affected organ. During massage, the accumulated inflammatory secret in the prostate gland is squeezed in the ducts and enters the urethra and removes from the body. The procedure improves blood circulation in the prostate, which allows to minimize stagnation and provides the best penetration of antibacterial medications in the tissue of the affected organ.
• Physiotherapy. To improve blood circulation, laser exposure, ultrasonic waves and electromagnetic vibrations are used. If it is impossible to perform physiotherapeutic procedures, the patient receives hot medicinal microclisms.

In long -term chronic inflammation, an immunologist consultation is indicated for the choice of immunocorgative therapy tactics. The patient receives recommendations for a change in lifestyle. The introduction of certain changes in the lifestyle of a patient with chronic prostatitis is both therapeutic and a preventive measure. The patient is recommended to normalize sleep and wakefulness, to establish a diet and perform moderate physical activity.

Prediction and prevention

Acute prostatitis is a disease that has a chronic pronounced tendency. Even with proper timely treatment, more than half of patients, chronic prostatitis becomes a result. Recovery is always far from possible, however, with correct sequential therapy and compliance with the doctor's recommendations, it is possible to eliminate unpleasant symptoms and obtain persistent long remission in the chronic process.

Prevention is to eliminate risk factors. It is necessary to avoid hypothermia, alternative sedentary work and with periods of physical activity and eat regularly and fully. With constipation, laxatives should be used. One of the preventive measures is the normalization of sex life, since both excessive sexual activity and sexual abstinence are risk factors in the development of prostatitis. If the symptoms of a urological or sexually transmitted disease appear, you need to consult a doctor in a timely manner.