Prostatitis is an inflammation of the prostate gland of a person.The prostate is just under the bladder and the size of a chestnut.About the first section of the urethra and extends to the pelvic floor so called, which consists of muscles.
Prostate produces secretion, which includes PSA and sperm.PSA makes more liquid ejaculate.Spermina is important for the mobility of spermatozoa.
Prostatitis is mainly associated with severe pain in the perineum and in the anal region.In addition, symptoms such as urination frequency, pain during urination and pain during ejaculation occur during inflammation of the prostate.
The prostate is relatively influenced by inflammation.The probability of prostate infection increases with age.Studies show that most cases aged 40 and 50.
Prostatitis syndrome
At the same time, an expanded understanding of the term prostatitis appeared in medicine.With prostatitis syndrome so called, several complaints are summarized in the area of the human basin, which usually have an unknown reason.The term "prostatitis syndrome" summarizes various clinical paintings:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Inflammatory and non -inflammatory syndrome of chronic pelvic pain
- Asymptomatic prostatitis
Acute and chronic bacterial prostatitis
Acute prostatitis is caused by bacteria.The bacteria pass through the blood to the prostate or spread from the bacterial infection of the bladder or urethra to the prostate.Acute prostatitis is usually a serious general condition with severe pain during urination, fever and chills.
Chronic prostatitis can develop from acute: if for more than three months there is inflammation of the prostate gland and repeated microbes in the urine, the prostate thus called or ejaculated, then they are chronic inflammation.
Bacterial prostatitis.This is less speed of the lightning of acute prostatitis.Although chronic inflammation of the prostate gland causes pain during urination and, possibly, a feeling of pressure in the perineum, but complaints are usually not expressed as in acute prostatitis.
Chronic pelvic pain syndrome (abacterial prostatitis)
In most cases, prostate infections, bacteria cannot be detected in the urine, prostate or ejaculate as the cause of the disease.The trigger of prostatitis remains unclear.Doctors call it chronic pelvic pain.
However, in such cases, leukocytes can often be detected as an expression of inflammation in the prostate gland.To differentiate this, another form of the disease in which bacteria or leukocytes are not detected.Chronic pelvic pain syndrome is the most common form of prostatitis.
Asymptomatic prostatitis
In rare cases, asymptomatic prostatitis occurs.With this form of prostatitis, although there are signs of inflammation, but there is no pain or other symptoms.Asymptomatic prostatitis is generally detected by chance, for example as part of an infertility study.
Prostatitis: symptoms
Prostate inflammation can cause various symptoms of prostatitis.Although the symptoms of acute prostatitis can be very serious and cause a strong sense of malaise, with chronic prostatitis, they are usually a little weaker.
Acute prostatitis: symptoms
Acute prostatitis is often an acute disease in which patients suffer from fever and chills.The urination causes burning pain and the flow of urine is significantly reduced due to the edema of the prostate gland.Since the victims can only distinguish a small amount of urine, they have a constant frequency of urination and often should go to the bathroom.Other symptoms of prostatitis include bladder, pelvic pain and back pain.Pain can also occur during or after ejaculation.
Chronic prostatitis: symptoms
Prostatitis with a chronic course usually causes less serious symptoms than an acute inflammation of the prostate.Symptoms such as fever and chills are generally completely absent.Symptoms, such as a feeling of pressure in the perineum or in the lower abdomen, the darkening of ejaculate due to blood in sperm or in the blood in the urine is typical for chronic inflammation of the prostate. The symptoms of chronic bacterial and chronic abobinterial prostatitis do not differ.
Complications of prostatitis
The most common complication is the abscess to the prostate.The abscess of the prostate gland is a purulent inflammation of inflammation, which usually must be open and empty with a cut.
As further complication of the inflammation of the prostate, inflammation can apply to nearby structures, such as the appendix of the testicle or testicles.There are also suspicions that chronic prostatitis is associated with the development of prostate cancer.
Prostatitis: causes and risk factors
Bacterial prostatitis: causes
Only ten percent of prostatitis cases is caused by a prostate bacterium.Bacteria can enter the prostate through blood or nearby organs, such as bladder or urethra, where they can lead to an inflammatory reaction.
The bacterium of Escherichia coli, which is mainly found in the human intestine, is the most common cause of prostatitis.Klebsiella, Enterococci or mycobacteria can also cause prostatitis.Bacterial prostatitis can also be caused by sexual transmission diseases such as clamidia or tricomonas infections, as well as gonorrhea.
In chronic prostatitis, bacteria in the prostate gland have avoided the way not yet clarified to protect the human immune system.This allows microbes to constantly colonize the prostate.Antibiotics are relatively poor in the fabric of the prostate gland, which can be another cause of the survival of bacteria in the prostate gland.
Chronic pelvic pain syndrome: causes
The exact causes of chronic pelvic pain syndrome have not yet been completely studied.Scientists have appointed many theories, each of which seems plausible, but all have not yet been clearly demonstrated.In some cases, the genetic material of previously unknown microorganisms was found in the basin.Therefore, the cause of pelvic pain syndrome can be microorganisms that cannot yet be grown in the laboratory and, therefore, are not detected.
Another possible cause of chronic pelvic pain are bladder disorders.Due to compromised drainage, the volume of the bladder increases, which thus presses on the prostate.This pressure eventually damages the fabric of the prostate gland, causing inflammation.
However, in many cases, the cause of chronic pelvic pain cannot be clearly demonstrated.So doctors speak of idiopathic prostatitis.
Anatomical causes
In rare cases, prostatitis is caused by the narrowing of the urinary tract.If the urinary tract is restricted, the urine accumulates and, if it enters the prostate, it can also cause inflammation.This narrowing can be caused by tumors or prostate calculations so called.
Mental reasons
Recently, more and more psychological causes of prostatitis have been discussed.In particular, with the non -inflammatory syndrome of chronic pelvic pain, a mental trigger is likely.The exact mechanisms are still unknown.
Risk factors for the development of prostatitis
Some men are particularly at risk of developing prostate infection.These include, for example, men with a violation of the immune system or suppressed by the immune system.In addition, main diseases, such as diabetes mellitus, can contribute to the development of prostatitis: an increase in blood sugar level in patients with diabetes often leads to an increase in the sugar level in the urine.The abundant sugar content in the urine can provide bacteria with good growth conditions, facilitating the development of urinary tract infections.
Another risk factor in the development of prostatitis is the bladder coating.The introduction of a catheter through the urethra through the urethra can cause small ruptures of the urethra and damage to the prostate gland.In addition, as on any foreign body, bacteria can be satisfied with the bladder and form the biofilm so called.As a result, bacteria can climb along the urethra to the bladder, as well as bringing prostate infection.
Prostatitis: exams and diagnostics
A general practitioner can take a medical history, but if there is a suspicion of prostatitis, he will direct you to a urologist.This performs a physical examination.In case of suspicion of prostatitis, this is usually the digital rectal study so called.However, this study does not provide a clear evidence of prostate inflammation, but only confirms suspicion.To detect bacterial prostatitis, a laboratory exam can be carried out
Rectal examination of the finger
Since the prostate gland borders directly with the rectum, it can be palpated in the rectum.This digital rectal study is conducted on an outpatient basis and without anesthesia, usually painless.The patient is asked to lie down with his legs bent.Using a lubricant, the doctor slowly inserts the finger into the anus and scanches the prostate and adjacent organs.Examines the size and sensitivity to pain in the prostate gland.
Laboratory exam
To identify possible pathogens in most cases, urine analysis is carried out.The standard method is the sample so called of four glasses.Here Ertuin, Mittelstrahluin, Prostatataexprimat and Urin are tested after prostate massage.As ProstataxPrimat called, doctors call the prostate secretion.This is achieved by a doctor from light pressure on the prostate, for example, on palpation.Ejaculate can also be tested for pathogenic microorganisms and signs of inflammation.
Further searches
The ultrasound scan of the rectum can be used to determine exactly where inflammation is located and how much it spreads.An important goal of the study is also the exclusion of other diseases with similar symptoms.
To exclude that the existing violation of urine drainage is caused by the narrowing of the urethra, urinary flow is measured.The normal flow of urine is between 15 and 50 milliliters per second, while the urine flow is ten milliliters per second or not, there is a high probability of obstruction of the urethra.
Prostatitis: treatment
Drug therapy
Acute bacterial prostatitis is treated with antibiotics.In slight cases, the dose of the antibiotic is sufficient for about ten days.In chronic prostatitis, the drug should be taken for a longer period of time.Depending on the pathogenic microorganisms, the active substances of luxacin, ciprofloxacin, azithromycin, erythromycin or doxicicline are suitable.Even if the symptoms are already falling, antibiotics in any case should be continued in accordance with the appointment of a doctor.
In addition, asymptomatic prostatitis is treated with antibiotics.
If there is chronic abotteric prostatitis, antibacterial therapy is generally ineffective.With the inflammatory syndrome of chronic pelvic pain, despite the lack of evidence of the presence of pathogens, a study is conducted using antibiotics, since sometimes it is possible to obtain an improvement.However, with the non -inflammatory chronic pelvic pain syndrome, antibiotic therapy is not recommended.
Other therapeutic approaches to chronic abotic prostatitis are the so-called 5α-deductase inhibitors, such as fineride or dutasteride, pentosan politefatoes and vegetable drugs, such as oak or dust extract.If the improvement is not reached, drug therapy will be integrated with physiotherapy.Here we recommend physiotherapy exercises, exercises for the muscles of the pelvic floor or regular prostate massage.
In addition, symptomatic therapy can help relieve the acute symptoms of prostate infection.Anesthetic drugs can be prescribed for severe pain.In addition, heating bearings and heating bearings on the back or lower abdomen help to relax the muscles.This often relieves pain with the inflammation of the prostate.
Fell
The frequency of prostatitis relapse is generally very high.About 23 percent of the victims is subject to the second episode of the disease after a disease, 14 percent suffers from three and 20 percent - even from four or more cases of illness.To reduce the risk of relapse, avoid wearing wet clothing during or after prostatitis, hypothermia or use of bubbles, such as black tea or coffee.This reduces the risk of cystitis and, therefore, prostatitis.However, it is not possible to reliably prevent bacterial prostatitis using these methods.
The prognosis of prostatitis depends, on the one hand, on the cause of inflammation and on the other, on the speed with which correct therapy begins.
In acute bacterial prostatitis, which is treated as soon as possible with antibiotic therapy, the prognosis is generally good.Taking antibiotics, pathogens, which usually prevent the transition to chronic prostatitis.
About 60 percent of all patients with acute prostatitis has no more symptoms in six months and about 20 percent develop chronic prostatitis.Treatment and prognosis are more difficult here.In many cases, periodic episodes of the disease arise that can accompany those who suffer for many years.
Chronic prostatitis usually requires great patience from victims.Very often a long course can be a serious psychological burden.
Patients who have suffered should seek professional help, since the mental health situation has a huge impact on prostatitis forecast.