How is acute prostatitis diagnosed and treated?

Acute prostatitis is characterized by a pronounced clinical picture. The pathology is dangerous with a number of serious complications, so it needs timely and complex treatment. How to diagnose and cure the disease is described in this article.

Acute prostatitis is an inflammatory disease that is accompanied by pronounced painful sensations and can pose a great threat to health. For a successful prognosis of the disease you should consult a doctor in a timely manner to make a diagnosis and prescribe competent treatment.

General characteristics of the disease

Acute prostatitis is a rapidly developing inflammatory process in the prostate gland. It has four stages of development:

  1. Catarrhal.At this point, the gland swells slightly, with inflammation affecting only the mucous membrane of the gland’s excretory ducts. This period is the most favorable moment for treatment - if you start it at this point, you can get rid of the disease in less than two weeks. The nature of inflammation is not purulent, but the swelling that occurs is trapped in the ducts, preventing secretion from the gland. Stagnation begins.
  2. FollicularAs a result of stagnation, the bacteria entering the body begin their activity already in it. Because the body is made up of cells, grouped into lobules, and separated by connective tissue, inflammation primarily affects one part.
  3. Parenchymal.Inflammation spreads from one lobe to another, with many pustules in different parts of the gland.
  4. Purulent abscess.The pustules join and a bubble full of purulent contents forms in the gland. Over time, it may swell, pus may spread, and enter the space around the prostate and bladder, urethra, or rectum. When the abscess opens, the pus does not come out completely and this becomes a new round during the inflammatory process.

How quickly it develops and how the pathological process ends depends on many factors: the causes of inflammation, the timeliness of treatment, and the appropriateness.

ᲛReasons

In 90% of cases, the cause of acute inflammation of the prostate is an infectious lesion. The causative agents may be one or more types of bacteria and viruses:

  • Gonococci are one of the most dangerous bacteria, they quickly start purulent processes.
  • Trichomonas is a leader in sexually transmitted microorganisms. Reaches the intercellular space of the gland and therefore requires long stubborn treatment.
  • Chlamydia - In addition to toxicity, they can gluten erythrocytes, increase their rate of sedimentation and impede blood flow to the affected side. They penetrate deeper than Trichomonas.
  • Staphylococci, golden appearance are especially common. It can survive in any tissue and organ, causes pus and makes the blood thicker.
  • Ureaplasma is a cross between a cell and a virus. It can enter the prostate through the urinary tract or through unprotected sex.
  • Escherichia coli is a gram-negative bacterium, a common causative agent of acute inflammation. It enters the body as a result of insufficient hygiene during food preparation.

This is not a complete list of bacteria and viruses that can cause acute inflammation of the prostate gland.

Often the cause lies not only in infections that can live in the body for a long time with almost no symptoms. They begin to develop rapidly when there are contributing factors:

  • Regular or single hypothermia. Cold weakens the body's defenses and makes it more difficult for them to contain pathogenic bacteria, especially if hypothermia is associated with daily work.
  • Irregular sex life. Stagnation of glandular secretion (which is an integral part of sperm) promotes the multiplication of bacteria.
  • Running infections. These can be infections that result from unprotected sex, or bacteria that have caused mild inflammation in the urinary tract. The effects of purulent sore throat are not completely cured in the form of streptococcus and can also provoke inflammation. Even tooth decay can lead to prostatitis.
  • Weakened immunity. If the body becomes insufficient as a result of illness or uncontrolled intake of antibiotics, bacteria will inevitably appear.
  • Failure to follow the rules of personal hygiene.

Symptoms of acute prostatitis

The symptoms depend on the stage of the disease.

During catarrhal prostatitis there is a slight discomfort and a feeling of heaviness in the perineum, the desire to use the toilet at night becomes more frequent. Urination is accompanied by burning and pain. The gland itself is normal or uncritically enlarged, palpation examination causes pain. The temperature remains normal or rises slightly. No intoxication, general well-being.

The follicular period has more manifestations. The pain increases, becomes constant, sometimes radiating sharply from the penis, sac or rectum. Urinary retention occurs because urination is difficult due to pain. Defecation is also accompanied by severe pain.

The temperature rises to 38 degrees and remains at this level. The prostate gland noticeably increases in size, has a dense consistency, is tense, in some places touch causes severe pain.

Uterine pain with acute prostatitis

Parenchymal prostatitis is very complicated. Appetite disappears, chills appear, general weakness. Frequent urge to go to the toilet with short urination is replaced by acute urinary retention. Attempting to empty the bladder or bowel is almost impossible due to unbearable pain. It is aggravated by constipation and with a full bladder, extends to the entire perineum, slight relief may come only in a prone position, with the legs locked.

The temperature rises above 39 degrees. Inflammation begins to spread to other organs, mucus is secreted from the rectum. The prostate gland has an indistinct outline, is enlarged and painful. Palpation may not be possible due to swelling.

The formation of an abscess is accompanied by the localization of the point of acute pain - where the abscess appears. The movement of urine, feces, and gas is extremely difficult, accompanied by a strong excruciating pain that spreads to the intestines. The temperature is kept above 39. 5 degrees, there is a chill, fever and sometimes a dull state.

Then, suddenly, relief comes: the pain goes away, the temperature drops. However, this does not mean that the patient has recovered: the fact is that the abscess had burst and now urgent procedures are needed to clean the body of the abscess, as the negative consequences can be very varied.

Diagnosis

Diagnosis is based on assessment of the patient's complaints, analysis of urine, blood, and prostate secretions. In addition, they use digital rectal diagnostics, ultrasound and computed tomography.

The severity of urinary disorders is assessed using uroflowmetry.

A general urinalysis allows you to diagnose the disease at an early stage when the characteristic symptoms are not yet present. The alkaline acidity index itself indicates the development of inflammation.

Bacteriological examination of urine allows you to determine the nature of inflammation and its underlying causes. Changes in urine color, odor, or consistency are not considered absolute evidence of acute prostatitis.

A blood test is the basis for studying a disease. Characteristic indicators of acute prostatitis are low levels of hemoglobin (normal 130 g / l), high levels of urea and creatinine, as well as leukocyte levels and erythrocyte sedimentation rate. Protein should not be normal, as well as high levels of leukocytes - should not be more than 5 units.

Specific analysis of PSA allows you to detect not only inflammation but also malignancies.

PCR examination allows you to quickly detect genital infections, which are often the cause of acute prostatitis.

Ultrasound allows you to determine the size of the prostate gland, its edges, the presence of point and diffuse changes. If an abscess has formed, this examination can determine its size and location. If possible, the study is conducted transrectally; If pain and swelling do not allow this, a gland examination is performed on the abdomen.

Sometimes an ultrasound is performed by observing a change in the frequency of sound reflected from the body. This allows you to assess the blood supply to the prostate - vascularization, which may increase or decrease depending on the type of inflammation and its stage. Allows you to distinguish a malignant tumor from an acute prostatitis.

If the doctor determines that surgery is necessary, he or she will order a CT or MRI to examine the details of the inflammatory process.

MRI to diagnose acute prostatitis

Treatment of acute prostatitis

Disease therapy is always difficult, including a variety of medications, procedures, and diets. Treatment can last for about 2 months.

The main task of the doctor is to eliminate the cause of inflammation, which most often consists of infection. Antibiotics (alone or in combination) are prescribed for this. The choice of drug depends on several factors:

  • Susceptibility to the pathogen;
  • Diseases accompanying the patient;
  • Mode of action of the drug.

Self-diagnosis and therapy are impossible: an effective drug will be selected based on laboratory tests

Fluoroquinolones and third-generation cephalosporins are most commonly used to control agents causing acute inflammatory processes. The bactericidal action of antibiotics is fundamentally important in the treatment of acute prostatitis.

Depending on the stage and condition of the patient, the dose and form of release of the drug is selected: the more neglected the situation, the higher the dose and the more important it is for the drug to reach its destination faster, therefore drugs in the form of injections are preferred over tablets.

It is necessary to normalize the outflow of urine and secretions. If urinary retention has become acute, a trocar epicistomy is prescribed - a puncture of the bladder followed by the introduction of a thin tube.

If such drastic measures are not necessary, nonsteroidal anti-inflammatory drugs are prescribed to restore normal urination, which relieves swelling and pain. Preparations are prescribed in the form of tablets, injections or rectal suppositories.

If acute prostatitis has turned into an abscess, treatment depends on what stage it is at. The infiltration stage is treated with active therapy with antibiotics and immunostimulants. Painkillers are prescribed to block to help the patient cope with the pain.

If an abscess has formed, treatment is possible only with the help of surgical intervention: the purulent bladder is opened, rinsed, and drainage is installed. After surgery, therapy is prescribed to fight germs and intoxication.

Treatment of acute prostatitis is not limited to relieving symptoms. You should drink the course of antibiotics to the end and not until the pain disappears.

Once the seizure is removed, it is time for physiotherapy. It includes UHF and microwave procedures, electrophoresis and prostate massage. The goal is to alleviate the swelling (if left), to improve the outflow of glandular secretions, to prevent swelling.

It is important to follow your diet throughout the course of treatment. You must opt out of the following products:

  • Alcoholic beverages, coffee, fried and salted - contribute to the formation of edema;
  • White cabbage, apples, legumes and raw vegetables - cause swelling, causing the pelvic organs, including the prostate, to contract;
  • Sour drinks, by-products - they irritate the urinary tract.

The diet should include grains, stewed vegetables, dairy products and baked fruits. All this contributes to the normal functioning of the intestines. It is necessary to follow a drinking regime, drink at least 2 liters of fluid (water, fruit drinks, juices) a day. The more often the urinary tract is blocked, the lower the risk of inflammation.

You should drink vitamin complexes and peptides to improve tissue regeneration and for the rapid restoration of normal glandular function.

Pills for the treatment of acute prostatitis

A favorable course of treatment is determined by the restoration of glandular tissues, the normalization of chemical parameters of prostate secretion, the absence of pathogens in the analysis, and the general well-being of the patient.

Prognosis and complications

The earlier treatment is started, the faster and easier it is to get rid of acute prostatitis. Complication is each subsequent stage of the disease, the chronic course of the disease, the spread of inflammation to other organs, infertility, sepsis. If the disease has started, it may be necessary to remove the gland.

With timely treatment, at the end of the course of therapy, all the functions of the body are restored, the working capacity is fully restored.

Prevention

Preventive measures include the absence of unprotected sex (to exclude STIs), careful hygiene and timely treatment of inflammatory processes in the urinary tract. It is necessary to maintain immunity, not to start carious teeth and careful treatment of any infectious disease.

You should also rule out factors that contribute to the development of the disease. For this you need:

  • Regular sex life with one partner;
  • Avoid hypothermia (both permanent and single);
  • Give up alcohol, smoking and a sedentary lifestyle;
  • Undergo regular routine examination by a urologist;
  • Do not self-medicate at the first signs of inflammatory processes;
  • Follow a balanced diet;
  • Take vitamins, especially during the period of the spread of infectious diseases.

Acute inflammation of the prostate occurs due to infections that develop under favorable circumstances. Treatment is with antibiotics, anti-inflammatory drugs, painkillers and vitamins. It is important to follow a diet and drinking regimen during therapy.