Many doctors jokingly call male menopausal prostatitis. This disease is diagnosed in 20% of the cases in men after forty years, in 70% after sixty years and in 90% of the cases after the seventy years. The disease can present in two forms: acute and chronic prostatitis. This disease must be treated, especially since it lends itself well to therapy. But many men ignore the unpleasant symptoms, which leads to the development of many complications that become more difficult to cure.
Development reasons
Acute prostatitis is an acute pathology of the prostate that develops as a result of an inflammatory and infectious process in an organ due to the penetration of pathogens into its tissues. The disease is characterized by the appearance of swelling of the gland, purulent content in its tissues.This leads to the appearance of many unpleasant symptoms, impaired functionality of the organs of the genitourinary system.
There are many causes of acute prostatitis. In most cases, it is caused by pathogenic microbes.Some of the microbes can exist in a healthy person passively on the skin or intestines. Under the influence of some factors, they are activated, penetrate into the tissues of the gland and actively multiply there. Often the disease appears due to sexually transmitted diseases, for example,chlamydia, ureaplasmosis, gonorrhea, etc.
In addition, an acute form of prostatitis presents as a complication ofurethritis. Germs enter through tubes that lead into the urethra. Also, the spread of bacteria from other organs of the genitourinary system often becomes the cause of the appearance of prostatitis. Often times the gland can be affected. during surgical procedures, catheterization, diagnostic measures.
Since there are a large number of blood vessels in the prostate gland, the infection can get here with the blood flow in the presence of chronic pathologies in the body, for example,tonsillitis, bronchitis, etc.In the presence ofanal fissures, microbes can enter the prostate with lymphatic flow.
But infections do not always lead to the development of diseases. Stagnation in the vessels of the pelvic region, which developswith prolonged abstinence from sexual intercourse or a large number of them.
Congestion is also associated withlack of physical activity, constant constipation, alcoholism, varicose veins in the pelvic region, hypothermia.
Classification
In urology, various forms of pathology are distinguished, which are also their stages of development:
- The catarrhal formis characterized by the appearance of inflammation in the organ, a change in its mucous epithelium. Over time, swelling of the gland occurs, a mucopurulent secret accumulates, which contributes to the progression of the disease.
- Then the focal suppuration appears. The disease enters the second stage (form):follicular form. Urinary ducts are narrowed or blocked, the secret is no longer excreted normally from the organ. Pus can be secreted into the urinary tract, forming purulent foci there. The cells of the gland change, the prostate continues to swell and increase in size.
- Parenchymal formdevelops when an organ is completely inflamed and a purulent infection develops in it. In the absence of therapy, small purulent foci merge into a huge one, an abscess develops, often opening into the urethra, intestines and bladder. In some cases, it is possible to immediately develop this form of pathology when the infection enters the interstitial tissue of an organ with blood or lymphatic flow.
Symptoms
Shows symptoms of acute prostatitis. The strength with which the signs will be visible and felt will depend on the form (stage) of the disease. Common signs of the disease include the following:
- pain syndrome during urine excretion;
- symptoms of intoxication;
- pain in the genital area;
- frequent need to use the bathroom, especially at night;
- possible discharge from the urethra.
As prostatitis progresses in a man, the pain syndrome will spread to other areas. This is due to the transmission of impulses along the nerve endings. Urine excretion becomes very painful. Often at this stage, an acute delay develops, which is considered a dangerous condition as it can lead to the rupture of the bladder.
The symptoms of acute prostatitis continue to increase. There is severe pain during bowel movements, body temperature rises. The prostate becomes enlarged, tight, and painful. The urine will be cloudy due to the content of pus and mucus.
In the last stage, the disease manifests itself strongly.
The body temperature rises a lot, it is joined by fever and chills, loss of appetite, severe weakness, exhaustion of the body in general. Urination may stop completely and the man will experience severe, sharp pain when trying to go to the bathroom. This condition is unbearable, the pain syndrome begins to spread throughout the pelvic region. A man cannot find a place for himself, he is forced to lie with his limbs bent. If the inflammation has spread to the rectum, then mucus will come out of the anus. The urinary tract releases yellow-green mucus mixed with blood.
This condition can causesepsis, cystitis, pyelonephritis, chronic prostatitis, abscess. In this case, urgent hospitalization of the patient and emergency treatment is required.
Diagnosis
Since the symptoms of acute prostatitis in men are quite pronounced, the doctor may immediately suspect a pathology. But you need a full examination. Rectal examination in this case is strictly contraindicated.
The urologist must determine the stage (form) of the disease using instrumental and laboratory techniques. The doctor takes aprostate secretto examine it. The concentration of leukocytes will increase in it, indicating acute inflammation.
Thenlaboratory blood and urine tests are performed. Urine is sent for bacterial culture for examination, as well as to determine the causative agent of the infection and its sensitivity to antibacterial drugs. It is also possible to perform:
- PCR for STD detection;
- uroflowmetry to identify the severity of organic disorders;
- Ultrasound of the prostate to determine the shape and size of the organ, changes in it, the stage of the disease;
- Dopplerometry helps distinguish acute prostatitis from other pathologies;
- MRI of the pelvic organs is often prescribed when planning a surgical procedure;
- analysis of SPA concentration in blood;
- urethral discharge smear examination;
- puncture of parts of the organ in case of suspected purulent infection and abscess.
Treatment
A urologist will tell you in detail how to treat acute prostatitis. The main component of therapy is an antibacterial drug, which is selected according to the results of bacterial culture. In two to three days, the antibiotic begins to help, the person feels much better, and the pain begins to decrease. But with this form of the disease, such drugs have to be taken for a month, even if the symptoms have completely disappeared.
It is also necessary to prevent the disease from becoming chronic, which is quite common.
When choosing a drug, the doctor considers other factors:
- some agents do not penetrate well into the tissues of the gland;
- other agents accumulate in tissues in large quantities.
The treatment of acute prostatitis in men should be based on the use of powerful drugs, as in other cases that threaten a person's life. Doctors usually prescribe fluoroquinolones. When using macrolides, the dose should be large. This is especially true in immunosuppressed patients.
Antibiotics are usually given through intravenous injections. In the initial stage, the disease can be treated at home or on an outpatient basis.In this case, bed rest is prescribed, as any energy load can lead to the spread of infection and the development of sepsis.
In combination with antibiotics, the following medications are also prescribed:
- painkillers;
- antipyretic drugs;
- NSAIDs;
- an opioid may be prescribed for severe pain;
- diuretics to reduce intoxication of the body;
- laxatives to facilitate bowel movements;
- antispasmodic medications to facilitate the excretion of urine;
- alpha blockers.
If a man has acute urinary retention, a urea catheterization is done. Anti-androgens are often used to reduce swelling and inflammation in the organ, improve secretion output, normalize blood flow in the gland, and reduce the risk of the infection spreading throughout the body.
Use of hormones such as estrogens, cold enemas to relieve swelling and pain. Massages and thermal procedures for this form of the disease are strictly prohibited. They can only be applied during the recovery period.
Surgery
In the absence of pain, the doctor may suspect the development of an abscess. In this case, a surgical intervention is performed to remove the areas in which it occurs. Puncture drainage of an abscess is often used. In severe and extreme cases, the organ is removed.
The operation is prescribed in the presence of an abscess, acute retention of urine, severe pain syndrome that cannot be eliminated with any medication, the appearance of stones and neoplasms, as well as the ineffectiveness of drug treatment, frequent infections of the genitourinary system, paraproctitis.
The surgeon may use one of the following techniques:
- TRUP (transurethral resection)involves the removal of the interior of the organ. Most frequently used;
- Prostatectomyinvolves the partial or complete removal of an organ through an incision in the lower abdomen;
- Laser surgeryIn this case, the affected areas of the organ are removed with a laser;
- The abscess is drainedthrough the rectum. A drain is inserted into the incision, through which pus is pumped;
- To facilitate the elimination of urine, atransurethral incisionis made in the organ.
When the structure of the gland tissues is restored, its functions are normalized, the secret of the prostate normalizes its composition, the causative agent of the pathology will be completely removed from the body, we can talk about the cure of prostatitis.
Forecast
With therapy, the prognosis of the disease will be good. Sometimes negative consequences of acute prostatitis develop. The disease can become chronic, then it will be more difficult to eliminate. The dangerous consequences of an untreated disease are organ abscess, sepsis, acute urinary retention. In some cases, due to the appearance of complications, death can occur. But usually men do not allow such consequences to develop, since they go to the doctor and start a course of therapy.
Prevention
For prevention purposes, it is necessary to prevent the appearance of predisposing factors. This requires timely treatment of all infections in the body so that they do not become chronic and do not become potential foci of infection that will spread to the prostate gland.
When performing surgical procedures, the physician should pay attention to the use of antiseptics. Otherwise, the risk of germs entering the patient's body increases. It is important for a man and his sexual partner to treat STDs in a timely manner and it is best to prevent them from occurring. Sex life must take place with a regular partner, it must be regular.
It is necessary to lead an active lifestyle, play sports or exercise, observe the rules of intimate hygiene.
Men often seek medical assistance in an emergency. But when negative signs appear, it is better to contact them immediately. This will help prevent many health problems and even save lives in some cases.