Prostatitis in men is inflammation of the male prostate. This is a relatively common condition in men, accompanied by pain when emptying the bladder (urination) and during emptying. Doctors distinguish between acute and chronic prostatitis. Therapy and prognosis depend on the form and causes of prostatitis. Read all information about prostatitis.
Prostatitis: description
Inflammation of the prostate (inflammation of the prostate) is an inflammation of the human prostate. The prostate is located just below the bladder and is about the size of a chestnut. It surrounds the first part of the urethra and extends to the so-called pelvic floor, which is made up of muscle.
The prostate produces a secretion that contains PSA (prostate-specific antigen) and spermine. PSA makes the ejaculate thinner. Sperm are important for sperm motility.
Prostatitis is mainly associated with severe pain in the barrier and anal area. In addition, symptoms of inflammation of the prostate include frequency of urination, pain when urinating, and pain during ejaculation.
The prostate is relatively common in inflammation. It is estimated that men in Germany are about. 15% suffer from prostatitis once. The likelihood of prostate constriction increases with age. Research shows that most cases are between 40 and 50 years old.
Prostatitis syndrome
At the same time, an expanded understanding of the term prostatitis has emerged in medicine. The so-called prostate syndrome syndrome summarizes a number of complaints in a person’s pelvic area, usually of unknown cause. The term "prostate syndrome" summarizes various clinical images:
- Acute bacterial prostatitis
- chronic bacterial prostatitis
- Chronic pelvic pain inflammatory and non-inflammatory syndrome ("Abacterial chronic prostatitis")
- Asymptomatic prostatitis
Acute and chronic bacterial prostatitis
Acute prostatitis is caused by bacteria (acute bacterial prostatitis). Bacteria either pass through the bloodstream to the prostate or spread from the bacterial infection of the bladder or urethra to the prostate. Acute prostatitis is usually a severe general condition with severe pain during urination, fever and chills. Inflammation of the prostate in cases of approx. Ten percent of it is caused by bacteria
Chronic prostatitis can develop acutely: if inflammation of the prostate and microbes repeated in the urine, called prostate expressions (obtained by massaging the prostate fluid) or in the ejaculate, are observed for more than three months, it is chronic inflammation. bacterial prostatitis. Less lightning fast than acute prostatitis. Although chronic inflammation of the prostate causes pain when urinating and possibly a feeling of pressure in the perineal region, the symptoms are usually not as severe as in acute prostatitis.
Chronic pelvic pain syndrome (inflammatory prostate inflammation)
Prostate infection In most cases, bacteria cannot be detected in the urine, prostate, or ejaculate as the cause of the disease. The cause of prostatitis is still unclear. Doctors call this chronic pelvic pain syndrome (chronic bacterial prostatitis).
However, in such cases, leukocytes (leukocytes) are often found in the expression of inflammation of the prostate (chronic pelvic pain syndrome). For differentiation, this is a form of the disease in which neither bacteria nor leukocytes are found (non-inflammatory chronic pelvic pain syndrome). In general, chronic pelvic pain syndrome (bacterial prostatitis) is the most common form of prostatitis.
Asymptomatic prostatitis
In rare cases, asymptomatic prostatitis occurs. In this form of prostatitis, although there are signs of inflammation, there is no pain or other symptoms. Asymptomatic prostatitis is usually detected at random, for example as part of a fertility test.
Prostatitis: symptoms
Inflammation of the prostate can cause various symptoms of inflammation of the prostate. Although the symptoms of acute prostatitis can be very severe and can cause severe discomfort, they are usually milder in chronic prostatitis. Not all people involved may have these symptoms, and the severity of the symptoms may vary from person to person.
Acute prostatitis: symptoms
Acute prostatitis is often an acute condition in which patients suffer from fever and chills. Inflammation of the prostate surrounding the urethra also causes characteristic urinary tract symptoms. Urination causes burning pain (alguria) and urine flow is significantly reduced (dysuria) due to swelling of the prostate. Because victims can only excrete a small amount of urine, they have a constant urinary frequency and often have to go to the toilet (pollakisuria). Other symptoms of prostatitis include bladder, pelvic pain and back pain. Pain can also occur during or after ejaculation.
Chronic prostatitis: symptoms
Chronic prostatitis usually causes less severe symptoms than acute inflammation of the prostate. Symptoms such as fever and chills are usually absent. Chronic inflammations of the prostate are characterized by symptoms such as a feeling of pressure in the rectum or lower abdomen, darkening of the sperm in the blood of the sperm or in the urine in the urine (hematuria). Sex drive and potential disorders are also common symptoms in chronic form, often due to pain during or after ejaculation. Chronic bacterial and chronic bacterial prostatitis (chronic pelvic pain syndrome) are no different.
How to recognize?
The onset of prostatitis is rarely clearly recognized, as it is sometimes asymptomatic, its symptoms are unique to each patient, and change over time.
These features are
- It is difficult for a person to pass urine in the toilet. The gland gradually grows, the urinary tract contracts
- The patient loses interest in sex. When attempting to have sex, the difficulty with the excitement of the penis increases. Orgasm is difficult to achieve or poorly achieved.
- Urethral burning, itching in the perineum.
- I want to urinate often, but I get it drop by drop.
- Sperm come out quickly during intercourse with minimal pleasure.
- Increases general fatigue, depression, irritability, aggression, anxiety
In the morning, a person feels overwhelmed, losing initiative in life.
At the same time, spontaneous, sometimes prolonged erections and painful ejaculation occur at night and are not associated with sex.
Observing these phenomena, the patient calms down and believed that he is fulfilling his potential well, in his opinion, the problems are related to the partner, their relationship. Depression overcomes, which aggravates the development of the disease
Incidence statistics
Prostatitis is one of the most common diseases of the male genitourinal system in the world. According to various sources, this is observed in 60-80% of sexually mature men. According to official medical statistics, more than 30% of young people of reproductive age suffer from chronic prostatitis. The cases are approx. It occurs in one-third of people over the age of 20 and under the age of 40. According to the WHO, urologists diagnose chronic prostatitis in every tenth patient.
Complications ofprostatitis
In addition to acute symptoms, prostatitis can lead to complications that complicate the course of the disease and prolong the healing period. The most common complication is prostate abscess (especially in acute bacterial prostatitis). An abscess in the prostate is a purulent inflammatory inflammation that usually needs to be opened and emptied by incision.
As a further complication of prostatitis, the inflammation can spread to nearby structures such as the epididymis or testicles (epididymitis, orchitis). Chronic prostatitis is also thought to be associated with the development of prostate cancer.
Prostatitis: causes and risk factors
There can be various causes of inflammation of the prostate. The treatment and prognosis of inflammation depends on the cause of the prostate.
Bacterial prostatitis:
causesOnly ten percent of cases of prostatitis are caused by bacteria in the prostate (bacterial prostatitis). Bacteria can enter the prostate through the blood (hematogenous) or from nearby organs such as the bladder or urethra, where they can lead to an inflammatory reaction.
Escherichia coli (E. coli), which occurs primarily in the human gut, is the most common cause of prostatitis. Klebsiella, enterococci, or mycobacteria can also cause prostatitis. Bacterial prostate can also be caused by inflammatory sexually transmitted diseases such as chlamydial or Trichomonas infections, as well as gonorrhea.
In chronic prostatitis, the bacteria in the prostate have fled in an as yet unclear way to protect the human immune system. This allows the microbes to continuously colonize the prostate. Antibiotics are relatively poor in prostate tissue, which may be another reason for bacterial survival in the prostate.
Chronic pelvic pain syndrome:
causesThe exact causes of chronic pelvic pain syndrome are not yet fully understood. Scientists have set up a number of theories, all of which seem plausible, but these have not yet been clearly demonstrated. In some cases, genetic material from previously unknown microorganisms was found in the small basin. Therefore, pelvic pain syndrome can be caused by microorganisms that still cannot be cultured in the laboratory and therefore cannot be detected.
Another possible cause of chronic pelvic pain syndrome is bladder failure. Violation of drainage increases the volume of the bladder, which puts pressure on the prostate. This pressure eventually damages the prostate tissue, causing inflammation
Another possible cause is that inflammation of the bladder tissue can spread to the prostate gland.
It is also possible that nerve irritation around the prostate causes pain that is mistaken forattributed to the prostate gland.
Finally, it is also possible that an overactive or misdirected immune system causes chronic pelvic pain syndrome.
In many cases, however, the cause of chronic pelvic pain cannot be clearly identified. Then doctors talk about idiopathic prostatitis.
Anatomical causes
In rare cases, prostatitis is caused by urinary tract stenosis. If the urinary tract narrows, urine accumulates and if it gets into the prostate, it can also cause inflammation. This narrowing is caused by tumors or so-calledProstate stones can cause
Doctors also suspect that pelvic floor muscle dysfunction may contribute to the development of prostatitis.
Mental causes
Recently, more and more psychological causes of prostatitis have been discussed. Especially in non-inflammatory chronic pelvic pain syndrome, it is likely to be a psychic trigger. The exact mechanisms are still unknown.
Risk factors for prostatitis
Some men are at particular risk of developing prostate infections. These include, for example, men with a compromised immune system or a suppressed immune system (e. g. , medication, immunosuppressive therapy). In addition, underlying diseases such as diabetes can contribute to the development of prostatitis: in diabetics, elevated blood sugar levels are often elevated in urinary sugar levels. Urine-rich sugar can provide good bacteria for bacteria, facilitating the development of urinary tract infections. In addition, the immune system is weakened in diabetes mellitus.
Another risk factor for the development of prostatitis is a bladder catheter. Inserting the catheter into the urethra on the urethra can cause small tears in the urethra and damage the prostate. In addition, as with any foreign body, bacteria can deposit on the bladder and so-calledThey form a biofilm. As a result, bacteria can enter the urethra into the bladder and lead to prostate infections.
Prostatitis: tests and diagnosis
For prostate problems, the appropriate physician is your GP or urologist. Your GP may have a medical history (history), but if a prostate is suspected, you should refer you to a urologist. This is a physical examination. If prostatitis is suspected, it is usually a so-called digital rectal examination. However, this study does not provide clear evidence of prostatitis, it only confirms the suspicion. Laboratory tests may be performed to detect bacterial prostatitis. If no specific cause is found, treatment is continued even if the prostate is well suspected
Case History
Typical questions when recording a medical history may be:
- Do you have pain when urinating?
- Where exactly do you feel the pain?
- Does your back hurt?
- Observed a change in ejaculation?
Digital rectal examination
Because the prostate gland is located right next to the rectum, it can be felt along the rectum. This digital rectal examination is performed on an outpatient basis, without anesthesia, and is usually painless. The patient should be asked to lie with bent legs. With lubricant, the doctor slowly inserts a finger into the anus and examines the prostate and surrounding organs (palpation). It examines the size and sensitivity of the prostate to pain: the inflamed prostate is greatly enlarged and very sensitive to pain.
Laboratory test
In most cases, a urine test is done to identify possible pathogens. The standard method is called the four-glass sample. Here, Ersturin, Mittelstrahlurin, Prostataexprimat and Urine are tested after a prostate massage. Because Prostateexprimate is called, doctors call for prostate secretion. The doctor does this by applying light pressure to the prostate, such as palpation. The ejaculate can also be tested for pathogens and signs of inflammation.
Further research
Rectal ultrasound (sonography) can be used to determine exactly where the inflammation is and how far it has spread. An important aim of the study is to exclude other diseases with similar symptoms (differential diagnoses).
Uroflowmetry is performed to rule out that the existing urethral problem is caused by narrowing of the urethra. The patient urinates in a special funnel that measures the amount of urine per unit time. Normal urine flow is 15-50 milliliters per second, while urine flow is up to ten milliliters per second, there is a high probability of urethral obstruction.
Prostatitis: PSA measurement
Elevated blood PSA (prostate-specific antigen) levels are generally considered an indicator of prostate cancer. However, even with prostatitis, blood PSA levels can rise significantly. If the reading increases significantly, the tissue sample (biopsy) is usually done in a laboratory and examined to safely rule out prostate cancer.
Prostatitis: Treatment
As with other diseases, the treatment of the prostate and the duration of treatment depend on the cause.
Medication
Acute bacterial prostatitis is treated with antibiotics. In mild cases, a dose of antibiotic is sufficient for about ten days. In case of chronic prostatitis, the medicine should be taken for a longer period of time (about four to six months). Even if symptoms have subsided, antibiotics should be continued as prescribed by your doctor. This prevents relapse and reduces the likelihood of relapse.
Asymptomatic prostatitis can also be treated with antibiotics
If you have chronic bacterial prostatitis (chronic pelvic pain syndrome), antibiotic treatment is usually not effective. In inflammatory syndrome of chronic pelvic pain, although there is no evidence of the pathogen, an antibiotic test is performed because improvement can sometimes be achieved. However, antibiotic treatment is not recommended for non-inflammatory chronic pelvic pain syndrome.
Other therapeutic approaches for chronic abacterial prostatitis are so-called 5α-reductase inhibitors and herbal medicines (herbal). If improvement is not achieved, medication is supplemented with physiotherapy. He recommends physiotherapy, pelvic floor exercises or regular prostate massage. In addition, microwave heat therapy can stimulate tissues to increase blood flow and reduce pain.
In addition, symptomatic treatment can help relieve the acute symptoms of prostate infection. Painkillers can also be prescribed for severe pain. In addition, heating pads and pads on the lower back or lower abdomen can help relax the muscles. It often relieves pain due to inflammation of the prostate.
Home medications such as processing rye or eating soft-shelled pumpkin seeds can also help with the symptoms of prostatitis. Other tips for regular training on the pool floor without sharp bike saddles and beer, meat, fat and sugar.
Complication Management
If you have severe urinary outflow obstruction associated with the disease, prostate protection may be helpful as the residual urine is always at high risk of urinary tract infection.
If the inflammation secretes the prostate gland (abscess), it should be emptied with an incision. The pathway is usually the rectum.