Prostatitis is the most common urological pathology in reproductive men. According to the polls, every third at least once in his life has had symptoms that can be interpreted as inflammation of the prostate gland. Despite such a great onset of pathology, prostatitis remains a poorly studied disease.To date, there is no consensus that it becomes a starting factor in inflammation, because it is possible to distinguish the pathogens of the IST from the parental parenting trait only in 10% of cases.
The absence of clear diagnostic criteria and characteristic signs of the disease complicate patient accounting. The symptoms of prostatitis are so non -specific that each doctor interprets them with a large part of subjectivity and can attribute it to a completely different pathology. Consequently, the approach to treatment also varies and often patients wander from one hospital to the other without positive dynamics for years. Prostatitis deprives a trusted man in his sexual strength, he hung his thoughts on a problem and does not bring him as physical as 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 under the bladder. It strictly wraps the urethra, forming one of its sfinter: a muscle jack designed to contain urine. In its shape and size, the prostate recalls a chestnut nut, with which it is often compared with anatomists. The part of the urethra, which passes inside the gland is called prostate. Its rear part of the prostate is in contact with the rectum, so it can be easily felt with a rectal finger exam. The front surface of the gland is close to the pubic joint and is connected with it with ligaments of the moving connective tissue and the venous plexus is located between them.
The prostate gland is made up of lobules, each of which is made by Alveoli - small bags flanked by secreted epithelium. The alveoli are interconnected from the output ducts in the form of pipes, which merge with each other, widen and eventually fall into the simplest part of the urethra. Inside the secretory bags, the prostate juice is synthesized and accumulated, which includes nutrients for sperm. It allows male sexual cells to maintain its activity in the female body up to 5 days, which significantly increases the possibilities of fertilization.
The lighting of the gland occurs at the time of ejaculation. The prostate juice is mixed with the secret of the testicles and represents 10-30% of the final volume of the sperm. As,The prostate gland performs 2 main functions in a man's body:
- Take part in the urination process - keeps the urine when the muscle fibers are reduced and passes it freely when they are relaxed;
- It provides the vitality of sperm, distinguishing nourishing prostate juice in ejaculation.
What is the disease developing?
Prostatitis is inflammatory changes in the prostate gland and it should be understood that they arise not only under the influence of the bacterial microflora.The causes of inflammation can be all the factors that lead to damage to the tissue of the gland and the destruction of its cells.
As in any other fabric, the inflammatory process in the prostate proceeds through certain phases:
- Alteration: damage to prostate cells. Cytoplasm squirrels, fragments of the cell nucleus and the remains of the membranes leave the cells destroyed in the intercellular space - all are a rescue signal for the immune system. Immunity cells begin to actively fight for injury, penetrating blood vessels and connective tissue. They launch biologically active substances into the place of damage, under the influence of which the blood vessels expand and the "reinforcement" arrives.
- Esudation: the release of the liquid part of the blood from the vessels.Under the influence of immune cells, the walls of the dilated vessels become plasma permeable and rushes into the damage injury. If it is on the surface of a cable organ or pipeline of the gland, the liquid part of the blood is released in its light, if the inflammation is woven, swelling is formed. This measure is necessary to limit the focus of the damage and prevent the further diffusion 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 outbreaks of the destruction of the fabric of the prostate gland are replaced by the same functional cells and the organ restores its work in full. Deep disorders are admitted through scars: the replacement of the dead tissue with connective tissue elements. Chronic prostatitis can ultimately lead to complete atrophy of the prostate gland and the change of its secretory tissue to cicatricial.
For the proposed reason, prostatitis is divided into:
- Acute bacterial- The pathogenic microflora causes serious damage to prostate tissues with a pronounced inflammatory reaction. Very often it develops with gonococcus infection and other pathogens.
- Chronic bacterial-Association of pathogenic bacteria or conditioned pathogens causes slow inflammation, whose activity remains for more than 2 months. As a rule, pathogenic agents are streptococci, staphylococci, E. coli, klebsiella, mycoplasma, ureaplasma, chlamydia, herpesvirus and candidate yeast mushroom.
- 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 ducts of the prostate gland, stagnation of venous blood in the pelvis, a violation of its emptying (rare or too frequent ejaculation). In the latter case, the disease is called stagnant prostatitis.
How does the disease manifest?
Easier acute prostatitis to diagnose,which proceeds with signs of intoxication and pronounced inflammation. In a man, the temperature increases abruptly to 38-39 degrees c, the pain pronounced in the perineum, in the rectum area , . They can give the groin, in the testicle, to the penis and be so unbearable that a man's daily activity is clearly disturbed. In some cases, the body temperature measured in the axillary cavity does not exceed normal indicators, but the rectal in any case will be 1-2 degrees for normal. Even the signs of prostatitis become a violation of urination: serious impulses of urinating, after which it is impossible to retain acute delay in the urine due to the serious edema of the gland. Sometimes defecation becomes painful, since the enlarged prostate of size protrudes into the lumen of the rectum.
Chronic prostatitisIn its events, it is so varied that it can be easily confused with another pathology. In the most typical cases the symptoms of prostatitis are presented:
- Pain in the horse, pelvis.It is difficult for the patient to determine a specific place in which it is located, often the pain spreads in the groin, scrotum, head and stern of the penis, sacred. Its gravity can be different: from just distinguishable to intense stupid or shot. Often, pain is associated with urination or ejaculation, it occurs in the end or at the beginning of the process.
- Violation of urination- The patient has frequent impulses of emptying the bladder, he must repeatedly get up at night to urinate. However, the pressure of the jet is normal, urinary retention rarely develops.
- Sexual disorders- Against the background of the constant discomfort in the horse of a man, an erection worsens and self -confidence disappears. Violations are aggravated if the pain is associated with the time of ejaculation: the patient cannot completely relax, since unpleasant sensations are expected.
As a rule, with chronic prostatitis, the general well -being of a man is not disturbed, body temperature is preserved normal throughout the disease.
How is the disease diagnosed?
The diagnosis is established by the urologist or andrologistAfter examining the patient, collect an anamnesis and study the symptoms. The doctor must discover the patient's contraception method, the presence of IST in a sexual partner, 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 gravity. The urologist necessarily examines the patient's genital organs and leads a rectal examination of the prostate gland. To do this, it inserts a finger in the back passage of the patient and tries the protruding prostate on the front wall of the rectum. Pain and its size indicate the intensity of the inflammatory process.
In addition, the doctor leads a series of instrumental, microscopic, bacteriological and immunological studies in order to clarify the cause of the disease. The most common diagnostic method is a 4 or 3 glass urine sample. The first method is more time and difficult to practice in practice, as it requires the patient several times to consciously stop urination. The second change is simpler: the patient urine continuously in three different containers in equal portions. The first part speaks of the state of the urethra, the second on the pathology of the bladder and kidneys, from the third, information is obtained on the state of the prostate gland. All the material collected is studied under a microscope. With prostatitis in the third portion of urine, there are leukocytes and sometimes bacteria.
Access for the study of the prostate and massage during the collection of secrets
For microscopy, the secret of the prostate gland is also taken.To do this, the doctor performs a prostate massage through the rectum wall for some time so that it is emptied in the urethra. The sums are made by the material collected in the laboratory, painted and studied with a high increase. A sign of inflammation are leukocytes, the bacterial etiology of the disease - bacteria in a strip. To determine the type of pathogen, the prostate secret is sown on nutritional means. If there are pathogenic microorganisms, after 3-5 days they form microbial colonies, which can therefore be studied with the bacteriological method allows to obtain data on the sensitivity of the microflora to antibiotics.
Of instrumental diagnostic methods, :
- Ultrasound of the kidneys;
- Prostate trust with dopplerography: an ultrasound sensor is inserted in the rectum for the best display of the prostate gland, its blood flow is also evaluated;
- Increased, it is necessary with a stubborn recurrent path of prostatitis. A X -ray contract is introduced into the urethra, after which a series of subsequent images are performed.
By starting the treatment of chronic prostatitis, you should tune in to a long fight, since it is not always possible to cure 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 needed, interrupted sexual acts are unacceptable. The patient -emotional background is important: depression, depression, problems in personal life and sexual sphere are able to cancel 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 IST;
- Regular sexual life, bringing relationships in full ejaculation;
- The prevention of horse injuries, when classes, traumatic sports should be used by all possible protection methods;
- Compliance with personal hygiene;
- Ensure sufficient physical activity.
Despite the fact that 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 sex weakness, tired of prolonged treatment, changes significantly externally and expert doctors define these patients at first sight. To avoid such a destiny, you should be careful of health, carefully protected with each new partner and treat sexual transmission diseases in time. Prostatitis is not completely treated in all cases, but an expert urologist is able to significantly improve the patient's condition and the quality of his life.