Acute prostatitis is characterized by a pronounced clinical picture. The pathology is dangerous with a number of serious complications, so it requires timely and complex treatment. How to recognize and treat a disease is described in this article.
Acute prostatitis is an inflammatory disease that is accompanied by pronounced painful sensations and can pose a great threat to health. For a successful prognosis of the disease, you should consult a doctor in a timely manner to diagnose and prescribe competent treatment.
General characteristics of the disease
Acute prostatitis is a rapidly developing inflammatory process in the prostate. It has four stages of development:
- Catarrhal.At this stage, the gland swells a little, the inflammation affects only the mucous membranes of the excretory ducts of the gland. This time is the most favorable time for treatment - if you start at this point you can get rid of the disease in less than two weeks. The nature of the inflammation is not purulent, but the edema that occurs clogs the ducts and prevents the secretion from leaving the gland. Standstill begins.
- Follicular.As a result of stagnation, bacteria that have invaded the organ start their activity there. Since the organ consists of cells that are grouped in lobules and separated by connective tissue, the inflammation initially affects one part.
- Parenchyma.The inflammation passes from one lobule to another, there are many pustules in different parts of the gland.
- Purulent abscess.The pustules merge into one, and a blister filled with purulent contents is formed in the gland. Over time, it can burst, pus spreads and gets into the space around the prostate and bladder, urethra or rectum. When an abscess is opened, pus does not come out completely and this becomes a new round in the inflammatory process.
How quickly the pathological process develops and how it will end depends on a number of factors: the reasons for inflammation, timeliness and adequacy of treatment.
causes
In 90% of cases, the cause of acute prostate inflammation is an infectious lesion. The pathogens can be one or more types of bacteria and viruses:
- Gonococci are one of the most dangerous bacteria, they quickly trigger purulent processes.
- Trichomonas is the leader among sexually transmitted microorganisms. Penetrates into the intercellular space of the gland, therefore requires long persistent treatment.
- Chlamydia - In addition to toxicity, they are able to stick together erythrocytes, increase their sedimentation rate and impede blood flow in the affected area. They penetrate deeper than Trichomonas.
- Staphylococci, the golden appearance, are particularly common. It can survive in all tissues and organs, causing suppuration and making the blood thicker.
- Ureaplasma is a cross between protozoa and viruses. May enter the prostate through the urinary tract or through unprotected intercourse.
- Escherichia coli is a gram-negative bacterium, a common cause of acute inflammation. It gets into the body through inadequate hygiene during food preparation.
This is not an exhaustive list of the bacteria and viruses that can cause acute inflammation of the prostate.
Often the reason is not only due to infections that can live in the body for a long time with almost no symptoms. They begin to develop quickly if there are contributing factors:
- Regular or one-off hypothermia. Cold weakens the body's defenses and makes it harder for it to contain pathogenic bacteria, especially when hypothermia is associated with daily work.
- Irregular sex life. The stagnation of the secretion of the gland (which is an essential part of the sperm) promotes the multiplication of bacteria.
- Ongoing infections. These could be infections caused by unprotected sex or bacteria that caused mild inflammation of the urinary tract. The consequences of an incompletely healed purulent sore throat in the form of streptococci can also cause inflammation. Tooth decay can also cause prostatitis.
- Weakened immunity. If the body's defenses become insufficient due to illness or uncontrolled use of antibiotics, the bacteria are sure to manifest themselves.
- Failure to comply with the rules of personal hygiene.
Symptoms of acute prostatitis
Symptoms depend on the stage of the disease.
During catarrhal prostatitis, there is a slight discomfort and a feeling of heaviness in the perineum, the urge to use the toilet at night becomes more frequent. Urination is accompanied by burning sensation and pain. The gland itself is enlarged normally or uncritically, the palpation examination causes pain. The temperature remains normal or increases slightly. No intoxication, general wellbeing.
The follicular period has more manifestations. The pain grows, becomes constant, sometimes radiates sharply into the penis, sacrum or rectum. Urinary retention occurs because urination is difficult due to acute pain. The bowel movement is also accompanied by severe pain.
The temperature rises to 38 degrees and remains at this level. The prostate noticeably increases in size, has a dense consistency, is tense, touching in some places causes severe pain.
Parenchymal prostatitis is very difficult. Appetite disappears, chills appear, general weakness. Frequent use of the toilet with short urination is replaced by acute urinary retention. Trying to empty the bladder or bowel becomes almost impossible due to the excruciating pain. It is aggravated by constipation and a full bladder, spreads all over the perineum, slight relief can only come in the prone position with legs drawn up.
The temperature rises to over 39 degrees. The inflammation begins to spread to other organs, mucus is secreted from the rectum. The prostate is indistinct, enlarged, and painful. Palpation may not be possible due to edema.
The formation of an abscess is accompanied by the localization of the acute point of pain - where the abscess appeared. The passage of urine, stool and gas is extremely difficult, accompanied by severe throbbing pain that spreads to the intestines. The temperature is kept above 39. 5 degrees, chills, fever and sometimes a delusional state occur.
Then comes unexpected relief: the pain disappears, the temperature drops. But this does not mean that the patient has recovered: the fact is that the abscess has burst, and now urgent procedures are needed to cleanse the pus body, since the negative consequences can be very different.
diagnosis
The diagnosis is made on the basis of an assessment of the patient's symptoms, an analysis of urine, blood and prostate secretions. In addition, they use the method of digital rectal diagnostics, ultrasound and CT.
The severity of urinary tract diseases is assessed using uroflowmetry.
A general urinalysis allows you to identify the disease at its earliest stage, when the characteristic symptoms are still absent. The alkaline acid index itself indicates the development of inflammation.
Bacteriological examination of the urine allows you to determine the nature of the inflammation and its causes. Changes in the color, smell or consistency of the urine are not absolute indicators of acute prostatitis.
A complete blood count is the basis for investigating the disease. The characteristic indicators of acute prostatitis are low hemoglobin values (normally 130 g / l), high urea and creatinine values, as well as the leukocyte level and the erythrocyte sedimentation rate. Protein shouldn't be normal, as should a high level of white blood cells - it shouldn't be more than 5 units.
The specific analysis of PSA allows you to identify not only inflammation, but also malignant formations.
PCR research allows you to quickly identify genital infections that are often the cause of acute prostatitis.
Ultrasound allows you to determine the size of the prostate, its margins, the presence of punctiform and diffuse changes. If an abscess has formed, this study can determine its size and location. If possible, the study will be carried out transrectally; If the pain and swelling prevent this, the gland is examined from the side of the abdomen.
Sometimes ultrasound is performed while observing the change in the frequency of the sound reflected from the organ. This allows you to assess the blood supply to the prostate - vascularization, which can increase or decrease depending on the type of inflammation and its stage. Allows you to differentiate a cancerous tumor from acute prostatitis.
If the doctor determines that surgery is needed, they will prescribe a CT scan or MRI to examine the details of the inflammatory process.
Treatment of acute prostatitis
Disease therapy is always complex and involves taking various medications, procedures, and diet. Treatment can last about 2 months.
The main task of the doctor is to get rid of the cause of inflammation, which most often consists in infection. For this, antibiotics are prescribed (alone or in combination). The choice of a drug depends on several factors:
- the sensitivity of the pathogen;
- Comorbidities of the patient;
- How the drug works.
Self-diagnosis and therapy are impossible: an effective drug is selected on the basis of laboratory tests
To combat the causative agents of an acute inflammatory process, fluoroquinolones and third-generation cephalosporins are most often used. The bactericidal effect of the antibiotic is of fundamental importance for the treatment of acute prostatitis.
Depending on the stage and condition of the patient, the dosage and form of release of the drug are chosen: the more neglected the situation, the higher the dose and the more important it is that the drug gets to its destination faster. Drugs in the form of injections are preferable to tablets.
It is necessary to normalize the outflow of urine and secretions. When urinary retention has turned into an acute form, a trocar epicystomy is prescribed - a puncture of the bladder, followed by the introduction of a thin tube.
When such drastic measures are not required, nonsteroidal anti-inflammatory drugs are prescribed to restore normal urination, which will remove swelling and pain. The drugs are prescribed in the form of tablets, injections, or rectal suppositories.
If acute prostatitis has turned into an abscess, treatment depends on what stage it is at. The infiltration stage is treated with active therapy with antibiotics and immunostimulants. A blockade is given with pain relievers to help the patient overcome the pain.
If an abscess has formed, treatment is possible only with the help of surgical intervention: the purulent bladder is opened, washed, and a drain is installed. After the operation, therapy to fight microbes and poisoning is prescribed.
Treatment for acute prostatitis is not limited to symptom relief. The course of antibiotics must be drunk until the end, not until the pain goes away.
After the seizure itself has been removed, it's time for physical therapy. It includes UHF and microwave procedures, electrophoresis, and prostate massage. The aim is to relieve swelling (if left on), to improve the outflow of glandular secretions in order to avoid congestion.
It is important to stick to your diet throughout treatment. You must decline the following products:
- alcoholic beverages, coffee, fried and salted - contributes to the appearance of jams;
- white cabbage, apples, legumes and raw vegetables - cause flatulence, which compresses the pelvic organs, including the prostate;
- acidic drinks, offal - they irritate the urinary tract.
The diet should include cereals, steamed vegetables, dairy products, and baked fruits. All of this contributes to normal bowel function. It is necessary to adhere to the drinking regime and drink at least 2 liters of liquid (water, fruit drinks, juices) per day. The more often the urinary tract is flushed, the lower the risk of inflammation.
Vitamin complexes and peptides should be drunk to improve tissue regeneration and the rapid restoration of normal glandular function.
The favorable course of treatment is judged by the restoration of glandular tissue, the normalization of the chemical indications of prostatic secretions, the absence of pathogens in the analyzes and the general well-being of the patient.
Prognosis and complications
The earlier treatment was started, the faster and easier it is to get rid of acute prostatitis. Complication is any next stage of the disease, the chronic course of the disease, the spread of inflammation to other organs, infertility, sepsis. Once the disease has started, it may be necessary to remove the gland yourself.
With timely treatment, at the end of the course of therapy, all functions of the body are restored, the ability to work is fully restored.
prevention
Preventive measures include the absence of unprotected sexual intercourse (to rule out STIs), careful hygiene and timely treatment of inflammatory processes in the urinary tract. It is necessary to maintain immunity, do not get carious teeth and carefully treat all infectious diseases.
You should also exclude factors that contribute to the development of the disease. To do this, you need:
- have a regular sex life with a partner;
- Avoid hypothermia (both permanent and one-off);
- refrain from alcohol, smoking and a sedentary lifestyle;
- regularly undergo a routine examination by a urologist;
- do not self-medicate at the first signs of inflammatory processes;
- stick to a balanced diet;
- take vitamins, especially in times of the spread of infectious diseases.
Acute inflammation of the prostate occurs due to infections that develop under favorable circumstances. Treatment is with antibiotics, anti-inflammatory drugs, pain relievers, and vitamins. It is important to maintain a diet and drinking schedule during therapy.