Acute prostatitis is characterized by a pronounced clinical picture. Pathology is dangerous with a number of serious complications, therefore it needs timely and complex treatment. How to recognize and treat a disease is described in this article.
Acute prostatitis is an inflammatory disease, which is accompanied by pronounced painful sensations and can pose a great danger to health. For a successful prognosis of the disease, you should consult a doctor in time for diagnosis and prescription of 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 swells a little, the inflammation affects only the mucous membranes of the excretory ducts of the gland. It is this period that is the most favorable moment for treatment - if you start it at this moment, you can get rid of the disease in less than two weeks. The nature of the inflammation is not purulent, but the edema that appears clogs the ducts, preventing the secretion from leaving the gland. Stagnation begins.
- Follicular.As a result of stagnation, bacteria that have entered the organ begin their activity already in it. Since the organ consists of cells grouped into lobules and separated by connective tissue, inflammation first affects one part.
- Parenchymal.Inflammation passes from one lobule to others, there are many pustules in different parts of the gland.
- Purulent abscess.The pustules merge into one, and a bladder filled with purulent contents forms in the gland. Over time, it can burst, pus spreads, getting 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 will develop and how it will end depends on a number of factors: the reasons for the inflammation, the timeliness and expediency of the treatment received.
Causes
In 90% of cases, the cause of acute inflammation of the prostate is an infectious lesion. The causative agents can be one or several types of bacteria and viruses:
- Gonococci are one of the most dangerous bacteria, they quickly start purulent processes.
- Trichomonas is the leader among sexually transmitted microorganisms. Penetrates into the intercellular space of the gland, therefore, requires a long stubborn treatment.
- Chlamydia - in addition to toxicity, they are able to glue erythrocytes, increasing their sedimentation rate and impeding blood circulation in the affected area. They penetrate deeper than Trichomonas.
- Staphylococci, the golden appearance is especially common. It can survive in any tissues and organs, causes suppuration and makes the blood thicker.
- Ureaplasma is a cross between unicellular and viruses. Can enter the prostate from the urinary tract or through unprotected intercourse.
- Escherichia coli is a gram-negative bacterium, a frequent causative agent 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 reason lies not only in infections that can live in the body for a long time with almost no symptoms. They begin to develop rapidly when there are contributing factors for this:
- Regular or one-time hypothermia. Cold weakens the body's defenses and it is more difficult for them to contain pathogenic bacteria, especially if hypothermia is associated with daily work.
- Irregular sex life. Stagnation of the secretion of the gland (which is an integral part of the sperm) promotes the multiplication 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 consequences of a purulent sore throat 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 manifest themselves.
- Failure to comply with the rules of personal hygiene.
Symptoms of Acute Prostatitis
Symptoms depend on the stage of the disease.
During the period of 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 and pain. The gland itself is normal or noncritically enlarged, palpation examination causes pain. The temperature remains normal or slightly rises. No intoxication, overall well-being.
The follicular period has more manifestations. The pain grows, becomes constant, sometimes sharply radiates to the penis, sacrum or rectum. Retention of urine appears, since urination is difficult due to acute pain. Defecation is also accompanied by severe pain.
The temperature rises to 38 degrees and remains at this level. The prostate gland noticeably increases in size, has a dense consistency, is tense, touching it in some places causes severe pain.
Parenchymal prostatitis is very difficult. Appetite disappears, chills appear, general weakness. Frequent urge to go to the toilet with short urination is replaced by acute urinary retention. Attempting to empty the bladder or bowel becomes nearly impossible due to the unbearable pain. It is aggravated by constipation and a full bladder, spreads over the entire perineum, slight relief can come only in a prone position with tucked legs.
The temperature rises above 39 degrees. The inflammation begins to spread to other organs, mucus is secreted from the rectum. The prostate gland has a fuzzy outline, enlarged and painful. Palpation may not be possible due to edema.
The formation of an abscess is accompanied by the localization of the point of acute pain - where the abscess appeared. Passage of urine, stools and gas is extremely difficult, accompanied by severe throbbing pain that spreads to the intestine. The temperature is kept above 39. 5 degrees, chills, fever, and sometimes a delusional state appear.
Then, unexpectedly, relief comes: the pain goes away, the temperature drops. However, 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 body of pus, because the negative consequences can be very diverse.
Diagnostics
The diagnosis is made on the basis of an assessment of the patient's complaints, analysis of urine, blood and prostate secretions. Additionally, they use the method of digital rectal diagnostics, ultrasound and CT.
The severity of urinary disorders is assessed using uroflowmetry.
A general analysis of urine allows you to identify the disease at 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 the inflammation and its causes. Changes in the color, odor, or consistency of urine are not considered absolute evidence of acute prostatitis.
A complete blood count is the basis in the study of the disease. The characteristic indicators of acute prostatitis are low levels of hemoglobin (normal 130 g / l), high levels of urea and creatinine, as well as the level of leukocytes and erythrocyte sedimentation rate. Protein should not be normal, as well as a high level of leukocytes - there should be no more than 5 units.
Specific PSA analysis can detect not only inflammation, but also malignant formation.
PCR research allows you to quickly identify any genital infections that are often the cause of acute prostatitis.
Ultrasound allows you to determine the size of the prostate gland, its edges, the presence of point and diffuse changes. If an abscess has formed, this study can determine its size and location. If possible, the study is carried out transrectally; if pain and swelling do not allow this, the study of the gland is carried out from the side of the abdomen.
Sometimes ultrasound is performed with observation of 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 be increased or weakened depending on the type of inflammation and its stage. Allows you to distinguish a cancerous tumor from acute prostatitis.
If the doctor determines that surgery is necessary, he or she prescribes CT or MRI to examine the details of the inflammatory process.
Treatment of acute prostatitis
Disease therapy is always complex, including taking different drugs, procedures and diet. The treatment can last about 2 months.
The main task of the doctor is to eliminate the cause of the inflammation, which most often consists in infection. For this, antibiotics are prescribed (alone or in combinations). The choice of a drug depends on several factors:
- the sensitivity of the pathogen;
- 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
To combat the causative agents of an acute inflammatory process, fluoroquinolones and third-generation cephalosporins are most often used. For the treatment of acute prostatitis, the bactericidal effect of the antibiotic is fundamentally important.
Depending on the stage and condition of the patient, the dosage and form of release of the drug are selected: the more neglected the situation, the higher the dose and the more important it is for the drug to get to its destination faster, therefore, drugs in the form of injections are preferable to tablets.
It is necessary to normalize the outflow of urine and secretions. If 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.
If such drastic measures are not required, non-steroidal anti-inflammatory drugs are prescribed to restore normal urination, which 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 in. The infiltration stage is treated with active therapy with antibiotics and immunostimulants. A blockage is given with painkillers to help the patient overcome pain.
If an abscess has formed, treatment is possible only with the help of surgical intervention: the purulent bladder is opened, washed, and drainage is installed. After the operation, therapy is prescribed to combat microbes and intoxication.
Treatment of acute prostatitis is not limited to symptom relief. The course of antibiotics must be drunk to the end, and not until the pain disappears.
After the seizure itself is removed, it is time for physiotherapy. It includes UHF and microwave procedures, electrophoresis and prostate massage. The goal is to relieve swelling (if it remains), to improve the outflow of glandular secretions in order 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;
- acidic drinks, offal - they irritate the urinary tract.
The diet should include cereals, stewed vegetables, dairy products and baked fruits. All this contributes to the normal functioning of the intestines. It is necessary to observe the drinking regime, drinking at least 2 liters of liquid (water, fruit drinks, juices) per day. The more often the urinary tract is flushed, the less the risk of inflammation.
Vitamin complexes and peptides should be drunk to improve tissue regeneration and the speedy restoration of the normal functioning of the gland.
The favorable course of treatment is judged by the restoration of the gland tissues, the normalization of the chemical indications of prostate 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 each next stage of the disease, the chronic course of the disease, the spread of inflammation to other organs, infertility, sepsis. If the disease has been started, it may be necessary to remove the gland itself.
With timely treatment, at the end of the course of therapy, all functions of the body are restored, working capacity is fully restored.
Prevention
Preventive measures include the absence of unprotected sexual 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 carefully treat any infectious diseases.
You should also exclude factors contributing to the development of the disease. For this you need:
- have regular sex life with one partner;
- avoid hypothermia (both permanent and one-time);
- give up 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 during periods of the spread of infectious diseases.
Acute inflammation of the prostate appears due to infections that develop under favorable circumstances. Treatment is carried out with antibiotics, anti-inflammatory drugs, pain relievers and vitamins. During the period of therapy, it is important to adhere to a diet and drinking regimen.