Acute prostatitis is an acute inflammation of the prostate caused by an infection.With the disease, swelling of the prostate occurs and purulent foci appear in its tissue.Statistical data gives us the right to claim that acute prostatitis is a common disease in men;With increasing 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 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:
- catarrhal;
- follicular;
- parenchymatous.
First, catarrhal inflammation occurs, characterized by dilatation 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 ducts of the prostate.We are talking in particular about the ducts of the prostate gland, which lead to the back of the urethra.Inflammatory changes only affect the mucous membranes.The ducts lose their contractility, they narrow significantly or become completely blocked, thereby hindering the outflow of prostatic secretions.The catarrhal form is directly related to the infectious pathogen that has migrated from the posterior part of the urethra.Since the inflammatory process also affects prostate secretion, it can provoke the appearance of posterior urethritis.
In the follicular stage, foci of inflammation spread into individual lobules or the entire prostate gland.Purulent foci appear, pus enters the urethra.The enlargement of the prostate does not stop;The tissues undergo destructive changes.
During the parenchymal phase of acute prostatitis, inflammatory processes affect the interstitial tissue of the prostate.This stage occurs after invasion of an infectious agent via contact or hematogenous routes, for example after surgery.
Parenchymal prostatitis is accompanied by the appearance of individual pustules at the beginning of the disease, which unite during the development process and become associated with a prostate abscess.
In the follicular and parenchymal forms, inflammatory changes often occur in the posterior part of the urethra and in the bladder neck during their development.
Prognosis and prevention of acute prostatitis
In the vast majority of cases, timely etiotropic therapy can eliminate the signs of acute prostatitis.If no treatment is given, it is entirely possible that an abscess will develop or the disease will become chronic.
Prevention of this disease usually means timely treatment of any infectious diseases in the body, as well as detection and treatment of sexually transmitted diseases and urethritis.A man needs to lead a healthy lifestyle and especially pay attention to more physical activity.In addition, the development of the disease is prevented by regular sex life and the absence of unprotected casual contacts.Strict adherence to the rules of personal hygiene is another important requirement for a man of any age.
Causes of the disease
Acute prostatitis can occur in men of any age.The reason is often the invasion of various infectious pathogens.This is E. coli, but streptococci, staphylococci, candida fungi, chlamydia and trichomonas can also occur.The most common route of entry is the ducts.The pathogen can also enter the prostate via the bladder, where an inflammatory process is currently taking place (for example acute cystitis).The infection can also originate from purulent foci located in the immediate vicinity.
The inflammatory process in the prostate caused by the presence of microorganisms can have various causes.Factors that increase your risk include:
- surgical interventions in the urethra area;
- 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 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 commonalities that unite all forms.These are primarily pain, general intoxication and problems with urination.
The catarrhal form is usually accompanied by severe pain, a feeling of heaviness in the perineal area, frequent urination and painful sensations.During palpation, the doctor may notice an enlargement of the prostate.The results of secretion tests may show a high level of white blood cells.
The symptoms of acute prostatitis in the follicular form are more pronounced.A man feels pain in the perineum, which radiates to the sacrum or penis.The process of urination is accompanied by pain, urine is retained and difficulties with bowel movements often occur.There is general malaise and the patient has a fever.Palpation reveals an enlarged prostate, the outlines of which become asymmetrical.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 sharp increase in body temperature, values can reach 39.5 degrees.General symptoms are pronounced: chills, loss of appetite and weakness.Urination is delayed and the process is accompanied by severe pain.Bowel movements are also difficult and constipation can be severe.
In such cases, treatment of acute prostatitis must be started urgently.When the process begins, there is a high probability of prostate abscess, paraprostatitis and phlebitis of the paraprostatic venous plexus.If the patient does not see a doctor, the disease becomes chronic and the likelihood of complete recovery decreases significantly.
Diagnosis of acute prostatitis
When a patient visits a urologist, the doctor diagnoses acute prostatitis and determines what stage the disease is at.The specialist receives the information after conducting a comprehensive study.The methods used for diagnosis in this case consist of physical, instrumental and laboratory studies.
The physical examination examines the condition of the prostate from the rectum.This gives the specialist 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 detect a decrease in the number of lecithin grains and an increase in the level of leukocytes.
Palpation of the gland also includes collecting and transferring urine for examination.In most cases, acute prostatitis is signaled by an increase in the number of leukocytes.In addition, urine culture, PCR and blood culture, as well as analysis of urethral discharge are prescribed.
Instrumental methods for this disease are ultrasound diagnostics carried out transrectally. If the pain is severe, the transabdominal method can be used as an examination method.
If the question arises about surgical intervention, it is necessary to carry out a CT and MRI scan of the pelvis.
Treatment of acute prostatitis
Acute prostatitis is treated in hospital.This is due to two factors.Firstly, there is a risk of serious complications that can affect a man's health and, as a result, affect reproductive function and erection quality.Secondly, the disease is complex and is accompanied by pronounced symptoms and painful sensations.Treatment of acute prostatitis begins with drug therapy, in which the patient is prescribed etiotropic drugs.The most important role is played by antibacterial agents that suppress the function of microorganisms.
To reduce the severity of pain and eliminate spasms, the patient is recommended to take antispasmodics and analgesics.Thermal enemas and rectal suppositories are sometimes used to relieve the condition.After acute symptoms have been overcome, the use of physiotherapy is possible.These procedures increase microcirculation, improve local immunity and help eliminate inflammation.Among the physiotherapy methods for treating acute prostatitis, the most effective are prostate massage, as well as microwave therapy and electrophoresis.Prostate massage has been a particularly popular measure for removing congestion for many years;Regular use as a preventative measure is also recommended for men aged 40 and over.
If there are problems with the urinary tract, a catheter is not used;Instead, a trocar cystostomy is preferred.
Recovery means the regeneration of prostate tissue, the complete restoration of its functions, while laboratory tests indicate the absence of infectious pathogens and the prostate secretion returns to its normal composition.
Surgery is not a widely used treatment method 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, and retrograde ejaculation is also common, in which sperm enter the bladder during ejaculation and sometimes narrowing of the ureter occurs.The surgical method offers no guarantee against relapse.Therefore, surgical intervention is resorted to only in certain cases, such as:
- the appearance of a prostate abscess that needs to be opened and cleaned;
- lack of results when treated with conservative methods in the form of medications, traditional medicine and physiotherapeutic procedures;
- development of serious complications;
- the presence of a focus of inflammation in the pelvic area;
- Formation of paraproctitis (purulent abscess in cells surrounding the rectum);
- presence of blood in urine;
- delayed urination and cessation of urination (anuria);
- the presence of stones in the bladder and kidneys, the cause of which was prostatitis;
- Suspicion of a malignant tumor.