Prostatitis - the disease of the prostate (prostate), developing as a result of inflammatory changes in it. According to statistics, the disease prevalence reaches 35-50%, and is diagnosed in men aged 20-40 years.
Kinds
Allocate 4 forms of prostatitis:
- acute (bacterial);
- chronic bacterial;
- chronic non-bacterial;
- asymptomatic chronic.
Acute prostatitis is very rare because of the rapid flow of the inflammatory process and the immediate transition into the chronic stage (lzheuluchshenie).
Chronic non-bacterial prostatitis, otherwise it is called chronic pelvic pain syndrome, can be inflammatory (with presence in urine or semen high content of white blood cells) And non-inflammatory in nature.
Causes
The cause of acute and chronic bacterial prostatitis are pathogenic microorganisms (viruses, bacteria, fungi). Most often, the source of inflammation are:
- E. coli;
- streptococci;
- staphylococci;
- Proteus;
- Klebsiella;
- Pseudomonas aeruginosa;
- pathogens, sexually transmitted diseases (chlamydia, mycoplasma, Gonococci, trichomonas, cytomegalovirus and others).
Most of the microbes found in the intestines, on the skin, but getting into the prostate tissue, they cause inflammation. Usually, the cause of the disease is not a pathogen, and the association of several types of microbes.
Development of chronic prostatitis can trigger the following factors:
- Related diseases of the urinary system (cystitis, pyelonephritis);
- sedentary lifestyle ( "sedentary" work);
- disposition to constipation;
- weakening the body's defenses;
- trauma;
- hormonal imbalance;
- alcohol and smoking;
- promiscuity;
- irregular sexual life (long-term abstinence);
- coitus interruptus;
- irregular emptying of the bladder;
- unsatisfied sexual desire;
- chronic stress;
- hypothermia;
- Availability carious teeth and other sources of chronic infection (e.g. chronic tonsillitis).
symptoms of prostatitis
Acute prostatitis - a very insidious disease. "Catch" it is rather difficult because, firstly, the process is very fast hroniziruetsya, and secondly, the majority of patients prefer to "sit out" manifestations of acute prostatitis home. To the doctor, patients with inflammation of the prostate are often treated already in advanced cases with erectile dysfunction and other consequences.
The acute form of the disease occurs in the background:
- elevated temperature;
- chills;
- other signs of intoxication (weakness, lethargy, loss of appetite and the like).
Inflammation of the prostate gland is accompanied by pain in the perineum, groin and scrotum.
It is also characteristic painful and frequent urination. Sometimes the urine can be noticed whitish pus.
In addition, the patient can draw attention to the lack of night and morning erections, poor erection during sexual intimacy and dramatic shortening of the coitus.
Symptoms of chronic bacterial prostatitis may be absent or appear in periods of exacerbation. This stage is characterized by pain in the groin and lower abdomen, they often radiating to the rump, back and scrotum.
There are the typical symptoms of urinary disorders: a weak urine stream and frequent urge, though very little urine is released.
Subsequently, if untreated chronic prostatitis reaches apogee: sexual function disorders appear. For example:
- lack of erection or her absence;
- painful erections, due to which the patient avoids sexual intercourse;
- effacement of orgasm;
- short sexual intercourse;
- painful ejaculation.
Poor and overall male: he gets tired quickly, constantly annoyed, trouble sleeping.
Chronic abacterial prostatitis is 95% of all prostate, they suffer mostly men about 30 years. It is characterized by persistent or recurrent pain in the pelvis, prostate, scrotal, and the laboratory analyzes are no signs of inflammation. The causes of the disease is not well established.
Diagnostics
In the diagnosis of acute and chronic prostatitis complaints in addition to the collection, the history and examination of the patient using the following methods:
- general analysis of blood and urine;
- microscopic examination of prostate secretions and sowing it to the culture medium for the detection of the pathogen (the secret is obtained after the finger massaging the prostate through the rectum);
- urine cytology;
- Ultrasound of the prostate and pelvic organs;
- CT scan and nuclear magnetic resonance (MRI);
- swab of the urethra in the microflora.
Differential diagnosis aimed at delineation of prostatitis, BPH, Prostate cancer, signs of the stones in the prostate gland.
Full list of diagnostic procedures and medications for the treatment of prostatitis The federal standards of care from 2012.
Treatment of prostatitis
Treatment of prostatitis leads surgeon urologist.
The purpose etiotrop treatment aimed at eliminating the causes of prostatitis, is the elimination of the pathogen. Depending on the detected reason appointed antibiotics, antiviral or antifungal agents. Duration of therapy in acute prostatitis is 7-10 days, in chronic course - 4-8 weeks.
For the treatment of bacterial infection are used:
- fluoroquinolone antibiotics (ciprofloxacin, levofloxacin, moxifloxacin);
- macrolides (erythromycin, clarithromycin);
- doxycycline;
- antimicrobials.
Antifungal (Diflucan fluconazole), and antivirals (neovir, acyclovir), administered orally and rectal suppositories.
In addition, using other kinds of therapy:
- antiallergic (Suprastinum, Claritin, diphenhydramine);
- antiinflammatory (indomethacin, diclofenac);
- analgesic (no-spa, analgin, baralgin).
Also appointed:
- physiotherapy;
- physiotherapy;
- prostate massage.
To stimulate immunity shown immunomodulators (levamisole, methyluracil, timalin, taktivin, pirogenal, prodigiozan) and holding interferon.
In order to restore the intestinal microflora can receive bifidumbacterin, laktobakterina.
The whole treatment takes 3-4 months.
complications
Untreated prostate dangerous complications following:
- Bladder obstruction followed acute urinary retention;
- infertility;
- recurrent inflammation of the bladder;
- abscess prostate;
- depression;
- impotence;
- prostate adenoma;
- calculous prostatitis (stonelike with debilitating pain);
Forecast
The prognosis of acute prostatitis favorable timely treatment leads to complete recovery. The frequency of exacerbations in chronic prostatitis reaches 50% and above, but with appropriate supportive care is possible to achieve stable remission.
prevention
For the prevention of diseases of the following conditions must be met:
- regular sexual life with a permanent partner;
- rejection of bad habits;
- maintaining a healthy lifestyle (exercise, walking outdoors);
- dieting;
- regular visits to the urologist.
* When creating a partition on the diagnosis and treatment of prostatitis used standards primary care for chronic prostatitis by 2012.
