How is acute prostatitis diagnosed and treated?

Acute prostatitis is characterized by a pronounced clinical picture. Pathology is dangerous with a number of serious complications and therefore requires timely and complex treatment. This article describes how to recognize and treat the disease.

Acute prostatitis is an inflammatory disease accompanied by pronounced painful feelings and can be a major health hazard. To successfully predict the disease, consult a physician in a timely manner to diagnose and prescribe appropriate treatment.

General characteristics of the disease

Acute prostatitis is a rapidly developing inflammatory process in the prostate gland. It has four stages of development:

  1. Catarrhal.At this stage, the gland swells slightly, the inflammation only affects the mucous membranes of the gland's excretory ducts. This period is the best time to start treatment - if you start at this point, you can get rid of the disease in less than two weeks. The nature of the inflammation is not purulent, but the edema that appears clogs the ducts, preventing the secretions from leaving the gland. Stagnation begins.
  2. Follicular.As a result of the stagnation, the bacteria that enter the organ already start working in it. Because the organ is made up of cells, grouped into lobules and separated by connective tissue, inflammation first affects one part.
  3. Parenchymal.Inflammation passes from one lobe to another, with many pustules in different parts of the gland.
  4. Purulent abscess.The pustules merge and a bladder filled with purulent contents forms in the gland. Over time, it can explode, pus spread, enter the space around the prostate and bladder, urethra, or rectum. When the abscess is opened, the pus does not come out completely and this becomes a new round in the inflammatory process.

How quickly the pathological process develops and how it ends depends on a number of factors: the causes of the inflammation, the timeliness and expediency of treatment.

Cause

In 90% of cases, the cause of acute prostatitis is an infectious lesion. Pathogens can be one or more bacteria and viruses:

  • Gonococci are one of the most dangerous bacteria, quickly triggering purulent processes.
  • Trichomonas is a leader among sexually transmitted microorganisms. It penetrates the intercellular space of the gland and therefore requires a long stubborn treatment.
  • Chlamydia - in addition to toxicity, they are able to glue red blood cells, increasing their sedimentation rate and impeding blood circulation in the affected area. They penetrate deeper than Trichomonas.
  • Staphylococci, the golden appearance is particularly common. It can survive in any tissue and organ, causing bloating and thickening the blood.
  • Ureaplasma is a cross between unicellulars and viruses. It can enter the prostate from the urinary tract or through unprotected intercourse.
  • Escherichia coli is a gram-negative bacterium that often causes acute inflammation. It gets into the body during food preparation due to poor hygiene.

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

Often the cause is not just infections that can live in the body for a long time, almost without symptoms. They begin to develop rapidly if the following contribute to this:

  • Regular or single hypothermia. The cold weakens the body’s defenses and makes it harder to keep pathogenic bacteria in them, especially when hypothermia involves daily work.
  • Irregular sex life. Stagnation of glandular secretion (which is an integral part of sperm) promotes the growth of bacteria.
  • Running infections. These can be infections that come from unprotected sex or bacteria that have caused mild inflammation in the urinary tract. The consequences of purulent sore throat, which have not completely healed in the form of streptococci, can also trigger inflammation. Even tooth decay can cause prostatitis.
  • Weakened immunity. If the body's defenses become insufficient as a result of illness or uncontrolled antibiotic intake, the bacteria will certainly manifest.
  • Non-compliance with personal hygiene rules.

Symptoms of acute prostatitis

Symptoms depend on the stage of the disease.

During catarrhal prostatitis, there is a slight discomfort and difficulty in the perineum, and nighttime toilet use becomes more common. Urination is accompanied by burns and pain. The gland itself is normal or not critically enlarged, and palpation causes pain. The temperature remains normal or rises slightly. No drunkenness, no general well-being.

The follicular period has several manifestations. The pain increases, becomes permanent, and sometimes radiates sharply to the penis, sacrum, or rectum. Urinary retention appears as it is difficult to urinate due to acute pain. Emptying is accompanied by severe pain.

The temperature rises to 38 degrees and stays at that level. The prostate grows noticeably, its size is dense, tense, and touching it causes sharp pain in some places.

lumbar pain with acute prostatitis

Parenchymal prostatitis is very severe. Appetite disappears, chills appear, general weakness. The frequent urge to go to the toilet with a short urination is replaced by acute urinary retention. Attempting to empty the bladder or intestine becomes almost impossible due to unbearable pain. It is aggravated by constipation and full bladder, spreads throughout the perineum, slight relief can only come in a supine position, with legs stretched.

The temperature rises above 39 degrees. The inflammation begins to spread to other organs, with mucus secreted from the rectum. The prostate has blurred outlines, is enlarged and painful. Touching is not possible due to edema.

The formation of an abscess is accompanied by the localization of the point of acute pain - where the abscess appeared. The passage of urine, feces and gas is extremely difficult with severe throbbing pain that spreads into the intestines. The temperature is kept above 39. 5 degrees, chills, fever and sometimes delusions occur.

Then, unexpectedly, relief comes: the pain goes away, the temperature drops. However, this does not mean that the patient has recovered: it is a fact that the abscess has exploded and now urgent procedures are needed to cleanse the purulent body because the negative consequences can be very diverse.

Diagnostics

Diagnosis is made based on an assessment of the patient’s complaints, analysis of urine, blood, and prostate secretions. In addition, digital rectal diagnostics, ultrasound and CT methods are used.

The severity of urinary tract disorders is assessed using uroflowmetry.

A general analysis of the urine allows the disease to be identified at the earliest stages when the 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 and causes of inflammation. Changes in the color, odor, or texture of urine are not considered to be absolute evidence of acute prostatitis.

A complete blood count is the basis for examining the disease. Characteristic indicators of acute prostatitis are low hemoglobin levels (normal 130 g / l), high urea and creatinine levels, and leukocyte and erythrocyte sedimentation rates. Protein may not be normal as well as high levels of leukocytes - up to 5 units.

Specific analysis of PSA allows the identification of not only inflammation but also malignancy.

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

Ultrasound allows you to determine the size, edges, point, and presence of diffuse changes in the prostate. If an abscess has formed, this examination may determine its size and location. If possible, the test should be performed transrectally; if pain and swelling do not allow this, examination of the gland is done from the side of the abdomen.

Sometimes ultrasound is performed by observing a change in the frequency of sound reflected from an organ. This allows the blood supply to the prostate to be assessed - vascularisation, which can be increased or decreased depending on the type and stage of inflammation. It makes it possible to distinguish a cancerous tumor from an acute prostatitis.

If your doctor determines that surgery is needed, he or she will prescribe a CT or MRI to examine the details of the inflammatory process.

MRI to diagnose acute prostatitis

Treatment of acute prostatitis

Disease therapy is always complex, including different medications, procedures, and diets. The treatment can last for about 2 months.

The main task of the doctor is to eliminate the cause of the inflammation, which most often consists of an infection. To do this, antibiotics are prescribed (alone or in combination). The choice of drug depends on several factors:

  • susceptibility of the pathogen;
  • concomitant illnesses of the patient;
  • mechanism of action of the drug.

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

Fluoroquinolones and third-generation cephalosporins are most commonly used to control the pathogens of the acute inflammatory process. The bactericidal effect of an antibiotic is essential in the treatment of acute prostatitis.

Depending on the stage and condition of the patient, the dose and form of release of the drug are selected: the more negligible the situation, the higher the dose, and more importantly, the faster the drug reaches its destination, injectable drugs are preferred over tablets.

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

When such drastic measures are not required, non-steroidal anti-inflammatory drugs are prescribed to restore normal urination, which will remove swelling and pain. The drugs are prescribed in the form of tablets, injections or suppositories.

If the acute prostatitis has become an abscess, treatment depends on what stage it is at. The infiltration phase is treated with active therapy with antibiotics and immunostimulants. It is blocked with painkillers to help the patient overcome the pain.

If an abscess has formed, treatment is only possible through surgery: the purulent bladder is opened, washed, and drained. After surgery, therapy is prescribed to combat microbes and poisoning.

Treatment of acute prostatitis is not limited to relieving symptoms. The antibiotic course should be taken until the end and not until the pain disappears.

Once the seizure itself has been removed, it’s time for physiotherapy. Includes UHF and microwave procedures, electrophoresis and prostate massage. The goal is to relieve the swelling (if left), to improve the outflow of glandular secretions to avoid congestion.

It is important to follow your diet during treatment. You must reject the following products:

  • alcoholic beverages, coffee, fried and salted - contributes to the appearance of congestion;
  • white cabbage, apples, legumes and raw vegetables - cause bloating, causing the pelvic organs, including the prostate, to compress;
  • acidic drinks, offal - irritate the urinary tract.

The diet should include cereals, steamed vegetables, dairy products and fried fruits. All this contributes to the normal functioning of the gut. It is necessary to adhere to the drinking system, drink at least 2 liters of fluids (water, fruit drinks, juices) daily. The more often you flush the urinary tract, the lower the risk of inflammation.

Vitamin complexes and peptides should be taken to improve tissue regeneration and quickly restore normal gland function.

tablets for the treatment of acute prostatitis

Favorable treatment is judged by the restoration of glandular tissues, the normalization of the chemical indications of prostate secretions, and the absence of pathogens on the basis of analyzes and the general well-being of the patient.

Prognosis and complications

The earlier treatment is started, the faster and easier it is to get rid of acute prostatitis. The complication is every subsequent stage of the disease, the chronic course of the disease, the spread of inflammation to other organs, infertility, sepsis. Once the disease has started, it may be necessary to remove the gland itself.

With timely treatment, at the end of therapy, all functions of the body are restored, and the ability to work is fully restored.

Prevention

Preventive measures include lack of unprotected sex (to rule out STIs), careful hygiene, and timely treatment of urinary tract inflammation. It is necessary to maintain immunity, not to start carious teeth and to treat infectious diseases carefully.

It should also rule out factors that contribute to the development of the disease. To do this, you need:

  • regular sex life with a partner;
  • avoid hypothermia (permanent and single);
  • give up alcohol, smoking and a sedentary lifestyle;
  • urologist undergoes regular routine examinations;
  • do not self-heal the first signs of inflammatory processes;
  • stick to a balanced diet;
  • take vitamins, especially during the spread of infectious diseases.

Acute inflammation of the prostate occurs due to infections that develop under favorable conditions. Treatment is with antibiotics, anti-inflammatory drugs, painkillers and vitamins. It is important to follow a diet and drinking routine during therapy.