Acute prostatitis is an acute inflammation of the prostate caused by an infection.Along with the disease, swelling of the prostate occurs, and purulent foci appear in its tissues.Statistical data give us the right to claim that acute prostatitis in men is a common disease;the risk of its occurrence increases with age.
The effectiveness of the treatment of acute prostatitis directly depends on the timely treatment of the patient.The disease quickly turns 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:
- catarrhal;
- follicular;
- parenchymatous.
First, catarrhal inflammation occurs, which is characterized by enlargement of the acini and the appearance of reactive edema of the interstitial tissue.This leads to a significant enlargement of the prostate.The next stage is the rapid spread of inflammatory processes to the lobules and outlet ducts of the prostate.In particular, we are talking about the excretory ducts of the prostate gland that lead to the back of the urethra.Inflammatory changes affect only the mucous membrane.The ducts lose their contractility, become significantly narrowed or completely blocked, creating obstacles for the release of prostate secretions.The catarrhal form is directly related to an infectious pathogen that has migrated from the back of the urethra.Since the inflammatory process also affects the secretion of the prostate, it can cause the appearance of posterior urethritis.
During the follicular phase, foci of inflammation reach and spread through individual lobules or the entire prostate.Purulent foci appear, the pus passes into the urethra.Prostate enlargement does not stop;tissues undergo destructive changes.
In the parenchymal phase of acute prostatitis, inflammatory processes affect the interstitial tissue of the prostate.This phase 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 accompanied by the appearance of individual pustules, which in the process of development merge and merge with prostate abscess.
As for the follicular and parenchymal forms, during their development inflammatory changes often occur in the back of the urethra and bladder neck.
Prognosis and prevention of acute prostatitis
In the vast majority of cases, etiotropic therapy, carried out on time, can eradicate the signs of acute prostatitis.If treatment is not carried out, it is quite possible for an abscess to occur or for the disease to become chronic.
Prevention of this disease usually involves 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 taking care to increase physical activity.Also, the development of the disease is prevented by regular sexual life and the absence of unprotected casual contacts.Strict adherence to the rules of personal hygiene is another important requirement for a man at any age.
Causes of disease
Acute prostatitis in men can occur at any age.The reason is the frequent penetration of various infectious pathogens.This is E. coli, but it can also be streptococci, staphylococci, Candida fungi, chlamydia, trichomonas.The most common route of entry is the outlet ducts.The pathogen can also enter the prostate from the bladder, which is undergoing an inflammatory process (for example, acute cystitis).The infection can also spread from purulent foci located in the immediate vicinity.
The inflammatory process in the prostate caused by the presence of microorganisms can occur for various reasons.Factors that increase the risk include:
- surgical interventions in the area of the urethra;
- unprotected sexual intercourse, inflammatory diseases of the genitourinary tract in partners;
- use of a urethral catheter;
- prostate stones etc.
The onset of acute prostatitis may not be related to 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 characteristics 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.Secretion test results may show a high level of white blood cells.
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 general weakness, and the patient has a fever.Palpation reveals an enlarged prostate, its contours become asymmetrical.A focal pain may occur.Tests show an increase in the level of leukocytes and the presence of purulent threads in the urine.
The parenchymal form is accompanied by a sudden increase in body temperature, values can reach 39.5 degrees.General symptoms are expressed: chills, loss of appetite and lack of strength.Urination is delayed, the process is accompanied by severe pain.Emptying is also difficult, and constipation becomes severe.
In such cases, treatment for acute prostatitis should be started immediately.If the process starts, there is a high probability of prostate abscess, paraprostatitis, phlebitis of the paraprostatic venous plexus.If the patient does not see a doctor, the disease becomes chronic, and the probability of full recovery decreases significantly.
Diagnosis of acute prostatitis
When the patient consults a urologist, the doctor diagnoses acute prostatitis, identifying the stage of the disease.The specialist receives information after conducting a comprehensive study.The methods used in diagnostics in this case consist of physical, instrumental and laboratory studies.
The physical examination consists of studying the state of the prostate 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 leukocyte levels.Urine culture, PCR and blood culture, and analysis of urethral secretions are also prescribed.
Instrumental methods in the case of this disease are ultrasound diagnostics performed transrectally.If the patient has severe pain, the choice of examination is the transabdominal method.
When the question of surgical intervention is raised, it becomes necessary to perform CT and MRI of the pelvis.
Treatment of acute prostatitis
Treatment of acute prostatitis is carried out in hospital conditions.This is due to two factors.First of all, there is a risk of serious complications that can affect men's health and subsequently affect reproductive function and erection quality.Secondly, the disease is complex, accompanied by pronounced symptoms and painful feelings.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 work of microorganisms.
To reduce the intensity of pain, as well as to eliminate 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 remove 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, a trocar cystostomy is preferred.
Recovery is considered the regeneration of the prostate tissue, the complete restoration of its functions, while laboratory tests show that infectious pathogens are absent, and prostate secretions return to their 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 common side effect of the operation is erectile dysfunction, retrograde ejaculation is also common, in which sperm enters the bladder during ejaculation, and sometimes the urethra narrows.The surgical method does not guarantee a return.Therefore, surgical intervention is resorted to only in certain cases, such as:
- appearance of prostate abscess, which must be opened and cleaned;
- lack of results of treatment with conservative methods in the form of drugs, traditional medicine, physiotherapeutic procedures;
- development of serious complications;
- the presence of foci of inflammation in the pelvic region;
- 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;
- suspected malignant tumor.