Acute prostatitis is characterized by a pronounced clinical picture. The pathology is dangerous with a number of serious complications, which is why it needs timely and complex treatment. How to recognize and treat the disease is described in this article.
Acute prostatitis is an inflammatory disease that is accompanied by severe pain and can be a major health hazard. For a successful prognosis of the disease you should consult a doctor in time for diagnosis and prescribing competent treatment.
General characteristics of the disease
Acute prostatitis is a rapidly developing inflammatory process in the prostate gland. It has four stages of development:
- Catarrhal.At this stage, the gland is slightly swollen, the inflammation affects only the mucous membranes of the secretory ducts of the gland. This period is the most favorable time for treatment - if you start at this time, you can get rid of the disease in less than two weeks. The nature of the inflammation is not purulent, but the swelling that occurs clogs the ducts, preventing the secretion from leaving the gland. Stagnation begins.
- Follicular.As a result of stagnation, the bacteria that have entered the body begin their activity already in it. Because the organ is made up of cells grouped into lobules and separated by connective tissue, the inflammation first affects one part.
- Parenchymal.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 bladder full of purulent contents forms in the gland. Over time, it can burst, pus spreading, falling into the space around the prostate and bladder, urethra or rectum. When an abscess opens, the pus does not come out completely and this becomes a new round in the inflammatory process.
How quickly the pathological process will develop and how it will end depends on a number of factors: the causes of inflammation, the timeliness and appropriateness of treatment.
Reasons
In 90% of cases, the cause of acute inflammation of the prostate is an infectious lesion. The causative agents can be one or more types of bacteria and viruses:
- Gonococci are one of the most dangerous bacteria, they quickly begin purulent processes.
- Trichomonas is a leader among sexually transmitted microorganisms. Therefore, penetrating the intercellular space of the gland requires a long persistent treatment.
- Chlamydia - in addition to toxicity, they are able to stick to red blood cells, increasing the rate of sedimentation and impeding blood circulation in the affected area. They penetrate deeper than Trichomonas.
- Staphylococci, the golden species is especially common. It can survive in all tissues and organs, causing pus and making the blood thicker.
- Ureaplasma is a cross between unicellular and viruses. It can enter the prostate from the urinary tract or through unprotected intercourse.
- Escherichia coli is a gram-negative bacterium, a common cause of acute inflammation. It enters the body as a result of inadequate hygiene during food preparation.
This is not a complete list of bacteria and viruses that can cause acute inflammation of the prostate gland.
Often the cause lies not only in infections that can live in the body for a long time without almost any symptoms. They begin to develop rapidly when there are contributing factors:
- Regular or single hypothermia. The cold weakens the body's defenses and makes it harder for them to contain pathogenic bacteria, especially if the hypothermia is associated with daily work.
- Irregular sex life. Stagnation of glandular secretion (which is an integral part of semen) promotes the growth of bacteria.
- Running infections. These can be infections that result from unprotected sex, or bacteria that have caused mild inflammation in the urinary tract. The effects of a sore throat that is not completely cured in the form of streptococci can also provoke inflammation. Even tooth decay can cause prostatitis.
- Weakened immunity. If as a result of illness or uncontrolled intake of antibiotics the body's defenses become insufficient, the bacteria will certainly appear.
- Failure to follow the rules of personal hygiene.
Symptoms of acute prostatitis
The symptoms depend on the stage of the disease.
In the period of catarrhal prostatitis there is a slight discomfort and a feeling of heaviness in the perineum, the desire to use the toilet at night becomes more frequent. Urination is accompanied by burning and pain. The gland itself is normal or uncritically enlarged, palpation causes pain. The temperature remains normal or rises slightly. No intoxication, general well-being.
The follicular period has more manifestations. The pain increases, becomes constant, sometimes radiating sharply to the penis, sacrum or rectum. Urinary retention occurs as urination is difficult due to acute pain. Defecation is also accompanied by severe pain.
The temperature rises to 38 degrees and remains at that level. The prostate gland noticeably increases in size, has a thick consistency, is tense, touching it in places causes sharp pain.
Parenchymal prostatitis is very difficult. Appetite disappears, chills appear, general weakness. The frequent urge to go to the toilet with a short urination is replaced by acute urinary retention. Attempting to empty the bladder or bowel becomes almost impossible due to the unbearable pain. It is aggravated by constipation and full bladder, spreads throughout the perineum, slight relief can occur only in a supine position with legs folded.
The temperature rises above 39 degrees. Inflammation begins to spread to other organs, mucus is secreted from the rectum. The prostate gland has a vague outline, is enlarged and painful. Palpation may not be possible due to swelling.
The formation of an abscess is accompanied by the localization of the point of acute pain - where the abscess appeared. Excretion of urine, feces and gas is extremely difficult, accompanied by severe throbbing pain that spreads in the intestines. The temperature is maintained above 39, 5 degrees, chills, fever and sometimes a delusional state appears.
Then relief comes unexpectedly: the pain disappears, the temperature drops. However, this does not mean that the patient has recovered: the fact is that the abscess has ruptured and urgent procedures are now needed to cleanse the body of pus, because the negative consequences can be very varied.
Diagnosis
The diagnosis is made on the basis of an assessment of the patient's complaints, analysis of urine, blood and prostate secretion. In addition, they use the method of digital rectal diagnosis, ultrasound and CT.
The severity of urinary disorders is assessed using uroflowmetry.
The general analysis of urine allows you to identify the disease in the earliest stages, when the characteristic symptoms are still absent. The alkaline acidity index itself indicates the development of inflammation.
Bacteriological examination of urine allows you to determine the nature of inflammation and its causes. Changes in the color, odor or consistency of urine are not considered absolute evidence of acute prostatitis.
Complete blood count is the basis for the study of the disease. Typical indicators of acute prostatitis are low hemoglobin levels (normal 130 g / l), high urea and creatinine levels, as well as leukocyte levels and erythrocyte sedimentation rate. The protein should not be normal, as well as a high level of leukocytes - there should not be more than 5 units.
The specific analysis of PSA allows you to identify not only inflammation but also malignancy.
PCR testing allows you to quickly identify genital infections, which are often the cause of acute prostatitis.
Ultrasound allows you to determine the size of the prostate gland, its edges, the presence of punctate and diffuse changes. If an abscess has formed, this test can determine its size and location. If possible, the study is performed transrectally; if the pain and swelling do not allow this, the examination of the gland is performed on the side of the abdomen.
Sometimes ultrasound is performed by observing the change in the frequency of the sound reflected by the organ. This allows you to assess the blood supply to the prostate - vascularization, which can be increased or decreased depending on the type of inflammation and its stage. Allows you to distinguish a cancerous tumor from acute prostatitis.
If the doctor deems surgery necessary, he or she prescribes a CT scan or MRI to examine the details of the inflammatory process.
Treatment of acute prostatitis
Disease therapy is always complex, involving taking various medications, procedures and diet. The treatment can last about 2 months.
The main task of the doctor is to eliminate the cause of inflammation, which most often consists of infection. For this, antibiotics are prescribed (alone or in combination). The choice of drug depends on several factors:
- pathogen susceptibility;
- concomitant diseases of the patient;
- mode of action of the drug.
Self-diagnosis and therapy are not possible: an effective drug is selected on the basis of laboratory tests
Third-generation fluoroquinolones and cephalosporins are most commonly used to control the causes of acute inflammation. For the treatment of acute prostatitis, the bactericidal effect of the antibiotic is essential.
Depending on the stage and condition of the patient, the dose and form of drug release are chosen: the more neglected the situation, the higher the dose and the more important it is for the drug to reach its destination faster, therefore, the drugsin the form of injections are preferable to tablets.
It is necessary to normalize the flow of urine and secretions. If urinary retention has progressed to an acute form, trocar epicystomy is prescribed - a puncture of the bladder, followed by the introduction of a thin tube.
If such drastic measures are not necessary, nonsteroidal anti-inflammatory drugs are prescribed to restore normal urination, which eliminate swelling and pain. The drugs are prescribed in the form of tablets, injections or rectal suppositories.
If acute prostatitis has become an abscess, treatment depends on what stage it is. The stage of infiltration is treated with active therapy with antibiotics and immunostimulants. Blockade with painkillers is given to help the patient overcome the pain.
If an abscess has formed, treatment is possible only with the help of surgery: the purulent bladder is opened, washed and drainage is installed. After the operation, microbial therapy and intoxication are prescribed.
Treatment of acute prostatitis is not limited to relieving symptoms. The course of antibiotics should be taken until the end, not until the pain disappears.
After removing the seizure itself, it is time for physiotherapy. It includes UHF and microwave procedures, electrophoresis and prostate massage. The purpose is to relieve swelling (if any), to improve the outflow of secretions from the glands to avoid congestion.
It is important to stick to your diet throughout the course of treatment. You must refuse the following products:
- alcoholic beverages, coffee, fried and salted - contributes to the appearance of congestion;
- white cabbage, apples, legumes and raw vegetables - cause bloating, as a result of which the pelvic organs, including the prostate, are compressed;
- sour drinks, offal - irritate the urinary tract.
The diet should include cereals, stewed vegetables, dairy products and baked goods. All this contributes to the normal functioning of the intestines. It is necessary to follow the drinking regime by drinking at least 2 liters of fluid (water, fruit drinks, juices) per day. The more often the urinary tract becomes red, the lower the risk of inflammation.
Vitamin complexes and peptides should be taken to improve tissue regeneration and the rapid restoration of normal gland function.
The favorable course of treatment is judged by the recovery of glandular tissues, the normalization of the chemical indications for prostate secretion, the absence of pathogens in the analysis and the general well-being of the patient.
Prognosis and complications
The earlier treatment is started, the faster and easier it is to get rid of acute prostatitis. Complication is any subsequent stage of the disease, the chronic course of the disease, the spread of inflammation to other organs, infertility, sepsis. If the disease has started, the gland itself may need to be removed.
With timely treatment, at the end of the course of therapy, all body functions are restored, performance is fully restored.
Prevention
Preventive measures include the absence of unprotected intercourse (to exclude STIs), careful hygiene and timely treatment of inflammatory processes in the urinary tract. It is necessary to maintain immunity, not to start carious teeth and to carefully treat any infectious diseases.
You should also rule out factors that contribute to the development of the disease. For this you need:
- lead a regular sex life with one partner;
- avoid hypothermia (both permanent and single);
- to give up alcohol, smoking and sedentary lifestyle;
- regularly undergo a routine examination by a urologist;
- do not self-medicate at the first signs of inflammatory processes;
- follow a balanced diet;
- take vitamins, especially during periods of spread of infectious diseases.
Acute inflammation of the prostate occurs due to infections that develop under favorable circumstances. The treatment is carried out with antibiotics, anti-inflammatory drugs, painkillers and vitamins. During therapy it is important to adhere to a diet and drinking regime.