Chronic inflammation of the prostate gland occurs in men of any age.In most cases, the catalyst is an infectious factor: Trichomonas, staphylococci and gonococci.Bacteria entering the body provoke inflammation of the urethral canal, the prostate gland itself.
The chronic form of prostatitis is often asymptomatic.The disease itself is determined only after passing into an acute form.The late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.
Statistics show a constant "renewal" of the disease.More and more, patients aged 30 are turning to urologists.
Chronic prostatitis - what is it?
The prostate gland is located under the bladder.The main functions are reduced to the protection of the vesica urinaria from the entry of seminal fluid, as well as from the production of prostate secretion, a necessary component of male sperm.Inflammation of the gland tissue, provoked by infection, congestion and other factors, gradually becomes permanent.
Chronic prostatitis leads to degenerative changes.The tissue structure is gradually deformed.Often, against the background of inflammation, stones appear in the channels.Some types of prostatitis cause the development of cancer.
An international classification system has been developed to facilitate the differentiation between different prostate diseases.
Chronic prostatitis - causes
It is generally accepted that inflammation of the prostate gland is caused by two main factors: bacterial and bacterial.
The first is related to the entry of pathogens and infections into the patient's body.Most often, the catalyst is sexually transmitted bacteria.
The second cause of occurrence is not related to an infectious agent.The catalyst for inflammation can be:
- Hypothermia of the body.
- Hormonal imbalances related to aging and irregular sex life.
- Bad habits.
- Damage to pelvic organs.
- Stagnation caused by metabolic disorders and a sedentary lifestyle.
After diagnosing prostatitis, the main cause of chronic prostatitis must be determined.The course of therapy is prescribed based on what exactly caused the inflammation.Bacterial and non-infectious prostatitis are treated differently.
Urologists mention several additional factors that worsen the situation and affect the severe course of the disease:
- Sexual abstinence.
- Inferior ejaculation (choosing interrupted sexual intercourse as a method of contraception).
- Stress.
- Bad habits - alcohol abuse and smoking.
- Poor nutrition.
- Inflammatory diseases have suffered in the past.Often urethritis and cystitis act as causes of chronic prostatitis.
Inflammation is associated with destructive changes in the prostate gland, which makes it possible to classify the disease into several categories.
Classification of chronic inflammation of the prostate
Varieties of prostatitis received their ICD-10 code - N41.To clarify the diagnosis and differentiate the infection of the catalyst, a special classification B95-B97 is used.The symptom rating scale divides the disease into several groups and subgroups:
- I - acute inflammation, accompanied by a sharp increase in temperature and fever.
- II - chronic prostatitis, provoked by an infectious factor.
- Class III includes a disease in which the pelvic pain syndrome begins to appear.It is customary to distinguish two subgroups:
- IIIA - there are signs of an inflammatory process.Low-grade fever is maintained.
- IIIB - no inflammation.
- IV - prostatitis in which there are no symptomatic manifestations.Deviations from the norm are detected exclusively by instrumental diagnostic methods.
By ICD code:
- N41.1 is diagnosed with chronic prostatitis.
- N41.8 Inflammatory diseases of the prostate gland.
- N41.9 a correct diagnosis is not made.
How is chronic prostatitis manifested - 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.Symptoms, even if present, are temporary, short-term and of low intensity.
According to clinical manifestations, three stages of prostatitis development are distinguished:
- Initial indirect signs of chronic prostatitis - as already noted, the onset of the disease is not expressed by clearly recognizable symptoms.Manifestations are subtle or absent altogether.Signs you should pay attention to: burning sensation during ejaculation, decreased potency, painful urination.
- Secondary signs of chronic inflammation of the prostate - at this stage, pathological changes in tissue structure, the appearance of scar-like formations and a decrease in genitourinary function occur.The stage is characterized by a sharp deterioration of power and urination, increased sweating, severe pain in the pelvic area, lumbar spine and scrotum.
- Signs of an advanced disease - the prostate stops functioning normally.Healthy tissue begins to metamorphose.The gland increases in size.Blood and pus 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 decreases so much that we can talk about complete sexual impotence.
In addition to the characteristic symptoms for each stage of development, there are general signs that appear throughout the course of the disease.
Pain syndrome
Chronic prostatitis in the late stage of development has pronounced symptoms.The characteristic clinical manifestations are pains of severe intensity that do not go away by themselves and require the use of analgesics and antispasmodics.
The pain syndrome accompanies the entire period of development of the disease.During the primary signs of prostatitis, discomfort and burning in the urethral canal are of low intensity and therefore often ignored.The pain is often mistakenly attributed to radiculitis or fatigue.After relieving the pain or taking an antispasmodic, the symptom usually goes away.
Over time, the clinical picture becomes more intense.The pain syndrome manifests more intensively and 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 limbs, and is accompanied by cramps and numbness.Redness of the skin, itching and burning of tissues in the prostate and genital areas are a normal reaction of the body to internal inflammation.
Increase in temperature
Chronic inflammation of the prostate gland in acute form is accompanied by heat and fever.There is a sharp increase in temperature, reaching 39-40 °.Indicators are stable.Body temperature does not decrease even after taking antipyretics.
Slow prostatitis is characterized by a low temperature.Constant indicators of chronic inflammation, within 37-37.2°.
Lowering the temperature and taking medications yourself to reduce external manifestations is strictly prohibited!
dysuria
The first signs of chronic prostatitis appear in various urination disorders.Over time, the symptoms become more intense, which helps to identify 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 during urination.
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 genitourinary system, hyperplasia and oncology.
Disorders of the genital organs
Chronic prostatitis leads to the appearance of scar formations that damage the blood supply.Lack of nutrients leads to the following manifestations:
- Decreased potency - with chronic prostatitis, sexual disorders are observed.One of the characteristic symptoms is a normal erection, which decreases significantly during sexual intercourse.In the advanced stage, sustained potency appears.
- Sterility - after the appearance of wounds in the seminal ducts, the viability of sperm decreases.Inflammation changes the structure and composition of the ejaculate.In the advanced stage, the spermatozoa thickens and lumps appear.
- Pain during sexual intercourse - discharge from the urethra is observed.During sexual intercourse, discomfort and painful symptoms are felt, especially during ejaculation.Often psychosomatic reasons lead to the patient's constant impotence.
The main symptoms of chronic prostatitis: pain, increased body temperature, dysuria, dysfunction of the genital organs.When establishing the diagnosis, the intensity and duration of the period from the onset of clinical signs, as well as the symptoms associated with them, are taken into account.
How can chronic inflammation of the prostate be detected?
Prostatitis has no symptoms that can accurately differentiate the disease.Some disorders of the genitourinary system have similar symptoms.An accurate diagnosis can be made only after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.
Suspecting the presence of disturbances in the functioning of the pelvic organs, the urologist will prescribe a mandatory rectal examination.If tissue changes are detected during palpation, some laboratory tests are prescribed.
Laboratory research methods
Clinical tests of blood and urine distinguish the presence of an inflammatory process and can often explain the catalyst for the development of the disease.When making a diagnosis, additional information will be required from the results of the following laboratory tests:
- Cytological and bacteriological analysis of urine.The PSA level is set.Protein levels increase significantly with inflammation of the glandular tissue.
- Taking a smear from the urethra.
- Microscopy of prostate secretions – malfunctions in the prostate gland are determined based on the results.Distinguish cancer from chronic tissue inflammation.Sowing prostate secretions is prohibited during an acute period of the disease, accompanied by high body temperature, worsening of hemorrhoids or fissures in the anus.
- Tests for STIs (sexually transmitted infections) - one of the common catalysts for inflammation of the prostate gland are pathogenic microorganisms.Trichomonas, staphylococci and gonococci can all cause the disease.Prostatitis develops during the active phase of bacterial proliferation and after the infection has already healed.
Laboratory tests are a mandatory component of the diagnosis of prostatitis and the subsequent choice of treatment method.
Instrumental detection of the disease
There are three main methods of testing for prostatitis.Each instrumental diagnostic method provides information about changes in the structure of the gland tissue and has its own indications and contraindications:
- Tomography - MRI is often prescribed to diagnose chronic prostatitis.The study allows you to get a layer-by-layer image of the prostate.MRI signs accurately indicate chronic inflammation, and also indicate the beginning of tissue degeneration into a malignant formation.Magnetic resonance technology is absolutely harmless, but has contraindications due to the impossibility of studying patients with pacemakers, metal clips and shunts (left during surgical operations).
- Transrectal TRUS is an informative method that reliably shows the presence of inflammation.Sonographic signs of structural changes in the prostate gland according to the type of chronic prostatitis include: deviations from the norm in volume and size, structure and the presence of pathological formations.Ultrasound techniques are not prescribed for acute inflammation of the rectum, the presence of fissures in the anus or hemorrhoids.
- Ultrasound - transabdominal technique has no contraindications.The method is less informative compared to TRUS and MRI.Sonographic signs make it difficult to determine the space 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 ultrasound picture depends mainly on the experience of the doctor who performs the study.
Differential search for disease
After receiving the results of clinical and biochemical studies, the symptoms of chronic inflammation of the prostate gland are evaluated.Common diagnostic standards have been developed that are valid worldwide.
To facilitate the task of the urologist, the NIH-CPSI symptom index was invented, made in the form of a questionnaire or questionnaire.The doctor fills in the fields in the document and then makes a diagnosis.
There are computer programs based on the NIH-CPSI index.The doctor must fill out a questionnaire and the system will independently perform a summary assessment of symptoms for chronic prostatitis.The effectiveness of the technique has been proven all over the world.
After calculating the results of the questionnaire, when a diagnosis is made, an additional evaluation of instrumental and clinical studies is taken into account: the presence of echo signs of chronic prostatitis, increased PSA level, identification of an infectious marker by microscopy of secretions.The more data the urologist has, the more accurate the result will be.
What is dangerous for chronic prostatitis - its consequences
The consequences of chronic prostatitis in men are disorders in the functioning of the genitourinary system.These include:
- Impotence.
- Acute retention of urine.
- Sterility.
Fibrous changes accompanying the advanced disease cause the development of oncology.Normal tissues degenerate into malignant ones.Therefore, preventing functional changes in the prostate gland to prevent the development of cancer is an extremely important task facing the urologist.
When establishing the diagnosis, the presence of intraepithelial neoplasia of the prostate, a warning sign of oncology and fibrous changes, is taken into account.Advanced disease often leads to the need for surgery: prostatectomy.
Diagnosis of prostatitis and differentiation of the disease from disorders related to the pelvic organs is an important task for doctors and patients.The detection of the first symptoms depends entirely on the person himself.If you experience any discomfort during urination, decreased erection or persistent low-grade fever, these are reasons to seek professional medical help immediately.Delay is dangerous!