About 40 - 60% of clinic urological patients are patients with chronic prostate.Symptoms of prostatitis in men are often the cause of depressive conditions and changes in the psyche.
The disease that every third person suffers over 25-30 years old does not threaten life, but the difficulties of diagnosing and treating it determine a long chronic course and often lead to disability.
The idea of prostate functions, mechanisms and causes of inflammation development allow us to correctly understand the symptoms and the need for timely treatment.
The functional value of the prostate gland
Its main function is the secretion of a specific (secret) fluid 40 - 50 glands that form the entire glandular tissue of the organ.The secret of 90 - 95% consists of water and the main trace elements, phospholipids, sperm amino acids, which gives sperm a specific odor, enzymes, protein, citric acid and fructose.All ingredients have their purpose and are strictly balanced.
The secret of the prostate provides:
- Forming and maintaining a neutral or slightly alkaline environment in the urethra and sperm.This environment provides semen for sperm life.
- Sperm adjustment, indispensable to prevent sperm connecting to each other and ensure their promotion.In the process of sexual intercourse, sperm mixed with prostate juice.
- Sperm stability: The substances involved in the secret are a nourishing medium for microbial cells, thanks to which they can be placed for several days in the female genitals until egg fertilization.
- Protecting the genitourinary system from infection using zinc, sperm, polyamines and immunoglobulin A. Zinc concentration in the prostate is 100 times higher than in other organs.It has a pronounced antimicrobial activity, accumulates in iron in the form of protein complexes and is in semen in a free state;Spermine and polyamines also have high anti -bacterial activity, and immunoglobulins are involved in immune protection of the prostate and urethra.
Prostate iron also participates:
- in hormonal metabolism through the conversion of testosterone that comes from blood, into active dihydrotestosterone;The latter regulates the secretory activity of the gland;This process continues with the participation of the same zinc;
- In the act of urination using the smooth muscle fibers contained in the gland capsule;
- in the process of spilling along with the last pelvic muscles and the urethra part passing through the prostate;
- in the formation of orgasm sensation due to the vasation of the ducts passing along the lateral surface of the seed tubercle;It contains receptors that transmit impulses to the brain during spilling.
Thus, the prostate, along with participating in a human hormonal status and providing its possibility of reproduction, protects the urogenital organs from the aggression of pathogenic and pathogenic conditional microorganisms.
Contributing Causes and Factors
The main cause of prostate inflammation is to introduce into it pathogenic and pathogenic germs.At 60%, this is an E. coli.Recent studies, confirm the role of participation of gonococcal infections and trichomonna in inflammation.In the event of a violation of the protective barrier of the gland and a decrease in local immune protection, the penetration of an infection such as yeast, mycoplasmas and ureapaplasma, herpes virus and cytomegalinirus, microorganisms that cause respiratory diseases (with oral-genital contact), microflora (in cases of analysis).
For tuberculosis diseases, the distribution of mycobacteria through the blood flow to the prostate is possible.The isolated cases of tuberculosis prostatitis are found, but rarely.
Ways to penetrate the infection into the gland:
- hematogenic - with blood from other seals of infection;This occurs through the prostate venous vessels, communicating with the veins of the penis, testicles, rectum, bladder and kidneys (including tuberculosis lesions)
- Lymphogenic - through lymph vessels
- urethrogens - through the urethra
Contributing Factors:
- Violation of the hormonal background, in particular, a decrease in testosterone levels, as a result of which the prostatic antimicrobial barrier decreases.
- Varicocele (extension of seed veins), hemorrhoids, varicose veins of the lower extremities.These diseases are the result of a genetic defect in the venous valves, which leads to disorders of blood microcirulation in organs located in the pelvis, an increase in local temperature, reduced to normal (compared to overall body temperature), and creating favorable conditions for the vital activity of microorganisms.
- Osteochondrosis, lumbar spine hernia and other intrigue disorders, a sedentary lifestyle.They can lead to prolonged spasm (narrowing) of the prostate vessels or, conversely, to their long -term expansion.The first leads to damaged blood supply, the second - to stagnant blood phenomena.
- Intoxication is alcohol, leading to small vessel paralysis, and nicotine, contributing to their extended spasm.
- Various infectious diseases, diabetes mellitus, frequent and long negative mental effects, stress, sleep disturbances - all this helps to reduce overall immunity.
Types of prostate
In essence, the first symptoms of prostatitis are explained by worsening blood supply to the gland as a result of inflammation or vascular spasm leading to the absence of oxygen, impaired metabolic processes with the formation of underestimated decay products.They cause strong irritation of a large number of nerve receptors associated with the edges of the testicles, bladder, rectum, penis, lower pelvic muscles.
In accordance with the classification proposed by the National Institute of Health (depending on the course of the inflammatory process), acute bacterial prostatitis is rare (about 5% of all cases) and chronic prostate.The latter can develop after acute, but in 90% - 98% of cases is primary.It is assumed that it leads to sexual disorders and infertility.
The chronic form is divided into:
- Bacterial.
- Abacterial, or chronic pelvic pain (in the absence of bacteria in studies).It, on the other hand, is divided into inflammatory and not -inflammatory.
- Asymptomatic inflammatory (in the absence of obvious symptoms).
Clinical manifestations
Acute prostatitis
The acute course is provoked by any microorganism and is characterized by almost simultaneous damage to all gland lobules.The most common cause is gonococcus.The inflammatory process can be in the form of an abscess or diffuse non -inflammation.The most characteristic symptoms of acute prostatitis are as follows:
- Chills and high body temperature (up to 38.5O and above).
- Severe intoxication - weakness, joints in the joints, headaches, increased pulse frequency, lack of appetite, etc.
- Severe pain in the perineum, in inguinal and lumbar areas.
- Disordishes Urinary disorders - frequent and false demand, pain and difficulty in urination, acute urinary retention.
- Belovoy or transparent discharge from the urethra.
An examination of the prostate finger through the rectum is impossible due to severe pain.Moreover, it is contraindicated due to the possibility of distributing (spread) of blood infection and the development of a septic state.
Chronic prostatitis
The recommended classification reflects the fact that signs of chronic prostatitis in men are very diverse, and doctors' views on the causes and mechanisms of the development of the disease are largely different.The diagnosis is based on the patient's complaints, clinical examination in the finger examination of the gland through the rectal (rectal) and ultrasound examination.At the same time, the degree of pain, size and volume, contours, uniformity of consistency and the presence of softening or sealing areas is evaluated.
Partially the functional ability of the organ and, most importantly, the presence or absence of inflammation processes, as well as the form of the disease, allows you to evaluate the study of prostate secretion.It is taken as a result of a finger massage of a prostate with subsequent bacteriological analysis of the material (secret), PCR behavior (polymerase chain reaction) to detect pathogenic microorganisms and pathogens of sexual infections and a sperm analysis.
General symptoms of various forms of chronic prostatitis:
- Embarrassment or/or moderate pain in the form of "pain" and severity in the perineum, which occur or intensify after drinking alcoholic beverages, physical activity, sexual contact.Sometimes they are going through a paroxysmal nature.
- A feeling of disturbance and intersection in the urethra during urination or sexual contact, small serous discharge from the urethra (mainly after a long -term delay in the urine).
- Sudden frequent demand to urinate (sometimes up to 3 times within 1 hour) and a feeling of inadequate bladder emptying, which is explained by a violation of the nerve adjustment of the prostate, its muscle fibers and bladder.
- Reducing the ability to fertilize, which is caused by an increase in the acidity of the secretion, a decrease or lack of sperm mobility, their agglutination (climbing) with heads.
- Pain for orgasm or deleted orgasm sensations, spill disorders, expressed in premature or, conversely, in excessive duration of sexual intercourse.These phenomena are associated with the inflammatory process in the field of seminal tubercle or its tooth as a result of inflammation.
The information presented allows us to understand the need and importance of timely attraction for a qualified specialist in the event of certain symptoms and abandoning different non -transmission methods of self -medication.Treatment is prescribed only after a thorough and thorough examination in order to determine the cause and form of the disease.
Diagnosis
Differential diagnosis of acute prostatitis and distinctive signs of chronic prostatitis in men are reflected in the table:
| The form of prostate | The main symptoms | Laboratory |
| Acute bacterial |
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| Chronic bacterial |
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| Chronic abacterial (chronic pelvic syndrome): |
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| inflammatory |
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| not -inflammatory, or stagnant (40% of patients with prostate) |
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| Asymptomatic inflammatory prostatitis |
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