prostatitis

23 May 2026

Prostatitis is a disease in which the prostate gland becomes inflamed.Prostatitis, the symptoms of which most often occur in men of reproductive age (20-40 years), is diagnosed in an average of 35% of the population.

Depending on the origin, prostatitis can be bacterial or non-bacterial, depending on the nature of the course - acute or chronic.

When the first signs of prostatitis are detected, the choice of treatment method depends on the form of the disease.As a rule, specific and symptomatic treatment is carried out.

Prostatitis is not a disease that can be diagnosed by a picture, because the disease has no visible manifestations.To notice the first symptoms in time, you need to listen to your own health.

General description

The prostate gland, which is affected by the disease in question, is an exclusively male organ;therefore, prostatitis can develop only in men.If we look at a similar area in women and this is the distal third of the urethra or the urethra, then here they have Skene's glands.These glands are essentially analogues of the prostate, and if their inflammation develops, the symptoms can resemble those of prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.Thanks to it, the process of urination is controlled, in addition, due to the presence of the prostate, a certain secretion is released that makes the sperm liquid.

Quite often, prostatitis occurs in combination with diseases such as vesiculitis or urethritis, in elderly patients - in combination with benign prostatic hyperplasia.

Prostatitis: causes

Bacterial prostatitis, as the name suggests, develops when exposed to the relevant pathogens.Basically, these are pathological agents that are constantly present on the surface of the skin or in the environment of the digestive tract.In this case, a certain combination of factors can cause the development of prostatitis.

The causes of prostatitis include various factors.So, it can be untimely emptying of the bladder, the presence of diseases of the genitourinary system, constant hypothermia, irregular sex life, sedentary lifestyle, bad habits, etc.The relevance of this type of factor either causes the possibility for microbial agents to enter the prostate gland, or causes disruption of the blood supply to these organs located in the pelvis, or leads to the development of stagnant processes.All this leads to the proliferation of microorganisms, as well as the development and progression of pathological inflammation.

If the infectious pathogen is not detected in prostatitis, then a non-bacterial form of prostatitis is diagnosed.Various reasons can explain this form of pathology, although none of them has been proven at the moment.For example, some experts believe that in this form the disease can develop against the background of actual neurogenic disorders, while another part, on the contrary, focuses on the immune nature of the disease in this form.This is just some of the existing theories about prostatitis.

Let's focus on the acute and chronic forms of the disease.Acute prostatitis is based on the influence of a bacterial factor.As for chronic prostatitis, here this factor is not the main one, but rather as a secondary factor and important in its impact only at the beginning of the disease.Over time, the pathogenetic mechanism can be supplemented by a neurogenic, autoimmune or allergic factor, due to the influence of which the chronic form of inflammation is maintained even when there is no bacterial invasion.

Prostatitis: symptoms

Inflammation is accompanied by pain in prostatitis, in particular, this is due to damage to the excretory channels of the acini, from the walls of which the epithelium peels off, which gradually accumulates with mucus in the tubules.In addition, microliths are also formed;they look like small pebbles.Mixing with the epithelium and mucus, they cause the appearance of special plugs, which in turn lead to blockage of the excretory channels.Over time, such plugs turn into suppuration (or microabscesses), the lobules are no longer subject to drainage, they simply stop functioning.

Meanwhile, before the beginning of such a stage as clogging of the excretory channels, as a rule, a lot of time passes, in some cases this time is calculated in months, in others even years.The process progresses gradually, the patient may not notice anything special, especially since the production of secretions from the prostate does not stop.Another thing is that when these microabscesses form, it is already accompanied by the appearance of not very pleasant symptoms, manifested in varying degrees of intensity.

As the first of these symptoms, patients note some difficulty in urinating.Due to the fact that the prostate increases against the background of the inflammatory process, the urethra is pressed to some extent.Further progression of the inflammatory process causes the development of sclerosis of the bladder neck;in an even more severe form of the pathological process, complete closure of the ureter occurs.

The next symptom is sexual dysfunction.Due to the pathological processes occurring in the disease, the erection mechanism is disturbed and the orgasm is weakened.

There are other signs of prostatitis, in particular they include:

the appearance of a burning sensation in the urethra and perineum;
constant and frequent urge to urinate;
the appearance of discomfort during a bowel movement;
"floating threads" in the urine;
the appearance of stretching of the urethra during defecation;
the appearance of prolonged nocturnal erections;
frequent and difficult urination;
too fast ejaculation;
increased general fatigue;
reduced potency;
manifestation of orgasm in a deleted form;
waiting for the development of other forms of complications in the area under consideration, against the background of which anxiety and general mental depression appear.

I would like to separately add that the listed signs (symptoms) do not necessarily appear overnight.The disease is characterized by a very variable pattern of manifestation, this applies to different variants in each individual patient and to different time periods of its course.

When looking at the symptoms, it would be helpful to go back to the causes.Naturally, the inflammatory process will not appear "suddenly".We are mainly talking about pathogenic agents, which were already mentioned above.Meanwhile, it was this factor that led to the formation of a wrong idea about the presence of certain causative agents of prostatitis, which is still supported by many specialists today.However, there is no specific type of causative agent of this disease.At the same time, any chronic infectious disease can cause the development of prostatitis;it can be any kind, be it sinusitis, tonsillitis, cholecystitis or any other disease.In this case, the pathogen can penetrate the prostate through the bloodstream, which is characterized by a rather powerful blood supply (otherwise its functionality would be in question).

There is a certain risk group for prostatitis, in particular the following people fall into it:

persons whose professional activity falls under the criterion of "sedentary" work;
people with a sedentary lifestyle;
individuals who have previously been diagnosed with a certain genitourinary infection;
persons for whom the problem of chronic constipation is important;
persons who are promiscuous;
persons whose family relations do not fall under the criterion of regularity;
persons who abuse alcohol.

Often men are diagnosed with "abacterial prostatitis", "prostatitis in the stage of prostatosis".If a man is diagnosed with prostatosis, we can say that at this stage there is nothing particularly alarming.In the meantime, you will need to make some adjustments to your lifestyle.In other words, what we are talking about here is that the stagnant phenomena discussed above are already present, but there is still no inflammation as such, this refers to prostatosis.If we consider such a variant as abacterial prostatitis, then we are already talking about the stage of the beginning of the development of an inflammatory process in a man, but so far without an accompanying infection.

A distinctive feature of prostatitis is that it practically does not manifest itself in an acute form.In other words, when it manifests itself, it is already a chronic process, which is explained by its often long and gradual development.Complete recovery due to the treatment of the disease or due to the spontaneous disappearance of the pathological process is assessed in individual cases in the initial acute stage.The disease is characterized, as already noted, by its extremely slow course, the manifestations of symptoms usually have a smoothed form.

Prostatitis: consequences

Acute prostatitis, if its manifestations are ignored and the search for medical help is excluded, can cause the development of an abscess of the prostate gland, that is, the reason for the development of purulent focal inflammation in it.This is accompanied by an increase in temperature (within 39-40 degrees), which at the same time becomes hectic, i.e.its differences exceed one degree.Patients also experience high fever, which periodically gives way to chills.The pain in the perineum becomes so severe that it makes urination difficult, while defecation becomes almost impossible due to the pain.After some time, swelling of the prostate gland develops, which in turn causes acute urinary retention.At the same time, it rarely comes to acute prostatitis, which manifests itself against the background of chronic spread of the pathological process - unless, at one's own risk and risk, the person "endures and endures".

Returning to chronic prostatitis, we can say that it is characterized by undulation of its own course, i.e.periodically the symptoms of the chronic form of prostatitis appear more intensively, and periodically they are practically not felt.Because of this type of change, many patients choose a wait-and-see approach.Meanwhile, as indicated above, the inflammatory process can worsen, spreading more and more.When it spreads, even pyelonephritis can develop.Meanwhile, the complications of prostatitis in most cases are reduced to diseases such as vesiculitis, in which the inflammatory process affects the seminal vesicles, as well as epididymorchitis, in which the testicles and appendages become inflamed.As a result of the transfer of the disease in a similar form of its spread, the development of male infertility can be indicated.Treatment of infertility is a long and complicated process, and in some cases it is completely impossible.The listed characteristics mainly fall into the development of a chronic form of prostatitis, due to the specific etiology of its occurrence (in particular, we are talking about sexually transmitted diseases).

Diagnosis

Examination of patients to identify their specific type of prostate pathology can be done in different ways.Meanwhile, in each specific case, an individual approach to the problem under consideration is important, on the basis of which it is already possible to determine the diagnostic possibility of obtaining sufficient information about the disease.

First, the doctor conducts a survey of the patient's complaints, studies the medical history, if any, based on which a preliminary conclusion is subsequently made and the principles of the individual diagnostic algorithm are determined.We want to add that the first consultation with a urologist (namely, this is the specialist you should turn to if alarming symptoms of prostatitis appear) is not final and reliable for making a diagnosis, since the first examination is only an opportunity for the doctor to assess what additional diagnostic measures are needed.

Given the sensitivity of the problem, men are interested in what questions the urologist asks if they suspect prostatitis.In particular, he will ask about current problems related to urination, as well as how the patient himself evaluates his own sexual function (that is, are there any changes, what exactly has changed, since what period).In addition, the doctor will ask what diseases you currently have, etc.

An examination follows, in particular an external examination, rectal examination, laboratory and instrumental examination.During an external examination, the doctor examines the man's genitals, determining whether there are accompanying rashes, irritation, secretions, etc.

Then, after an external examination, the doctor proceeds to the next stage, which is a rectal examination.Rectal examination allows determining the general contours of the prostate, its consistency, borders, etc.

After that, you will need to receive results of instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which in extended form means transrectal ultrasound.It is the most accurate method of identifying diseases in a man compared to standard ultrasound.

As for laboratory tests, this includes pap smear, urine test, prostate secretion test, PCR (laboratory test for detection of sexually transmitted infections).

Based on the modern classification of methods for diagnosing prostatitis, only the microscopic examination of the secretion obtained from the prostate gland, as well as any of the possibilities of local diagnostics that can establish the presence of an inflammatory process in the lower genital tract, can be considered a necessary possibility.Other types of diagnostic methods act only as clarifying methods;they are necessary for differential diagnosis and to identify existing complications of the underlying disease.In addition, it is important to remember that with overdiagnosis, this stage itself is prolonged and the symptoms only worsen.That is, here, as in any case, the principle of the "golden mean" is appropriate.

Treatment of prostatitis

Treatment of prostatitis today is a serious problem, but this does not mean that the doctor cannot help and the disease should be left to its own devices.In fact, it is not always possible to completely cure prostatitis, but it is possible to eliminate the symptoms of the disease, as well as to achieve long-term and sustainable remission.Depending on how seriously a person takes the doctor's recommendations, how long the periods of remission will be for him.

Basically, the treatment of prostatitis can include a number of measures, in particular methods of antibacterial therapy, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.Only on the basis of a set of these measures can the desired result be achieved;in general, the disease is difficult to treat, so it cannot be neglected.

Antibacterial therapy

This type of therapy is considered the basis of conservative treatment.The basis for the choice of antibacterial drugs is a number of factors, in particular these:

the ability of the components of the proposed drug to enter the secretion and tissue of the prostate to create a concentration exceeding the MIC values of the pathogens;
characteristics of the spectrum of antimicrobial activity (for example, the use of macrolide antibiotics determines the possibility of their good penetration into the prostate tissue, while they do not have any activity against gram-negative bacteria, namely, they are the main etiological agents when considering the acute form of prostatitis).

It is worth noting that acute prostatitis, compared to the chronic form of the disease, is characterized by the fact that it allows the accumulation of aminoglycosides and beta-lactam antibiotics in the tissues of the gland and in concentrations that are sufficient to suppress the activity of most types of pathogens.This is due to the increased perfusion of the prostate, as well as the increased degree of permeability characteristic of the hemoprostatic barrier.Another feature of drugs from this group is that as the inflammation subsides, the degree of their penetration into the prostate decreases.For this reason, switching to another type of oral medication is recommended.

Prostate massage

For the most part, experts consider this method of influence to be a fairly effective solution in the treatment of prostatitis.The main principles for achieving a therapeutic effect in this case are the following:

restoring the patency of the canals;
improvement of muscle tone and blood circulation in the prostate gland;
increased penetration of used antibiotics into the tissue of the gland;
the possibility of activating microorganisms that are in an inactive state, thereby improving the results of the sale of antibacterial drugs.

How is a prostate massage performed?To begin with, of course, it is important to establish a certain trusting contact between the doctor and the patient;this will provide greater relaxation to the patient, which in turn will make it possible to carry out the necessary manipulations with minimal pain and maximum efficiency.When preparing for a massage, the patient leans forward, spreading his legs about 60 cm wide and leaning on the examination table with his elbows.The doctor puts on gloves and applies a gel to the index finger (sometimes this gel has an analgesic effect).Then, with his free hand, he opens the buttocks to such a width that it will allow palpation of the anal sphincter with the help of the index finger.The natural response to such contact is muscle contraction.Then, after relaxing them, the index finger is inserted into the ampulla of the rectum.

In some cases, patients experience dizziness and even fainting during these manipulations (on average in 10% of cases).These manifestations are mainly caused by excessive fear, shame and anxiety, and if the massage is performed correctly, they do not accompany it at all.The massage can be called successful when it is possible to get at least 4 drops of secretion released from the prostate.

The most popular recognized method of treating chronic prostatitis is the Manila Protocol massage.In this case, the massage is performed three times a week, a microbiological dynamic study is carried out and antibiotics are taken.

Immunotherapy

This direction in the treatment of prostatitis is often extremely necessary, because with a prolonged manifestation of inflammation in combination with previously incorrect antibacterial treatment, the possibility of a negative impact on the general state of the immune system cannot be excluded.The treatment of prostatitis requires not only removing the infection from the gland and, in fact, the inflammation, but also preventing the re-development of inflammation in it.However, like other areas of treatment, immunotherapy should not be reduced to self-medication or treatment based on the recommendations of a pharmacist in a pharmacy;here you will need to consult an immunologist and most likely conduct some tests.

Physiotherapy

In prostatitis, this direction of treatment can be applied in a wide variety of impact options, but regardless of the specific solution, the impact is aimed at improving blood circulation in the pelvic organs, thereby increasing the overall effectiveness of the application of antibacterial therapy measures.Physiotherapy can use ultrasound waves, electromagnetic waves, laser therapy, raising the temperature directly in the rectum, etc.If there are no options for physical therapy, the doctor may recommend microenemas with warm water and certain medications.

Lifestyle adjustment

This type of impact is aimed both at the treatment of prostatitis and at its prevention.It should be treated in the same way as the main treatment, because if the factors predisposing to the development of prostatitis remain, then sooner or later the disease will make itself felt again.Taking this into account, you need to make some changes in your life, this applies to sports, normalizing the schedule of wakefulness / sleep, a nutritious balanced diet, walking, eliminating bad habits.

If symptoms indicating prostatitis appear, you should consult a urologist.