Symptoms of prostatitis in men, causes and diagnostics

Around 40 - 60% of the clinic's urological patients are patients with chronic prostatitis.Symptoms of prostatitis in men are often the cause of depressive diseases and changes in the psyche.

The disease that every third man suffers over 25 to 30 years does not threaten life, but the difficulties of his diagnosis and treatment determine a long chronic course and often lead to disabilities.

The idea of the functions of the prostate, mechanisms and the causes of the development of inflammation enables us to correctly understand the symptoms and the need for timely treatment.

The function value of the prostate gland

Its main function is the secretion of a specific fluid (secret) 40 - 50 glands, which form the entire glandular tissue of the organ.The secret of 90 - 95% consists of water and the main trace elements, phospholipids, spermamino acids, which give sperm a specific smell, enzymes, proteins, citric acid and fructose.All components have their own purpose and are strictly balanced.

The secret of the prostate offers:

1. The formation and maintenance of a neutral or slightly alkaline environment in urethra and sperm.This environment offers sperm for the life of sperm.
2. Sperm dilution, necessary to prevent the sperm binding with each other and to ensure their transportation.Mixed sperm with prostate juice in sexual intercourse.
3. The livelihood of spermatozoen: The substances contained in the secret are a nutrient medium for germ cells, thanks to which they can be found in the female genital organs for several days until the egg fertilizes.
4. Protection of the genitals system against infection using zinc, sperm, polyamines and immunoglobulin A. The zinc concentration in the prostate is 100 times higher than in other organs.It has a pronounced antimicrobial activity, accumulated in iron in the form of protein complexes and is in a free state in sperm.Spermines and polyamins also have a high anti -bacterial activity, and immunoglobulins are involved in the immune protection of the prostate and urethra.

The prostate iron also takes part:

• in hormonal metabolism by converting testosterone from the blood into active dihydrotestosterone;The latter regulates the secretorial activity of the gland;This process takes place with the participation of the same zinc;
• in the act of urination with smooth muscle fibers contained in the capsule of the gland;
• In the process of ejaculation together with the muscles of the pelvis and the part of the urethra through the prostate;
• In the formation of the feeling of orgasm due to the vasation of the channels that drive past the side surface of the seed tuberkel;It contains receptors that transmit impulses via the brain during ejaculation.

Thus, the prostate, together with participation in the general hormonal status of a person and the possibility of reproduction, protects the urogenital organs from aggression physically pathogenic and pathogenic microorganisms.

Causes and contribute factors

The main cause of inflammation of the prostate is to enter into pathogenic and caused pathogenic microbes.At 60%this is an E. coli.In recent studies, the role of participation of gonococcal and trichomonna infections is confirmed in inflammation.In the event of a violation of the protective barrier of the gland and a decrease in local immune defense, the penetration of such an infection such as yeast -like, mycoplasm and uepta plasma, herpes virus and cytomegalinirus, microorganisms, which cause breathing deli (with the oral genital method) (in cases of oral genital method), in the oralGenital method).

In the case of diseases of tuberculosis, the spread of mycobacteria through the bloodstream into the prostate is possible.Isolated cases of tuberculosis prostatitis are found, but rare.

Opportunities for penetrating into the infection into the gland:

• Hematogenic - with blood from other types of infection;This is done by the venous vessels of the prostate and communicate with the veins of the penis, testicular, rectum, bladder and kidneys (including tuberculosis lesion)
• Lymphogenic - through lymphatic vessels
• Urethrogenic - through the urethra

Contribute to factors:

1. In particular, a violations of the hormonal background, a decrease in the testosteronnonation, as a result of which the antimicrobial prostate barrier is reduced.
2. Varicocele (expansion of the veins of the seed), hemorrhoids, varicose veins of the lower extremities.These diseases are the result of a genetic defect in the venous valves, which leads to a bleeding disorders in the pelvis in organs, an increase in local temperature, which is reduced in normal (compared to the total body temperature) and the creation of favorable conditions for the vital activity of the microorganisms.
3. Osteochondrosis, hernia of the lumbar spine and other innervative disorders, a sitting lifestyle.You can lead to a longer cramp (narrowing) of the vessels of the prostate or vice versa to your long -term expansion.The first leads to an impaired blood supply, the second - to be stagnant blood phenomena.
4. Poison is alcohol that leads to paralysis to paralysis of small vessels and nicotine and contributes to its extended cramp.
5. Different infectious diseases, diabetes mellitus, frequent and long negative mental effects, stress states, sleep disorders - all of this helps to reduce general immunity.

Types of prostatitis

In principle, the first symptoms of prostatitis are explained by the deterioration in blood supply to the gland as a result of inflammation or vascular spasms, which lead to lack of oxygen and impair metabolic processes with the formation of underestimated decay products.They cause strong irritation of a large number of nerve receptors associated with the ends of the nerves of the testicles, blisters, rectum, penis, muscles of the soil of the pelvis.

In accordance with the classification proposed by the National Institute of Health (depending on the course of the inflammatory process), acute bacterial prostatitis is differentiated, which is rare (about 5% of all cases) and chronic prostatitis.The latter can develop according to acute, but in 90% - 98% of cases is primary.It is believed that it leads to sexual disorders and infertility.

The chronic shape is divided into:

• Bacterial.
• Abacterial or chronic pelvic pain (in the absence of bacteria in studies).It is in turn in inflammatory and non -inflammatory.
• Asymptomatic inflammation (without obvious symptoms).

Clinical manifestations

Acute prostatitis

The acute course is provoked by all microorganisms and is characterized by almost simultaneous damage to all glandular lovers.The most common cause is gonococcus.The inflammatory process may not exist in the form of an abscess or diffuse.The most characteristic symptoms of acute prostatitis are as follows:

• Chills and high body temperature (up to 38.5^O and above).
• Severe poisoning - weakness, pain in the joints, headaches, increasing the frequency of the impulse, lack of appetite, etc.
• Severe pain in the perineum, in the groin and lumbar area.
• Urine disorders - more often and false urge, pain and difficulties when urinating, acute urinary retention.
• Belovoy or transparent discharge from the urethra.

A finger examination of the prostate through the rectum is impossible due to severe pain.In addition, due to the possibility of distribution (distribution) of the infection in the blood and the development of a septic state, it is contraindicated.

Chronic prostatitis

The recommended classification reflects the fact that the signs of chronic prostatitis in men are very different and the views of doctors to the causes and mechanisms of the development of the disease are largely different.The diagnosis is based on symptoms of the patient, the clinical examination of a finger examination of the gland through the rectum (rectal) and ultrasound examination.At the same time, pain, size and volume, contours, uniformity of the consistency and the presence of softening or sealing areas are assessed.

In some cases, the functional ability of the organ and, above all, the presence or lack of inflammatory processes as well as the form of the disease enable you to evaluate the examination of the prostate stress.It is obtained as the result of a finger massage of a prostate with subsequent bacteriological analysis of the material (secret), the management of PCR (polymerase chain reaction) to proof physically pathogenic microorganisms and pathogens of sexual infections and sperm analysis.

General symptoms of different forms of chronic prostatitis:

1. Complaints or/and moderate pain in the form of "pain" and severity in the perineum that occur or intensify after drinking alcoholic beverages, physical activity and sexual contact.Sometimes they pass a paroxysm in nature.
2. A feeling of symptoms and cruises in the urethra during urination or sexual contact, a minor serous grazing from the urethra (mainly after a long -term delay in the urine).
3. Suddenly frequent urine (sometimes up to three times within 1 hour) and a feeling of the inadequate emptying of the bladder, which is explained by a violation of the nervous regulation of the prostate, its muscle fibers and the bladder.
4. Reduction of the ability to fertilize, which is caused by an increase in the acid of the secret, a decrease or lack of sperm mobility, its agglutination (gluing) with the heads.
5. Pain against orgasm or deleted sensations of orgasm, ejaculation disorders, expressed in its premature babies or vice versa in the excessive duration of sexual intercourse.These phenomena are associated with the inflammatory process in the area of the pioneering tuberkel or its scarring due to inflammation.

The information presented enables us to understand the need and meaning of a timely attractiveness of a qualified specialist in the event of certain symptoms and to give various non -traditional methods of self -medication.The treatment is only prescribed after a complete and thorough examination in order to determine the cause and form of the disease.

Differential diagnosis

Differential diagnosis of acute prostatitis and characteristic signs of chronic prostatitis in men are reflected in the table:

The form of prostatitis	The main symptoms	Laboratory data
Acute bacteria	Acute beginning, severe pain in the crotch High temperature, poisoning, muddy, often with an admixture of blood, urine	Leukocytosis (increased number of leukocytes in the blood) Accelerated ESR A large number of red blood cells and leukocytes when analyzing the urine Maybe the presence of gonococci
Chronic bacteria	Pain in the pelvic floor of moderate nature, Pain for ejaculation, Earlyborn ejaculation, dysuria. Some symptoms cannot be present	Red blood cells in a microscopic examination of the secret of the gland, The detection of E. coli, enterobacteria, clebs or other microorganisms in the bacteriological examination of ejaculate
Chronic offside (chronic pelvic pain syndrome):	Pain in the pelvis of a moderately expressed nature for 3 months	In conventional studies, bacteria are not detected
inflammatory	Pronounced dysuric disorders, In 40 - 65% moderate pain in the lower abdomen and in the genital area of 3 or more months	The presence of leukocytes in the secret of the gland and in the third part of the urine during the Meares stamey test (study of 4 sequential parts of the urine gold standard “of laboratory diagnostics of chronic prostatitis))
Non -inflammatory or stagnating (40% of patients with prostatitis)	Unpressed pelvic pain and symptoms of 3 months or more. Dizurian disorders rarely.	Laboratory data of the inflammation are not determined
Asymptomatic inflammatory prostatitis	Clinical subjective symptoms are missing	The presence of signs of inflammation