How is acute prostatitis diagnosed and treated?

Acute prostatitis is characterized by a pronounced clinical picture. The pathology is dangerous with a series of serious complications, therefore, it needs complex and timely treatment. How to recognize and treat an illness is described in this article.

Acute prostatitis is an inflammatory disease that is accompanied by strong painful sensations and can pose a great health hazard. For a successful prognosis of the disease, you should consult a physician in time for the diagnosis and the prescribing of competent treatment.

General characteristics of the disease

Acute prostatitis is an inflammatory process that develops rapidly in the prostate. It has four stages of development:

  • Catarrhal.At this stage, the gland swells a little, the inflammation only reaching the mucous membranes of the gland's excretory ducts. This period is the most favorable time for treatment - if you start now, you can get rid of the disease in less than two weeks. The nature of the inflammation is not purulent, but the swelling that appears clogs the ducts, preventing secretions from leaving the gland. Stagnation begins.
  • Follicular.As a result of stagnation, bacteria that have entered the organ already begin their activity in it. As the organ is made up of cells, grouped into lobes and separated by connective tissue, inflammation affects one part first.
  • Parenchymal.Inflammation passes from one lobe to another, there are many pustules in different parts of the gland.
  • Purulent abscess.The pustules merge into one and a bladder filled with purulent content forms in the gland. Over time, it can burst, the pus spreads, reaching the space around the prostate and bladder, urethra or rectum. When an abscess is opened, the pus does not completely come out, and this becomes another round of the inflammatory process.
  • How quickly the pathological process will develop and how it will end depends on a number of factors: the reasons for the inflammation, the timing and appropriateness of treatment.

    Causes

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

    • Gonococci are one of the most dangerous bacteria, they quickly start purulent processes.
    • Trichomonas is the leader among sexually transmitted microorganisms. It penetrates the gland's intercellular space, therefore, requires a long and stubborn treatment.
    • Chlamydia - in addition to toxicity, they manage to stick erythrocytes, increasing their sedimentation rate and preventing blood circulation in the affected area. They penetrate deeper than Trichomonas.
    • Staphylococci, the golden appearance is especially common. It can survive in any tissues and organs, causes suppuration and thickens the blood.
    • Ureaplasma is a cross between unicellular and virus. It can enter the prostate through the urinary tract or through unprotected sex.
    • Escherichia coli is a gram-negative bacterium, a frequent causative agent of acute inflammation. It enters the body as a result of inadequate hygiene during food preparation.

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

    Often the reason is not just that infections can stay in the body for a long time with almost no symptoms. They start to develop quickly when there are factors that contribute to it:

    • Regular or single hypothermia. Cold weakens the body's defenses and makes it harder for them to contain pathogenic bacteria, especially if hypothermia is associated with daily work.
    • Irregular sex life. Stagnant secretion from the gland (which is an integral part of sperm) promotes the multiplication of bacteria.
    • Running infections. These could be infections resulting from unprotected sex or bacteria that have caused mild inflammation in the urinary tract. The consequences of an incompletely cured purulent sore throat in the form of streptococci can also cause inflammation. Even tooth decay can cause prostatitis.
    • Weakened immunity. If, as a result of an illness or uncontrolled ingestion of antibiotics, the body's defenses become inadequate, the bacteria will certainly manifest.
    • Failure to comply with personal hygiene rules.

    Acute Prostatitis Symptoms

    Symptoms depend on the stage of the disease.

    During the period of catarrhal prostatitis, there is a slight discomfort and a feeling of heaviness in the perineum, the urge to go to the bathroom at night becomes more frequent. Urination is accompanied by burning and pain. The gland itself is normal or non-critical, the palpation exam causes pain. Temperature remains normal or rises slightly. No intoxication, general well-being.

    The follicular period has more manifestations. The pain increases, becomes constant, sometimes radiates sharply to the penis, sacrum or rectum. Retention of urine appears as it is difficult to urinate due to acute pain. Defecation is also accompanied by severe pain.

    The temperature rises to 38 degrees and remains at this level. The prostate visibly increases in size, has a dense consistency, becomes tense, touching it in some places causes acute pain.

    groin pain with acute prostatitis

    Parenchymal prostatitis is very difficult. Appetite disappears, chills appear, general weakness. The frequent urge to go to the bathroom with short urination is replaced by acute urinary retention. Trying to empty your bladder or bowel becomes almost impossible due to the excruciating pain. It is aggravated by constipation and a full bladder, spreads throughout the perineum; slight relief can only occur in the prone position with the legs bent.

    The temperature rises above 39 degrees. Inflammation starts to spread to other organs, mucus is secreted by the rectum. The prostate has an indistinct outline, is dilated and painful. Palpation may not be possible due to edema.

    The formation of an abscess is accompanied by the location of the point of acute pain - where the abscess appeared. The passage of urine, feces and gas is extremely difficult, accompanied by severe throbbing pain that spreads to the intestine. The temperature is kept above 39, 5 degrees, chills, fever and sometimes a delusional state appear.

    Then, unexpectedly, relief comes: the pain passes, the temperature drops. However, this does not mean that the patient has recovered: the fact is that the abscess has burst and urgent procedures are now needed to clear the pus from the body, as the negative consequences can be very different.

    Diagnosis

    Diagnosis is based on the assessment of the patient's complaints, analysis of urine, blood and prostate secretions. Also, they use digital rectal diagnostic method, ultrasound and CT scan.

    The severity of urinary disorders is assessed using uroflowmetry.

    A general urine analysis allows identification of the disease in the early stages, when characteristic symptoms are still absent. The alkaline acidity index itself indicates the development of inflammation.

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

    A complete blood count is the basis for studying the disease. The characteristic indicators of acute prostatitis are low hemoglobin levels (normal 130 g / l), high urea and creatinine levels, as well as the white blood cell level and erythrocyte sedimentation rate. The protein should not be normal, as well as a high level of white blood cells - there shouldn't be more than 5 units.

    The specific analysis of PSA allows to identify not only inflammation, but also malignant formation.

    PCR research allows you to quickly identify any genital infections that are often the cause of acute prostatitis.

    Ultrasound makes it possible to determine the size of the prostate, its borders, the presence of punctual and diffuse alterations. If an abscess has formed, this study can determine its size and location. If possible, the study is carried out transrectally; if pain and swelling do not allow, the study of the gland is done from the side of the abdomen.

    Ultrasound is sometimes performed by observing the change in the frequency of the sound reflected by the organ. This allows you to assess the blood supply to the prostate - vascularity, which can be increased or weakened depending on the type of inflammation and its stage. Allows to distinguish a cancerous tumor from acute prostatitis.

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

    Magnetic resonance imaging for the diagnosis of acute prostatitis

    Acute Prostatitis Treatment

    Disease therapy is always complex, including the use of different medications, procedures and diet. The treatment can take about 2 months.

    The doctor's main task is to eliminate the cause of inflammation, which most often consists of infection. For this, antibiotics are prescribed (alone or in combination). Choosing a drug depends on several factors:

    • the sensitivity of the pathogen;
    • simultaneous illnesses of the patient;
    • mode of action of the drug.

    Self-diagnosis and therapy are not possible: an effective drug is selected based on laboratory tests

    To combat the causative agents of an acute inflammatory process, third-generation fluoroquinolones and cephalosporins are the most used. For the treatment of acute prostatitis, the bactericidal effect of the antibiotic is of fundamental importance.

    Depending on the stage and state of the patient, the dosage and the form of drug release are chosen: the more neglected the situation, the higher the dose and the more important it is that the drug reaches its destination faster, therefore, drugs in the form of injections are preferable to pills.

    It is necessary to normalize the flow of urine and secretions. If urinary retention has become an acute form, a trocar epicystomy is prescribed - a bladder puncture, followed by insertion of a thin tube.

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

    If the acute prostatitis has turned into an abscess, treatment depends on what stage it is at. The infiltration phase is treated with active therapy with antibiotics and immunostimulants. A block is administered with pain relievers to help the patient overcome the pain.

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

    The treatment of acute prostatitis is not limited to symptom relief. The course of antibiotics should be drunk to the end and not until the pain subsides.

    Once the seizure itself is removed, it's time for physical therapy. Includes UHF and microwave procedures, electrophoresis and prostate massage. The goal is to relieve swelling (if left over), to improve the flow of gland secretions to avoid congestion.

    It is important to follow the diet throughout the treatment. You must refuse the following products:

    • alcoholic beverages, coffee, fried and salty beverages - contributes to the appearance of congestion;
    • white cabbage, apples, vegetables and raw vegetables - cause swelling, as a result of which the pelvic organs, including the prostate, are compressed;
    • acidic drinks, offal - irritate the urinary tract.

    The diet should include cereals, cooked vegetables, dairy products and baked fruits. All of this contributes to the normal functioning of the intestines. It is necessary to observe the intake regimen, ingesting at least 2 liters of liquid (water, juices, juices) per day. The more often the urinary tract is flushed, the lower the risk of inflammation.

    Vitamin complexes and peptides must be ingested to improve tissue regeneration and rapid restoration of normal gland function.

    pills for the treatment of acute prostatitis

    The favorable course of treatment is judged by the restoration of the gland tissues, the normalization of the chemical indications of the prostate secretions, the absence of pathogens in the tests, and the patient's general well-being.

    Prognosis and complications

    The sooner treatment is started, the quicker and easier it will be to get rid of acute prostatitis. The complication is each next stage of the disease, the chronic course of the disease, the spread of inflammation to other organs, infertility, sepsis. If the disease has already started, it may be necessary to remove the gland itself.

    With timely treatment, at the end of the course of therapy, all body functions are restored, the ability to work 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 start decayed teeth and carefully treat any infectious diseases.

    You must also exclude factors that contribute to the development of the disease. For this you need:

    • have a regular sex life with a partner;
    • avoid hypothermia (permanent and single);
    • quitting alcohol, smoking and being sedentary;
    • regularly undergo a routine examination by a urologist;
    • do not self-medicate at the first signs of inflammatory processes;
    • maintain a balanced diet;
    • take vitamins, especially during periods of spread of infectious diseases.

    Acute inflammation of the prostate appears due to infections that develop under favorable circumstances. Treatment is with antibiotics, anti-inflammatory drugs, analgesics and vitamins. During the therapy period, it is important to follow a diet and drinking regimen.