Chronic inflammation of the prostate gland occurs in men of any age. In most cases, the catalyst is an infectious agent: Trichomonas, staphylococcus and gonococcus. Bacteria that enter the body cause inflammation of the urethral canal, the prostate itself.
Chronic prostatitis is often asymptomatic. The disease itself is determined only after the transition to the acute form. Delayed diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.
Statistics show the constant "rejuvenation" of the disease. Increasingly, urologists are reporting patients over the age of 30.
Chronic prostatitis - what it is
The prostate gland is located below the bladder. The main functions are the protection of vesica urinaria from the entry of sperm, as well as the production of prostate secretions, an essential component of male sperm. Inflammation of the glandular tissues, caused by the entry of infection, congestion and other factors, gradually becomes permanent.
Chronic prostatitis leads to degenerative changes. The structure of the tissue is gradually deformed. Very often, against the background of inflammation, stones appear in the ducts. Some types of prostatitis cause cancer.
An international classification system has been developed to facilitate the differentiation between different prostate diseases.
Chronic prostatitis - causes
Inflammation of the prostate gland is believed to be caused by two main factors: bacterial and bacterial.
The first is related to the ingestion of pathogens and infections in the patient's body. Most often, sexually transmitted bacteria act as catalysts.
The second cause is not related to the infectious agent. Inflammation can be catalyzed by:
- Hypothermia of the body.
- Hormonal disorders associated with aging, irregular sex life.
- Bad Habits.
- Injury of the pelvic organs.
- Congestion caused by metabolic disorders and sedentary lifestyle.
After the diagnosis of prostatitis, the main cause of chronic prostatitis must be determined. The course of treatment is prescribed based on what exactly caused the inflammation. Bacterial and non-infectious prostatitis are treated differently.
Urologists name several additional factors that aggravate the condition and affect the serious course of the disease:
- Sexual abstinence.
- Incomplete ejaculation (choice of intermittent sexual intercourse as a method of contraception).
- Bad habits - alcohol abuse and smoking.
- Inadequate nutrition.
- Previous inflammatory diseases. Urethritis and cystitis are often the cause of chronic prostatitis.
Inflammation is accompanied by catastrophic changes in the prostate gland, which makes it possible to classify the disease into different categories.
Classification of chronic prostatitis
The prostatitis varieties received the code ICD -10 - N41. A separate classification B95-B97 is used to clarify the diagnosis and differentiation of catalyst infection. The symptom score scale divides the disease into different groups and subgroups:
- I - acute inflammation, accompanied by a sharp rise in temperature, fever.
- II - chronic prostatitis caused by an infectious agent.
- III - this category includes a disease in which pelvic pain syndrome begins to manifest. It is common to distinguish two subgroups:
- IIIA - there are signs of inflammatory process. The sub-febrile temperature is maintained.
- IIIB - without inflammation.
- IV - prostatitis in which there are no symptomatic manifestations. Deviations from the rule are detected exclusively by diagnostic methods.
According to the ICD code:
- The N41. 1 is diagnosed with chronic prostatitis.
- N41. 8 inflammatory diseases of the prostate gland
- N41. 9 has not been definitively diagnosed.
How does chronic prostatitis manifest itself - its symptoms
The first signs of chronic prostatitis in men appear in an advanced stage of the disease. Often, early development has no clinical manifestations. The symptoms, even if present, are temporary, short-term and low-intensity.
According to clinical manifestations, there are three stages in the development of prostatitis:
- The initial indirect signs of chronic prostatitis - as already noted, the onset of the disease is not expressed with clearly distinguishable symptoms. The events are subtle or absent. Signs to watch out for: burning sensation during ejaculation, decreased strength, painful urination.
- Secondary signs of chronic inflammation of the prostate - at this stage, there are pathological changes in the structure of tissues, the appearance of scar-like formations and a decrease in urogenital function. The stage is characterized by a sharp deterioration of strength and urination, increased sweating, severe pain in the pelvic area, lumbar spine, scrotum.
- Signs of a neglected disease - the prostate stops working normally. Healthy tissues begin to transform. The gland increases in size. Blood and pus spots appear in the urine, there is a constant feeling of incomplete emptying of the bladder and night trips to the toilet become more frequent. Erectile function is reduced so much that we can talk about complete impotence.
In addition to the typical symptoms for each stage of development, there are general signs that manifest throughout the course of the disease.
Chronic prostatitis at a late stage of development has strong symptoms. Typical clinical manifestations are pain of intense intensity, which does not subside on its own and requires the use of analgesics and anticonvulsants.
Pain syndrome accompanies the entire period of disease development. During the primary signs of prostatitis, the discomfort and burning sensation in the urethral canal is low in intensity, so it is often overlooked. The pain is often falsely attributed to sciatica, fatigue. After taking analgesics or anticonvulsants, the symptom usually disappears.
Over time, the clinical picture becomes more and more saturated. The pain syndrome is more pronounced, it remains after taking analgesics. Unpleasant sensations accompany every act of urination, defecation and ejaculation.
The pain radiates from the spine to the scrotum, sometimes to the extremities, accompanied by convulsions, numbness. Skin rashes, itching and burning of tissues in the prostate and genital area are a normal reaction of the body to internal inflammation.
Chronic inflammation of the prostate in acute form is accompanied by fever and chills. There is a sharp rise in temperature, reaching 39-40 °. The indicators are stable. The body temperature does not decrease even after taking antipyretics.
Hypotonic prostatitis is characterized by a sub-febrile course. Stable indicators of chronic inflammation, in the range 37-37, 2 °.
It is strictly forbidden to lower the temperature and take medicines yourself to reduce the external manifestations!
The first signs of chronic prostatitis are manifested in various urinary disorders. Over time, the symptoms become more intense, which helps to diagnose the disease. Manifestations of dysuria:
- Frequent urge to go to the toilet at night.
- Feeling of incomplete emptying of the bladder.
- Hematuria (blood in the urine), purulent discharge.
- Pain when urinating.
The clinical signs and the intensity of their manifestation directly affect the diagnosis and require mandatory additional research. Symptoms may indicate other inflammatory diseases of the urogenital system, hyperplasia and oncology.
Chronic prostatitis leads to scarring that affects blood flow. Lack of nutrients leads to the following manifestations:
- Decreased potency - with chronic prostatitis, sexual dysfunction is observed. One of the characteristic symptoms is a normal erection, which decreases sharply during intercourse. At an advanced stage, a constant power is displayed.
- Infertility - after the appearance of scars on the seminal vesicles, the viability of the sperm decreases. Inflammation changes the structure and composition of the ejaculate. At an advanced stage, the sperm thickens, lumps appear.
- Pain during intercourse - there is discharge from the urethral canal. During intercourse, they feel discomfort and painful manifestations, especially during ejaculation. Often, psychosomatic causes lead to persistent impotence of the patient.
The main symptoms in chronic prostatitis: pain, fever, dysuria, genital dysfunction. During the diagnosis, the intensity and duration of the period from the beginning of the appearance of the clinical signs, as well as the relevant symptoms are taken into account.
How can chronic prostatitis be diagnosed?
Prostatitis has no symptoms that can accurately differentiate the disease. Some disorders of the urogenital system have similar symptoms. An accurate diagnosis can only be made after a thorough examination of the patient, including laboratory tests and instrumental methods of detecting the disease.
Suspecting the existence of abnormalities in the work of the pelvic organs, the urologist will prescribe a mandatory rectal examination. If palpation reveals tissue changes, several laboratory tests are prescribed.
Laboratory research methods
Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the catalyst for the development of the disease. During the diagnosis, additional information is required from the results of the following laboratory tests:
- Cytological and bacteriological analysis of urine. The PSA level is set. Protein markers increase sharply with inflammation of the glandular tissues.
- Obtaining a smear from the urethra.
- Prostate secretion microscopy - according to the results, prostate gland dysfunctions are identified. Differentiation of cancer from chronic tissue inflammation. Sowing of prostate secretion is prohibited during the acute period of the disease, accompanied by high body temperature, exacerbation of hemorrhoids, cracks in the anus.
- Tests for STIs (sexually transmitted infections) are one of the most common catalysts for prostate inflammation - pathogens. Hair follicles, staphylococci and gonococci can all cause disease. Prostatitis develops during the active phase of bacterial reproduction and after the infection has already healed.
Laboratory research is a mandatory component of the diagnosis of prostatitis and the subsequent choice of a method of treatment.
Organic disease detection
There are three main research methods for prostatitis. Each diagnostic method provides information about changes in the structure of glandular tissues, has its own indications and contraindications:
- Tomography - MRI is often prescribed to diagnose chronic prostatitis. The study allows you to get a multilevel picture of the prostate. MRI scans accurately indicate chronic inflammation and also indicate the onset of tissue degeneration into malignancy. The magnetic resonance technique is completely harmless, but it has contraindications related to the inability to examine patients with pacemakers, metal braces and protectors (left during surgery).
- Transrectal TRUS are informative methods that with high reliability indicate the presence of inflammation. Ultrasound signs of structural changes in the prostate gland from the type of chronic prostatitis include: deviations from the norm in volume and size, structure and presence of pathological formations. Ultrasound technique is not prescribed for acute inflammation of the rectum, the presence of cracks in the anus, hemorrhoids.
- Ultrasound - intra-abdominal technique has no contraindications. The method is less informative compared to TRUS and MRI. Ultrasound scans make it difficult to determine the area of the abdominal cavity. Diagnostic results are often controversial and require clarification. The advantage of ultrasound is the simplicity and speed of the study.
The accuracy of the sound image depends to a large extent on the experience of the doctor conducting the study.
Search for differential disease
After receiving the results of clinical and biochemical studies, the symptoms of chronic inflammation of the prostate are evaluated. Common diagnostic standards have been developed that apply worldwide.
To facilitate the work of the urologist, the NIH-CPSI symptom index was invented, which was done in the form of a questionnaire or questionnaire. The doctor fills in the columns of the document, after which he makes a diagnosis.
There are computer programs based on the NIH-CPSI index. The doctor is asked to complete a questionnaire and the system will independently assess the symptoms of chronic prostatitis. The effectiveness of the technique has been proven all over the world.
After calculating the results of the questionnaire, during the diagnosis, the assessment of the organs and the clinical studies are additionally taken into account: the presence of signs of chronic prostatitis echo, increased PSA level, recognition of infectious marker by microscopic secretion. The more data the urologist has, the more accurate the result will be.
What is the risk of chronic prostatitis - its consequences
The consequences of chronic prostatitis in men are disorders of the urogenital system. These include:
- Acute urinary retention.
The fibrous changes that accompany an advanced disease become the cause of the development of oncology. Normal tissues degenerate into malignant. Therefore, preventing functional changes in the prostate gland in order to prevent the development of cancer is an extremely important task facing the urologist.
When diagnosing, consider the presence of intraepithelial prostate cancer - a harbinger of oncology and fibrotic changes. A neglected disease often leads to the need for surgery: prostatectomy.
Diagnosing prostatitis and differentiating the disease from adjacent pelvic disorders is an important task for both physicians and the patient. The detection of the first symptoms depends entirely on the person himself. If you experience discomfort when urinating, reduced erection, persistent low-grade fever are reasons to seek professional medical help immediately. Delay is dangerous!