Around 40 to 60% of urological patients of the clinic are patients with chronic prostatitis.The symptoms of prostatitis in men are often the cause of depressive conditions and changes in psyche.
The disease that each third man suffers more than 25-30 years does not threaten life, but the difficulties of his diagnosis and treatment determine a long chronic course and often lead to a disability.
The idea of the functions of the prostate, the mechanisms and the causes of the development of inflammation allow us to correctly understand the symptoms and the need for timely treatment.
The functional value of the prostate gland
Its main function is the secretion of a specific fluid (secret) 40 - 50 glands that form all the glandular tissue of the organ.The 95% secret consists of water and the main trace elements, phospholipids, sperm amino acids, which gives 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 provides:
- The formation and maintenance of a neutral or slightly alkaline environment in the urethra and sperm.This environment provides sperm for the life of sperm.
- The thinning of sperm, necessary to avoid the union of sperm with each other and guarantee their promotion.In the sexual relations process, sperm are mixed with prostate juice.
- The viability of the sperm: the substances contained in the secret are a means of nutrients for germ cells, thanks to which they can be located for several days in the female genital organs until egg fertilization.
- Protection of the genitourinary system of the infection using zinc, sperm, polyamines and immunoglobulin A. The concentration of zinc in the prostate is 100 times greater than in other organs.It has a pronounced antimicrobial activity, accumulates in iron in the form of protein complexes and is in sperm in free state;The sperm and polyamines also have high antibacterial activity, and immunoglobulins are involved in the immune protection of the prostate and urethra.
The prostate iron also participates:
- in hormonal metabolism through the transformation of testosterone from the blood, towards active dihydrotestosterone;The latter regulates the secretory activity of the gland;This process continues with the participation of the same zinc;
- in the urine act using smooth muscle fibers contained in the gland capsule;
- in the ejaculation process together with the muscles of the back of the pelvis and the part of the urethra that passes through the prostate;
- in the formation of the sensation of orgasm due to the vasation of the ducts that pass along the lateral surface of the seed tuber;It contains receptors that transmit impulses to the brain during ejaculation.
Therefore, the prostate, together with the participation in the general hormonal state of a man and guaranteeing its possibility of reproduction, protects the urogenital organs of the aggression of pathogenic microorganisms and conditionally pathogens.
Contributing causes and factors
The main cause of inflammation of the prostate is to enter the pathogens and conditionally pathogens.In 60%, this is an E. coli.In recent studies, the role of the participation of gonococcal and tricomonna infections in inflammation is confirmed.In case of violation of the protective barrier of the gland and a decrease in local immune defense, the penetration of an infection such as yeast, mycoplasma and oreapaplasma, herpes virus and cytomegalinirus, microorganisms that cause respiratory diseases (with the oral-genital method), the intestinal microflora (in the case of cases of cases of cases of cases of cases of cases of cases of cases of casescases.
For tuberculosis diseases, the dissemination of mycobacteria is possible through the bloodstate towards the prostate.Isolated cases of tuberculosis prostatitis are found, but rarely.
Ways to penetrate infection in the gland:
- Hematogen: with blood from other infection spotlights;This occurs through the venous vessels of the prostate, communicating with the veins of the penis, testicle, straight, bladder and kidneys (even with tuberculosis lesion))
- Lympogogen - Through lymphatic vessels
- urethrogenic through the urethra
Taxpayers:
- Hormonal background violation, in particular, a decrease in the level of testosterone, as a result of which the antimicrobial prostatic barrier is reduced.
- Varicocele (expansion of seed veins), hemorrhoids, varicose veins of the lower extremities.These diseases are the result of a genetic defect in venous valves, which leads to blood microcirculation disorders in organs located in the pelvis, an increase in local temperature, reduced in total body temperature (compared to total body temperature) and the creation of favorable conditions for the vital activity of the microorganisms.
- Osteochondrosis, lumbar column hernia and other innervation disorders, a sedentary lifestyle.They can lead to a prolonged spasm (narrowing) of the prostate vessels or, on the contrary, to their long -term expansion.The first leads to a deteriorated blood supply, the second: to stagnant blood phenomena.
- Intoxication is alcohol, which leads to the paralysis of small vessels and nicotine, contributing to its prolonged spasm.
- Several infectious diseases, diabetes mellitus, frequent and long negative mental effects, stress states, sleep disorders: all this helps reduce general immunity.
Types of prostatitis
Basically, the first prostatitis symptoms are explained by the deterioration of the blood supply to the gland as a result of inflammation or vascular spasm that leads to oxygen deficiency, altered metabolic processes with the formation of underestimated decomposition products.It causes a powerful irritation of a large number of nerve receptors associated with the ends of the nerves of the testicles, bladder, straight, penis, muscles of the pelvis bottom.
According to the classification proposed by the National Institute of Health (depending on the course of the inflammatory process), acute bacterial prostatitis is distinguished, which is rare (approximately 5% of all cases) and chronic prostatitis.The latter can develop after acute, but in 90% - 98% of cases is primary.It is supposed to lead to sexual disorders and infertility.
The chronic form is divided into:
- Bacterial.
- Abaster or chronic pelvic pain (in the absence of bacteria in studies)., In turn, it is divided into inflammatory and non -inflammatory.
- Asymptomatic inflammatory (in the absence of obvious symptoms).
Clinical manifestations
Acute prostatitis
The acute course is caused by any microorganism and is characterized by almost simultaneous damage to all glandular lobes.The most common cause is gococcus.The inflammatory process can be in the form of abscess or diffuse, not inflammation.The most characteristic symptoms of acute prostatitis are the following:
- Chills and high body temperature (up to 38.5EITHER and above).
- Severe poisoning: weakness, joint pain, headache, increased pulse frequency, lack of appetite, etc.
- Severe pain in the perineum, in the inguinal and lumbar areas.
- Urine disorders: frequent and false urgency, pain and difficulty in urination, acute urinary retention.
- Belovoy or transparent discharge of the urethra.
An examination of the prostate fingers through the rectum is impossible due to severe pain.In addition, it is contraindicated due to the possibility of dissemination (propagation) of blood infection and the development of a septic state.
Chronic prostatitis
The recommended classification reflects the fact that the signs of chronic prostatitis in men are very diverse, and the opinions of doctors about the causes and mechanisms of the development of the disease are largely different.The diagnosis is based on patient complaints, clinical examination in an examination of the gland fingers through the rectal (rectal) and the ultrasound exam.At the same time, the degree of pain, size and volume, contours, consistency uniformity and the presence of softening or sealed areas are evaluated.
Partially the functional capacity of the organ and, most importantly, the presence or absence of inflammation processes, as well as the form of the disease, allows it to evaluate the study of prostate secretion.It is obtained as a result of a finger massage from a prostate with posterior bacteriological analysis of the material (secret), PCR behavior (polymerase chain reaction) to detect conditionally pathogens and pathogens of sexual infections and spermagrams analysis.
General symptoms of several forms of chronic prostatitis:
- Moderation or moderate pains in the form of "pains" and severity in the perineum, which occur or intensify after drinking alcoholic beverages, physical activity, sexual contact.Sometimes a paroxysmal nature is happening.
- A feeling of discomfort and crusia in the urethra during urine or sexual contact, the minor discharge of serous grace of the urethra (mainly after a long -term delay in the urine).
- Frequent sudden repressive of urinating (sometimes up to 3 times in 1 hour) and a feeling of insufficient emptying of the bladder, which is explained by a violation of the nerve regulation of the prostate, its muscle fibers and the bladder.
- Reduction of the ability to fertilize, which is caused by an increase in the acidity of the secret, a decrease or absence of sperm mobility, their agglutination (stuck) with heads.
- Pain for orgasm or erased orgasm sensations, ejaculation disorders, expressed in their O, on the contrary, in the excessive duration of sexual relations.These phenomena are associated with the inflammatory process in the field of seminal tuber or its scars as a result of inflammation.
The information presented allows us to understand the need and importance of timely attractiveness to a qualified specialist in case of certain symptoms and abandon several non -traditional methods of auto -Medication.The treatment is prescribed only after a complete and complete examination to establish the cause and shape of the disease.
Differential diagnosis
The differential diagnosis of acute prostatitis and distinctive signs of chronic prostatitis in men are reflected in the table:
| The form of prostatitis | The main symptoms | Laboratory data |
| Acute bacterial |
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| Chronic bacterial |
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| Chronic abacerial (chronic pelvic pain syndrome): |
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| inflammatory |
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| non -inflammatory or stagnant (40% of patients with prostatitis) |
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| Asymptomatic inflammatory prostatitis |
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