Prostatitis – an inflammatory disease of a prostate gland, the most widespread disease of urinogenital system at men. Prostatitis can proceed sharply or chronically. Most often strikes patients at the age of 25-50 years. According to various data, prostatitis suffers from 30-85% of men aged 30 years are more senior. Pains, the complicated and painful urination, sexual frustration belong to symptoms of prostatitis. The diagnosis of prostatitis is established by the urologist or the andrologist more often on a typical clinical picture. Ultrasonography of a prostate, a pro-static secret and urine is in addition carried out.
Prostatitis – an inflammation of seed (predstatelny) gland – a prostate. It is shown by frequent urinations with impurity of blood, pus in urine, pain in a penis, a scrotum, a rectum, sexual frustration (violation of an erection, an early ejaculation, etc.), sometimes an urine delay. Perhaps abstsedirovany a prostate gland, an inflammation of testicles and appendages that threatens with infertility. Ascension of an infection conducts to an inflammation of the top departments of urinogenital system (cystitis, pyelonephritis).
Prostatitis at penetration of the infectious agent who gets to prostate tissue from bodies of urinogenital system (an urethra, a bladder) or from the remote inflammatory center develops (at pneumonia, flu, quinsy, a furunkuleza). There is a number of the risk factors increasing probability of development of prostatitis.
The contributing factors
The risk of development of prostatitis increases during the overcooling, existence in the anamnesis of the specific infections and states which are followed by developments of stagnation in prostate tissues. Allocate the following factors increasing probability of development of prostatitis:
- The general overcooling (single or constant, connected with working conditions).
- Inactive way of life, the specialty forcing the person long time to be in a sitting position (the operator of the COMPUTER, the driver, etc.).
- Constant locks.
- Violations of a normal rhythm of sexual activity (excessive sexual activity, long abstention, an incomplete ejaculation during the "habitual" sexual intercourse deprived of emotional coloring).
- Existence of chronic diseases (cholecystitis, bronchitis) or the chronic infectious centers in an organism (chronic osteomyelitis, uncured caries, tonsillitis etc.).
- The postponed urological diseases (uretrit, cystitis, etc.) and diseases, sexually transmitted (clamidiosis, trichomoniasis, gonorrhea).
- The states causing oppression of immune system (chronic stresses, irregular and defective food, a regular sleep debt, a condition of an overtraining at athletes etc.).
It is supposed that the risk of development of prostatitis increases at chronic intoxications (alcohol, nicotine, morphine etc.). Some researches conducted in the field of urology prove that the contributing factor in developing of prostatitis is the chronic injury of a crotch (vibration, concussion) at motorists, motorcyclists and cyclists. However, the overwhelming number of experts believes that all listed factors are not the real reasons of development of prostatitis, and only promote an aggravation of latent inflammatory process in prostate tissues.
The crucial role in developing of prostatitis is played by developments of stagnation in prostate tissues. Violation of a capillary blood-groove causes strengthening of perekisny oxidation of lipids, hypostasis, an ekssudation of tissues of prostate and creates conditions for development of infectious process.
Golden staphylococcus (Staphylococcus aureus), (Enterococcus), an enterobakter (Enterobacter), a sinegnoyny stick (Pseudomonas), proteas (Proteus), a klebsiyell (Klebsiella) and colibacillus (E. Coli) can act as the infectious agent at sharp prostatitis. The majority of microorganisms belongs to conditionally pathogenic flora and causes prostatitis only in the presence of other contributing factors.
The inflammation at chronic prostatitis is usually caused by polymicrobic associations.
Symptoms of sharp prostatitis
Allocate three stages of sharp prostatitis which are characterized by existence of a certain clinical picture and morphological changes:
- Sharp catarrhal prostatitis. Patients show complaints to the speeded-up, quite often painful urination, pains in a sacrum and a crotch.
- Sharp follicular prostatitis. Pains become more intensive, sometimes irradiate in back pass, amplify at defecation. The urination is complicated, urine follows a squirt. The urine delay is in some cases noted. Subfebrilitet or moderate hyperthermia.
- Sharp parenchymatous prostatitis. The expressed general intoxication, a hyperthermia to 38-40 °C, oznoba. Dizurichesky frustration, it is frequent – a sharp delay of an urination. The sharp, pulsing crotch pains. Difficulty of the act of defecation.
Symptoms of chronic prostatitis
In rare instances chronic prostatitis becomes the result of sharp process, however initially chronic prostatitis with the erased symptomatology, as a rule, develops. Temperature occasionally increases up to the subfebrilny sizes. The patient with chronic prostatitis notes unpleasant feelings or a mild pain in crotches, unpleasant feelings during the act of an urination and defecation. The most characteristic symptom of chronic prostatitis - poor allocations from an urethra at the act of defecation.
It is necessary to remember that initially chronic prostatitis develops throughout the considerable period of time. Precedes it (stagnation of blood in capillaries), gradually passing into abacterial prostatitis (an initial stage of an inflammation).
Chronic prostatitis quite often is a complication of the chronic inflammatory process caused by the causative agent of a specific infection (a hlamidiya, a trichomonad, an ureaplasma, ). Symptoms of specific inflammatory process in many cases mask displays of chronic prostatitis. Perhaps insignificant strengthening of pains at an urination, mild pains in crotches, poor allocations from an urethra at defecation. Minor change of a clinical picture and accession of chronic prostatitis often takes place unnoticed for the patient.
Chronic prostatitis can be shown by burning sensation in an urethra and a crotch, dizuriy, sexual frustration, the increased general fatigue. A consequence of violations of a potentiality (or fear of these violations) it becomes frequent mental depression, uneasiness and irritability. The clinical picture of chronic prostatitis not always includes everything, without exception, the listed groups of symptoms, differs at different patients and changes eventually.
Allocate three main syndromes characteristic of chronic prostatitis:
- Pain syndrome at chronic prostatitis
In tissue of a prostate there are no pain receptors. Involvement in inflammatory process of nervous ways becomes the reason of pains at chronic prostatitis almost inevitable, owing to a plentiful innervation of bodies of a small pelvis.
Patients with chronic prostatitis complain of pains of various intensity - from weak, aching to intensive, interrupting a sleep. Change of nature of pains (strengthening or easing) at an ejaculation, excessive sexual activity or sexual abstinence is noted. Pains irradiate in a scrotum, a sacrum, a crotch, sometimes – to the lumbar area. It is necessary to consider that waist pains arise not only at prostatitis. Osteochondrosis and some other diseases can become the reason of pains in this area.
- Dizurichesky syndrome (frustration of an urination)
As a result of an inflammation at chronic prostatitis the volume of the prostate squeezing a mochetochnik increases. The gleam of a mochetochnik decreases. The patient with prostatitis has frequent desires on an urination, feeling of incomplete depletion of a bladder. As a rule, the dizurichesky phenomena are expressed at early stages of chronic prostatitis. Then the compensatory hypertrophy of a muscular layer of a bladder and mochetochnik develops. Dizuriya symptoms during this period weaken, and then again accrue at a decompensation of adaptable mechanisms.
- Sexual violations at chronic prostatitis
At initial stages of chronic prostatitis the dispotention which is differently shown at different patients can develop. Patients can show complaints to frequent night erections, the erased orgasm or deterioration in an erection. The accelerated ejaculation is connected with decrease in threshold level of excitement of the orgastichesky center. Pain at an ejaculation can become a cause of failure of the patient with prostatitis from sex life. Further sexual violations become more expressed. At the started stage of chronic prostatitis impotence develops.
Extent of sexual frustration at chronic prostatitis is defined by many factors, including – the sexual constitution and a psychological spirit of the patient. Violations of a potentiality and a dizuriya can be caused both by changes in a prostate gland, and suggestibility of the patient who, at identification at it chronic prostatitis, expects inevitable development of sexual frustration and frustration of an urination. Especially often psychogenic dispotention and a dizuriya develops at the inspired, disturbing patients.
Impotence, and sometimes – and threat of possible sexual frustration is hard transferred by patients with prostatitis. Character change, irritability, grumpiness, excessive concern in own health and even "leaving in a disease" is quite often noted.
Complications of sharp prostatitis
In the absence of timely treatment of sharp prostatitis there is a great risk of development of abscess of a prostate gland. At formation of the purulent center in a prostate gland the body temperature of the patient increases to 39-40 °C and can gain gektichesky character. The periods of heat alternate with the expressed oznoba. Sharp crotch pains complicate an urination and make impossible defecation. Increase of hypostasis of a prostate gland leads to a sharp delay of an urination. In rare instances abscess is spontaneously opened in an urethra or a rectum. When opening in an urethra purulent muddy urine with an unpleasant pungent smell appears, when opening in a rectum of kcal contains pus and slime.
Complications of chronic prostatitis
For chronic prostatitis the wavy current with the periods of long remissions during which the inflammation in a prostate proceeds latentno or is shown by extremely poor symptomatology is characteristic. Patients whom nothing disturbs quite often stop treatment, and address only at development of complications.
Spread of an infection on uric ways at chronic prostatitis causes developing of pyelonephritis and cystitis. The most frequent complication of chronic prostatitis - an inflammation of testicles and appendages of testicles (epdidimoorkhit) and the inflammation of seed bubbles (vezikulit). An outcome of these diseases infertility becomes frequent.
Diagnosis of prostatitis
The characteristic clinical picture simplifies process of diagnosis at sharp and chronic prostatitis. At suspicion of prostatitis the rectal research of a prostate during which the urologist carries out a prostate gland secret intake is without fail made. Definition of sensitivity of microflora is carried out (crops of a secret of a prostate and urine).
For identification of structural changes (tumors, cysts, adenoma, etc.) and differentiations of prostatitis from other diseases of a prostate gland ultrasonography of a prostate is carried out. The spermogram allows to exclude or confirm development of infertility.
Treatment of prostatitis
Therapy of sharp prostatitis
Patients with uncomplicated sharp prostatitis receive medical treatment at the urologist or the andrologist on an outpatient basis. At the expressed intoxication, suspicion on purulent process hospitalization is shown. To patients with sharp prostatitis antibacterial therapy is carried out. Medicines select taking into account sensitivity of the infectious agent. The antibiotics capable are widely used it is good to get into prostate tissues (ciprofloxacin, etc.). At development of abscess of a prostate endoscopic transrectal or transurethral opening of an abscess is carried out.
Sharp prostatitis – the disease having the expressed tendency to synchronization. Even at timely adequate treatment more than a half of patients has the result of sharp process a chronic prostatitis.
Therapy of chronic prostatitis
Recovery manages to achieve not always, however, at adequate, consecutive therapy and observance of recommendations of the doctor elimination of unpleasant symptoms of prostatitis and achievement of long permanent remission is possible.
Treatment of chronic prostatitis has to be complex. To the patient appoint long rates of antibacterial medicines (within 4-8 weeks). Massage of a prostate, physical therapy, immunity correction is carried out. To the patient make recommendations about change of a way of life.
- Antibacterial therapy at chronic prostatitis
Selection of a look and dosage of antibacterial medicines, and also determination of duration of a course of treatment is carried out individually. Medicine is chosen, proceeding from sensitivity of microflora by results of crops of urine and a secret of a prostate.
- Massage of a prostate at chronic prostatitis
Massage of a prostate makes complex impact on the struck body. During massage the inflammatory secret which accumulated in a prostate gland is squeezed out to canals, then comes to an urethra and is removed from an organism. The procedure improves blood circulation in a prostate that allows to minimize developments of stagnation and provides the best penetration of antibacterial medicines into fabric of the struck body.
- Physical therapy at chronic prostatitis
For improvement of blood circulation use laser influence, ultrasonic waves and electromagnetic oscillations. At impossibility to carry out physiotherapeutic procedures to the patient appoint warm medicinal microenemas.
- Immunocorrection at chronic prostatitis
Decrease in the general immunity quite often is one of the contributing factors increasing risk of development of chronic prostatitis. Further immune violations are aggravated with numerous long courses of antibacterial therapy. At chronic, it is long the current prostatitis consultation of the immunologist for the choice of tactics of immunocorrective therapy is shown.
- Change of a way of life and habits at chronic prostatitis
Entering of certain changes into a way of life of the patient with chronic prostatitis is both a medical, and preventive measure. To the patient recommend to normalize the mode of a dream and wakefulness, to adjust a diet, to conduct moderate physical activity.
Prevention of prostatitis
Prevention of prostatitis consists in elimination of risk factors. It is necessary to avoid overcoolings, to alternate sedentary work and with the periods of physical activity, to eat regularly and fully. At locks it is necessary to use depletive. One of preventive measures at prostatitis is normalization of sex life as both excessive sexual activity, and sexual abstinence are risk factors in development of prostatitis. At emergence of symptoms of an urological or venereal disease it is necessary to see a doctor in due time.