Prostatitis is an inflammatory process in the tissues of the prostate gland.Today, approximately 30% of men suffer from prostatitis after 30 years of age, and this figure increases with age.This disease is much easier to prevent than to treat, so it is important to know the causes of prostatitis, the symptoms of its acute and chronic forms and ways to prevent complications such as adenoma and prostate cancer.
Main causes of prostatitis
The clinical picture of prostatitis implies a wide range of symptoms associated with the body's systemic response to the inflammatory process.The most common and significant are problems with urination and disorders of sexual life.The degree of manifestation of prostatitis symptoms is multifactorial in nature, that is, it depends on many factors: the individual characteristics of the man’s body, the condition of the prostate and the presence of concomitant pathologies, the lifestyle the man leads, smoking, alcohol abuse, and the activity of the immune system.
Experts distinguish two main types of disease, on which further treatment will depend:
- Infectious.Inflammation is associated with the pathogenic action of microorganisms.
- Stagnant.Inflammation is associated with blood stagnation, hypoxia (lack of oxygen) and the manifestation against its background of ischemia and alteration (damage) and remodeling of the gland, replacement of functionally active connective tissue.
Often one form of the disease passes into another.The infectious process affects blood vessels and disrupts local circulation, causing stagnation; on the other hand, initial stagnation reduces the ability of the immune system to locally fight the developing infection, as it reduces the rate of blood transport of immunocompetent cells to the lesion.Prostatitis occurs in acute and chronic forms.More often, specialists encounter the first one - its symptoms are quite characteristic, so the process can be slowed down and further development can be completely prevented.
If the disease is not treated properly, it can become stationary and then chronic.At the time of exacerbation of prostatitis, a man experiences a general deterioration in his health, pain appears in the lower back, in the groin area, the process of urination is disrupted, and body temperature rises.
Spicy
An acute pathological process, unlike a chronic one, manifests itself suddenly and has clear clinical symptoms that force a man to see a doctor.The body temperature rises to 39 degrees, the man feels severe pain in the lumbar region.The highest point of incidence occurs between the ages of 30 and 40 years.
The cause of the pathological process is infectious foci that may be located in distant organs.The causative agent of the disease can enter the prostate gland either ascending rectally or through the urethra, or descending hematogenously (through the blood) and lymphogenously (through lymph).
The type of pathogen directly affects the therapy performed:
| Pathogen | Frequency of occurrence | Gram stain (needed to select antibiotic therapy) |
|---|---|---|
| Escherichia coli | Often | GR- |
| Pseudomonas aeruginosa (Pseudomonas aeruginosa) | Often | GR- |
| Klebsiella spp. | Often | GR- |
| Enterococcus fecalis | Often | GR+ |
| Proteus (Proteus mirabilis) | Often | GR- |
| Serratia marcescens | Rarely | GR- |
| Chlamydia (Chlamydia trachomatis) | Often | GR- |
| Staphylococci (Staphylococci spp) | Rarely | GR+ |
| Enterobacteriaceae | Rarely | GR- |
| Ureaplasma (Ureaplasma urealyticum) | Rarely | GR- |
| Gonococci (Neisseria gonorrhoeae) | Rarely | GR- |
| Mycoplasma (Mycoplasma hominis) | Rarely | Mollicutes |
| Candida (Candida spp) | Rarely | Mushrooms |
| Trichomonas | Rarely | Protozoa |
Prostatitis can be caused by:
- intestinal and urological infections;
- infectious diseases of the genital area;
- diseases of the upper and lower respiratory tract.
Often the cause of inflammatory lesions of internal organs is caries.
The ascending route of infection by bacteria, fungi and protozoa is when they enter the prostate tissue from the urethra and rectum.More often, the lesion is associated with urological infections, such as:
- urethritis (inflammation of the urethra);
- cystitis (inflammation of the bladder);
- pyelonephritis (inflammation of the renal pelvis).
Sexually transmitted diseases often become the main cause of inflammation in the prostate gland, gonorrhea being the most common.The formed pathological focus, located in close proximity to the prostate, easily spreads into the prostate tissue.To prevent such diseases, it is important to practice protected sexual intercourse.
The descending route of spread of the pathogen consists of its penetration from the primary focus into the prostate lymphogenously and hematogenously.The source of infection can be a pathological process in the throat (sore throat), in the upper and lower respiratory tract (bronchitis, flu) or in the oral cavity (caries).
Disseminated or hematogenous tuberculosis.The first symptoms appear 2-3 weeks after the underlying disease.Collecting an epidemiological history is an important component of diagnosis.
Immune status plays an important role in the incidence of prostatitis.Not all men exposed to infectious diseases develop prostatitis.If the immune system suppresses the development of a pathogenic microorganism, then the process in the gland tissue stops without the occurrence of pathology.On the other hand, weakened immunity leads to complications.The prostate gland is a vulnerable organ that is located close to potential entry points for infection, so it is the first to be negatively affected by microbes.
Chronic
A chronic process develops if acute prostatitis has not been treated.The symptoms of this form of pathology are less pronounced, the general condition is satisfactory, the temperature is normal.That is why men do not consider such a pathological process dangerous and put off going to the doctor.
Like any chronic disease, prostatitis occurs in stages of remission and exacerbation.In a chronic course, the inflammation of the prostate tissue is sluggish, and therefore the symptoms may not fully manifest themselves.They will intensify only at the moment of exacerbation.
A chronic pathological process causes a deterioration in the innervation of the organ, which leads to disorders of the trophism (nutrition) of the organ, which negatively affects its function.An autoimmune reaction is also likely to develop.A person's own immune system produces antibodies against prostate cells.In this case, inflammation will be maintained even after complete disposal of the pathogenic microorganism.
Stagnant
Non-infectious inflammation of the prostate occurs due to congestion in the pelvis.The disease develops progressively, and over time the intensity of the symptomatic complex increases.This form of prostatitis is the most common today.
The main reason is discirculatory phenomena, which lead to the fact that blood does not flow from the pelvic area, so all organs located in this area do not receive sufficient nutrition and adequate oxygenation.The outflow of secretions is disrupted, and degeneration of the pelvic diaphragm muscles occurs.The most important reason for stagnation is an inactive lifestyle.Traumas suffered also contribute to stagnation.Diabetes mellitus, through macro- and microangiopathy, can reduce blood flow to the pelvic organs.
Causes of congestive inflammation of the prostate:
| Etiological factor | Pathogenesis |
|---|---|
| Low level of physical activity | Experts consider it the most common cause of congestive prostatitis.This is facilitated by the increasing influence of technological progress on human life: escalators, elevators, cars.Low physical activity leads to failure of the muscle pump mechanism, which helps blood flow away from the organs.Prevention is exercise, sports, walking |
| Poor nutrition | Negatively affects all body systems and, above all, the regulation of the vascular system due to both local and systemic factors |
| Overweight | Obesity is one of the components of metabolic syndrome, which also includes hypertension, dyslipidemia and diabetes mellitus.One component has a beneficial effect on the likelihood of developing the others, all of which leads to vascular insufficiency and stagnation |
| Constipation | An increase in the volume of the rectum leads to compression of the veins and disruption of outflow |
| Sedentary lifestyle (common among drivers and office workers) | Sitting on a chair, a person does not change his position for a long time.As a result, compression of individual venous vessels and local congestion occurs.Prevention is a change in sitting position and periodic gymnastics, walks |
| Irregular sex life | Leads to stagnation of not only blood, but also prostate secretion.As a result of metabolic processes, the secretion can turn into poison and produce a systemic toxic effect.Excessive sexual activity is also harmful for a man, as it leads to depletion of the nervous and hormonal systems, loss of nutrients, hyperfunction of the gland and depletion of its regenerative properties |
| Frequently holding back the urge to urinate | The prostate is an additional sphincter in the male body.Its overstrain leads to an increase in the volume of muscle tissue and a decrease in the volume of glandular tissue.Moreover, an enlarged bladder puts pressure on the veins, impairing the outflow |
| Smoking and alcohol abuse | Smoking and alcohol lead to dysregulation of vascular tone |
| Traumatization in the lumbar region | Trauma often damages the prostate gland itself or important neurovascular bundles.This will disrupt the trophism of the gland and reduce blood flow |
| Excessive nervous tension, stress and depression | Lead to depletion of the nervous regulation of vascular tone.Hormonal imbalance develops, which leads to disruption of the regulation of the gland (development of prostate adenoma) and systemic hemocirculation |
| Features of the development and structure of the organs of the genitourinary system | May make the gland more likely to become infected or remodel |
All of these reasons have a destructive effect on the circulatory system, both local and general.
If a man feels that he has problems with urination, he begins to go to the toilet more often, he is bothered by pain in the lower back and groin when urinating, then he needs to consult a urologist.
Effect of age
Experts consider prostatitis to be a disease that more often manifests itself in old age, but recently the percentage of young people with this pathology has been increasing.According to unofficial statistics, based on a comparison of data on diagnostic cases and research, about 16% of males in the age range from 20 to 40 years are officially diagnosed with chronic prostatitis.
Taking as a basis the indicators of men from 20 to 39 years old, experts obtain the statistical incidence of prostatitis in the age interval from 40 to 49 years is 1.7 times higher, and in those over 55 years old – 3.1 times higher.However, statistics take into account only identified patients.However, official statistics have a noticeable error, and methods for diagnosing prostatitis are not sufficiently developed.
Diagnosis and treatment
The method of treatment directly depends on the cause of the disease, so the most important point is diagnosis, which includes:
- Collection of life history and epidemiological history.
- Ultrasound.
- Rectal digital examination.
- Bacteriology of prostatic secretion.
- PSA level - analysis (necessary to exclude prostate adenoma and prostate cancer).
- Urine tests.
- General and biochemical blood test.
Treatment of prostatitis is effective using a combination of the following methods:
- Pharmacological treatment.Drugs are selected, as a rule, comprehensively.
- Medical massage.
- Physiotherapy.Medicinal electrophoresis, Darsonvalization, UHF therapy, etc.
- Gymnastics and active lifestyle.
- Folk remedies.The use of various herbal preparations that are sold in pharmacies.
You should not prescribe pills on your own or practice traditional medicine without consulting a specialist.Many of the drugs and herbs for the treatment of prostatitis are systemic in nature and are contraindicated in some patients.
Don’t forget about prevention, which involves eliminating harmful factors and leading an active lifestyle.