Prostatitis – many faces of one disease. Symptoms of prostatitis How to treat prostatitis at home

10 minutes to read. Views 1.3k. Published 05/07/2017

Prostatitis is a purely male disease of the prostate gland of an inflammatory nature. Most men know that they have an organ such as the prostate gland, but not everyone understands what role it plays in their body. The prostate gland is a small but important organ in the male reproductive system. It is located under the bladder and surrounds the upper part of the urethra. The prostate gland has several functions.

Secretory function is the main one for the prostate gland. It produces a secretion that makes up two-thirds of the fluid that is ejaculated during orgasm and ensures the motor activity of sperm. This secret is a nutrient solution for male reproductive cells and contains everything necessary for their difficult journey to the egg - fructose for nutrition, water, minerals sodium, potassium, zinc and magnesium.

Motor function lies in the ability of the prostate to retain urine due to smooth muscle fibers. And during ejaculation, it prevents the mixing of sperm and urine.

Barrier function consists of preventing pathogenic microorganisms from penetrating from the lower urethra into the bladder and kidneys.

Prostate diseases

The prostate gland, like any other organ, is vulnerable. Prostate disease is any medical problem that is found in the prostate gland.

These problems include:

• prostatitis;
• benign prostatic hyperplasia (BPH), also called prostate adenoma;
• stones in the prostate;
• prostate cancer.

Types of prostatitis

Prostatitis is inflammation of the prostate gland caused by infection or other causes. This is the most common cause of premature loss of sexual function. Treatment of prostatitis is determined by its type. There are 4 main types of this disease. Each of them has its own set of symptoms and causes.

1. Acute bacterial prostatitis.
2. Chronic bacterial prostatitis.
3. Chronic nonbacterial prostatitis.
4. Asymptomatic chronic prostatitis.

Acute bacterial prostatitis

A relatively rare type of prostatitis. This type of prostatitis is always associated with a bacterial attack of the prostate tissue. Affects men of reproductive age from 35 to 50 years. Acute prostatitis is characterized by a sudden onset, an acute course with pronounced symptoms, which entails a rapid deterioration of the patient’s condition.

Acute bacterial prostatitis is easier to identify than chronic bacterial prostatitis due to its uniform clinical presentation. The reason is the penetration of pathogenic organisms into the prostate gland. These are the same bacteria that cause urinary tract infections and sexually transmitted diseases. These include the following pathogens:

1. Escherichia coli (Escherichia coli), which is always present on the external genitalia and is the causative agent of infections in most cases;
2. Chlamydia and mycoplasma, sexually transmitted diseases;
3. Klebsiella and Pseudomonas aeruginosa;
4. Enterococci, enterobacters;
5. Gonococci.

Causes of acute bacterial prostatitis

These pathogens enter the prostate gland from the urethra through the excretory ducts or from other neighboring organs: the bladder, kidneys, and rectum. Most of these microorganisms are opportunistic, that is, they live on the skin and mucous membranes of humans and do not pose a danger to them.

The immune system of a healthy person is strong enough to prevent microorganisms from multiplying. Even an infection in the prostate gland may go unnoticed. In order for an infection to manifest itself in the form of bacterial prostatitis, provoking factors, so-called triggers, are needed. Namely:

• decreased immunity due to a sedentary lifestyle, abuse of bad habits, long-term use of antibiotics;
• hypothermia;
• long hours of sedentary work;
• promiscuity, the presence of chronic inflammatory diseases in the partner (bacterial vaginosis, chronic salpingoophoritis);
• prolonged sexual abstinence or excessive sexual activity;
• chronic foci of infection;
• previous venereal and urological infections;
• surgical interventions on the urethra;
• constant stress, overwork, lack of sleep;
• bowel dysfunction (constipation, diarrhea).

Symptoms

Acute type of prostatitis is identified by the following characteristics:

• chills, fever, general malaise;
• pain in the lower back, in the genital area, in the rectum, sometimes throughout the body;
• frequent urge to urinate, especially at night;
• painful urination, weak stream, burning, strong smell of urine;
• blood in urine or semen;
• painful ejaculation;

Treatment of acute bacterial prostatitis

A urinary tract infection is confirmed by the presence of white blood cells and bacteria in the urine.
The course of therapy for acute bacterial prostatitis involves:

1. Stationary mode;
2. Diet;
3. Complete cessation of alcohol and tobacco;
4. Broad-spectrum antibiotics (ampicillins, cephalosporins, macrolides);
5. Painkillers and anti-inflammatory drugs (intravenously or intramuscularly);
6. If necessary, detoxification with saline solutions.

Duration of therapy is from two to four weeks.

Complication

The acute form lasts no more than 1–2 months. If treatment is not carried out during this time, the disease will become chronic. The most common complication of acute prostatitis is progression into a chronic form.
It is possible that a prostate abscess may develop – focal purulent inflammation with a temperature rise of up to 40°C.

Chronic bacterial prostatitis

Chronic prostatitis, as a rule, occurs without pronounced characteristic signs. Unlike the acute form, which is characterized by general weakness, malaise, fever and pain in the groin area, with chronic bacterial prostatitis the clinical picture is blurred and poorly expressed. If in the acute form poor health literally forces the patient to consult a urologist, then with the chronic form everything is different.

Exacerbation of prostatitis is replaced by periods of remission, sometimes very long, and a visit to the doctor is postponed indefinitely. Very often, signs of prostatitis are perceived by a man as an age-related inevitability, and not a reason to see a doctor. Without encountering any obstacles on its way, the disease “blooms.”

Symptoms of chronic bacterial prostatitis

Frequent urination, which causes pain. A weak stream appears only after several attempts.

There is a feeling of incomplete emptying of the bladder.

• Nagging pain in the lower abdomen, in the back, in the perineum.
• Sexual desire weakens.
• Sleep and attention are disturbed, apathy develops, headaches and ringing in the ears may appear.
• Excessive sweating is one of the atypical symptoms of this disease that you need to pay attention to.

Complications

If you do not fight chronic prostatitis, you will have to deal with its much more severe consequences, which are difficult to treat. Chronic prostatitis can have the following complications:

• cystitis;
• pyelonephritis;
• orchiepididymitis (inflammation of the testicles and their appendages);
• vesiculitis (inflammation of the seminal vesicles);
• erectile dysfunction, infertility.

Diagnosis and treatment

Treatment of chronic prostatitis is prescribed on the basis of laboratory tests. These include:

• general blood analysis;
• three-glass urine sample;
• microbiological examination of urine;
• transrectal ultrasound of the prostate gland;
• digital rectal examination;
• microscopy and microbiological examination of prostate secretions;
• microscopy of urethral smears to detect gonococci.

Medicines for prostatitis inhibit pathogenic flora and act on gram-negative and gram-positive bacteria. The complex of therapy includes not only drug treatment, but also physical therapy. Treatment of prostatitis includes:

• antibacterial therapy;
• anti-inflammatory therapy;
• immunomodulatory therapy;
• physiotherapy;
• laser therapy;
• physical therapy;
• ozone therapy.

Duration of treatment is from 8 to 12 weeks.

Chronic nonbacterial prostatitis

This type is also called pelvic pain syndrome. Characterized by spasms of the pelvic floor muscles. There is a version about its neurological origin.

Symptoms of non-bacterial prostatitis

1. Pain in the pelvic area and lower back, also during urination;
2. Aches in the joints and throughout the body;
3. Discomfort and itching during sex;
4. Gastrointestinal disorders.

Types of nonbacterial prostatitis

Chronic nonbacterial prostatitis has 2 forms: inflammatory and non-inflammatory.

An increased concentration of leukocytes and an increase in erythrocyte sedimentation indicate the inflammatory nature of the disease.

The non-inflammatory form is more difficult to diagnose. It is discovered after the patient complains of pain in the pelvis during sexual intercourse.

Causes of non-bacterial chronic prostatitis

• unbalanced, monotonous diet;
• sedentary lifestyle;
• irregular sex life;
• genetic predisposition;
• injury to the genital organ;
• diffuse changes in the prostate gland.

With this type of prostatitis, a large number of inflammatory cells are found in the secretion of the prostate gland, but there is no genitourinary tract infection in the medical history.

Diagnosis and treatment

To diagnose the abacterial type, the following indications are needed:

• Analysis of urine;
• general blood analysis;
• urine culture to identify microorganisms;
• Ultrasound of the prostate gland;
• CT and MRI;
• bacterial smear.

Treatment of abacterial prostatitis

Antibiotics are sometimes effective even when tests show no signs of bacteria. For this reason, they are also often prescribed as the first stage of treatment for chronic non-bacterial prostatitis. Alpha blockers help relax the smooth muscle tissue of the prostate gland and bladder neck.

Nonsteroidal anti-inflammatory drugs such as ibuprofen help relieve pain and fever. These can also be suppositories for prostatitis.

Regular prostate massage performed by a doctor can help drain fluid from inflamed prostate ducts and relieve pressure.

Asymptomatic chronic prostatitis

Little studied, asymptomatic and therefore the most dangerous species. As a rule, it is discovered by chance during an examination.

Symptoms according to research results

• elevated PSA (prostate specific antigen) levels;
• leukocytes in urine.

Complications of asymptomatic prostatitis are adenoma and prostate cancer.

Medicine for asymptomatic prostatitis is selected depending on the etiology of the disease. When infected, the disease is treated with antibiotics or antiviral agents. And if the cause of the disease is not bacteria, then the doctor may limit himself to prescribing ultrasound therapy or massage.

Treatment of prostatitis with folk remedies

The treatment of prostatitis must be approached individually and comprehensively.

1. Healing mixture.
   To prepare the miracle mixture you will need:
   • fresh cucumber;
   • red beets;
   • carrot.

   You need to squeeze the juice out of these vegetables and mix them in equal parts. Drink 100 ml 3 times a day half an hour before meals. We recommend, in parallel with taking the mixture, to use propolis candles. Insert into the rectum at night.

2. Spirulina.
   Buy spirulina powder at the pharmacy and add to cranberry juice, mix well. For 100 ml. juice 2 g powder. Drink the resulting mixture throughout the day.
   The course of treatment is 7 days, then a 3-day break and repeat again. For a positive effect, you need to take 3-4 such courses.
3. A mixture of lobaznik and honey.
   Grind raw meadowsweet tubers with honey. Take the resulting mixture 2 times a day (morning and evening) 1 tsp.
4. A mixture of parsley and honey.
   You need to squeeze out the parsley juice and mix it in equal proportions with honey. The resulting mixture is taken 3 times a day, 2 tablespoons.

Prevention of prostatitis

The good old truth that prevention is the best treatment has proven itself to be the best in relation to prostatitis. After all, prostatitis is promoted by violation of the basic rules of a healthy lifestyle. Lack of sleep, unbalanced diet, poor hygiene, refusal of sports, physical activity, smoking, alcohol - this is the surest path to inflammation of the prostate gland. In order to never experience all the troubles that prostatitis “rewards” men, it is enough to follow the following preventive measures:

1. Do not abuse alcohol and stop smoking. Smoking, according to doctors, is the main cause of blood stagnation in the pelvis;
2. Gymnastics and physical exercises are useful, especially to strengthen the pelvic muscles. Healthy running has a great effect on the health of the prostate gland and maintains potency until adulthood;
3. Food should consist of foods rich in vitamins, minerals, and fiber. Zinc is especially beneficial for the prostate. There is a lot of it in pine nuts and sunflower seeds. It is better to avoid fried and fatty foods;
4. Drink a lot of clean water (2l);
5. During the cold season, use warm underwear;
6. Check with a doctor once a year.

All these points are quite simple and they are addressed against prostatitis - an insidious disease that disguises itself as old age, impotence and can lead to life-threatening consequences.

is an inflammatory disease of the prostate gland. It manifests itself as frequent urination, pain in the penis, scrotum, rectum, sexual disorders (erectile dysfunction, early ejaculation, etc.), sometimes urinary retention, and blood in the urine. The diagnosis of prostatitis is established by a urologist or andrologist based on a typical clinical picture and the results of a rectal examination. Additionally, an ultrasound of the prostate and culture of prostatic secretions and urine are performed. Treatment is conservative - antibacterial therapy, immunotherapy, prostate massage, lifestyle correction.

ICD-10

N41.0 N41.1

General information

Prostatitis is inflammation of the seminal (prostate) gland - prostate. It is the most common disease of the genitourinary system in men. Most often it affects patients aged 25-50 years. According to various data, prostatitis affects 30-85% of men over the age of 30 years. Possible abscess formation of the prostate gland, inflammation of the testicles and appendages, which threatens infertility. Ascending infection leads to inflammation of the upper parts of the genitourinary system (cystitis, pyelonephritis).

The pathology develops with the penetration of an infectious agent that enters the prostate tissue from the organs of the genitourinary system (urethra, bladder) or from a remote inflammatory focus (pneumonia, influenza, sore throat, furunculosis).

Causes of prostatitis

Staphylococcus aureus, Enterococcus, Enterobacter, Pseudomonas, Proteus, Klebsiella and E. Coli can act as infectious agents in acute cases. Most microorganisms belong to the conditionally pathogenic flora and cause prostatitis only in the presence of other predisposing factors. Chronic inflammation is usually due to polymicrobial associations.

The risk of developing the disease increases with hypothermia, a history of specific infections and conditions accompanied by congestion in the prostate tissue. The following predisposing factors are identified:

• General hypothermia (one-time or permanent, associated with working conditions).
• A sedentary lifestyle, a profession that forces a person to be in a sitting position for a long time (computer operator, driver, etc.).
• Constant constipation.
• Disturbances in the normal rhythm of sexual activity (excessive sexual activity, prolonged abstinence, incomplete ejaculation during “habitual” sexual intercourse devoid of emotional overtones).
• The presence of chronic diseases (cholecystitis, bronchitis) or chronic infectious foci in the body (chronic osteomyelitis, untreated caries, tonsillitis, etc.).
• Past urological diseases (urethritis, cystitis, etc.) and sexually transmitted diseases (chlamydia, trichomoniasis, gonorrhea).
• Conditions that cause suppression of the immune system (chronic stress, irregular and poor nutrition, regular lack of sleep, overtraining in athletes).

It is assumed that the risk of developing pathology increases with chronic intoxication (alcohol, nicotine, morphine). Some studies in the field of modern andrology prove that the provoking factor is chronic trauma to the perineum (vibration, shock) in motorists, motorcyclists and cyclists. However, the overwhelming number of specialists believe that all of the above circumstances are not the real causes of the disease, but only contribute to the exacerbation of the latent inflammatory process in the prostate tissues.

A decisive role in the occurrence of prostatitis is played by congestion in the prostate tissue. Disruption of capillary blood flow causes increased lipid peroxidation, swelling, exudation of prostate tissue and creates conditions for the development of an infectious process.

Symptoms of prostatitis

Acute prostatitis

The degree of sexual disorder is determined by many factors, including the sexual constitution and psychological mood of the patient. Impaired potency and dysuria can be caused both by changes in the prostate gland and by the suggestibility of the patient, who, if he is diagnosed with chronic prostatitis, expects the inevitable development of sexual disorders and urinary disorders. Psychogenic dyspotence and dysuria develop especially often in suggestible, anxious patients.

Impotence, and sometimes the very threat of possible sexual disorders, is difficult for patients to tolerate. Often there is a change in character, irritability, grumpiness, excessive concern for one’s own health, and even “sickness.”

Complications

In the absence of timely treatment of acute prostatitis, there is a significant risk of developing a prostate abscess. When a purulent focus forms, the patient’s body temperature rises to 39-40°C and can become hectic in nature. Periods of fever alternate with severe chills. Sharp pain in the perineum makes urination difficult and makes defecation impossible.

Increasing swelling of the prostate gland leads to acute urinary retention. In rare cases, the abscess spontaneously ruptures into the urethra or rectum. When opened, purulent, cloudy urine with an unpleasant, pungent odor appears in the urethra; when opened, the feces contain pus and mucus into the rectum.

Chronic prostatitis is characterized by a wave-like course with periods of long remissions, during which inflammation in the prostate is latent or manifests itself with extremely scant symptoms. Patients who are not bothered by anything often stop treatment and turn only if complications develop.

The spread of infection along the urinary tract causes the occurrence of pyelonephritis and cystitis. The most common complication of the chronic process is inflammation of the testicles and epididymis (epdidymo-orchitis) and inflammation of the seminal vesicles (vesiculitis). The outcome of these diseases is often infertility.

Diagnostics

The characteristic clinical picture simplifies the process of diagnosing acute and chronic prostatitis. It is mandatory to:

• sampling of prostate secretion to determine the sensitivity of the microflora (culture of prostate secretion and bacterial culture of urine).
• Ultrasound of the prostate to identify structural changes (tumors, cysts, adenoma) and differentiate prostatitis from other diseases is performed
• spermogram to exclude or confirm the development of infertility.

Treatment of chronic prostatitis

Treatment of chronic prostatitis should be comprehensive, including etiotropic therapy, physiotherapy, correction of immunity:

• Antibiotic therapy. The patient is prescribed long courses of antibacterial drugs (for 4-8 weeks). Selection of the type and dosage of antibacterial drugs, as well as determination of the duration of the course of treatment is carried out individually. The drug is selected based on the sensitivity of the microflora based on the results of culture of urine and prostate secretions.
• Prostate massage . Gland massage has a complex effect on the affected organ. During the massage, the inflammatory secretion accumulated in the prostate gland is squeezed into the ducts, then enters the urethra and is removed from the body. The procedure improves blood circulation in the prostate, which minimizes congestion and ensures better penetration of antibacterial drugs into the tissue of the affected organ.
• Physiotherapy. To improve blood circulation, laser exposure, ultrasonic waves and electromagnetic waves are used. If it is impossible to carry out physiotherapeutic procedures, the patient is prescribed warm medicinal microenemas.

In case of chronic, long-term inflammation, consultation with an immunologist is indicated to choose the tactics of immunocorrective therapy. The patient is given recommendations for lifestyle changes. Making certain changes in the lifestyle of a patient with chronic prostatitis is both a therapeutic and preventive measure. The patient is recommended to normalize sleep and wakefulness, adjust the diet, and engage in moderate physical activity.

Prognosis and prevention

Acute prostatitis is a disease that has a pronounced tendency to become chronic. Even with timely adequate treatment, chronic prostatitis becomes the outcome in more than half of patients. Recovery is not always achieved, however, with correct consistent therapy and following the doctor’s recommendations, it is possible to eliminate unpleasant symptoms and achieve long-term, stable remission in a chronic process.

Prevention consists of eliminating risk factors. It is necessary to avoid hypothermia, alternate sedentary work with periods of physical activity, and eat regularly and nutritiously. For constipation, laxatives should be used. One of the preventive measures is the normalization of sexual life, since both excessive sexual activity and sexual abstinence are risk factors in the development of prostatitis. If symptoms of a urological or sexually transmitted disease appear, you should consult a doctor promptly.

Prostatitis is a disease in which the prostate tissue becomes inflamed. It occurs in many men of reproductive age, significantly worsening the quality of intimate life. In this regard, urologists recommend not delaying treatment of prostatitis (the cost of the course is quite reasonable). After all, it is necessary to take into account not only the sexual aspect, but also the risk of a rapid transition of the disease from an acute stage to a chronic stage that is difficult to treat.

To undergo treatment for prostatitis in Moscow, come to the Academy of Health clinic. We employ highly qualified specialists with extensive experience in the treatment of diseases of the genitourinary system. They will create an effective treatment regimen and help you quickly get rid of unpleasant symptoms.

What worries a patient with prostatitis?

After undergoing prostatitis treatment in Moscow with us, the patient will get rid of:

• frequent urination, accompanied by discomfort and a feeling of incomplete emptying of the bladder;
• pain in the groin, in the rectal area;
• pain in the pelvic area;
• problems with erection.

Don't wait for the disease to lead to infertility and impotence!

We are talking about this with Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of the Department of Urology and Human Reproductive Health, Rostov State Medical University, Honorary Member of the Russian Society of Urologists Mikhail Kogan.

Complex diagnostics

Elena Nechaenko, AiF Health: Mikhail Iosifovich, please tell us what kind of disease this is and is there any hope of coping with it?

Mikhail Kogan: Prostatitis is a chronic inflammatory disease, mostly of bacterial origin. As a rule, it develops slowly - over months and even years, but the pace of development is different for all patients. And although prostatitis is an incurable disease, it can and should be controlled - that is, to achieve stable and long-term remission.

Quite difficult in most cases. Today we often have to deal with overdiagnosis. After all, it is believed that this disease affects all middle-aged men, and even more so older men. And indeed, inflammation in the prostate gland is found in many people, and by the age of 70-80, almost all men have it. However, inflammation is not the same as curing disease. In order for a urologist to make such a diagnosis and treat a patient, it is necessary that, in addition to the inflammatory process, the patient also has a corresponding clinical picture. In addition, the doctor must be able to carry out differential diagnosis. After all, prostatitis is a many-sided disease and, in addition to the typical symptoms, it can also manifest itself as pain in the abdomen, as well as in the pelvic area, genitals and parts of the body. Therefore, it is sometimes confused with musculoskeletal, vascular, neurological and even mental diseases. A urologist must be highly qualified to understand what is causing the symptoms.

- What research methods are used to confirm the diagnosis?

Unfortunately, standard methods (special analysis of urine and prostate secretions) are not always informative and sometimes do not allow identifying the causative agent of prostatitis. And without this, it is impossible to adequately select an antibiotic that can suppress the activity of inflammation and also relieve (or reduce) the symptoms.

Who will benefit from antibiotics?

- Do properly prescribed antibiotics help everyone?

Alas, not everyone. There are many reasons for this. One of them is a global problem: the development of resistance of pathogenic bacteria to antibiotics. As a result of this process, microbes develop resistance to drugs, and they have no effect on them. Therefore, before prescribing treatment, it is necessary to conduct a study on the sensitivity of bacteria to antibacterial drugs. But this, alas, is not a guarantee that therapy will help. After all, the sensitivity of pathogenic microbes to a drug can be different: strong, medium, or even weak. Or even zero. In addition, microbes may react differently to the medicine already in the body. For example, in a test tube they showed high sensitivity to them, but in the body - already weak. And there are very few drugs that meet clinical standards for the treatment of prostatitis - literally the fingers of one hand are enough to count them. Therefore, standard treatment is effective in only about one third of patients.

- How can one explain such inequality? And what should the remaining two-thirds of patients do?

All organisms are different. For example, a person may have reduced immunity, both general and local (in particular, in the pelvic organs). In this case, the man will be more predisposed to inflammatory diseases of the genital area. In addition, in addition to prostatitis, there may be other features and diseases that reduce the effectiveness of treatment. The most common and significant of them are diabetes mellitus, vascular disorders, metabolic syndrome, hormone deficiency (including the main male hormone - testosterone). Finally, the cause of prostatitis may also be non-bacterial. If laboratory tests do not reveal the causative agent of the disease, it is necessary to continue the diagnosis. You definitely need to do an ultrasound of the prostate gland. It is necessary to exclude other causes of the inflammatory process in this organ - for example, stones, cysts, ulcers. If any of this is detected, the patient will first need surgery. A special ultrasound is also performed, which shows the function of the vessels of the prostate gland - whether the blood flow is impaired, whether there is oxygen starvation of the organ. In this case, medications that improve blood circulation will be needed. Physiotherapy (magnets, heat, electric and laser treatments) can also be used. Despite the fact that the effectiveness of these methods has not yet been proven, but is only being studied, in some cases they help.

Non-standard approach

- What should we do with patients in whom surgical pathology is not detected, but antibiotics are not effective?

Such patients need to be prescribed medications that are not officially recommended for the treatment of prostatitis, but nevertheless have a general beneficial effect, and thus can indirectly affect the health of the prostate gland - improve metabolic processes in it, blood circulation, and reduce inflammation. Among these medicines there are many herbal preparations. But for such treatment to be effective, it naturally must be approved by a doctor. Self-medication is unacceptable. With the help of individually selected therapy, another third of patients can be helped. But there are still about one third of those for whom none of the above helps. Such people should not give up, but should go to specialized clinics where serious research work is being carried out on their disease. The search for a non-standard approach to the treatment of prostatitis may well be crowned with good results.

- What can be recommended in terms of prostatitis prevention?

Of course, this is a healthy lifestyle, you need to protect yourself from sexually transmitted diseases, try to protect yourself from evidence-based risk factors (smoking, chronic stress, physical inactivity, hypothermia and overheating of the genitals). And also - do not stop sexual activity. After all, regular sex life improves blood flow in the prostate gland and prevents the development of inflammation.

13. Acute prostatitis

Prostatitis is an inflammation of the prostate gland, which can be combined with inflammatory damage to the posterior part of the urethra, seminal tubercle and seminal vesicles. Most often observed at the age of 30-50 years. According to the course, acute and chronic are distinguished.

Etiology acute prostatitis: any pyogenic microbe (staphylococcus), entering the prostate gland, can cause an inflammatory process in it. The routes of infection into the gland are hematogenous (after infectious and purulent diseases), lymphogenous (with inflammatory processes in the rectum), canalicular (from the back of the urethra). Hypothermia contributes to the development of prostatitis. According to the stages of the disease, catarrhal, follicular and parenchymal acute prostatitis are distinguished. Purulent damage to the follicles and fiber can lead to their destruction and the formation of an abscess, which sometimes spontaneously opens into the urethra, rectum, perineum and leads to pelvic phlegmon. With parenchymal prostatitis, in advanced cases, paraproctitis and paracystitis, and sepsis can develop.

Clinic. Catarrhal prostatitis can be characterized by pollakiuria, especially at night, pain in the perineum, sacrum, and often pain at the end of urination. With follicular prostatitis, pain in the perineum and sacrum is more intense, intensifies during defecation, radiates to the anus, difficulty urinating, a thin stream of urine, and rarely urinary retention. Body temperature ranges from subfebrile to 38 °C. Parenchymal prostatitis occurs with signs of general intoxication (weakness, decreased appetite, nausea, vomiting, adynamia); body temperature rises to 38-40 °C, chills occur periodically; dysuria occurs day and night; pain in the perineum is intense, throbbing; acute urinary retention is often observed; the act of defecation is difficult. When a prostate abscess occurs, all symptoms become more intense. If the abscess spontaneously opens, the patient’s condition improves significantly.

Diagnostics. The diagnosis of acute prostatitis is made on the basis of symptoms, data from palpation examination of the prostate gland through the rectum, urine and blood tests. In the catarrhal form, the gland is almost not enlarged and is only slightly sensitive to palpation. With follicular – moderately enlarged, distinctly painful, increased density in some areas with uneven contours. When parenchymatous, it is sharply tense and painful, with a dense consistency, the longitudinal groove is often smoothed. With an abscess, fluctuation is determined. After palpation and secretion into the urethra, areas of softening are determined. Urine tests in the second portion reveal a large number of purulent threads, leukocyturia, more significant in the last portions, inflammatory changes in the blood (leukocytosis with a band shift).

Treatment. Bed rest, broad-spectrum antibiotics, sulfonamides, analgesics for pain, and laxatives for constipation. Locally: warm sitz baths at 38-40 °C for 10-15 minutes and microenemas at a temperature of 39-40 °C from 1 glass of chamomile infusion with the addition of a 1-2% solution of novocaine, sage decoction 3-4 times a day. The liquid is slowly introduced into the rectum, where it is left for as long as possible. The patient should take a semi-sitting or semi-lying position (the patient lies on the bed with pillows under his head and back). For severe pain and dysuria, a paraprostatic novocaine blockade can be performed. Dairy-vegetable diet, drink plenty of fluids. In case of prostate abscess, its opening through the perineum or rectum and its drainage are indicated.

Prevention. Avoid hypothermia (sitting on cold ground, swimming in cold water), lead an active, moving lifestyle. Prevention of complications of acute prostatitis - long-term treatment with control of prostate secretions 2-3 weeks after the elimination of the inflammatory process; compliance with diet and regularity of sexual activity.

Forecast in acute catarrhal and follicular prostatitis, favorable. Timely treatment ensures complete elimination of the inflammatory process within 10-14 days. To eliminate parenchymal prostatitis it takes at least 3-4 weeks; this form of prostatitis often becomes chronic and can be complicated by disorders in the sexual sphere, up to complete aspermia, if the inflammatory process affects the ejaculatory ducts.

Prostatitis According to official statistics, every fourth man has heard this diagnosis addressed to him at least once in his life. The prostate, or prostate gland, performs two functions: it produces substances that contribute to the normal maturation of sperm, and