Prostatitis is the most common urological pathology in men of reproductive age. According to research, every third of them at least once in their life has 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 pathogens from STDs from the patient's genitourinary tract in only 10% of cases.
The absence of clear diagnostic criteria and characteristic signs of the disease complicate patients' 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 from one hospital office to another without any positive dynamics for years. Prostatitis deprives a man of trust in his sexual strength, hanging his thoughts on a problem, and brings him as much physically and psycho -emotional suffering.
What is a prostate and why is it necessary?
The prostate gland (prostate) is a small glandular organ of a man located around the urethra below the bladder. He firmly writes the urethra, forming one of his sphincters - a muscle monkey designed to maintain urine. In its shape and size, the prostate resembles a nut of chestnut, with which it is often compared to anatomists. The part of the urethra, which passes within the gland is called prostatic. Its convex rear of the prostate is in contact with the rectum, so that it can easily be felt with a rectal finger examination. The front surface of the gland is close to the pubic joint and is connected to it with moving connective tissue ligaments, and the venous plexus is between them.
The prostate gland consists of lobes, each of which is made by alveoli - small bags aligned with secretory epithelium. The alveoli are interconnected by the pipe output ducts, which fuse, increase and finally fall into the simple part of the urethra. Within the secretory bags, prostatic juice is synthesized and accumulated, including nutrients for sperm. It allows male sex cells to maintain their activity in the female body up to 5 days, which significantly increases the chances of fertilization.
The gland lighting occurs at the time of ejaculation. Prostatic juice is mixed with the secrets secret and represents 10 to 30% of the final volume of sperm. That's why,The prostate gland performs two main functions in a man's body:
- Participates in the urination process - maintains urine when muscle fibers are reduced and pass freely when they are relaxed;
- Provides the feasibility of sperm, distinguishing the prostatic juice of nutrients in ejaculation.
What is developing the disease?
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 may be any factors that lead to damage to the tissue of the gland and the destruction of their cells.
As in any other tissues, the inflammatory process in the prostate continues through certain stages:
- Change - Damage to prostate cells.Cytoplasm squirrels, cell nucleus fragments and membrane remains come out of cells destroyed in the intercellular space - they are all a sign of anguish to the immune system. Immunity cells begin to actively strive for the lesion, penetrating -in the blood vessels and connective tissue. They throw biologically active substances in the place of damage, under the influence of which blood vessels expand and the "reinforcement" of cells.
- Exudation - The release of the liquid part of the blood of the vessels.Under the influence of immunological cells, the walls of dilated vessels become permeable to plasma and rush into damage injury. If it is on the surface of an organ or hollow duct of the gland, the liquid part of the blood will be released into its lumen if the inflammation is tissue, the swelling will be formed. This measure is necessary to limit the focus of damage and prevent the additional spread of the pathogen.
- Proliferation is the replacement of damaged cells by similar ones or connective tissue.The proliferation mechanism is launched a little later on the events described above and its course depends directly on the depth of damage. Small outbreaks of prostate gland fabric destruction are replaced by the same functional cells and the organ restores its work fully. Deep disorders are allowed by scars - the replacement of dead tissue with connective tissue elements. Chronic prostatitis can lead to the complete atrophy of the prostate gland and the change of its secretory tissue to the scar.
For the proposed reason, prostatitis is divided into:
- Acute bacterial- Pathogenic microflora causes serious damage to prostate tissues with a pronounced inflammatory reaction. Most of the time, it develops with Gonococcus infection and other pathogens.
- Chronic bacterial-Association of pathogenic or conditionally pathogenic bacteria causes slow inflammation, whose activity remains for more than 2 months. As a rule, pathogens are streptococci, staphylococci, E. coli, klebsiella, mycoplasma, ureaplasma, chlamydia, herpesvirus and the candidate's fungi.
- 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 into the prostate gland ducts, venous blood stagnation in the pelvis, a violation of its emptying (rare or very frequent ejaculation). In the latter case, the disease is called stagnant prostatitis.
How does the disease manifest itself?
The easiest to diagnose acute prostatitis,that continues with signs of poisoning and pronounced inflammation. In a man, the temperature increases markedly to 38-39 degrees C, the pain pronounced in the perineum in the rectum area appears. They can give in to the groin, the testis, to the penis and to be so unbearable that a man's daily activity is right. In some cases, body temperature measured in the axillary cavity does not exceed normal indicators, but rectal in any case will be 1-2 degrees per normal. Signs of prostatitis also become a violation of urination: serious urinating impulses, after which it is impossible to restrict acute urine delay due to severe gland edema. Sometimes defecation becomes painful as the prostate increased in size stands out in the lumen of the rectum.
Chronic prostatitisIn its manifestations, it is so different that it can be easily confused with another pathology. In the most typical cases, the symptoms of prostatitis are presented:
- Groin pain, pelvis.It is difficult for the patient to determine a specific place where it is located, often the pain spreads in the groin, scrotum, head and penis bridge, sacred. Its gravity may be different: from almost not distinguishable to intense stupid or pulling. Often, pain is associated with urination or ejaculation, occurs at the end or early process.
- Violation of urination- The patient has frequent desires to empty the bladder, he needs to get up repeatedly at night to urinate. However, jet pressure is normal, urinary retention develops with little frequency.
- Sexual disorders- Against the background of constant discomfort in a man's groin, an erection worsens and self -confidence disappears. Violations are aggravated if the pain is associated with the moment of ejaculation: the patient cannot relax completely as he expects unpleasant sensations.
As a rule, with chronic prostatitis, the general well of a man is not disturbed, body temperature is preserved normal in the entire 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 find out the patient's contraception method, the presence of STDs in a sexual partner, the possibility of anal contacts without condom. These data facilitate diagnosis and direct the doctor's thoughts in the right direction. The prescription of disease symptoms or perineum discomfort allows us to judge the course of prostatitis and its severity. The urologist necessarily examines the patient's genitals and conducts a rectal examination of the prostate gland. To do this, he inserts a finger into the patient's rear pass and grope the protruding prostate into the front wall of the rectum. Pain and its size indicate the intensity of the inflammatory process.
In addition, the doctor conducts several instrumental, microscopic, bacteriological and immunological studies in order to clarify the cause of the disease. The most common diagnostic method is the 4 or 3 glass urine sample. The first method is more time than it consumes and difficult to practice in practice, as it requires the patient to consciously interrupt urination. The second modification is simpler: the patient urine continually in three different containers in equal portions. The first part speaks of the state of the urethra, the second about the pathology of bladder and kidneys, from 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 the urine, leukocytes are found and sometimes bacteria.
Access to prostate study and massage by collecting secrets
For microscopy, the secret of the prostate is also taken.To do this, the doctor performs a prostate massage through the rectum wall for some time to be emptied in the urethra. Smops are made with the material collected in the laboratory, painted and studied under a high increase. A sign of inflammation are leukocytes, bacterial etiology of the disease - bacteria in a smear. To determine the type of pathogen, the prostatic secret is sown in the nutrient media. If pathogenic microorganisms are present in it, after 3-5 days, they form microbial colonies, which can be studied by the bacteriological method, allows data on microflora sensitivity to antibiotics.
Of the methods of instrumental diagnosis : :
- Kidney ultrasound;
- Prostate Confidence with Dopplerography - An ultrasonic sensor is inserted into the rectum for better visualization of the prostate gland, its blood flow is additionally evaluated;
- Ugly rising, it is necessary with a stubborn recurring course of prostatitis. An X -ray contract is introduced into the urethra, after which several successive images are held.
Starting the treatment of chronic prostatitis, you should tune a long struggle, as it is not always possible to heal it in a few weeks or even months. It is recommended to combine various methods and tools for therapy, it is useful to improve drug therapy with families. With stagnant prostatitis, regular sex is necessary, interrupted sexual acts are unacceptable. Psycho -emotional formation of the patient is important: depression, depression, problems in personal life and sexual sphere are able to deny all the efforts of doctors.
How to prevent?
Prostatitis prevention includes:
- The use of barrier contraception methods (condom), especially when it comes to anal sex;
- Timely treatment of STDs;
- Regular sex life, bringing relationships to full ejaculation;
- Prevention of groin injuries when classes, traumatic sports should be used by all possible protection methods;
- Compliance with personal hygiene;
- Ensuring sufficient physical activity.
Although 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 these patients at first glance. To avoid this destination, you should be careful with your health, carefully protected with all new partners and treat sexually transmitted diseases in time. Prostatitis is not completely treated in all cases, but an experienced urologist is able to significantly improve the patient's condition and the quality of his life.