Acute prostatitis is an acute inflammation of the prostate caused by an infection.With the disease, swelling of the prostate gland forms and purulent foci appear in its tissues.Statistical data give us the right to assert that acute prostatitis in men is a common disease;with age, the risk of its occurrence increases.
The effectiveness of treatment of acute prostatitis directly depends on the timeliness of the patient's treatment.The disease quickly evolves 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;
- parenchymal.
The first to occur is catarrhal inflammation, characterized by dilation 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 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 only affect mucous membranes.The excretory ducts lose contractility, narrow significantly or become completely blocked, creating obstacles to the release of prostate secretions.The catarrhal form is directly related to the infectious pathogen that has moved from the back of the urethra.As the inflammatory process also affects prostate secretion, it can cause the appearance of posterior urethritis.
During the follicular stage, pockets of inflammation reach and spread to individual lobes or the entire prostate.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.This phase occurs after the penetration of an infectious pathogen by contact or hematogenous routes, for example, after surgery.
Parenchymal prostatitis at the beginning of the disease is accompanied by the appearance of single pustules, which during the development process unite and combine with a prostatic abscess.
As for the follicular and parenchymal forms, during their development, inflammatory changes often occur in the back of the urethra and in the bladder neck.
Forecast and prevention of acute prostatitis
In the vast majority of cases, etiotropic therapy, carried out at the right time, can eradicate the signs of acute prostatitis.If treatment is not carried out, it is quite possible that an abscess will occur or the disease will become chronic.
Prevention of this disease usually means timely treatment of any infectious diseases in the body, as well as the identification and treatment of sexually transmitted diseases and urethritis.A man needs to lead a healthy lifestyle, paying particular attention to increasing physical activity.Furthermore, the development of the disease is prevented by regular sexual life and the absence of unprotected casual contacts.Strict adherence to personal hygiene rules is another important requirement for a man of 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 in the immediate vicinity.
The inflammatory process in the prostate caused by the presence of microorganisms can occur for several reasons.Factors that increase risk include:
- surgical interventions in the urethra region;
- unprotected sexual intercourse, inflammatory diseases of the genitourinary tract in the partner;
- use of a urethral catheter;
- prostate stones, etc.
The occurrence of acute prostatitis may not be associated with infections.It can occur as a consequence of a sedentary lifestyle, hypothermia and various disorders that lead to stagnation in the pelvic region.
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, these are pain, general intoxication, and also 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 an elevated level of white blood cells.
Symptoms of acute prostatitis in the follicular form are more pronounced.A man feels pain in the perineum, radiating to the sacrum or penis.The urination process is accompanied by pain, urine is retained and difficulties with defecation often occur.There is general malaise and the patient has a fever.Palpation demonstrates an enlarged prostate, its contours become asymmetrical.Focal pain may occur.Exams show an increase in the level of leukocytes and the presence of purulent threads in the urine.
The parenchymal form is accompanied by 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 begin treatment for acute prostatitis.If the process is started, there is a high probability of prostatic abscess, paraprostatitis, phlebitis of the paraprostatic venous plexus.If the patient does not consult a doctor, the disease becomes chronic and the likelihood of complete recovery decreases significantly.
Diagnosis of acute prostatitis
When a patient seeks a urologist, the doctor diagnoses acute prostatitis, identifying what stage the disease is at.The specialist receives the information after carrying out a comprehensive study.The methods used in diagnosis 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 has 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 involves collecting and transferring urine for examination.In most cases, acute prostatitis is signaled by an increase in the level of leukocytes.Urine culture, PCR and blood culture and analysis of urethral discharge are also prescribed.
Instrumental methods in the case of this disease are represented by ultrasound diagnosis carried out transrectally.If the patient presents severe pain, the choice of examination is the transabdominal method.
When the question of surgical intervention arises, it becomes necessary to perform computed tomography and magnetic resonance imaging of the pelvis.
Treatment of acute prostatitis
Treatment of acute prostatitis is carried out in a hospital setting.This is due to two factors.Firstly, 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 sensations.Treatment of acute prostatitis begins with drug therapy, prescribing etiotropic medications to the patient.The most important role is played by antibacterial agents that suppress the functioning of microorganisms.
To reduce the intensity of pain, as well as get rid of spasms, the patient is recommended to take antispasmodics and analgesics.Sometimes heat enemas and rectal suppositories are used to alleviate the condition.After overcoming the acute symptoms, it becomes possible to resort to 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 that helps eliminate congestion;It is also recommended for regular use as a preventive measure for men who have already reached the age of forty.
In case of problems with the urinary process, a catheter is not used;instead, cystostomy with a trocar is preferred.
Recovery is considered the regeneration of prostate tissue, the complete restoration of its functions, while laboratory tests indicate that infectious pathogens are absent and 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 common side effect of the operation is erectile dysfunction, retrograde ejaculation is also common, in which during ejaculation sperm enters the bladder and sometimes narrowing of the ureter occurs.The surgical method does not guarantee relapses.Therefore, surgical intervention is used only in some cases, such as:
- the occurrence of an abscess in the prostate, which must be opened and cleaned;
- lack of results from treatment with conservative methods in the form of medications, traditional medicine, physiotherapeutic procedures;
- development of serious complications;
- the presence of a focus of inflammation in the pelvic region;
- formation of paraproctitis (purulent abscess in the cells located around the rectum);
- presence of blood in the urine;
- delay in urination and cessation of urination (anuria);
- the presence of stones in the bladder, kidneys, the cause of which was prostatitis;
- suspected malignant tumor.