Causes and symptoms of chronic prostatitis in men

Chronic inflammation of the prostate gland occurs in men of any age.In most cases, the catalyst is an infectious factor: Trichomonas, staphylococci and gonococci.Bacteria that enter the body provoke inflammation of the urethral canal, the prostate gland itself.

The chronic form of prostatitis is often asymptomatic.The disease itself is determined only after the transition to an acute form.Late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.

Statistics show a constant “rejuvenation” of the disease.Increasingly, patients aged 30 years are turning to urologists.

Chronic prostatitis - what is it?

The prostate gland is located under the bladder.The main functions are reduced to protecting the vesica urinaria from the ingress of seminal fluid, as well as the production of prostate secretion, a necessary component of male semen.Inflammation of the gland tissue, provoked by infection, congestion and other factors, gradually becomes permanent.

Chronic prostatitis leads to degenerative changes.The structure of the tissues gradually deforms.Often, against the background of inflammation, stones appear in the ducts.Some types of prostatitis cause the development of cancer.

An international classification system has been developed to facilitate differentiation between different prostate diseases.

Chronic prostatitis - causes

It is generally accepted that inflammation of the prostate gland is caused by two main factors: bacterial and abacterial.

The first is associated with the entry of pathogens and infections into the patient’s body.Most often, the catalyst is sexually transmitted bacteria.

The second cause of occurrence is not associated with an infectious agent.The catalyst for inflammation can be:

• Hypothermia of the body.
• Hormonal imbalances associated with aging and irregular sex life.
• Bad habits.
• Injury to the pelvic organs.
• Stagnation caused by metabolic disorders and a sedentary lifestyle.

After diagnosing prostatitis, the root cause of chronic prostatitis must be determined.The course of therapy is prescribed based on what exactly caused the inflammation.Bacterial and non-infectious prostatitis are treated differently.

Urologists name several additional factors that aggravate the situation and influence the severe course of the disease:

• Sexual abstinence.
• Inferior ejaculation (choosing interrupted sexual intercourse as a method of contraception).
• Stress.
• Bad habits – alcohol abuse and smoking.
• Poor nutrition.
• Inflammatory diseases suffered in the past.Often urethritis and cystitis act as the cause of prostatitis in chronic form.

Inflammation is accompanied by destructive changes in the prostate gland, which makes it possible to classify the disease into several categories.

Classification of chronic inflammation of the prostate

Varieties of prostatitis received their own ICD-10 code - N41.To clarify the diagnosis and differentiate the infection of the catalyst, a separate classification B95-B97 is used.The symptom rating scale divides the disease into several groups and subgroups:

• I - acute inflammation, accompanied by a sharp rise in temperature and fever.
• II - chronic prostatitis, provoked by an infectious factor.
• III - class includes a disease in which pelvic pain syndrome begins to manifest itself.It is customary to distinguish two subgroups:
  1. IIIA - there are signs of an inflammatory process.Low-grade fever is maintained.
  2. IIIB - no inflammation.
• IV - prostatitis in which there are no symptomatic manifestations.Deviations from the norm are detected exclusively by instrumental diagnostic methods.

According to the ICD code:

• N41.1 is diagnosed with chronic prostatitis.
• N41.8 inflammatory diseases of the prostate gland.
• N41.9 an exact diagnosis has not been made.

How does chronic prostatitis manifest itself - its symptoms

The first signs of chronic prostatitis in men appear at an advanced stage of the disease.Often, early development has no clinical manifestations.Symptoms, even if present, are temporary, short-term and of low intensity.

According to clinical manifestations, three stages of prostatitis development are distinguished:

• Initial indirect signs of chronic prostatitis - as already noted, the onset of the disease is not expressed by clearly distinguishable symptoms.Manifestations are subtle or absent altogether.Signs you should pay attention to: burning sensation during ejaculation, decreased potency, painful urination.
• Secondary signs of chronic inflammation of the prostate - at this stage, pathological changes occur in the structure of tissues, the appearance of scar-like formations, and a decrease in genitourinary function.The stage is characterized by a sharp deterioration in potency and urination, increased sweating, severe pain in the pelvic area, lumbar spine, and scrotum.
• Signs of an advanced disease - the prostate ceases to function normally.Healthy tissues begin to metamorphose.The gland increases in size.Blood and pus appear in the urine, there is a constant feeling of incomplete emptying of the bladder, and night trips to the toilet become more frequent.Erectile function decreases so much that we can talk about complete sexual impotence.

In addition to the symptoms characteristic of each stage of development, there are general signs that appear throughout the entire course of the disease.

Pain syndrome

Chronic prostatitis in the late stage of development has pronounced symptoms.Characteristic clinical manifestations are pain of severe intensity that does not go away on its own and requires the use of analgesics and antispasmodics.

Pain syndrome accompanies the entire period of development of the disease.During the primary signs of prostatitis, discomfort and burning in the urethral canal are of low intensity and are therefore often ignored.Pain is often falsely attributed to radiculitis or fatigue.After pain relief or taking an antispasmodic, the symptom usually goes away.

Over time, the clinical picture becomes more intense.The pain syndrome manifests itself more intensely and remains after taking analgesics.Unpleasant sensations accompany every act of urination, defecation and ejaculation.

The pain radiates from the spine to the scrotum, sometimes to the limbs, and is accompanied by cramps and numbness.Skin rashes, itching and burning of tissue in the prostate and genital areas are a normal reaction of the body to internal inflammation.

Temperature rise

Chronic inflammation of the prostate gland in acute form is accompanied by heat and fever.There is a sharp increase in temperature, reaching 39-40°.The indicators are stable.Body temperature does not decrease even after taking antipyretics.

Sluggish prostatitis is characterized by a low-grade fever.Constant indicators of chronic inflammation, within 37-37.2°.

Reducing the temperature and taking medications on your own to reduce external manifestations is strictly prohibited!

Dysuria

The first signs of chronic prostatitis appear in various urination disorders.Over time, the symptoms become more intense, which helps to identify the disease.Manifestations of dysuria:

• Frequent urge to go to the toilet at night.
• Feeling of incomplete emptying of the bladder.
• Hematuria (blood in urine), purulent discharge.
• Pain during urination.

Clinical signs and the intensity of their manifestation directly affect the diagnosis and require mandatory additional research.Symptoms may indicate other inflammatory diseases of the genitourinary system, hyperplasia and oncology.

Disorders of the genital organs

Chronic prostatitis leads to the appearance of scar formations that impair blood supply.Lack of nutrients leads to the following manifestations:

• Decreased potency - with chronic prostatitis, sexual disorders are observed.One of the characteristic symptoms is a normal erection, which sharply decreases during sexual intercourse.In the advanced stage, stable potency occurs.
• Infertility - after the appearance of scars in the seminal ducts, the viability of sperm decreases.Inflammation changes the structure and composition of the ejaculate.In the advanced stage, the sperm thickens and lumps appear.
• Pain during sexual intercourse - discharge from the urethral canal is observed.During sexual relations, discomfort and painful symptoms are felt, especially during ejaculation.Often psychosomatic reasons lead to persistent impotence of the patient.

The main symptoms of chronic prostatitis: pain, increased body temperature, dysuria, dysfunction of the genital organs.When making a diagnosis, the intensity and duration of the period from the onset of clinical signs, as well as related symptoms, are taken into account.

How can chronic inflammation of the prostate be detected?

Prostatitis has no symptoms that can accurately differentiate the disease.Some disorders of the genitourinary system have similar symptoms.An accurate diagnosis can be made only after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.

Having suspected the presence of disturbances in the functioning of the pelvic organs, the urologist will prescribe a mandatory rectal examination.If tissue changes are detected upon palpation, several laboratory tests are prescribed.

Laboratory research methods

Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the catalyst for the development of the disease.When making a diagnosis, additional information will be required from the results of the following laboratory tests:

• Cytological and bacteriological analysis of urine.The PSA level is established.Protein levels increase sharply with inflammation of the gland tissue.
• Taking a smear from the urethra.
• Microscopy of prostate secretions - based on the results, malfunctions in the prostate gland are determined.Differentiate cancer from chronic tissue inflammation.Sowing prostate secretions is prohibited during an acute period of the disease, accompanied by high body temperature, exacerbation of hemorrhoids, or fissures in the anus.
• Tests for STIs (sexually transmitted infections) - one of the common catalysts for inflammation of the prostate gland is pathogenic microorganisms.Trichomonas, staphylococci and gonococci can all cause the disease.Prostatitis develops during the active phase of bacterial proliferation, and after the infection has already been cured.

Laboratory tests are an obligatory component of the diagnosis of prostatitis and the subsequent choice of treatment method.

Instrumental detection of the disease

There are three main methods of testing for prostatitis.Each instrumental diagnostic method provides information about changes in the structure of gland tissue and has its own indications and contraindications:

• Tomography - MRI is often prescribed to diagnose chronic prostatitis.The study allows you to obtain a layer-by-layer image of the prostate.MRI signs accurately indicate chronic inflammation, and also indicate the beginning of tissue degeneration into a malignant formation.Magnetic resonance technology is absolutely harmless, but has contraindications due to the inability to study patients with pacemakers, metal staples and shunts (left during surgical operations).
• Transrectal TRUS is an informative method that reliably indicates the presence of inflammation.Sonographic signs of structural changes in the prostate gland according to the type of chronic prostatitis include: deviations from the norm in volume and size, structure, and the presence of pathological formations.Ultrasound techniques are not prescribed for acute inflammation of the rectum, the presence of cracks in the anus, or hemorrhoids.
• Ultrasound - transabdominal technique has no contraindications.The method is less informative compared to TRUS and MRI.Sonographic signs make it difficult to determine the space of the abdominal cavity.Diagnostic results are often controversial and require clarification.The advantage of ultrasound is the simplicity and speed of the study.

The accuracy of the echographic picture largely depends on the experience of the doctor conducting the study.

Differential search for disease

After receiving the results of clinical and biochemical studies, the symptoms of chronic inflammation of the prostate gland are assessed.Common diagnostic standards have been developed that are valid throughout the world.

To facilitate the task of the urologist, the NIH-CPSI symptom index has been invented, made in the form of a questionnaire or questionnaire.The doctor fills out the fields in the document and then makes a diagnosis.

There are computer programs based on the NIH-CPSI index.The doctor is required to fill out a questionnaire, and the system will independently conduct a summary assessment of symptoms for chronic prostatitis.The effectiveness of the technique has been proven all over the world.

After calculating the results of the questionnaire, when making a diagnosis, an additional assessment of instrumental and clinical studies is taken into account: the presence of echo signs of chronic prostatitis, an increased PSA level, identification of an infectious marker by microscopy of secretions.The more data the urologist has, the more accurate the result will be.

What is dangerous about chronic prostatitis - its consequences

The consequences of chronic prostatitis in men are disorders in the functioning of the genitourinary system.These include:

• Impotence.
• Acute urinary retention.
• Infertility.

Fibrous changes that accompany advanced disease cause the development of oncology.Normal tissues degenerate into malignant ones.Therefore, preventing functional changes in the prostate gland in order to prevent the development of cancer is an extremely important task facing the urologist.

When making a diagnosis, the presence of prostatic intraepithelial neoplasia, a harbinger of oncology and fibrous changes, is taken into account.Advanced disease often leads to the need for surgery: prostatectomy.

Diagnosis of prostatitis and differentiation of the disease from related disorders of the pelvic organs is an important task for doctors and patients.Detection of the first symptoms depends entirely on the man himself.If you experience any discomfort when urinating, decreased erection, or persistent low-grade fever, these are reasons to immediately seek professional medical help.Delay is dangerous!