Treatment of prostatitis is one of the most difficult tasks of modern urology. Despite the achievements of diagnosis and timely detection of the disease, only in 30% of cases it is possible to achieve a complete cure. In most cases, the goal is to achieve a sustained long-term remission. At the same time, chronic prostatitis is difficult to treat with drug therapy alone.

Without getting satisfactory results from the prescribed drugs, patients change doctors, try to take new antibiotics, conduct multiple courses of massages, spend a lot of time and money on treatment. Many develop impotence, which sometimes destroys the family. Some patients completely "go into their illness", they are no longer interested in work, family, children. Sometimes you are convinced that the expression of some jokers: "The prostate gland is the second heart of a man" - has serious grounds. There is a paradox-a physically healthy, young man loses interest in life, and sometimes becomes incapacitated.

What is prostatitis?
Prostatitis is an inflammation of the prostate gland (prostate), a disease that is extremely common. According to various sources, 35-45% of the stronger sex face it. At the same time, the disease mainly affects men aged 20 to 50 years, that is, in the prime of life, during active sexual life. The main function of the prostate is to participate in the formation of sperm. Its numerous glandular lobules secrete a secret that makes the sperm fluid, less viscous, and gives the spermatozoa nutrients, ensuring their activity and vitality. Seminal fluid flows into the prostate, is enriched with this secret, and during arousal is poured into the urethra (urethra). The muscle fibers of the prostate are involved in the "ejaculation" of sperm during sexual intercourse. Thus, prostate diseases, including prostatitis, affect the male sexual sphere, affect the potency, worsen the quality of sperm, reduce the ability to fertilize.

The prostate is located in a narrow space, limited by the bones of the small pelvis, next to other organs that are involved in the daily functions of a person. Therefore, prostate inflammation affects other physiological processes. So, the upper part of the urethra (urethra) passes through the prostate gland, so prostate disease often leads to problems with urination in men, which become frequent, and the process itself is painful and difficult. The posterior part of the prostate is closely adjacent to the wall of the rectum, so when it is inflamed, constipation can also be observed.

Prostatitis has symptoms similar to other diseases of the genitourinary system (prostate adenoma, cystitis, urethritis, etc.), so for proper treatment of discomfort in this area, you should immediately contact a urologist.

Types of prostatitis
Prostatitis has symptoms similar to other diseases of the genitourinary system (prostate adenoma, cystitis, urethritis, etc.), so for proper treatment of discomfort in this area, you should immediately contact a urologist.

According to the severity of the inflammatory process and the duration of the disease, prostatitis is divided into two types: acute (the duration of which is no more than 3 months) and chronic. The causes of acute prostatitis, the features of changes in the gland at different stages, the symptoms are well studied, and sufficiently effective treatment methods have been developed. As for chronic prostatitis, today there are more questions than answers - this applies to both the diagnosis and treatment of the disease.

Acute prostatitis: symptoms, stages, causes:

* Local manifestations - pain in the lower abdomen, perineum, glans penis, rectum, pain can give in the lower back and coccyx. Due to inflammatory edema of the prostate, the lumen of the urethra passing through the gland narrows, there are difficulties and pain when urinating. Acute urinary retention may develop, in which the patient cannot urinate independently (hospitalization and catheter insertion are required).

* General - high fever, weakness, thirst, nausea, vomiting, blurred consciousness, etc.

There are three forms (or otherwise they can be called stages) of acute prostatitis: catarrhal, follicular and parenchymal. As a separate form, there is also an abscess (abscess) of the prostate gland (N. A. Lopatkin, 2002).
They differ in the depth of the lesion of the prostate tissue, the severity of the inflammatory process and the symptoms of the disease:

1. First, the mucous membrane of the excretory ducts - tubules, through which the secret of the prostate is excreted into the urethra, is affected. Catarrhal prostatitis develops.

2. The inflammation involves the glands themselves, which are responsible for the production of secretions - follicular prostatitis.

3. The inflammation spreads to most of the organ-parenchymal prostatitis develops.

4. The course of acute prostatitis can be complicated by the development of an abscess - an abscess of the prostate. This is the most dangerous form of the disease, because in the absence of proper treatment, the infection can get into the blood - microbes spread throughout the body and infect the blood (sepsis develops) with a high probability of death.

The severity of symptoms depends on the form of the disease: in catarrhal prostatitis, they are minimal. Further, in the absence of adequate measures, severe forms develop, characterized by pronounced manifestations - both local and general.

The main cause of acute prostatitis is infection. In most cases, pathogens enter the prostate from the urethra via the ascending pathway.

These can be:

* sexually transmitted infections: gonococci (pathogens of gonorrhea), chlamydia, trichomonas, ureaplasma, etc. They are the most common causes of acute prostatitis in young men 20-30 years old, leading a promiscuous sexual life;

* conditionally pathogenic microorganisms, that is, microbes that can be constantly present in the body, but become active only with a decrease in general and local immunity. The most common is E. coli, also the" culprits " can be klebsiella, proteus, less often-streptococci, staphylococci, etc. More often this cause is diagnosed in men over 40 years old.

Much less often, microbes (for example, staphylococci) can enter the prostate in other ways:

* with the flow of blood or lymph from purulent foci in the body (chronic tonsillitis, sinusitis, boils, carious teeth, etc.). In this case, acute prostatitis can begin immediately with an abscess (abscess);

* from the urethra through the descending pathway, when there is inflammation of the bladder (cystitis), kidneys, upper urinary tract;

* during various medical and diagnostic manipulations in the prostate area (insertion of a catheter into the urethra, administration of drugs, etc.). Through the injured areas, the infection enters the prostate.

However, infection is not the only cause of inflammation. The prostate gland is an organ that is well protected from invading microbes, its sterility is maintained due to the work of the general immune system, as well as local defense mechanisms: the secret of the prostate has the ability to destroy germs that have entered the organ. Therefore, certain conditions must be created for the development of infection in the organ.

A favorable environment for the development of microbes is the accumulation of dead cells in the tissues, which, due to their protein content, are an excellent breeding ground for infection. For example, the infection may feed on the stagnant prostate secretions left in the excretory ducts as a result of incomplete ejaculation.

In this regard, for the effective treatment of prostatitis and its prevention, it is necessary to pay attention to the stagnant processes in the small pelvis and the causes of their occurrence.

Chronic prostatitis: symptoms, causes.

Chronic prostatitis has a long-term (more than 3 months) recurrent (recurring) character. The disease has a number of unpleasant symptoms:

* Violation of urination. Due to inflammation, the nerve endings in the urethra are irritated, which leads to frequent urination (especially at night), sudden and imperative (imperative) urges, as well as urinary incontinence. At the same time, the process of urination itself is difficult, it can be accompanied by cutting pain, as the urethra is squeezed due to the swelling of the gland.

* Disorders of sexual function. During sexual intercourse, there is a faster ejaculation, soreness during or after this process. The erection is weakened, the sexual desire decreases. Prolonged illiterate treatment can lead to impotence and infertility.

* Pain that the patient experiences not only in the genitals and in the small pelvis (testicles, head of the penis, perineum, rectum), but also in the lower back, on the inner side of the thighs.

* Prostatorrhea, when the secret of the prostate gland is released from the urethra outside of sexual intercourse. This is due to the weakening of the muscle tone of the excretory ducts of the prostate, which is why the secret flows freely into the urethra. With bacterial prostatitis, the secret can be mixed with pus, and with calculous prostatitis (with the formation of stones) - with blood.

* Depressive states, increased fatigue, anxiety, etc. Some are so emotionally absorbed by the disease that they are no longer interested in anything, which leads to the loss of their jobs, the destruction of their families - " going into the disease with a separation from reality."

The term "chronic prostatitis" combines a whole group of conditions that have different causes and features of the course.