Prostatitis is an inflammation of the prostate gland, accompanied by the appearance of pain in the groin, scrotum and perineum, impaired urination and erectile dysfunction. The severity of the manifestations of the disease will depend on its form. The type of prostatitis also largely determines the treatment tactics and prognosis for this disease.
Different causes of prostatitis cause various types of disease
The American National Institute of Health (NIH USA) in 1995 developed certain criteria according to which the disease is divided into several varieties:
- Category I – acute prostatitis.
- Category II – chronic bacterial prostatitis.
- Category III – chronic non-bacterial prostatitis (chronic pelvic pain syndrome).
- Syndrome of chronic inflammatory pelvic pain.
- Chronic non-inflammatory pelvic pain syndrome.
- Category IV – asymptomatic chronic prostatitis.
In the classification, a rare form is not mentioned – chronic granulomatous prostatitis.
Inflammation of the prostate is often combined with the pathology of other organs of the genitourinary system. With prostatitis, urethritis, cystitis, vesiculitis are detected. In older men, inflammation of the prostate often occurs simultaneously with its benign hyperplasia.
Acute inflammation of the prostate gland develops when infected with various microorganisms. During the examination, Escherichia coli, enterobacteria, staphylococci, Klebsiella, Proteus and other representatives of the conditionally pathogenic flora are revealed. Penetrating into the tissue of the prostate, these bacteria can cause inflammation. The disease usually proceeds against the background of a decrease in immunity.
The acute form of the disease with pronounced symptoms.
- rise in rectal temperature (even at normal temperature in the axillary region);
- signs of general intoxication: severe weakness, muscle pain, headaches;
- severe pain in the perineum, scrotum, lumbar and inguinal region, rectum;
- dysuric phenomena: frequent urination, nocturia (frequent urges to empty the bladder at night), pain and burning sensation during urination;
- difficulty urinating up to an acute delay;
- constipation and pain during bowel movements.
In a rectal examination, the prostate gland is sharply painful, enlarged. There is an increase in lymph nodes.
The treatment of acute prostatitis involves taking antibiotics. Analgesics, antispasmodics, diuretics, anti-inflammatory drugs are required. In acute urinary retention, catheterization of the bladder or temporary fistula is performed. Thermal treatments and prostate massage in the acute stage are not shown. With the development of purulent complications, surgical treatment is performed.
Chronic bacterial prostatitis
The main cause of pathology is the propagation of opportunistic bacteria. The risk of the disease increases with hypothermia, a sedentary lifestyle, as well as in the presence of another pathology of the genitourinary sphere.
Chronic bacterial prostatitis may be asymptomatic
Chronic prostatitis develops over many years and can be asymptomatic for a long time. An alternation of exacerbations and remission is noted. With an exacerbation of the process, the following symptoms occur:
- dull aching pain in the perineum, rectum, scrotum, lower abdomen and lumbar region;
- frequent urination in small portions;
- decreased potency.
The general condition of the man is not broken, the body temperature remains normal. The severity of dysuric phenomena can be different. There is increased nervousness, irritability, short temper.
In the treatment of this form of pathology, antibiotics and anti-inflammatory drugs are used. The course of antibiotic therapy lasts at least 8 weeks. The appointment of immunomodulators is shown. A good effect is the use of physiotherapeutic methods.
Chronic non-bacterial prostatitis
This form of the disease is considered the most common and accounts for 95% of cases of prostatitis. The onset of the disease is associated with impaired blood flow and a malfunction in the immune system. The role of microorganisms in the development of inflammation of the prostate is not ruled out. A certain role is allocated to urethro-prostatic reflux (urine reflux from the urethra to the prostate).
Non-bacterial prostatitis is detected by seeding
Symptoms are similar to those of chronic bacterial prostatitis. This form of pathology can be determined during bacteriological culture. In secret of the prostate and ejaculate, microorganisms are not detected, which allows you to put an accurate diagnosis and select a treatment.
Treatment of chronic non-bacterial prostatitis is the use of drugs that improve blood flow in the body. Reception of anti-inflammatory drugs, immunomodulators is shown. Applied prostate massage, physiotherapy. The question of the appointment of antibiotics is decided individually.
Chronic asymptomatic prostatitis
The disease is asymptomatic. The only symptom is periodic bacteriuria and leukocyturia – the detection of bacteria and white blood cells in the urine. When searching for the causes of this condition after a full examination, chronic prostatitis is often detected. The treatment is not carried out. An observation by a urologist is shown.
What to do?
The consequences of prostatitis – decreased potency, infertility and prostate cancer
Types of surveys:
- rectal examination of the prostate;
- bacteriological examination of prostate secretion;
- assessment of PSA (prostatic specific antigen);
Further tactics will depend on the form of the disease and the presence of concomitant pathology.