Prostatitis is an inflammation of the prostate of a person.The prostate is located directly under the bladder and the size of a chestnut.It surrounds the first section of the urethra and extends into the so -called pelvic floor, which consists of muscles.
The prostate produces secretion that includes PSA and sperm.PSA makes ejaculate more liquid.Spermine is important for the mobility of the sperm.
Prostatitis is mainly associated with severe pain in the perineum and in the anal area.In addition, symptoms such as urine frequency, pain during urination and pain occur during ejaculation during the inflammation of the prostate.
The prostate is influenced relatively often by inflammation.The probability of a prostate infection increases with age.Studies show that most cases aged 40 to 50 years.
Prostatitis syndrome
At the same time, an expanded understanding of the term prostatitis appeared in medicine.With the prostatitis syndrome mentioned in this way, several complaints are summarized in the area of human pelvis, which normally have an unknown reason.The term "prostatitis syndrome" summarizes various clinical paintings:
- 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.Bacteria either go through the blood to the prostate or spread from the bacterial infection of the bladder or urethra onto the prostate.Acute prostatitis is usually a serious general condition with severe pain in urination, fever and chills.
Chronic prostatitis can develop from acute: If prostate inflammation and repeated microbes in the urine, the so -called prostate express or ejaculation for more than three months, this is chronic inflammation.
Bacterial prostatitis.This is less lightning speed than acute prostatitis.Although chronic inflammation of the prostate gland causes pain while urinating and possibly pressure of the perineum, symptoms are usually not as expressed as in acute prostatitis.
Chronic pelvic pain syndrome (abacterial prostatitis)
In most cases, bacteria of prostate infections cannot be detected as the cause of the disease in the urine, prostate or ejak.The trigger of prostatitis remains unclear.Doctors call it chronic pelvic pain.
In such cases, however, leukocytes can often be detected as expression of inflammation in the prostate gland.To distinguish this, a different form of 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 there are signs of inflammation, but there is no pain or other symptoms.Asymptomatic prostatitis is usually proven by chance as part of an examination of infertility.
Prostatitis: Symptoms
The inflammation of the prostate can cause various symptoms of prostatitis.Although the symptoms of acute prostatitis can be very serious and cause a strong feeling of discomfort, they are usually a bit weaker in chronic prostatitis.
Acute prostatitis: symptoms
Acute prostatitis is often an acute illness in which patients suffer from fever and chills.The urination leads to burning pain, and the urine flow is noticeably reduced due to the edema of the prostate gland.Since the victims can only distinguish a small amount of urine, they have a constant urine frequency and should often go to the toilet.Other symptoms of prostatitis are the bladder, pelvic pain and back pain.Pain can also occur during or after ejaculation.
Chronic prostatitis: Symptoms
Prostatitis with a chronic course usually causes less serious symptoms than acute inflammation of the prostate.Symptoms such as fever and shaking frost usually lack completely.Symptoms such as a feeling of pressure in the perineum or in the lower abdomen, the darkening of the ejaculate by blood in sperm or blood in the urine is typical of the chronic inflammation of the prostate. The symptoms of chronic bacterial and chronic abacterial prostatitis do not differ.
Complications of prostatitis
The most common complication is the prostate abscess.The abscess of the prostate is a purulent inflammation of the inflammation, which usually has to be opened and empty with a cut.
Inflammation for nearby structures such as the appendix to the testicle or the testicles can be considered a further complication of the inflammation of the prostate.There is also suspicion that chronic prostatitis is associated with the development of prostate cancer.
Prostatitis: causes and risk factors
Bacterial prostatitis: causes
Only ten percent of the cases of prostatitis are caused by a prostate bacterium.Bacteria can penetrate the prostate through blood or from neighboring organs such as bladder or urethra, where they can lead to an inflammatory reaction.
Escherichia coli bacterium, which mainly occurs 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 chlamydia or trichomonas infections and gonorrhea.
In chronic prostatitis, bacteria in the prostate gland avoided the non -clarified way of protecting the human immune system.This enables microbes to constantly colonize the prostate.Antibiotics are relatively bad in the tissue of the prostate, which can 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 completely examined.Scientists have nominated many theories, each of which sounds plausible, but all of them have not yet been clearly demonstrated.In some cases, the genetic material of previously unknown microorganisms was found in the pool.Therefore, the cause of the pelvic pain syndrome can be microorganisms that still cannot be cultivated in the laboratory and are therefore not determined.
Another possible cause of chronic pelvic pain is disorders of the bladder.Due to the impaired drainage, the volume of the bladder increases, which presses the prostate.This pressure ultimately damages the tissue of the prostate and causes inflammation.
In many cases, however, the cause of chronic pelvic pain cannot be clearly demonstrated.Then doctors talk about idiopathic prostatitis.
Anatomical causes
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 the so -called prostate stones.
Mental reasons
Recently, more and more psychological causes of prostatitis have been discussed.In particular, there is probably a mental trigger for chronic pelvic pain in which chronic pelvic pain intervenes.Exact mechanisms are still unknown.
Risk factors for the development of prostatitis
Some men are particularly at risk of developing a prostate infection.This includes, for example, men with a violation of the immune system or suppressed by the immune system.In addition, the main diseases such as diabetes mellitus can contribute to the development of prostatitis: an increased blood sugar level in patients with diabetes often leads to an increased sugar content in the urine.The abundant sugar content in the urine can provide bacteria with good growth conditions and facilitate the development of urinary tract infections.
Another risk factor in the development of prostatitis is the supplement of the bladder.The introduction of a catheter through the urethra through the urethra can cause small ripens of the urethra and damage to the prostate.In addition, bacteria like on any foreign body can settle on the bladder and form the so -called biofilm.As a result, bacteria along the urethra can rise to the bladder and lead to a prostate infection.
Prostatitis: studies and diagnostics
A general practitioner can accept a medical history, but if there is suspicion of prostatitis, he will instruct it to a urologist.This carries out a physical examination.If prostatitis is suspected, this is usually the so -called digital rectal study.Nevertheless, this study does not provide any clear indications of inflammation of the prostate, but only confirms suspicion.In order to recognize bacterial prostatitis, a laboratory examination can be carried out
Rectal examination of the fingers
Since the prostate borders directly to the rectum, it can be scanned in the rectum.This digital rectal study is carried out on an outpatient basis and without anesthesia usually painlessly.The patient is asked to lie down with curved legs.With a lubricant, the doctor slowly inserts the finger into the anus and scans the prostate and the adjacent organs.It examines the size and sensitivity to pain in the prostate.
Laboratory examination
In order to identify possible pathogens in most cases, urine analysis is carried out.The standard method is the so -called sample of four glasses.Here, Erturin, rayurine, prostate explorer and urine are tested for the prostate massage.As the prostate, the doctors call the secretion of the prostate.This is achieved by a doctor by lighting pressure on the prostate, for example in the case of palpation.Ejaculate can also be tested for pathogenic microorganisms and signs of inflammation.
Further research
The ultrasound scanning 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 also to exclude other diseases with similar symptoms.
In order to rule out that the existing violation of urine wasting is caused by narrowing of the urethra, the urine flow is measured.The normal urine current is between 15 and 50 milliliters per second, while the urine flow is ten milliliters per second or less, there is a high probability of an obstruction of the urethra.
Prostatitis: treatment
Pharmaceutical 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 pathogenic microorganisms, the active substances of luxacine, ciprofloxacin, azithromycin, erythromycin or doxycycline are suitable.Even if the symptoms decrease, antibiotics should always be continued according to the appointment of a doctor.
Asymptomatic prostatitis is also treated with antibiotics.
If there is chronic abacterial prostatitis, antibacterial therapy is usually ineffective.Despite the lack of indications of the presence of pathogen, a study using antibiotics is carried out with inflammatory syndrome of chronic pelvic pain, since sometimes an improvement can be achieved.However, no antibiotic therapy is recommended for non -flammatory syndrome of chronic pelvic pain.
Other therapeutic approaches to chronic abacterial prostatitis are the so-called 5α-reductase inhibitors such as fineride or duta, pentosan polyisulfate and plant medication such as quercetin or dust extract.If the improvement is not achieved, drug therapy is supplemented by physiotherapy.Here physiotherapy exercises, exercises for the muscles of the pelvic floor or a regular massage of the prostate are recommended.
In addition, symptomatic therapy can help relieve acute symptoms of prostate infection.Anesthesia medication can be prescribed for severe pain.In addition, heating pillows and heating pillows on the back or lower abdomen help to relax the muscles.This often relieves the pain with prostate inflammation.
Relapse
The frequency of the relapse of prostatitis is generally very high.About 23 percent of the victims are subject to the second episode of the disease after an illness, 14 percent below three and 20 percent - even under four or more cases of the disease.To reduce the risk of relapse, avoid wearing moist clothing during or after prostatitis, hypothermia or using bubbles such as black tea or coffee.This reduces the risk of cystitis and thus prostatitis.However, you cannot reliably prevent bacterial prostatitis based on these methods.
The prognosis of prostatitis depends on the one hand on the cause of the inflammation and on the other hand on how quickly the correct therapy begins.
With acute bacterial prostatitis, which is treated with antibiotic therapy as soon as possible, the forecast is usually good.Taking antibiotics die pathogens that normally prevent the transition to chronic prostatitis.
About 60 percent of all patients with acute prostatitis have no symptoms in six months, and about 20 percent develop chronic prostatitis.Treatment and forecast are more difficult here.In many cases, periodic disease episodes arise that can accompany those who suffer 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 because mental health has a major impact on the prognosis of prostatitis.