About 40 - 60% of the urological patients of the clinic are patients with chronic prostatitis.Symptoms of prostatitis in men are often the cause of depressive conditions and psychic changes.
The disease that all third people experiences over the age of 25-30 does not endanger life, but the difficulties in its diagnosis and treatment determine the long chronic course and often cause disability.
The idea of prostate functions, mechanisms, and the causes of inflammation allow us to understand the symptoms and the need for timely treatment.
The functional meaning of the prostate gland
Its main function is the secretion of specific fluid (secret) of 40 - 50 glands, which forms the body of the entire glandular tissue.The secret of 90 - 95% consists of water and basic trace elements, phospholipids, sperm amino acids, which gives sperm specific smell, enzymes, proteins, citric acid and fructose.All components have their own purpose and are strictly balanced.
Prostate Secret provides:
- Neutral or slightly alkaline environment formation and maintenance in urethra and sperm.This environment provides sperm sperm.
- Sperm rash is essential to prevent sperm connection and promote them.In the process of sexual intercourse, sperm is mixed with prostate juice.
- Spermatozoa viability: Mysterious substances are nutrients of nutrients that can be placed in the female genitals for several days before egg fertilization.
- Protecting the genital system from infection with zinc, sperm, polyamins and immunoglobulin A. Zinc concentration in the prostate is 100 times higher than in other organs.It has a pronounced antimicrobial effect, accumulates in the form of protein complexes and is spermic in free state;Sperminos and polyamins also have high anti -bacterial action, and immunoglobulins participate in the immune protection of prostate and urinary tract.
Prostate iron also participates:
- By transforming testosterone from blood in hormonal metabolism, active dihydrotestosterone;The latter regulates the secretory action of the gland;This process is carried out with the participation of the same zinc;
- In the action of urine using smooth muscle fibers containing a gland capsule;
- During the ejaculation process, the lower pelvic muscle muscles and prostate passes through that part of the urethra;
- In the formation of orgasm sensation, it passes along the lateral surface of the seed tuberculosis due to the duct carcinum;It contains receptors that transmit impulses in the brain during ejaculation.
Thus, the prostate, along with participating in human hormonal status and to ensure the possibility of reproduction, protects the urogenital organs from the aggression of the pathogenic and pathogenic microorganisms.
Causes and auxiliary factors
The main cause of prostate inflammation is the pathogenic and conditionally pathogenic microbes.In 60%, this is E. coli.Recent studies have confirmed the role of gonococcal and trichomonas infections in inflammation.In case of impairment of protective barrier and local immune defense, infection such as yeast -like, mycoplasma and uric acid, herpes virus and cytomegalinic, microorganisms that cause respiratory diseases (along with oral contact), instinctive micro -organisms)
Due to TB diseases, mycobacteria can spread to the bloodstream in the prostate.Tuberculosis prostatitis occurs, but rarely.
Ways to penetrate infection in the gland:
- Hematogenous - from other focuses of infection with blood;This is done through the venous vessels of the prostate, by communicating with penis, testicles, rectum, bladder and kidney veins (including tuberculosis damage)
- Lymphogenic - through lymph vessels
- Urethrogenic - through the urethra
Auxiliary factors:
- Disruption of hormonal background, in particular, lowering of testosterone levels, resulting in a decrease in the antimicrobial prostate barrier.
- Varicocele (seed vein enlargement), hemorrhoids, varicose veins of the lower extremities.These diseases are the result of a genetic defect in venous valves, which results in disruption of blood microcirculation in the organs of the pelvic muscles, increasing local temperature, decreasing in normal condition (compared to total body temperature) and creating favorable conditions for vital action of microorganisms.
- Osteochondrosis, lumbar spine hernia and other innervation disorders, seductive lifestyle.They can cause prostate vessels to prolong (narrowing) or, on the contrary, to their long -term expansion.The first leads to blood loss, the second - to the phenomena in the blood.
- Intoxication is alcohol, which results in paralysis of small vessels and nicotine, which promotes prolonged spasms.
- Various infectious diseases, diabetes mellitus, frequent and long negative mental effects, stress, sleep disturbances - all of which help reduce general immunity.
Types of prostatitis
Mostly, the first symptoms of prostatitis are explained by impaired blood supply to the gland, inflammation or vascular spasm, which results in oxygen deficiency, decreased decreased metabolic processes.They cause irritation of large numbers of nerve receptors associated with the ends of tests, bladder, rectum, penis, pelvic nerves.
In accordance with 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 (about 5%of all cases) and chronic prostatitis.The latter may develop after acute, but in 90% of cases - 98% are primary.It is suggested that it causes sexual disorders and infertility.
The chronic form is divided:
- Bacterial.
- Abacterial, or chronic pelvic pain (in the absence of bacteria in studies).This, in turn, is divided into inflammation and non -information.
- Asymptomatic inflammation (in the absence of obvious symptoms).
Clinical manifestations
Acute prostatitis
Acute course is provoked by any microorganisms and is characterized by almost simultaneous damage to all glandular lobes.The most common cause is gonococcus.The inflammatory process can be in the form of an abscess or diffuse and not inflammation.The most characteristic symptoms of acute prostatitis are as follows:
- Coldness and high body temperature (up to 38.5O And above).
- Strong intoxication - weakness, joint pain, headache, pulse rate, lack of appetite, etc.
- Severe pain in the perinum, in areas and lumbar areas.
- Urinary Disorders - Frequent and false demand, pain and difficulty in urination, acute urinary retention.
- From the urethra or transparent discharge.
Through the rectum it is impossible to examine the prostate finger due to severe pain.Moreover, it is contraindicated due to the possibility of spread (spread) of infection in the blood and the development of a septic condition.
Chronic prostatitis
The recommended classification reflects the fact that the signs of chronic prostatitis in men are very diverse, and physicians' views are largely different from the causes and mechanisms of the disease.The diagnosis is based on patient complaints, clinical examination of the gland finger through the rectum (rectal) and ultrasound examination.At the same time, the presence of pain, size and volume, contours, unity and softening or sealing areas is evaluated.
Partly the functional ability of the body and, most importantly, the presence or absence of inflammatory processes, as well as the form of the disease, allows you to evaluate the study of prostate secretion.It is obtained as a result of a prostate finger massage, with further bacteriological analysis of the material (secret), PCR (polymerase chain reaction) behavior, conditionally pathogenic microorganisms and sexual infections.
General symptoms of various forms of chronic prostatitis:
- Discomfort and/or moderate pains in the perinum in the form of "pain" and gravity that occur or intensify after drinking alcohol, physical activity, sexual contact.Sometimes they go through paroxysmal in nature.
- During urethra or sexual contact, the feeling of discomfort and cruise in the urethra, small serous gray discharge from the urethra (mainly after long -term urinary tract).
- Sudden frequent urination (sometimes 3 times up to 1 hour) and insufficient emptying of the bladder, which is explained by disruption of the nerve regulation of the prostate, its muscle fibers and the bladder.
- Fertility reduction caused by the increase in the acidity of mysteries, decreased or absorbed by sperm mobility, their agglutination chapters.
- Orgasm pain or orgasm sensations, ejaculation disorders expressed in premature or, on the contrary, with excessive duration of sexual intercourse.These phenomena are associated with an inflammatory process in the field of seminar tuberculosis or as a result of inflammation of its scars.
The information presented allows us to understand the need for timely appeal of a qualified specialist in the case of certain symptoms and to abandon various unorthodox methods of self -determination.Treatment is prescribed only after a thorough and thorough examination to determine the cause and form of the disease.
A differential diagnosis
The table reflects the differential diagnosis of acute prostatitis and distinctive signs of chronic prostatitis in men:
| The form of prostatitis | Main Symptoms | Laboratory data |
| Acute bacterial |
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| Chronic bacterial |
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| Chronic Abacterial (Chronic Pelvic Pain Syndrome): |
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| Inflammatory |
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| Non -information or stagnant (40%of patients with prostatitis) |
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| Asymptomatic inflammatory prostatitis |
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