The urological patients of the clinic are approx.40-60% of patients with chronic prostatitis.Symptoms of prostatitis in men are often the cause of depression and psychological changes.
The disease in which one in three people is over 25-30 years of age does not threaten life, but the difficulties of diagnosis and treatment determine a long chronic course and often lead to disability.
The idea of prostate functions, mechanisms and causes of inflammation allows us to correctly understand the symptoms and the need for timely treatment.
The functional value of the prostate
Its main function is the selection of a specific liquid (secret) 40-50 glands that form the entire glandular tissue of the organ.The 90-95% secret consists of water and the main trace elements, phospholipids, sperm amino acids that provide specific odors, enzymes, proteins, citric acid and fructose.Each component has its own purpose and is strictly balanced.
The secret of the prostate assures you:
- The formation and maintenance of a neutral or slightly alkaline environment in the urethra and sperm.This environment provides sperm in sperm life.
- Sperm thinning, which is needed to prevent sperm and ensure their promotion.In the process of intercourse, sperm mixed with prostate juice.
- Viability for spermatosoids: Secretary substances are nutrient media for germ cells, thanks to several days in the female genitalia until egg fertilization.
- Protection of the genitourinary system using zinc, sperm, polyamines and immunoglobulin A.Zinc concentration in prostate is 100 times higher than in other organs.It has outstanding antimicrobial activity, accumulates in an iron in the form of protein complexes, and is free in sperm;Spermin and polyamines also have a high anti -bacterial activity and immunoglobulins are involved in the immune protection of the prostate and urethra.
Prostate iron is also involved:
- By converting testosterone from the blood to active dihydrotosterone in the blood;The latter regulates the secretory activity of the gland;This process continues with the participation of the same zinc;
- in urination using the smooth muscle fibers in the glandular capsule;
- in the process of ejaculation, along with the muscles of the bottom of the pool and the passage of the prostate through the urethra;
- When the sensation of the orgasm is formed, due to the vasation of channels passing through the side surface of the seed tuber;It contains receptors that transmit impulses to the brain during ejaculation.
Thus, to ensure the possibility of participating in the general hormonal status of the prostate and the general hormonal status of man, it protects the urogenital organs from the aggression of conditionally pathogenic and pathogenic microorganisms.
Reasons and contributing factors
The main reason for prostate inflammation is to get into pathogenic and conditionally pathogenic microbes.60%is an E. coli.In recent studies, the participation of the participation of gonococcus and trichomonna infections in inflammation is confirmed.In case of violation of the glandular barrier and a reduction in local immune protection, penetration of infection such as yeast-like, mycoplasma and ureapaplasma, herpes virus and cytomegalinirus, microorganisms (in the case of analogues) (in the case of analogues)).
In the case of tuberculosis diseases, it is possible to spread mycobacteria into the prostate in the bloodstream.Isolated cases of tuberculosis prostatitis are found, but rarely.
The penetration of infection into the gland:
- Hematogen - blood from other focuses of infection;This is done through the veins of the prostate, communicating with the veins of the penis, the testicles, the rectum, the bladder and the kidneys (including the lesion of tuberculosis)
- lymphogen - lymphatic vessels
- urethra - through the urethra
Contributing Factors:
- Violation of hormonal background, especially a decrease in testosterone levels, resulting in a reduction in the antimicrobial prostate barrier.
- Varicocele (expansion of the veins of the seed), hemorrhoids, the varicoosus of the lower limbs.These diseases are the consequences of the genetic defect of venous valves, which leads to abnormalities in the pelvic organs, increasing local temperature, reduced (compared to total body temperature) and creating favorable conditions for microorganisms.
- Osteochondrosis, lumbar spine hernia and other innervation disorders, sedentary lifestyle.These can lead to prostate vessels to long -lasting (narrowing) or long -term expansion.The first leads to damage to blood supply, the second - stagnant blood phenomena.
- Poisoning is the alcohol that leads to the paralysis of small blood vessels and nicotine, contributing to their prolonged cramps.
- Different infectious diseases, diabetes mellitus, frequent and long negative mental effects, stress states, sleep disorders - all of which contributes to reducing overall immunity.
Types of prostatitis
Basically, the first symptoms of prostatitis are explained by the deterioration of blood supply to the gland as a result of inflammation or vascular cramp leads to oxygen deficiency, with impaired metabolic procedures and undervalued decomposition products.These large numbers of nerve receptors cause strong irritation to the ends of the muscles of the testicles, bladder, rectum, penis, and pelvis.
In accordance with the classification proposed by the National Institute of Health (depending on the inflammatory procedure), acute bacterial prostatitis can be distinguished, which is rare (about 5% of all cases) and chronic prostatitis.The latter may develop after acute, but primary in 90% of the cases.It is assumed that it leads to sexual disorders and infertility.
The chronic form is divided:
- Bacterium.
- Abacterial or chronic pelvic pain (in the absence of bacteria in studies).This, in turn, is inflammatory and non -anti -inflammatory.
- Asymptomatic inflammatory (in the absence of obvious symptoms).
Clinical manifestations
Acute prostatitis
The acute course is provoked by all microorganisms and is characterized by almost simultaneous damage to all glandular lobulus.The most common cause is gonococcus.The inflammatory process may be abscess or diffuse, non -inflammatory.The most typical symptoms of acute prostatitis are as follows:
- Chills and high body temperature (up to 38.5HE and above).
- Severe intoxication - weakness, pain in the joints, headache, increased pulse frequency, lack of appetite, etc.
- Severe pain in the perineum, inguinal and lumbar.
- Urine disorders - frequent and fake urgency, pain and urinary difficulties, acute urinary retention.
- Belovoy or transparent discharge from the urethra.
The finger examination of the prostate through the rectum is impossible due to severe pain.In addition, it is contraindicated in the blood because of the spread (spread) of infection and the possibility of developing the septic condition.
Chronic prostatitis
The recommended classification reflects the fact that signs of chronic prostatitis in men are very diverse and that doctors' opinions on the causes and mechanisms of the disease are very different.The diagnosis is based on the patient's complaint, through the clinical examination of the glandular finger examination, through the rectum (rectum) and ultrasound examination.At the same time, we evaluate the pain, size and volume, contours, consistency, and the presence of softening or sealing areas.
It is partly the functional ability of the organ and, most importantly, the presence or absence of inflammatory processes and the form of the disease allows the study of prostate secretion.This is obtained as a result of a prostate finger massage, which is later bacteriological analysis, PCR (polymerase chain reaction) behavior (polymerase chain reaction), sexual infections and spermogram analysis on conditional pathogenic microorganisms and pathogens.
General symptoms of various forms of chronic prostatitis:
- Discomfort or/and moderate pains in the form of "pain" and perineum severity, which occur or increase after drinking alcoholic beverages, physical activity, sexual intercourse.They sometimes pass paroxysmy.
- During the urethra or sexual intercourse, the urethra and urethra, the feeling of small discomfort from the urethra and krusia (primarily after the long -term delay in the urine).
- Suddenly frequent urge for urination (sometimes three times within 1 hour) and a feeling of insufficient bladder, which is explained by violation of nervous regulation of prostate, muscle fibers and bladder.
- Reducing fertilization ability, which is an increase in the acidity of the secret, a decrease or absence of sperm mobility, and adhesive with heads.
- Orgasm or orgasm, the pain of deleted feelings of ejaculation disorders, early or vice versa for excessive sexual intercourse.These phenomena are associated with inflammatory tubercle as a result of inflammation as a result of inflammation.
The information presented will allow us to understand the need for an appeal for a qualified professional for certain symptoms and leave the various non -traradial methods of self -broadcasting.Treatment is prescribed only after a full and thorough examination to determine the cause and form of the disease.
Differential diagnosis
Differential diagnosis of acute prostatitis and distinctive signs of chronic prostatitis are reflected in the table:
| The form of prostatitis | The main symptoms | Laboratory data |
| Acute bacterium |
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| Chronic bacterium |
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| Chronic Abocatarium (chronic pelvic pain syndrome): |
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| inflammatory |
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| Non -anti -inflammatory or stagnant (40% of patients with prostatitis) |
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| Asymptomatic inflammatory prostatitis |
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