Prostatitis is an inflammation of the prostate gland of a person.The prostate is located just below the bladder and the size of the brown.It surrounds the first section of the urethra and extends to the so -called pelvis, which consists of muscles.
The prostate produces secretion that includes PSA and semen.PSA makes the ejaculate more liquid.Spermin is important for the mobility of sperm.
Prostatitis is mainly associated with severe pain in the perineum and the anal region.In addition, symptoms such as the frequency of urination, pain during urination and pain during ejaculation occur during inflammation of the prostate.
The prostate is relatively commonly affected by inflammation.The likelihood of prostate infection increases with age.Studies show that most cases aged 40 to 50 years.
Prostatitis syndrome
At the same time, an advanced understanding of the term prostatitis has emerged in medicine.With prostatitis Syndrome with so -called prostatitis, several complaints are summarized in the human pelvis, which usually have an unknown cause.The term "prostatitis syndrome" summarizes various clinical pictures:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Inflammatory and non -inflammatory syndrome of chronic pelvic pain
- Asymptomatic prostatitis
Acute and chronic bacterial prostatitis
Acute prostatitis is caused by bacteria.The bacteria either pass through the blood to the prostate or spread by the bacterial infection of the bladder or urethra to the prostate.Acute prostatitis is usually a serious general condition with severe pain during urination, fever and chills.
Chronic prostatitis can develop from acute: if for more than three months there is an inflammation of the prostate gland and recurrent germs in the urine, SO -covered prostate express or ejaculat, then it is chronic inflammation.
Bacterial prostatitis.This is a smaller lightning rate than acute prostatitis.Although chronic inflammation of the prostate gland causes pain during urination and a possible feeling of pressure in the perineum, but complaints are usually not as pronounced as in acute prostatitis.
Chronic pelvic pain syndrome (abacus prostatitis)
In most cases, prostate infections cannot be detected in the urine, prostate or ejaculation as a cause of the disease.The prostatitis trigger remains unclear.Doctors call it chronic pelvic pain.
In such cases, however, leukocytes can often be found as expression of inflammation in the prostate gland.To distinguish this, another form of the disease in which neither bacteria nor leukocytes are detected.Chronic pelvic pain syndrome is the most common form of prostatitis.
Asymptomatic prostatitis
In rare cases, asymptomatic prostatitis occurs.With this form of prostatitis, although there are signs of inflammation but there is no pain or other symptoms.Asymptomatic prostatitis is usually detected by accident, for example, as part of an infertility examination.
Prostatitis: Symptoms
Prostate inflammation can cause various symptoms of prostatitis.Although the symptoms of acute prostatitis can be very serious and cause a severe feeling of malaise, with chronic prostatitis, they are usually a little greater.
Acute Prostatitis: Symptoms
Acute prostatitis is often an acute disease in which patients suffer from fever and chills.Urination causes burning pain and the urine flow is noticeably reduced due to prostate swelling.Because victims can only distinguish a small amount of urine, they have a constant frequency of urination and often have to go to the toilet.Other symptoms of prostatitis include bladder, pelvic pain and back pain.Pain can occur during or after ejaculation.
Chronic Prostatitis: Symptoms
Chronic -course prostatitis usually causes less serious symptoms than acute prostate inflammation.Symptoms such as fever and chills are usually absent completely.Symptoms such as a sensation of pressure in the perineum or lower abdomen, the darkening of the ejaculate due to blood in semen or blood in the urine is characteristic of chronic inflammation of the prostate. Symptoms of chronic bacterial and chronic abacus prostatitis do not differ.
Complications of prostatitis
The most common complication is the prostate abscess.The prostate abscess is a purulent inflammation of the inflammation, which should usually be open and empty with incision.
As an additional complication of prostate inflammation, inflammation can be applied to nearby structures, such as appendage to the testes or testes.There are also suspicions that chronic prostatitis is associated with the development of prostate cancer.
Prostatitis: Causes and risk factors
Bacterial Prostatitis: Causes
Only ten percent of prostatitis cases are caused by a prostate bacterium.Bacteria can enter the prostate through blood or from adjacent organs, such as the bladder or urethra, where they can lead to an inflammatory reaction.
The Escherichia Coli bacterium, which is found mainly in the human intestine, is the most common cause of prostatitis.Klebsiella, Enterococci or Mycobacteria can also cause prostatitis.Bacterial prostatitis can also be caused by sexually transmitted diseases such as chlamydial or trichomone infections as well as gonorrhea.
In chronic prostatitis, bacteria in the prostate gland avoid not yet clarified a way to protect the human immune system.This allows germs to constantly colonize the prostate.Antibiotics are relatively bad in the tissue of the prostate gland, which may be another cause of the survival of bacteria in the prostate gland.
Chronic pelvic pain syndrome: Causes
The exact causes of chronic pelvic pain syndrome have not yet been fully studied.Scientists have nominated many theories, each of which sounds plausible, but all of them have not yet been clearly proven.In some cases, the genetic material of the unknown microorganisms has been found in the pelvis.Therefore, the cause of pelvic pain syndrome may be microorganisms that cannot yet be cultivated in the laboratory and are therefore not detected.
Another possible cause of chronic pelvic pain is bladder disorders.Due to drainage disorders, the volume of the bladder increases, which thus presses on the prostate.This pressure ultimately damages the tissue of the prostate gland, causing inflammation.
In many cases, however, the cause of chronic pelvic pain cannot be clearly demonstrated.Then doctors talk about idiopathic prostatitis.
Anatomical reasons
In rare cases, prostatitis is caused by narrowing of the urinary tract.If the urinary tract is narrowed, the urine accumulates and if it enters the prostate, it can also cause inflammation.This narrowing can be caused by tumors or so -called prostate stones.
Mental reasons
Recently, more and more psychological causes of prostatitis have been discussed.In particular, with non -inflammation syndrome of chronic pelvic pain, a mental trigger is likely.The exact mechanisms are still unknown.
Risk factors for the development of prostatitis
Some men are particularly at risk of developing prostate infection.These include, for example, men with immune system disorders or suppressed by the immune system.In addition, major diseases, such as diabetes mellitus, can contribute to the development of prostatitis: increased blood sugar levels in patients with diabetes often leads to increased levels of sugar in the urine.The justified content of sugar in the urine can provide bacteria with good growth conditions, facilitating the development of urinary tract infections.
Another risk factor for the development of prostatitis is more bladder.The introduction of a catheter through the urethra through the urethra can cause small ruptures of the urethra and damage to the prostate gland.In addition, as of any foreign body, bacteria can precipitate on the bladder and form SO -detached biofilm.As a result, the bacteria can rise on the urethra to the bladder, as well as lead to prostate infection.
Prostatitis: examinations and diagnostics
The general doctor may take a medical history, but if there is a suspicion of prostatitis, he or she will direct you to a urologist.This performs a physical examination.In the case of suspicion of prostatitis, this is usually the so -covered digital rectal study.Nevertheless, this study does not provide clear evidence of prostate inflammation, but only confirms suspicion.To detect bacterial prostatitis, a laboratory examination can be done
Rectal finger test
Because the prostate gland builds directly with the rectum, it can be palpated in the rectum.This digital rectal study is performed on an outpatient basis and without anesthesia, usually painless.The patient was asked to lie down with bent legs.Using a lubricant, the doctor slowly inserts his finger into the anus and scans the prostate and adjacent organs.It examines the size and sensitivity to prostate pain.
Laboratory
In most cases, to identify possible pathogens, urine analysis is performed.The standard method is the so -called four glasses sample.Here Erturin, Mittelstrahlurin, ProstataExprimat and Urin are tested after prostate massage.As prostataxprimat called, doctors call prostate secretion.This is achieved by a doctor by slight pressure on the prostate, such as palpation.Ejaculate can also be tested for pathogenic microorganisms and signs of inflammation.
Increasing
The ultrasound scan of the rectum can be used to determine exactly where the inflammation is and how far it spreads.An important goal of the study is the exclusion of other diseases with similar symptoms.
In order to exclude that the existing violation of urine drainage is caused by narrowing of the urethra, the flow of urine is measured.The normal stream of urine is from 15 to 50 milliliters per second, while the urine flow is ten milliliters per second or less, there is a high probability of preventing urethra.
Prostatitis: Treatment
Drug therapy
Acute bacterial prostatitis is treated with antibiotics.In mild cases, the dose of the antibiotic is sufficient for about ten days.In chronic prostatitis, the drug should be taken for a longer period of time.Depending on the pathogenic microorganisms, the active substances of luxacin, ciprofloxacin, azithromycin, erythromycin or doxycycline are suitable.Even if the symptoms already disappear, antibiotics should in any case continue in accordance with the appointment of a doctor.
Also, asymptomatic prostatitis is treated with antibiotics.
If there is chronic abacus prostatitis, antibacterial therapy is usually ineffective.With inflammatory chronic pelvic pain syndrome, despite the lack of evidence of a pathogen, an antibiotic study is conducted, as improvement can sometimes be achieved.However, with non -inflammation syndrome of chronic pelvic pain, antibiotic therapy is not recommended.
Other therapeutic approaches to chronic abacus prostatitis are the so-called 5α-reductase inhibitors, such as phenritis or duosteride, pentosan polyeulfate and plant medicines such as quercetin or dust extract.If the improvement is not achieved, drug therapy will be supplemented with physiotherapy.Physiotherapy exercises for the pelvic floor muscles or regular prostate massage are recommended here.
In addition, symptomatic therapy can help relieve the acute symptoms of prostate infection.Anesthetic drugs can be prescribed for severe pain.Also, heating pads and heating pads on the back or lower abdomen help to relax the muscles.This often relieves pain with prostate inflammation.
Relapse
The frequency of prostatitis relapse is usually very high.About 23 percent of victims are subjected to the second episode of the disease after one disease, 14 percent suffer from three and 20 percent - even four or more cases of the disease.To reduce the risk of relapse, avoid wearing wet clothing during or after prostatitis, hypothermia or use of bubbles such as black tea or coffee.This reduces the risk of cystitis and therefore prostatitis.However, you cannot reliably prevent bacterial prostatitis using these methods.
The prognosis of prostatitis depends on the one hand, the cause of the inflammation, and on the other, how quickly proper therapy begins.
In acute bacterial prostatitis, which is treated as soon as possible with antibiotic therapy, the prognosis is usually good.By taking antibiotics, pathogens die, which usually prevents the transition to chronic prostatitis.
About 60 percent of all patients with acute prostatitis no longer have symptoms for six months, and about 20 percent develop chronic prostatitis.Treatment and prognosis are more difficult here.In many cases, periodic episodes of the disease occur, which can accompany those who have suffered for many years.
Chronic prostatitis usually requires great patience from the victims.Very often a long course can be a serious psychological burden.
Patients who have suffered should seek professional help as the mental health situation has a huge impact on prognosis for prostatitis.