How is acute prostatitis diagnosed and treated?

Acute prostatitis is characterized by a pronounced clinical picture. The pathology is dangerous with a number of serious complications, therefore, it requires timely and complex treatment. How to recognize and treat a disease is described in this article.

Acute prostatitis is an inflammatory disease that is accompanied by pronounced painful sensations and can pose a great danger to health. For a positive prognosis of the disease, you need to consult a doctor in time for the diagnosis and prescription of 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:

  1. Catarrhal.At this stage, the gland swells a little, the inflammation affects only the mucous membranes of the excretory ducts of the gland. This period is the most favorable time 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 edema that appears obstructs the ducts, preventing the secretion from leaving the gland. The stagnation begins.
  2. Follicular.Due to stagnation, bacteria that have entered the organ already begin their activity in it. Since the organ is made up of cells, grouped together in lobules and separated by connective tissue, the inflammation first affects a part.
  3. Parenchymal.Inflammation passes from one lobule to another, there are many pustules in different parts of the gland.
  4. Purulent abscess.The pustules merge together and a bladder filled with purulent contents forms in the gland. Over time, it may burst, pus spread, enter the space around the prostate and bladder, urethra or rectum. When an abscess is opened, the pus does not come out completely and it becomes a new cycle 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 inflammation, the speed 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 trigger purulent processes.
  • Trichomonas is the leader among sexually transmitted microorganisms. Penetrates into the intercellular space of the gland, therefore requires long and tenacious treatment.
  • Chlamydia - in addition to toxicity, they are able to stick erythrocytes, increasing their sedimentation rate and hampering blood flow to the affected area. They penetrate deeper than Trichomonas.
  • Staphylococci, the golden appearance is particularly common. It can survive in all tissues and organs, causes suppuration and thickens the blood.
  • Ureaplasma is a cross between unicellular and virus. Can enter the prostate through the urinary tract or through unprotected sex.
  • Escherichia coli is a Gram-negative bacterium, a common causative agent of acute inflammation. It enters the body due to improper 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 is not just infections that can live in the body for a long time without almost any symptoms. They begin to grow rapidly when there are contributing factors to it:

  • Regular or occasional hypothermia. The cold weakens the body's defenses and it is more difficult for them to contain pathogenic bacteria, especially if hypothermia is associated with daily work.
  • Irregular sex life. The stagnation of the secretion of the gland (which is an integral part of the sperm) promotes the multiplication of bacteria.
  • Common infections. These could be infections resulting from unprotected sex or bacteria that have caused mild inflammation of the urinary tract. The consequences of a not fully cured purulent sore throat in the form of streptococci can also cause inflammation. Even tooth decay can cause prostatitis.
  • Weakened immunity. If, as a result of an illness or an uncontrolled intake of antibiotics, the body's defenses become insufficient, the bacteria will certainly appear.
  • Non-compliance with the rules of personal hygiene.

Symptoms of acute prostatitis

Symptoms depend on the stage of the disease.

During the period of catarrhal prostatitis, there is slight discomfort and a feeling of heaviness in the perineum, the urge to go to the toilet at night becomes more frequent. Urination is accompanied by burning and pain. The gland itself is normal or non-critically enlarged, examination on palpation causes pain. The temperature remains normal or increases slightly. No drunkenness, general well-being.

The follicular period has more manifestations. The pain increases, becomes constant, sometimes suddenly radiates to the penis, sacrum or rectum. Urine retention appears, as urination is difficult due to the sharp pain. Defecation is also accompanied by severe pain.

The temperature rises to 38 degrees and remains at that level. The prostate noticeably increases in size, has a dense consistency, is stretched, touching it in some places causes sharp pain.

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Parenchymal prostatitis is very difficult. Appetite disappears, chills appear, general weakness. The frequent urge to go to the toilet with short urination is replaced by acute urinary retention. Trying to empty the bladder or bowel becomes almost impossible due to the unbearable pain. It is aggravated by constipation and a full bladder, extends over the entire perineum, a slight relief can only come when lying down with the legs bent.

The temperature rises above 39 degrees. Inflammation begins to spread to other organs, mucus is secreted from the rectum. The prostate has an indistinct 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. The passage of urine, stools and gas is extremely difficult, accompanied by intense throbbing pain that spreads to the intestine. The temperature is kept above 39. 5 degrees, chills, fever, and sometimes delusional state appear.

Then, unexpectedly, relief arrives: the pain goes away, the temperature drops. However, this does not mean that the patient has recovered: the fact is that the abscess has burst, and now urgent procedures are required to cleanse the body of pus, since the negative consequences can be very diverse.

Diagnostic

The diagnosis is made on the basis of an evaluation of the patient's complaints, an analysis of urine, blood and prostatic secretions. In addition, they use the method of digital rectal diagnosis, ultrasound and computed tomography.

The severity of urinary disorders is assessed by flowmetering.

A general analysis of urine can identify the disease in the early stages, when the characteristic symptoms are still absent. The alkaline acidity index itself indicates the development of inflammation.

Bacteriological examination of the urine can determine the nature of the inflammation and its causes. Changes in urine color, odor or consistency 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 levels of hemoglobin (normal 130 g / l), high levels of urea and creatinine, as well as the level of leukocytes and the rate of erythrocyte sedimentation. Proteins should not be normal, as well as a high level of leukocytes - there should be no more than 5 units.

Specific analysis of PSA allows you to identify not only inflammation, but also malignant formation.

PCR research can quickly identify 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 point and diffuse changes. If an abscess has formed, this study can determine its size and location. If possible, the study is performed transrectally; if the pain and swelling do not allow it, the study of the gland is carried out from the side of the abdomen.

Sometimes an ultrasound is performed with observation of the change in frequency of sound reflected by the organ. This allows you to assess the blood supply to the prostate - vascularity, which can be increased or weakened depending on the type of inflammation and its stage. Helps distinguish a cancerous tumor from acute prostatitis.

If the doctor determines that surgery is needed, he or she orders a CT or MRI to look at the details of the inflammatory process.

MRI for the diagnosis of acute prostatitis

Treatment of acute prostatitis

The treatment of the disease is always complex, including taking different drugs, procedures and diets. The treatment can last about 2 months.

The main task of the doctor is to eliminate the cause of inflammation, which most often consists of infection. For this, antibiotics are prescribed (alone or in combination). The choice of a drug depends on several factors:

  • the sensitivity of the pathogen;
  • concomitant diseases of the patient;
  • mode of action of the drug.

Self-diagnosis and therapy is not possible: an effective drug is selected on the basis of laboratory tests

To combat the agents responsible for an acute inflammatory process, fluoroquinolones and third-generation cephalosporins are most often used. For the treatment of acute prostatitis, the bactericidal effect of the antibiotic is fundamentally important.

Depending on the stage and condition of the patient, the dosage and form of release of the drug is selected: the more neglected the situation, the higher the dose and the more important it is that the drug reaches its destination more quickly. drugs in the form of injections are preferable to tablets.

It is necessary to normalize the flow of urine and secretions. If the urinary retention has turned into an acute form, a trocar epicystomy is prescribed - a puncture of the bladder, 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 eliminates swelling and pain. Medicines are prescribed in the form of tablets, injections or rectal suppositories.

If the acute prostatitis has turned into an abscess, treatment depends on its stage. The infiltration stage is treated with active therapy with antibiotics and immunostimulants. A blockage is given with pain relievers 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, washed, and drainage is installed. After the operation, treatment is prescribed to combat germs and poisoning.

Treatment for acute prostatitis is not just about relieving symptoms. The course of antibiotics should be drunk until the end, and not before the pain subsides.

After the seizure itself is gone, it is time for physiotherapy. It includes UHF and microwave procedures, electrophoresis and prostate massage. The aim is to relieve swelling (if left), to improve the flow of glandular secretions in order to avoid congestion.

It is important to stick to your diet throughout the treatment. You must refuse the following products:

  • alcoholic drinks, coffee, chips and salty - contributes to the appearance of congestion;
  • white cabbage, apples, legumes and raw vegetables - cause bloating, as a result of which the pelvic organs, including the prostate, are squeezed;
  • acidic drinks, organ meats - they irritate the urinary tract.

The diet should include grains, cooked vegetables, dairy products, and baked fruits. All this contributes to the normal functioning of the intestines. It is necessary to observe the drinking regime, drinking at least 2 liters of liquid (water, fruit drinks, juice) per day. The more often the urinary tract is flushed, the lower the risk of inflammation.

Vitamin complexes and peptides should be drunk to improve tissue regeneration and the rapid restoration of normal functioning of the gland.

pills for the treatment of acute prostatitis

The favorable course of treatment is judged by the restoration of glandular tissues, the normalization of the chemical indications of prostatic secretions, the absence of pathogens in the analyzes and the general well-being of the patient.

Prognosis and complications

The earlier the treatment was started, the faster and easier it is to get rid of acute prostatitis. 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 treatment all functions of the body are restored, the working capacity is fully restored.

Prevention

Preventive measures include the absence of unprotected sex (to exclude STIs), careful hygiene and timely treatment of inflammatory processes in the urinary tract. It is necessary to maintain immunity, not to start decayed teeth, and to carefully treat infectious diseases.

You should also exclude factors contributing to the development of the disease. For this you need:

  • have a regular sex life with only one partner;
  • avoid hypothermia (both permanent and occasional);
  • give up alcohol, tobacco and a sedentary lifestyle;
  • undergo a regular routine examination by a urologist;
  • do not self-medicate at the first signs of inflammatory processes;
  • stick to a balanced diet;
  • take vitamins, especially during times of the spread of infectious diseases.

Acute inflammation of the prostate appears due to infections that develop under favorable circumstances. Treatment is carried out with antibiotics, anti-inflammatory drugs, pain relievers and vitamins. During the treatment period, it is important to follow a diet and diet.