Prostatitis is an inflammation of the prostate gland of a person.The prostate is located just below the bladder and the size of a chestnut.It surrounds the first section of the urethra and extends to the so -called pelvic floor, which consists of muscles.
The prostate produces secretion, which includes PSA and sperm.PSA makes ejaculate more liquid.Spermine is important for sperm mobility.
Prostatitis is mainly associated with severe pain in the perineum and anal region.In addition, symptoms such as urination frequency, pain during urination and pain during ejaculation occur during inflammation of the prostate.
The prostate is relatively often affected by inflammation.The probability of prostate infection increases with age.Studies show that most cases aged 40 to 50 years.
Prostatitis syndrome
At the same time, an expanded understanding of the term prostatitis appeared in medicine.With the so -called prostatitis syndrome, several complaints are summarized in the area of the human pelvis, which usually have an unknown reason.The term "prostatitis syndrome" summarizes various clinical paintings:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Inflammatory and non -inflammatory syndrome of chronic pelvic pain
- Asymptomatic prostatitis
Acute and chronic bacterial prostatitis
Acute prostatitis is caused by bacteria.Bacteria either pass through the blood to the prostate, or spread from the bacterial infection of the bladder or urethra to the prostate.Acute prostatitis is usually a serious general condition with severe pain during urination, fever and chills.
Chronic prostatitis can develop from acute: if for more than three months there is inflammation of the prostate gland and repeated microbes in the urine, the so -called prostate express or ejaculate, then this is chronic inflammation.
Bacterial prostatitis.This is less lightning speed than acute prostatitis.Although chronic inflammation of the prostate gland causes pain during urination and, possibly, a feeling of pressure in the perineum, but complaints are usually not as expressed as in acute prostatitis.
Chronic pelvic pain syndrome (abacterial prostatitis)
In most cases, prostate infections, bacteria cannot be detected in the urine, prostate or ejaculate as the cause of the disease.The trigger of prostatitis remains unclear.Doctors call it chronic pelvic pain.
However, in such cases, leukocytes can often be detected as an expression of inflammation in the prostate gland.To differentiate this, another form of the disease in which neither bacteria nor leukocytes are detected.Chronic pelvic pain syndrome is the most common form of prostatitis.
Asymptomatic prostatitis
In rare cases, asymptomatic prostatitis occurs.With this form of prostatitis, although there are signs of inflammation, but there is no pain or other symptoms.Asymptomatic prostatitis is usually detected by accident, for example, as part of a study of infertility.
Prostatitis: Symptoms
Inflammation of the prostate can cause various symptoms of prostatitis.Although the symptoms of acute prostatitis can be very serious and cause a strong sense of malaise, with chronic prostatitis they are usually somewhat weaker.
Acute prostatitis: symptoms
Acute prostatitis is often an acute disease in which patients suffer from fever and chills.Urination causes burning pain, and the flow of urine is noticeably reduced due to edema of the prostate gland.Since the victims can distinguish only a small amount of urine, they have a constant urination frequency and often should go to the toilet.Other symptoms of prostatitis include the bladder, pelvic pain and back pain.Pain can also occur during or after ejaculation.
Chronic prostatitis: symptoms
Prostatitis with a chronic course usually causes less serious symptoms than an acute inflammation of the prostate.Symptoms such as fever and chills are usually completely absent.Symptoms, such as a feeling of pressure in the perineum or lower abdomen, the darkening of ejaculate due to blood in sperm or blood in the urine is typical for chronic inflammation of the prostate. Symptoms of chronic bacterial and chronic abacterial prostatitis do not differ.
Complications of prostatitis
The most common complication is the prostate abscess.The abscess of the prostate gland is a purulent inflammation of the inflammation, which usually needs to be opened and empty with a cut.
As a further complication of inflammation of the prostate, inflammation can apply to nearby structures, such as the appendage of the testicle or testicles.There are also suspicions that chronic prostatitis is associated with the development of prostate cancer.
Prostatitis: Causes and risk factors
Bacterial prostatitis: causes
Only ten percent of cases of prostatitis is caused by a bacterium of prostate.Bacteria can enter the prostate through blood or from neighboring organs, such as the bladder or urethra, where they can lead to an inflammatory reaction.
Escherichia coli bacterium, which is mainly found in the human intestine, is the most common cause of prostatitis.Klebsiella, enterococci or mycobacteria can also cause prostatitis.Bacterial prostatitis can also be caused by sexually transmitted diseases such as chlamydial or trichomonas infections, as well as gonorrhea.
In chronic prostatitis, bacteria in the prostate gland avoided the not yet clarified way of protecting the human immune system.This allows microbes to constantly colonize the prostate.Antibiotics are relatively poor in the tissue of the prostate gland, which can be another cause of the survival of bacteria in the prostate gland.
Chronic pelvic pain syndrome: Causes
The exact causes of chronic pelvic pain syndrome have not yet been fully studied.Scientists have nominated many theories, each of which sounds plausible, but all of them have not yet been clearly proven.In some cases, the genetic material of previously unknown microorganisms was found in the pelvis.Therefore, the cause of pelvic pain syndrome may be microorganisms that still cannot be cultivated in the laboratory and, therefore, are not detected.
Another possible cause of chronic pelvic pain is disorders of the bladder.Due to the impaired drainage, the volume of the bladder increases, which thus presses on the prostate.This pressure ultimately damages the tissue of the prostate gland, causing inflammation.
However, in many cases, the cause of chronic pelvic pain cannot be clearly demonstrated.Then doctors talk about idiopathic prostatitis.
Anatomical causes
In rare cases, prostatitis is caused by narrowing of the urinary tract.If the urinary tract is narrowed, urine accumulates and, if it enters the prostate, it can also cause inflammation.This narrowing can be caused by tumors or the so -called prostate stones.
Mental reasons
Recently, more and more psychological causes of prostatitis have been discussed.In particular, with non -inflammatory syndrome of chronic pelvic pain, a mental trigger is likely.Exact mechanisms are still unknown.
Risk factors for the development of prostatitis
Some men are especially at risk of developing prostate infection.These include, for example, men with a violation of the immune system or suppressed by the immune system.In addition, the main diseases, such as diabetes mellitus, can contribute to the development of prostatitis: an increased blood sugar level in patients with diabetes often leads to an increased level of sugar in the urine.The abundant sugar content in the urine can provide bacteria with good growth conditions, facilitating the development of urinary tract infections.
Another risk factor in the development of prostatitis is the coatter of the bladder.The introduction of a catheter through the urethra through the urethra can cause small ruptures of the urethra and damage to the prostate gland.In addition, as on any foreign body, bacteria can settle on the bladder and form the so -called biofilm.As a result, bacteria can rise along the urethra to the bladder, as well as lead to prostate infection.
Prostatitis: examinations and diagnostics
A general practitioner can take a medical history, but if there is a suspicion of prostatitis, he will direct you to a urologist.This performs a physical examination.In case of suspicion of prostatitis, this is usually the so -called digital rectal study.Nevertheless, this study does not give clear evidence of inflammation of the prostate, but only confirms the suspicion.To detect bacterial prostatitis, a laboratory examination can be carried out
Finger rectal examination
Since the prostate gland borders directly with the rectum, it can be palpated in the rectum.This digital rectal study is carried out on an outpatient basis and without anesthesia, usually painlessly.The patient is asked to lie down with bent legs.Using a lubricant, the doctor then slowly inserts the finger into the anus and scans the prostate and adjacent organs.He examines the size and sensitivity to pain in the prostate gland.
Laboratory examination
To identify possible pathogens in most cases, urine analysis is carried out.The standard method is the so -called sample of four glasses.Here Erturin, Mittelstrahlurin, ProstataExPrimat and Urin are tested after prostate massage.As prostataxprimat called, doctors call the secretion of prostate.This is achieved by a doctor by light pressure on the prostate, for example, on palpation.Ejaculate can also be tested for pathogenic microorganisms and signs of inflammation.
Further research
The ultrasound scanning of the rectum can be used to determine exactly where the inflammation is and how far it spread.An important goal of the study is also the exclusion of other diseases with similar symptoms.
To exclude that the existing violation of urine drainage is caused by narrowing of the urethra, urinary flow is measured.The normal stream of urine is from 15 to 50 milliliters per second, while the flow of urine is ten milliliters per second or less, there is a high probability of obstruction of the urethra.
Prostatitis: treatment
Drug therapy
Acute bacterial prostatitis is treated with antibiotics.In mild cases, the dose of the antibiotic is enough for about ten days.In chronic prostatitis, the drug should be taken for a longer period of time.Depending on pathogenic microorganisms, the active substances of the luxacin, ciprofloxacin, azithromycin, erythromycin or doxycycline are suitable.Even if the symptoms are already subsiding, antibiotics in any case should be continued in accordance with the appointment of a doctor.
Also, asymptomatic prostatitis is treated with antibiotics.
If there is chronic abacterial prostatitis, antibacterial therapy is usually ineffective.With inflammatory syndrome of chronic pelvic pain, despite the lack of evidence of the presence of pathogen, a study is carried out using antibiotics, since sometimes improvement can be achieved.However, with non -inflammatory syndrome of chronic pelvic pain, antibiotic therapy is not recommended.
Other therapeutic approaches to chronic abacterial prostatitis are the so-called 5α-reductase inhibitors, such as fineride or dutasteride, pentosan polyisulfate and plant drugs, such as quercetin or dust extract.If the improvement is not achieved, drug therapy will be supplemented with physiotherapy.Here, physiotherapy exercises, exercises for the muscles of the pelvic floor or regular massage of the prostate are recommended.
In addition, symptomatic therapy can help relieve acute symptoms of prostate infection.Anesthetic drugs can be prescribed for severe pain.Also, heating pads and heating pads on the back or lower abdomen help to relax the muscles.This often relieves pain with prostate inflammation.
Relapse
The frequency of relapse of prostatitis is generally very high.About 23 percent of the victims are subjected to the second episode of the disease after one disease, 14 percent suffer from three, and 20 percent - even from four or more cases of the disease.To reduce the risk of relapse, avoid wearing wet clothing during or after prostatitis, hypothermia or use of bubbles, such as black tea or coffee.This reduces the risk of cystitis and, therefore, prostatitis.However, you cannot reliably prevent bacterial prostatitis using these methods.
The prognosis of prostatitis depends, on the one hand, on the cause of inflammation, and on the other, on how quickly the correct therapy begins.
In acute bacterial prostatitis, which is treated as soon as possible with antibiotic therapy, the prognosis is usually good.Taking antibiotics, pathogens die, which usually prevents the transition to chronic prostatitis.
About 60 percent of all patients with acute prostatitis no longer have symptoms in six months, and about 20 percent develop chronic prostatitis.Treatment and prognosis are more difficult here.In many cases, periodic episodes of the disease arise that can accompany those who suffer for many years.
Chronic prostatitis usually requires great patience from the victims.Very often a long course can be a serious psychological burden.
Patients who have suffered should seek professional help, since the mental health situation has a huge impact on the forecast of prostatitis.