Symptoms of prostatitis in men, causes and diagnostics

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

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

The idea of prostate functions, mechanisms and the causes of inflammation growth allows us to properly understand the symptoms and the need for early treatment.

The functional value of the prostate gland

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

The secret of the prostate provides:

1. The formation and maintenance of a neutral or slightly alkaline environment in the urethra and sperm.This environment provides sperm for sperm life.
2. Sperm dilution, necessary to prevent the semen connection between them and ensuring their promotion.In the contact process, the sperm is mixed with prostate juice.
3. Sperm Sustainability: The substances contained in the secret is a nutritional medium for genital cells, which can be detected for several days in female genitals until egg fertilization.
4. Protection of the genital system from infection using zinc, sperm, polyamines and immunoglobulin A. The concentration of zinc in the prostate is 100 times higher than in other organs.It has severe antimicrobial activity, accumulates in iron in the form of protein clashes and is in semen in free condition.Sperm and polyamines also have high anti -bacterial activity and immunoglobulins are involved in prostate and urethral immune protection.

Prostate iron also participates:

• in hormonal metabolism through the transformation of blood testosterone, into active dihydrotestosterone.The latter regulates the secretory activity of the gland.This process is proceeding with the involvement of the same zinc.
• In the act of urination using smooth muscle fibers contained in the capsule of the gland.
• In the process of ejaculation along with the muscles of the bottom of the basin and the part of the urethra passing through the prostate.
• In the formation of the sensation of the orgasm due to the heavy seeds passing along the side surface of the seed seed.Contains receptors that transmit impulses to the brain during ejaculation.

Thus, the patron, along with participating in a person's general hormonal state and ensuring his ability to reproduce, protects the urogenic organs from the aggression of the pathogens produced and pathogenic microorganisms.

Causes and factors that contribute

The main cause of prostate inflammation is to enter pathogens and conditional pathogenic germs.At 60%, this is an E. coli.Recent studies confirm the role of gonococcal infections and Trichomonna in inflammation.In the event of a violation of the gland protective barrier and a decrease in local immunological defense, the penetration of such an infection such as dough, mycoplasia and the Uapagala, herpes virus and the cytomegine, the microorganisms that cause the methods.

For tuberculosis diseases, it is possible to disseminate mycobacteria through the bloodstream to the prostate.Isolated cases of tuberculosis prostatitis are found, but rarely.

Ways of penetrating infection in the gland:

• Hematogenic - with blood from other outbreaks of infection.This happens through the venous vessels of the prostate, communicating with the veins of the penis, testicles, rectum, bladder and kidney (including tuberculosis)
• lymph nodes - through lymph nodes
• Urethogenic - through urethra

Contributing to factors:

1. The violation of the hormonal background, in particular, the decrease in the level of testosterone, as a result of which the prostate antimicrobial barrier is reduced.
2. Varicocele (extension of veins of the seed), hemorrhoids, veins of the lower extremity veins.These diseases are the result of a genetic defect in venous valves, leading to blood microcirculation disorders in pelvis organs, increased local temperature, reduced to normal
3. The osteochondria, the spine of the lumbar spine and other disorders of the integration, a sedentary lifestyle.They can lead to prolonged spasm (stenosis) of the prostate vascuses or, conversely, their long -term expansion.The former leads to a reduced blood supply, the second - to stagnant blood phenomena.
4. Poisoning is alcohol, leading to paralysis of small vessels and nicotine, contributing to their prolonged spasm.
5. Various infectious diseases, diabetes mellitus, frequent and long negative mental effects, stress situations, sleep disorders - all of which help reduce general immunity.

Prostatitis types

Basically, the first symptoms of prostatitis are explained by the deterioration of blood supply to the gland as a result of inflammation or vascular spasm that leads to oxygen deficiency, reduced metabolic processes with the formation of depreciated decomposition products.They cause strong irritation of a large number of nerve receptors associated with the ends of the testicular nerve, bladder, rectum, penis, bottom muscles of the pelvis.

According to the classification proposed by the National Institute of Health (depending on the course of the inflammatory process), there is acute bacterial prostatitis, which is rare (about 5% of all cases) and chronic prostatitis.The latter may develop after acid, but 90% - 98% of cases are primary.It is thought to lead to sexual disorders and infertility.

Chronic form is divided into:

• Bacterial.
• Athens 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 events

Oxytosis of prostatitis

The acute course is caused by any microorganisms and is characterized by almost simultaneous damage to all glandular lobes.The most common cause is Gonococcus.The inflammatory process may be in the form of abscess or diffuse non -inflammation.The most characteristic symptoms of acute prostatitis are as follows:

• Chills and high body temperature (up to 38.5^THE and above).
• Severe poisoning - weakness, joint pain, headache, increased pulse frequency, lack of appetite, etc.
• Severe pain in the perineum, groin and lumbar areas.
• Urinary disorders - frequent and false push, pain and difficulty urinating, acute urine retention.
• Belovoy or transparent rejection by urethra.

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

Chronic prostatitis

The recommended classification reflects the fact that signs of chronic prostatitis in men are very different and doctors' views on the causes and mechanisms of disease development are largely different.The diagnosis is based on patient complaints, clinical examination in a finger test through the rectum (rectum) and ultrasound examination.At the same time, the degree of pain, size and tumor, outlines, uniformity of consistency and presence of maming or sealing areas are evaluated.

In part the functional capacity of the organ and, above all, the presence or absence of inflammation processes, as well as the form of the disease, allows you to evaluate the study of protection.It is taken as a result of a finger massage of a prostate with subsequent bacteriological analysis of the material (Secret), the conduct of PCR (polymerase chain reaction) to detect conditional pathogenic microorganisms and pathogenic agents of sexual infections.

General symptoms of various forms of chronic prostatitis:

1. Discomfort and/or moderate pains in the form of "pain" and seriousness in the perineum, which occur or intensify after eating alcoholic beverages, physical activity, sexual intercourse.Sometimes they pass a paroxysmal in nature.
2. A sense of discomfort and crusading in the urethra during urination or sexual intercourse, low urethra rejection (mainly after long -term urine delay).
3. Sudden frequent urination (sometimes up to 3 times within 1 hour) and a feeling of inadequate bladder evacuation, explained by a violation of prostate nerve regulation, muscle fibers and bladder.
4. A decrease in fertilization capacity, which is caused by the increase in the acidity of the secret, the reduction or lack of sperm mobility, their welding (hell) with the heads.
5. Pain for orgasm or deleted orgasm sensations, ejaculation disorders, expressed in premature or, on the contrary, in excessive sexual intercourse.These phenomena are related to the inflammatory process in the field of sparkling or scarring as a result of inflammation.

The information presented allows us to understand the need and importance of early appeal to a specialist in the case of certain symptoms and abandonment of various non -traditional methods of self -mediation.The treatment is prescribed only after a complete and thorough examination to determine the cause and form of the disease.

Diagnosis

Differential diagnosis of acute prostatitis and chronic prostatitis discreet spots in men are reflected in the table:

The form of prostatitis	The main symptoms	Laboratory data
Bacterial	Acute principle, serious pain in the crotch High temperature, poisoning, muddy, often with blood bleeding, urine	Leukocytosis (increased number of leukocytes in the blood) Accelerated ESR A large number of red blood cells and leukocytes in urine analysis Perhaps the presence of gonococci
Chronic bacterial	Pain on the pelvic floor of a moderate nature, Pain for ejaculation, Early ejaculation, dysuria. Some symptoms may be absent	The red blood cells in a tiny examination of his secret gland, The detection of E. Coli, Enterobacteria, Klebsell or other microorganisms in Ejaculate Bacteric
Years Abacterial (Fire time Syndrome):	Pain in the basin of a moderately expressed nature for 3 months	In conventional studies, bacteria are not detected
incendiary	Obvious incomplete disorders, To 40 - 65% moderate pain in the lower abdomen and in the area of genital 3 or more months	The presence of leukocytes in the secret gland and in the third section of urine during the Meares-Tamey test (study of 4 consecutive parts of the "golden model" of chronic prostatitis laboratory diagnostics)
non -inflammatory or stagnant (40% of patients with prostatitis)	They were uninitiated pelvic pains and discomfort of 3 months or more. Dizuric disorders rarely.	The laboratory data of inflammation is not detected
Asymptomatic inflammatory prostatitis	Clinical subjective symptoms are absent	The presence of signs of inflammation