Acute prostatitis is characterized by a pronounced clinical picture. The pathology is dangerous with a number of serious complications and therefore requires timely and complex treatment. How to recognize and treat the 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 need to consult a doctor in time to diagnose and prescribe competent treatment.
General characteristics of the disease
Acute prostatitis is an inflammatory process that develops rapidly in the prostate. It has four stages of development:
- Catarrhal.At this stage the gland swells a little, the inflammation affects only the mucosa of the gland's excretory ducts. This period is the most favorable moment for treatment - if you start it 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 resulting edema clogs the ducts, preventing the secretion from leaving the gland. Stagnation begins.
- Follicular.As a result of stagnation, the bacteria that have entered the organ begin their activity already in it. Because the organ consists of cells, grouped into lobes and separated by connective tissue, the inflammation first affects one part.
- Parenchymal.Inflammation spreads from one lobe to another, 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 rupture, pus spread and enter the area around the prostate and bladder, urethra or rectum. When the 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 reasons for the inflammation, the timeliness and appropriateness of treatment.
Causes
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 start purulent processes.
- Trichomonas is a leader among sexually transmitted microorganisms. It penetrates the intercellular space of the gland, therefore requiring prolonged and stubborn treatment.
- Chlamydia - in addition to toxicity, they are able to stick to erythrocytes, increasing their deposition rate and interfering with blood circulation in the affected area. They penetrate deeper than Trichomonas.
- Staphylococci, the golden appearance is especially common. It can survive in any tissue and organ, causing pus and making the blood thicker.
- Ureaplasma is a cross between unicellular and viral. 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.
Often the reason does not lie only in infections that can live in the body for a long time without almost any symptoms. They begin to develop rapidly if there are contributing factors:
- Regular or single hypothermia. Cold weakens the body's defenses and makes it harder for them to keep pathogenic bacteria, especially if hypothermia is associated with daily work.
- Irregular sex life. Stagnation of glandular secretion (which is an integral part of sperm) stimulates bacterial growth.
- Current 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 that is not completely cured in the form of streptococci can also cause inflammation. Even tooth decay can cause prostatitis.
- Weakened immunity. If, due to illness or uncontrolled intake of antibiotics, the body's defenses become insufficient, the bacteria will certainly show up.
- 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 need to use the toilet at night is becoming more frequent. Urination is accompanied by tingling and pain. The gland itself is normal or uncritically enlarged, palpation causes pain. The temperature remains normal or increases slightly. No intoxication, common good.
The follicular period has multiple manifestations. The pain grows, becomes constant, sometimes radiating sharply into the penis, sacrum or rectum. Urinary retention occurs because urination is difficult due to acute pain. Defecation is accompanied by severe pain.
The temperature rises to 38 degrees and remains at this level. The prostate significantly increases in size, has a thick consistency, is tense, touching in some places causes sharp pain.
Parenchymal prostatitis is very severe. Appetite disappears, chills appear, general weakness. The frequent need to go to the toilet with short urination is replaced by acute urinary retention. Attempting to empty the bladder or bowel becomes almost impossible due to unbearable pain. It is aggravated by constipation and a full bladder, it spreads all over the perineum, slight relief can only come in a prone position with the legs retracted.
The temperature climbs above 39 degrees. Inflammation begins to spread to other organs, mucus is secreted from the rectum. The prostate has a vague outline, is 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. Excretion of urine, stool and gas is extremely difficult, accompanied by strong pulsating pain that spreads to the intestines. The temperature is maintained above 39. 5 degrees, chills, fever, and sometimes deception occur.
Then comes an unexpected relief: 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 that urgent procedures are now needed to cleanse the body of pus, as the negative consequences can be very different.
Diagnosis
The diagnosis is made based on an assessment of patient complaints, analysis of urine, blood, and prostate secretions. In addition, they are used by digital rectal diagnostics, ultrasound and CT.
The severity of urinary disorders is assessed using uroflowmetry.
A general urine analysis 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 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 for studying the disease. Characteristic 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 rates. Proteins should not be normal, nor should high levels of leukocytes - they should not be more than 5 units.
Specific PSA analysis allows you to identify not only inflammation but also malignant formation.
PCR research allows you to quickly identify all genital infections that are often the cause of acute prostatitis.
Ultrasound allows you to determine the size of the prostate, its edges, the presence of punctate and diffuse changes. If an abscess has formed, this study can determine its size and location. If possible, the study is performed transrectally; if pain and swelling do not allow it, examination of the gland is carried out on the side of the abdomen.
Sometimes an ultrasound is done while observing a change in the frequency of the sound reflected from the organ. This allows you to assess blood flow to the prostate - vascularization, which can increase or decrease depending on the type of inflammation and its stage. It enables the differentiation of a cancerous tumor from acute prostatitis.
If the doctor determines that surgery is needed, he prescribes a CT or MRI to examine the details of the inflammatory process.
Treatment of acute prostatitis
Treatment of the disease is always complex, including taking various medications, procedures, and diet. The treatment can last about 2 months.
The main task of the doctor is to remove the cause of the inflammation, which most often consists of an infection. Antibiotics (alone or in combination) are prescribed for this. The choice of drug depends on several factors:
- pathogen susceptibility;
- concomitant patient diseases;
- 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 combat the causative agents of the acute inflammatory process. For the treatment of acute prostatitis, the bactericidal effect of antibiotics is of fundamental importance.
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 more importantly the faster the drug reaches its destination, therefore, injectable drugs are preferable to tablets.
It is necessary to normalize the outflow of urine and secretions. If the retention of urine has turned into an acute form, a trocar epicistomy - puncture of the bladder is prescribed, 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. Medicines 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 phase is treated with active therapy with antibiotics and immunostimulants. The blockade is given with painkillers 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, flushed and drainage is placed. After the operation, therapy is prescribed to fight microbes and poisoning.
Treatment of acute prostatitis is not limited to relieving symptoms. The course of antibiotics must be taken to the end, not until the pain disappears.
After removing the attack itself, it is time for physiotherapy. It includes UHF and microwave procedures, electrophoresis and prostate massage. The goal is to alleviate swelling (if any), improve the outflow of glandular secretions to avoid congestion.
It is important to adhere to a diet throughout treatment. You must decline the following products:
- alcoholic beverages, coffee, fried and salty - contributes to 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, intestines - 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 adhere to 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 lower the risk of inflammation.
Vitamin complexes and peptides should be taken to improve tissue regeneration and quickly restore normal gland function.
The favorable course of treatment is judged by the renewal of glandular tissue, normalization of chemical indications of 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 you can get rid of acute prostatitis. The complication is each 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, it may be necessary to remove the gland itself.
With timely treatment, at the end of the course of therapy, all body functions are restored, and working ability is completely restored.
Prevention
Preventive measures include the absence of unprotected sex (to rule out STIs), careful hygiene and timely treatment of inflammatory processes in the urinary tract. It is necessary to maintain immunity, not to start caries and carefully treat all infectious diseases.
You should also rule out factors that contribute to the development of the disease. For this you need:
- have a regular sex life with one partner;
- avoid hypothermia (both permanent and single);
- give up alcohol, smoking and a sedentary lifestyle;
- undergo regular routine checkups with a urologist;
- do not self-medicate at the first signs of inflammatory processes;
- stick to 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. 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.