Acute prostatitis is an acute inflammation of the prostate gland caused by infection.With the disease, swelling of the prostate is formed and purulent foci appear in its tissues.Statistical data gives us the right to affirm that acute prostatitis in men is a common disease;with age, the risk of its occurrence increases.
The effectiveness of acute prostatitis treatment directly depends on the patient's treatment time.The disease quickly develops into a chronic form, the treatment of which is longer and more complex.
Forms of acute prostatitis
If we talk about the clinical development of acute prostatitis in men, there are three forms (stages) of the disease:
- catarrh;
- follicular;
- parenchymatous.
The first to appear is catarrhal inflammation, which is characterized by the expansion of acini and the appearance of reactive edema of the interstitial tissue.This leads to a significant increase in the prostate gland.The next stage is the rapid spread of inflammatory processes in the lobules and excretory ducts of the prostate.We are talking, in particular, about the excretory ducts of the prostate glands that lead to the back of the urethra.Inflammatory changes affect only the mucosa.The excretory ducts lose their contractility, they are significantly narrowed or completely blocked, creating obstacles for the release of prostate secretions.The catarrhal form is directly related to the infectious pathogen that has moved from the back of the urethra.Since the inflammatory process also affects the secretion of the prostate, it can provoke the appearance of posterior urethritis.
During the follicular phase, foci of inflammation reach and spread through individual lobules or throughout the prostate gland.Purulent foci appear, pus passes into the urethra.Prostate enlargement does not stop;tissues undergo destructive changes.
During the parenchymal phase of acute prostatitis, inflammatory processes affect the interstitial tissue of the prostate gland.This stage occurs after the penetration of an infectious pathogen through contact or hematogenous routes, for example, after surgery.
Parenchymal prostatitis at the beginning of the disease is associated with the appearance of single pustules, which during the development process merge and combine with a prostate abscess.
Regarding the follicular and parenchymal forms, during their development inflammatory changes often occur in the back of the urethra and in the neck of the bladder.
Prediction and prevention of acute prostatitis
In the vast majority of cases, etiotropic therapy, carried out on time, can eliminate the signs of acute prostatitis.If treatment is not carried out, it is very possible that an abscess will appear or that the disease will become chronic.
Prevention of this disease usually means timely treatment of any infectious disease in the body, as well as identification and treatment of sexually transmitted diseases and urethritis.A man should lead a healthy lifestyle, especially paying attention to increasing physical activity.Also, the development of the disease is prevented by a regular sexual life and the absence of casual unprotected contacts.Strict adherence to the rules of personal hygiene is another important requirement for a man at any age.
Causes of the disease
Acute prostatitis in men can occur at any age.The reason is often the penetration of various infectious pathogens.This is E. coli, but there can also be streptococci, staphylococci, Candida fungi, chlamydia, trichomonas.The most common route of entry is the excretory ducts.The pathogen can also enter the prostate gland from the bladder, which is undergoing an inflammatory process (for example, acute cystitis).The infection can also spread from purulent foci located nearby.
The inflammatory process in the prostate caused by the presence of microorganisms can occur for various reasons.Factors that increase your risk include:
- surgical intervention in the area of the urethra;
- unprotected sex, inflammatory diseases of the genitourinary tract in a partner;
- use of a urethral catheter;
- prostate stones etc.
The appearance of acute prostatitis may not be associated with infections.It can occur as a result of a sedentary lifestyle, hypothermia and various disorders that lead to stagnation in the pelvic area.
Symptoms of acute prostatitis
Since there are different stages of acute prostatitis, the symptoms of the disease often depend on them.But there are common features that unite all forms.First of all, it is pain, general intoxication, as well as problems with the urination process.
The catarrhal form is usually accompanied by severe pain, a feeling of heaviness in the perineal area, frequent urination, accompanied by painful sensations.During palpation, the doctor may notice an increase in the size of the prostate gland.The results of the secretion tests may show a high level of white blood cells.
The symptoms of acute prostatitis in follicular form are more pronounced.A man feels pain in the perineum, radiating to the sacrum or penis.The process of urination is accompanied by pain, urine is retained and often there are difficulties with defecation.There is a general illness and the patient has a fever.Palpation shows an enlarged prostate, its contours become asymmetrical.Focal pain may occur.Analyzes show an increase in the level of leukocytes and the presence of purulent threads in the urine.
The parenchymal form is associated with a sharp increase in body temperature, values can reach 39.5 degrees.General symptoms are pronounced: chills, loss of appetite and lack of strength.Urination is delayed, the process is accompanied by severe pain.Defecation is also difficult, and constipation becomes severe.
In such cases, it is necessary to urgently start treatment for acute prostatitis.If the process begins, there is a high probability of prostate abscess, paraprostatitis, phlebitis of the paraprostatic venous plexus.If the patient does not go to the doctor, the disease becomes chronic and the chances of a complete recovery are significantly reduced.
Diagnosis of acute prostatitis
When a patient contacts a urologist, the doctor diagnoses acute prostatitis, identifying the stage of the disease.The specialist receives the information after conducting a comprehensive study.The methods used in the diagnosis in this case consist of physical, instrumental and laboratory studies.
The physical examination consists of studying the state of the prostate gland from the rectum.Thus, the specialist gets the opportunity to assess the size, shape, consistency of the organ and the presence of pain.As a result of the analysis of the secreted secretion, it is easy to determine a decrease in the number of lecithin grains and an increase in the level of leukocytes.
Palpation of the gland also includes the collection and transfer of urine for examination.In most cases, acute prostatitis is signaled by an increase in the level of leukocytes.Urine culture, PCR, and blood culture, as well as urine discharge analysis, are also prescribed.
Instrumental methods in the case of this disease are represented by ultrasound diagnostics performed transrectally.If the patient has severe pain, the choice of examination is the transabdominal method.
When the question of surgical intervention arises, it becomes necessary to perform a CT and MRI of the pelvis.
Treatment of acute prostatitis
Treatment of acute prostatitis is carried out in a hospital setting.This is due to two factors.First, there is a risk of serious complications that can affect men's health and then affect reproductive function and the quality of erection.Secondly, the disease is complex, accompanied by pronounced symptoms and painful sensations.Treatment of acute prostatitis begins with drug therapy, prescribing etiotropic drugs to the patient.The most important role is played by antibacterial agents that suppress the functioning of microorganisms.
To reduce the severity of pain, as well as to get rid of spasms, the patient is recommended to take antispasmodics and analgesics.Sometimes thermal enemas and rectal suppositories are used to relieve the condition.After overcoming the acute symptoms, it becomes possible to use physiotherapy.These procedures increase microcirculation, improve local immunity and help eliminate inflammation.Among the physiotherapeutic methods of treating acute prostatitis, the most effective are prostate massage, as well as microwave therapy and electrophoresis.For many years, prostate massage has been considered a particularly popular measure, which helps to eliminate congestion;it is also recommended to be used regularly as a preventive measure for men who have reached the age of forty.
In case of problems with the urinary process, the catheter is not used;instead, trocar cystostomy is preferred.
Recovery is considered to be the regeneration of the prostate tissue, the complete return of its functions, while laboratory tests show that infectious pathogens are absent and the prostate secretion returns to its normal composition.
Surgery is not a widely used treatment for prostatitis.It doesn't always bring results.The surgical solution brings positive dynamics in less than half of the cases.The most frequent side effect of the operation is erectile dysfunction, retrograde ejaculation is also common, in which during ejaculation the sperm enters the urinary bladder and sometimes narrowing of the ureter occurs.The surgical method does not guarantee against recurrence.Therefore, surgical intervention is used only in certain cases, such as
- the appearance of a prostate abscess, which must be opened and cleaned;
- lack of results from treatment using conservative methods in the form of medicines, traditional medicine, physiotherapeutic procedures;
- the development of serious complications;
- the presence of a focus of inflammation in the pelvic area;
- the formation of paraproctitis (purulent abscess in cells located around the rectum);
- the presence of blood in the urine;
- delayed urination and cessation of urination (anuria);
- the presence of stones in the bladder, kidneys, the cause of which was prostatitis;
- suspicion of a malignant tumor.