What are the symptoms of prostatitis in men and how to treat them

Inflammation of the prostate today is a leader in the group of male diseases that are predominantly sexually transmitted. Its complications threaten infertility, decreased libido, and impotence.

Symptoms of prostatitis are not just pain, urination disorders, and inflammation of the spermatic cord. The most dangerous consequence of advanced inflammation can be cancerous degeneration of the prostate gland. Whereas a timely diagnosed pathological process is easily stopped.

Causes of inflammation

The risk of developing prostate inflammation increases due to various factors predisposing to the disease:

• Hypothermia, one-time or associated with the nature of work in the open air.
• A sedentary lifestyle leads to disruption of the functioning of the digestive system.
• Chronic somatic diseases (diabetes mellitus, hypertension).
• Foci of focal, perifocal infection (rhinitis, tonsillitis, stomatitis, gastritis).
• Persistent UGI (chlamydia, trichomoniasis, herpes virus).
• Stress, insomnia, chronic fatigue syndrome.
• Decreased immunity due to illness, surgery, emotional stress.
• Bad habits leading to the development of intoxication: alcohol, smoking, strong coffee.
• Occupational injuries to the perineum of car drivers, athletes, workers in hazardous industries.
• Promiscuous sex life, interrupted sexual intercourse, devoid of sensuality intercourse with incomplete ejaculation, prolonged absence of intimacy (low need for sperm leads to stagnation in the gland).
• Venereal diseases.

Despite a fairly large number of provocative moments, the essence of prostatitis is the occurrence of stagnation inside the organ against the background of impaired blood circulation and lymph outflow.

Symptoms of prostatitis

Prostatitis can be suspected based on the following disturbances in the functioning of the genitourinary system:

• discomfort when urinating, uncontrolled urination;
• potency disorder, weak erection, decreased libido;
• difficulty urinating, feeling of incomplete emptying of the bladder;
• pain in the perineum when sitting for a long time, for example while driving;
• infertility.

The acute stage of the disease causes significant discomfort. This phase is accompanied by the following symptoms:

• frequent painful urge to urinate;
• delay or inability to urinate;
• throbbing pain in the perineum, which is transmitted to the anus and intensifies during the act of defecation. As a result, difficulty in defecation;
• general intoxication of the body, feverish state.

The chronic form of prostatitis is accompanied by other symptoms:

• slight rise in body temperature;
• constant fatigue;
• mild pain in the perineum, burning in the urethra;
• discomfort when urinating and defecating;
• weakening of sexual function and the resulting psycho-emotional depression.

Classification

In modern urology there is no uniform classification of the disease. However, practicing doctors prefer this option for classifying the inflammatory process in the prostate

According to the course of the disease:

• Acute prostatitis. It accounts for more than 50% of cases of the disease in people no older than 30-35 years.
• Chronic option. It is considered a non-age category. It does not manifest itself for a long time; the impetus for its development is a cold or infection.

For the reason that caused the pathology:

• Bacterial inflammation of the prostate gland, predominates in men under 40 years of age, occurs against the background of ultrasonography, and does not extend beyond the boundaries of the organ.
• Non-bacterial pathological changes in the gland, predominantly chronic.
• Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.

According to the nature of structural changes in the prostate gland:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention. Clinically resembles prostate adenoma.
• Calculous inflammation of the prostate gland occurs due to the formation of stones inside the prostate. Considered as a harbinger of cancer.
• Congestive prostatitis, the result of a sedentary lifestyle, is diagnosed in every second patient.

Signs of the disease

If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:

• Disorder of urination with the occurrence of an intermittent, weak stream of urine, unusually short, causing splashing, difficulty and pain before urination. Frequent urge to empty the bladder occurs mainly at night.
• Soreness, which is localized in the lower abdomen, radiates to the scrotum, perineum, and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in sperm (consistency, quantity).

Acute prostatitis

The disease begins with a sharp rise in temperature (up to 40 degrees), painful headache, and fever. The symptoms that appear are accompanied by pain in the groin, perineum, back, discharge from the urethra, frequent urination and a constant urge to urinate.

Emptying the bladder occurs with a delay and a burning sensation. The urine itself becomes cloudy and may contain blood. Irritability and fatigue occur.

The outcome of acute prostatitis can be complete resolution of the process (if treatment is started in a timely manner). Since changes occur in many pelvic organs, they cannot be left to chance, otherwise the corresponding complications will arise:

• Vesiculitis is an inflammation of the seminal vesicles, the cause of the appearance of pus in the sperm, which not only reduces the quality of the ejaculate, but leads to loss of reproductive function.
• Colliculitis - inflammatory changes in the seminal tubercle become the reason for the development of severe pain during sex, interruption of orgasm, and impotence of a psychological nature.
• The formation of an abscess in the body of the prostate, its rupture, and purulent damage to the rectum leads to an exacerbation of symptoms, severe intoxication of the body, even death.
• Stagnation in the tissues of the prostate leads to changes in their structure, disruption of innervation, blood supply, both to the gland itself and to organs located nearby, with disruption of their functions. The erection becomes insufficient for full sexual intercourse, premature ejaculation and prolonged sexual intercourse without orgasm are observed.
• Cicatricial changes in the gland and spermatic cord lead to infertility, a decrease in the quality of sperm, and sperm motility. Narrowing of the urethra interferes with the normal process of urination; obstruction of the bladder can cause acute urinary retention, requiring emergency surgical care.

Chronic prostatitis

The main feature of the disease is the vagueness of clinical symptoms with a long, persistent course of the process. More often, the chronic form occurs independently, as a primary pathology against the background of stagnation of blood in the vessels (prostatosis), abacterial prostatitis.

The main symptoms of chronic prostatitis are:

• fever;
• pain occurs in the scrotum, perineum, anus, back;
• urinary disturbance;
• mucous or mucopurulent discharge from the rectum, urethra, even in the absence of urination or defecation;
• erectile dysfunction, painful ejaculation, interrupted sexual intercourse, prolonged intercourse without a feeling of satisfaction.

Inaction and improper treatment of chronic prostatitis can cause complications:

• Infertility is the result of chronic inflammation in the spermatic cord, vesicles, testicles, and their appendages.
• Cystitis, pyelonephritis (other diseases of the genitourinary system) are a consequence of hematogenous and mechanical spread of microbes.
• Sepsis.
• Persistent decrease in immunity.
• Untreated prostatitis can cause cancer in 35–40% of cases.

Diagnostics

The clinical picture of the disease is typical, so the diagnosis is not difficult. It is performed by a urologist based on medical history, examination of the patient, laboratory minimum using the most modern medical devices:

• Rectal examination of the gland, taking secretions for examination (culture with determination of sensitivity to antibiotics).
• UAC, UAM, bacterial culture of urine.
• Smear test for STDs, UGI examination.
• Daily monitoring of urination rhythm, measurement of urination rate (uroflowmetry).
• For differential diagnosis, ultrasound or TRUS is performed.
• If it is necessary to exclude oncology, a biopsy is taken, urography is performed, and PSA is determined - prostate specific antigen.
• To diagnose infertility, a spermogram is prescribed - an analysis of ejaculate to determine the fertility of a man.

Based on the results of the patient’s examination, an individual scheme for complex treatment of prostatitis is drawn up. When prescribing drugs, the form of the pathology and the presence of concomitant diseases are taken into account. The decision about where to conduct therapy (inpatient or outpatient) is made by the doctor. The course of treatment is carried out with careful laboratory monitoring of results.

Treatment of acute prostatitis

Acute prostatitis requires bed rest, a special, salt-free diet, and sexual rest.

Methods of course treatment:

• The most effective treatment for prostatitis is etiotropic therapy. If the basis of prostatitis is an infection, a course of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
• Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers. NSAIDs may be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes, and a combination of microelements have proven their effectiveness.
• Physiotherapeutic methods are possible only in the subacute stage of the disease. They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
• Massage is another effective method of influencing the prostate. It opens the ducts, normalizes blood circulation in the scrotum and pelvis.
• Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
• The purulent process involves surgical intervention.
• Psychologist consultations.

Therapy for acute inflammation of the prostate is complex.

Effective treatment of acute prostatitis in men includes drugs from different pharmacological groups:

• Antibiotics.Drugs with a wide spectrum of activity are used, which have a bactericidal effect on most pathogens. Most often, antimicrobial treatment is an etiotropic measure, since in most cases the cause of prostate inflammation is microbial pathogens. For a bacterial infection, antibiotics are prescribed, for a viral infection, antiviral drugs are prescribed, and if protozoa are detected, anti-trichomonas drugs are prescribed. The choice of antimicrobial agents is carried out empirically or based on the results of PCR, bacterioscopy, and bacterial culture. The selection of antimicrobial agents, determination of their dose, frequency and duration of administration can be carried out exclusively by the attending physician. Along with antibiotics, uroseptics can be prescribed, which have a disinfecting effect on the mucous membrane of the genitourinary tract.
• Anti-inflammatory drugs.Allows you to reduce the severity of swelling in the tissues and the intensity of pain. As a rule, non-steroidal anti-inflammatory drugs (NSAIDs) are used for this.
• Vascular drugs– reduce tissue swelling, eliminate congestion in the prostate, thereby helping to reduce pain, improve blood circulation and local metabolic processes in tissues.
• Enzymes– thin the prostate secretion and promote the drainage of pus. In addition, enzymatic drugs increase the effectiveness of antimicrobial treatment by improving the absorption of their active substances by affected tissues.
• Diuretics (diuretics).They increase urine output, which contributes to the mechanical "washing out" of the infection.
• While taking antibiotics, patients are prescribed hepaprotectors that protect the liver parenchyma from toxic damage and improve its functional state.
• To eliminate and prevent the development of intestinal dysbiosis during antibiotic therapy, patients are prescribed probiotics.
• After acute inflammatory phenomena in the prostate gland subside, patients are prescribed a course of physiotherapeutic treatment - medicinal electrophoresis, galvanization, magnetic, laser, mud therapy, etc. Such procedures improve local microcirculation and lymphatic drainage, metabolic processes and tissue nutrition, stimulate tissue repair, accelerate the final resolution of the inflammatory process, promote tissue restoration and normalization of the functional state of the prostate.

General activities must be carried out.

A diet for acute prostatitis in men is indicated, including a sufficient supply of easily digestible proteins and vitamins.

During the period of exacerbation of inflammation, spicy, fried, fatty, salty foods, and marinades are excluded from the diet.

Alcohol consumption is excluded, smoking cessation, abstinence from sexual intercourse and intense physical activity, including sports, are recommended.

It is necessary to normalize sleep, work and rest, and balance the emotional background.

During the period of illness, a person needs functional rest.

With timely, correct diagnosis and treatment of acute prostatitis in a medical institution, the prognosis is favorable - complete recovery occurs.

If acute prostatitis develops, consult a doctor immediately and do not self-medicate!

Treatment of chronic prostatitis

With a long-term, course (at least a month) effect on the prostate, there is no 100% guarantee of cure. Priority goes to herbal medicines, immunocorrection, changing household habits:

• Herbal preparations are widely used in urological practice. They are able to accumulate at the site of the most active pathological process, protect cells from oxidation, remove free radicals, and prevent the proliferation of glandular tissue.
• Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
• Drugs that enhance immunity not only help to cope with prostatitis, they also correct the negative effects of antibiotics that disrupt the function of the immune system.
• The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
• Prostate massage allows you to mechanically remove the "extra" secretion of the gland through the urethra, improve blood circulation, and minimize congestion.
• Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or microenemas with herbs.
• In severe cases, intravenous fluids with diuretics are indicated. This stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis, and pyelonephritis.
• For constipation, herbal laxatives are used.
• The urologist and psychologist, together with the patient, develop an individual long-term program of daily routine, necessary rest, diet, dosed physical activity, and sexual activity.
• If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). Practiced in exceptional cases, it is fraught with impotence and urinary incontinence. Young people do not undergo surgery because it can cause infertility.

Treatment with drugs

Treatment of prostatitis through antibacterial therapy must begin with bacterial culture, the purpose of which is to assess the body’s sensitivity to this type of antibiotic. If urination is impaired, the use of anti-inflammatory drugs gives a good result.

Medicines are taken in tablets, in acute cases - as a dropper or intramuscularly. Rectal suppositories are effective for treating chronic forms of prostatitis: with their help, medications reach their goals faster and have minimal effect on other organs.

Blood-thinning and anti-inflammatory drugs have also proven themselves to be effective.

Antibacterial therapy

Antibiotics are an effective remedy in the fight against bacterial prostatitis. In order to achieve the desired effect and not harm the body, the choice of medication, dosage and treatment regimen should be made by a doctor. To correctly select the most effective medications, he will have to find out what type of pathogen caused prostatitis, and also test the patient for tolerance to antibiotics of a particular group.

Antibiotics from the fluoroquinolone group have proven themselves to be effective in the treatment of chronic prostatitis. Their action is aimed at suppressing bacterial infection and strengthening the body's own immunity. In addition to this, the bacteriostatic antibiotic trimethoprim is recommended for the prevention and treatment of concomitant diseases of the genitourinary system.

Treatment of prostatitis caused by mycoplasma and chlamydia can additionally be carried out with drugs from the group of macrolides and tetracyclines, which slow down the spread of infection.

The duration of taking antibacterial drugs is from 2 to 4 weeks. In case of positive dynamics, the course may be extended.

Physiotherapy

Physiotherapeutic techniques in the treatment of prostatitis are aimed at activating blood circulation in the pelvic area, improving metabolic processes in the prostate gland, and cleansing the ducts. If physiotherapy is combined with taking antibiotics, the effect of the latter is enhanced.

The main methods include:

• magnetic therapy;
• laser therapy;
• electrophoresis;
• warming up;
• ultrasound;
• mud therapy;
• high frequency irradiation;
• physiotherapy.

One of the oldest methods, transrectal massage of the prostate gland, according to modern research, has no proven effectiveness.

Non-specific treatments

Nonspecific methods of treating prostatitis include:

• hirudotherapy;
• therapeutic fasting;
• acupuncture;
• diet according to the Ostrovsky method;
• alkalization of the body using the Neumyvakin method.

We strongly recommend that you discuss all non-traditional methods of treating prostatitis with your doctor.

Surgery

Surgical methods are used in complex and emergency cases:

• for drainage of purulent abscesses, which are removed by laparoscopic methods through a puncture;
• in case of difficulty urinating due to damage to the urinary tract;
• with a large volume of the affected area;
• with a significant number of stones in the body of the gland.

Stones and sclerotic tissue are removed using endoscopic methods. In case of a large affected area or multiple stones, resection of the prostate is resorted to.

Transurethral resection is also effective for bacterial prostatitis. In this way, the risk of relapse can be reduced.

Folk remedies

Treatment of prostatitis with folk remedies is unlikely to be effective on its own, but in combination with medication and physiotherapeutic methods it may be applicable. These include: beekeeping products, decoctions of herbs and seeds, tinctures of garlic, ginger, beaver stream, fresh vegetables, pumpkin seeds.

In acute cases of the disease, you must consult a doctor, and in no case should you self-medicate! If a purulent abscess ruptures, death is possible.

Suppositories for prostatitis

Treatment of prostatitis with rectal suppositories is much more effective than tablets, if only because the rectum is much closer to the prostate, which means the medicine will act faster.

The composition of drugs for the treatment of prostatitis can be completely different; they are prescribed to solve a particular problem.

1. Antibacterial agents are especially effective for prostatitis caused by chlamydia.
2. Painkillers are used for symptomatic treatment; they relieve pain well.
3. Immunostimulants help improve blood circulation, relieve swelling, and are used in complex therapy.
4. Herbal medicines have a mild effect. They, like candles on bee products, are used as an addition to the main treatment.
5. Ichthyol-based compositions promote blood flow in the intestinal mucosa area, which accelerates the attenuation of inflammatory processes and slightly improves immunity.
6. Products based on special enzymes prevent the formation of scar tissue. It is recommended to take it as part of complex therapy with antibiotics, anti-inflammatory and painkillers.

Ancillary drugs

For the symptomatic treatment of prostatitis in men, for example, relieving pain when urinating, you can additionally take antispasmodics, which relax smooth muscles and thereby quickly relieve pain.

General health is promoted by blood-thinning and anti-inflammatory dietary supplements based on bee products, pumpkin oil, and palm fruit extracts.

Diet and lifestyle

For the treatment of prostatitis, a proper, balanced diet and a healthy lifestyle are very important. Food should not contain spicy, fried, salty or pickled foods. In acute cases, alcohol is strictly prohibited.

Food should contain sufficient fiber to prevent constipation. Protein content should be reduced. It is advisable to supplement the diet with herbs, ginger, and pumpkin seeds.

Consequences of untreated prostatitis

Even if the symptoms of prostatitis have not appeared for a long time, it is necessary to undergo regular examination by a urologist. Incompletely cured prostatitis may be accompanied by the formation of calcifications, which will then have to be removed along with the gland. Experts are confident that there are no other ways to remove or dissolve stones.

In addition, pathogenic microorganisms can migrate to neighboring organs, causing inflammation. Advanced prostatitis can cause the development of adenoma and prostate cancer.

Prevention

To prevent the occurrence of a disease that is unpleasant for men, you need to eliminate provoking factors and follow simple rules:

• Lead a healthy lifestyle, give up bad habits.
• Don't get too cold.
• Drink at least 1. 5-2 liters of water per day.
• Strengthen your immune system, walk a lot, toughen up.
• Engage in physical education and sports, visit fitness clubs.
• Avoid stressful situations.
• Practice regular sex life with a regular partner.