Prostatitis is the most common urological pathology in men of reproductive age. According to surveys, every third of them, at least once in their life, experienced symptoms that can be interpreted as inflammation of the prostate gland. Despite such a high occurrence of pathology, prostatitis remains a poorly studied disease.To this day, there is no consensus that it becomes an initial factor in inflammation, because it is possible to distinguish the pathogens of the ITS of the genitourinary tract of patients in only 10% of cases.
The absence of clear diagnostic criteria and characteristic signs of the disease complicate patient accounting. The symptoms of prostatitis are so nonspecific that each doctor interprets them with a large part of subjectivity and can attribute it to a completely different pathology. Consequently, the treatment approach also varies and, often, patients roam a hospital cabinet to another without any positive dynamic for years. Prostatitis deprives a man of trust in his sexual strength, hung his thoughts about a problem and brings him not so much physical as psycho -emotional suffering.
What is a prostate and why is it needed?
The prostate (prostate) gland is a small glandular organ of a man located around the urethra under the bladder. They firmly catch the urethra, forming one of its sphincters, a muscular cat designed to sustain urine. In its shape and size, the prostate resembles a chestnut nut, with which it is often compared to anatomists. The part of the urethra, which passes inside the gland is called prostatic. Its rear convex of the prostate is in contact with the rectum, so you can easily feel with a rectal finger exam. The frontal surface of the gland is close to the pubic joint and is connected with it with connective tissue motion ligaments, and the venous plexus is among them.
The prostate gland consists of lobes, each of which is made by alveoli - small bags lined with secretory epithelium. The alveoli are interconnected by the output ducts in the form of tubes, which merger with each other, enlarged and finally fall into the simple part of the urethra. Within the secretory bags, the prostate juice is synthesized and accumulated, which includes nutrients for sperm. It allows male sex cells to maintain their activity in the female body up to 5 days, which significantly increases fertilization possibilities.
The lighting of the gland occurs at the time of ejaculation. The prostate juice is mixed with the secret of the testicles and represents 10 to 30% of the final sperm volume. Thus,The prostate gland performs 2 main functions in a man's body:
- Participate in the urine process: maintains urine when muscle fibers are reduced and passes it freely when they are relaxed;
- It provides the viability of sperm, distinguishing the prostate juice of nutrients in ejaculation.
What is the disease developing?
Prostatitis are inflammatory changes in the prostate gland and should be understood that they arise not only under the influence of bacterial microflora.The causes of inflammation can be any factor that generates damage to the tissue of the gland and the destruction of their cells.
As in any other fabric, the inflammatory process in the prostate proceeds through certain stages:
- Alteration: damage to prostate cells. Cytoplasma squirrels, cell core fragments and membranes remains leave the cells destroyed in the intercellular space; All of them are a sign of anguish for the immune system. Immunity cells begin to fight actively for injury, penetrating from blood vessels and connective tissue. They launch biologically active substances in the place of damage, under the influence of which the blood vessels expand and the cellular "reinforcement" comes.
- Exudation: the release of the liquid part of the blood of the vessels.Under the influence of immune cells, the walls of the dilated vessels become permeable to plasma and rushes to the injury of the damage. If it is on the surface of an organ or hollow duct of the gland, then the liquid part of the blood is released in its light, if the inflammation is tissue, then swelling is formed. Such a measure is necessary to limit the damage approach and avoid the additional spread of the pathogen.
- Proliferation is the replacement of damaged cells with similar ones or connective tissue.The proliferation mechanism is launched a little later than the events described above and its course depends directly on the depth of the damage. Small foci of destruction of the tissue of the prostate gland are replaced by the same functional cells and the organ restores its work in its entirety. Deep disorders are allowed through scars: the replacement of the dead tissue with connective tissue elements. Chronic prostatitis can ultimately lead to the complete atrophy of the prostate gland and the change from its secretory to the scar.
For the proposed reason, prostatitis is divided into:
- Acute bacterial- The pathogenic microflora causes severe damage to prostate tissues with a pronounced inflammatory reaction. Most of the time it develops with infection with gocococcus and other pathogens.
- Chronic bacterial-Sociation of pathogenically or conditionally pathogenic bacteria causes slow inflammation, whose activity remains for more than 2 months. As a general rule, pathogens are streptococci, staphylococci, E. coli, Klebsiella, Mycoplasma, ureaplasma, clamidia, herpesvirus and fungi of a candidate similar to yeast.
- Chronic Abacterial- In the presence of an inflammatory process in the prostate, it is not possible to detect a causal microflora. A similar form of the disease develops when urine is thrown in the ducts of the prostate gland, the stagnation of venous blood in the pelvis, a violation of its emptying (rare or too frequent ejaculation). In the last case, the disease is called stagnant prostatitis.
How does the disease manifest?
Acute prostatitis easier to diagnose,which proceeds with signs of poisoning and inflammation pronounced. In a man, the temperature roughly increases to 38-39 degrees C, the pain pronounced in the perineum appears, in the rectum area. They can give in the groin, in the testicle, to the penis and be so unbearable that a man's daily activity is very disturbed. In some cases, the body temperature measured in the axillary cavity does not exceed the normal indicators, but the rectal in any case will be 1-2 degrees by normal. Prostatitis signs also become a rape of urine: serious impulses to urinate, after which it is impossible to restrict acute delay in urine due to severe edema of the gland. Sometimes, the defecation becomes painful, since the prostate enlarged in size stands out in the light of the rectum.
Chronic prostatitisIn its manifestations, it is so diverse that it can be easily confused with another pathology. In the most typical cases, the symptoms of prostatitis are presented:
- Pain in the crotch, pelvis.It is difficult for the patient to determine a specific place where the pain is often spread in the groin, scrotum, head and stern of the penis, sacrum. Its severity can be different: barely distinguishable to intense stupid or pull. Often, pain is associated with urination or ejaculation, occurs at the end or at the beginning of the process.
- Urine violation- The patient has frequent impulses of emptying the bladder, he has to get up repeatedly at night to urinate. However, the jet pressure is normal, urinary retention develops low.
- Sexual disorders- In the context of constant discomfort in the crotch of a man, an erection worsens and self -confidence disappears. The violations are aggravated if the pain is associated with the moment of ejaculation: the patient cannot relax completely, since he expects unpleasant sensations.
As a general rule, with chronic prostatitis, the general well of a man does not alter, body temperature is normal throughout the disease.
How is the disease diagnosed?
The diagnosis is established by the Urologist or AndrologistAfter examining the patient, collecting an anamnesis and studying symptoms. The doctor needs to discover the patient's contraception method, the presence of STIs in a sexual couple, the possibility of anal contacts without a condom. These data facilitate diagnosis and direct the doctor's thoughts in the right direction. The prescription of the symptoms of the disease or discomfort in the perineum allows us to judge the course of prostatitis and its severity. The urologist necessarily examines the patient's genital organs and performs a rectal examination of the prostate gland. To do this, insert a finger into the patient's rear passage and touch the outstanding prostate on the front wall of the rectum. Pain and size indicate the intensity of the inflammatory process.
In addition, the doctor performs a series of instrumental, microscopic, bacteriological and immunological studies to clarify the cause of the disease. The most common diagnostic method is the urine sample of 4 or 3 glass. The first method is more time and difficult to practice in practice, since it requires that the patient several times consciously interrupts urine. The second modification is simpler: the patient urinates continuously in three different containers in equal portions. The first part speaks of the state of the urethra, the second about the pathology of the bladder and the kidneys, of the third, information about the state of the prostate gland is obtained. All collected material is studied under a microscope. With prostatitis in the third portion of urine, leukocytes are found and sometimes bacteria are found.
Access for the study of prostate and massage when collecting secrets
For microscopy, the secret of the prostate gland is also taken.To do this, the doctor performs a prostate massage through the wall of the rectum for some time to be emptied in the urethra. The SMOS are made of the material collected in the laboratory, painted and studied under a high increase. A sign of inflammation are leukocytes, the bacterial etiology of the disease, bacteria in a smear. To determine the type of pathogen, the prostate secret is sown in the nutrient media. If pathogenic microorganisms are present in it, then, after 3-5 days, they form microbial colonies, which can be studied by the bacteriological method allows you to obtain data on the sensitivity of microflora to antibiotics.
Of instrumental diagnostic methods:
- Ultrasound of the kidneys;
- Prostate confidence with dopplerography: an ultrasonic sensor is inserted in the rectum for the best visualization of the prostate gland, its blood flow is evaluated additionally;
- The increase in ugly, is necessary with a stubborn recurring course of prostatitis. An X -ray contract is introduced into the urethra, after which several successive images are made.
Starting the treatment of chronic prostatitis, it must tune in a long struggle, since it is not always possible to cure it in a few weeks or even months. It is recommended to combine several methods and tools for therapy, it is useful to improve drugs with homes. With stagnant prostatitis, regular sex is needed, interrupted sexual acts are unacceptable. The patient's psycho -emotional history is important: depression, depression, problems in personal life and the sexual sphere can deny all the efforts of doctors.
How to prevent?
Prostatitis prevention includes:
- The use of contraception barrier methods (condom), especially when it comes to anal sex;
- Timely treatment of STIs;
- Regular sex life, which brings relationships to complete ejaculation;
- The prevention of injury in the crotch, when classes, traumatic sports must be used by all possible protection methods;
- Compliance with personal hygiene;
- Ensure sufficient physical activity.
Although today prostatitis is not associated with the risk of developing adenoma or prostate cancer, the disease brings a lot of suffering to its owner. A man exhausted by chronic pain, feeling his sexual weakness, tired of prolonged treatment, changes remarkably externally and experienced doctors define such patients at first sight. To avoid such destiny, you must be careful with your health, carefully protected with each new partner and treat sexually transmitted diseases over time. Prostatitis is not completely treated in all cases, but an experienced urologist can significantly improve the condition of the patient and the quality of his life.