Prostatitis: How to recognize the disease

Prostatic inflammation is one of the major urinary tract problems in men under 50 years of age. Ten to twelve percent of representatives of the dominant gender experience prostatitis symptoms at least once in their lives. The disease can occur in both acute and chronic forms, and its signs and symptoms depend directly on these two forms.

What is prostatitis

Prostatitis is the term for inflammation of the prostate gland.The prostate, or prostate, is an organ of the male reproductive system. Its normal size is no larger than a walnut. This gland is located below the bladder and in front of the rectum. The prostate surrounds the urethra, the tube through which urine and semen exit the body. Its main function is to produce secretions (prostatic fluid) to support the vital activities of sperm after ejaculation.The inflammatory process in the prostate can be caused by infection as well as various other causes.

Types and first signs of illness

The initial signs and further symptoms depend on the type of prostatitis. Clinicians distinguish a total of 4 types.

1. acute bacterial prostatitis: Caused by a bacterial infection that usually comes on suddenly and may resemble flu-like symptoms. This is the least common of the four types of prostatitis.
2. chronic bacterial prostatitis: Characterized by recurrent bacterial infections of the prostate. There may be few symptoms between attacks, which is why it can be difficult to treat successfully.
3. Chronic prostatitis/chronic pelvic pain syndrome: Most cases of prostatitis fall into this category, but at the same time this type is the least understood. It can be classified as inflammatory or non-inflammatory, depending on the presence of infection-fighting cells (antibodies in urine, semen, and prostate secretions). It is often impossible to identify a single specific cause. Symptoms may come and go or appear intermittently.
4. asymptomatic inflammatory prostatitis: This disease is often diagnosed incidentally during treatment for infertility or prostate cancer. People with this form of prostatitis have no symptoms or symptoms of discomfort, but tests show the presence of infected cells in the prostate secretions.

The main symptoms

Symptoms associated with prostatitis may vary depending on the underlying cause of the disease.Common and increasing symptoms include:

• Pain or burning when urinating (dysuria);
• Difficulty urinating, such as thin urine or urinary stasis, intermittent urination;
• Frequent urination, especially at night (nocturia - going to the bathroom more than twice a night);
• Urgent need to urinate.

An important symptom is pain, which may occur or radiate to various parts of the lower body. She may be:

• In the rectum (rectum), sometimes accompanied by constipation;
• in the abdomen and/or lower back;
• In the perineum - between the scrotum and the rectum.

Patients often report discomfort in the penis and testicles. Pain during ejaculation is a characteristic feature, and prostatitis can also be accompanied by sexual dysfunction.Rapid and severe onset is often characteristic of the acute bacterial form, which is characterized by additional symptoms similar to those seen during influenza viruses.this:

• Fever and chills;
• general malaise and body aches;
• swollen lymph nodes;
• Sore throat.

If the patient ignores the first signs of the disease and does not seek the help of a urandrologist, a dangerous situation of suppurative complications can arise. Acute infectious prostatitis can develop into a severe pathological form when the prostate tissue becomes covered with pustules or abscesses. Symptoms include the following:

• Cloudy urine or blood in the urine;
• discharge from urethra;
• Urine and secretions have an unpleasant odor.

If the first signs of inflammation are detected, men should immediately consult a doctor for further diagnosis.

diagnosis method

Prostatitis is usually diagnosed by a urologist performing laboratory tests on a urine sample and examining the prostate.This exam involves palpating the prostate through the rectum to check for abnormalities. Sometimes doctors will collect and test a sample of prostate secretions. To get it, the urologist massages the gland during a rectal exam. This test is contraindicated in cases of acute bacterial prostatitis due to concerns that the procedure may release bacteria into the bloodstream.The urologist also takes the body temperature in the armpits and rectum and then compares the results. In acute prostatitis, the temperature in the anus will increase by about 0. 5 degrees.

lab testing

Laboratory tests that can be ordered include:

• clinical blood and urinalysis;
• Bacterioscopy and culture of urine sediment and prostate secretions – samples are examined under a microscope for the presence of bacteria;
• Smear of urethral discharge (if discharge is present);
• Prostate-specific antigen (PSA) levels are measured.

If a clinical blood test shows elevated levels of white blood cells (10-12 per field), this indicates inflammation. Acute infectious prostatitis is characterized by an increase in neutrophils, a type of white blood cell whose main function is to destroy pathogenic bacteria. There was also a decrease in levels of eosinophils (less than 1% of all white blood cells), another group of white blood cells responsible for protecting the body from foreign proteins. Erythrocyte sedimentation reaction or red blood cells is another indicator of a general clinical blood test, and if its value exceeds 10 mm/hour, it also indicates the presence of a pathological process in the body. The sedimentation rate of these blood cells increases with the concentration of markers of the inflammatory process in the plasma: fibrinogen protein, immunoglobulins, and C-reactive protein.Bacterioscopy of urinary sediment and prostate secretions will indicate the presence and number of pathological microorganisms in these biological fluids, and by culture for antibiotic susceptibility, the type of bacteria will be determined for further selection of treatment. The causative organism can be identified by, inter alia, microscopic examination of a smear of urethral secretions.The prostate-specific antigen test is a screening test in the form of a vein blood test that detects a protein produced only by cells in the prostate. Protein standards depend on a man's age and range from 2. 5 ng/ml for men 41-50 years old to 6. 5 ng/ml for men over 70 years old. This protein level, which is higher than normal for one's age, means a biopsy -- a tissue analysis in oncology -- is needed. However, excessive protein content can also be observed due to inflammation of the prostate.

PSA levels may also be slightly elevated due to benign enlargements of the prostate (adenomas) and urinary tract infections.

Age-Related PSA Indicators - Table

generation	PSA standard
Under 40 years old	Less than 2. 5 ng/ml
40-49 years old	2. 5 ng/ml
50-59 years old	3. 5 ng/ml
60-69 years old	4. 5 ng/ml
Over 70 years old	6. 5 ng/ml

Musical instrument studies

Since no test or analysis alone can provide complete guarantee of a correct diagnosis, other methods (instrumental methods) may be used as part of a comprehensive diagnosis. These include:

1. Bladder Urodynamic Study- Complex instrumental methods using special equipment allow you to determine whether the bladder is completely empty, urine flow, pressure within the bladder and urethra, and to evaluate the impact of prostatitis on normal urination. This study is recommended for people with chronic urinary problems: intermittent or trickling flow, incontinence, frequent urination, etc. It is also indicated for patients with long-term inflammation of the prostate, especially when standard treatments are ineffective. Before the examination, a special catheter sensor, which is also connected to a measuring device, is inserted into the patient's urethra in a horizontal position. Next, let the patient drink a certain amount of clean water, and at the same time record the feeling of bladder fullness, the urge to urinate for the first time, whether there is urine leakage, etc. The patient is then transferred to a specially equipped chair and seated in the chair. He needs to be relieved under the control of sensors and equipment that make the necessary measurements. The process consists of several stages, each taking approximately half an hour. The results of the urodynamic study are provided to the patient immediately upon completion.

2. Ultrasound Imaging (USA)- This method is used to diagnose existing diseases and is also suitable for men after the age of 45 for the annual prevention of prostatitis and other glandular diseases. The study was performed using an ultrasound machine through the anterior abdominal wall in the morning on an empty stomach, with the bladder filled with clean water, and a special transducer inserted 5-7 cm deep into the rectum (rectal method) or through the urethra. This procedure is completely safe and allows you to determine the contour, size and condition of various areas of your prostate. The volume of a healthy prostate is approximately 20-25 cm³. The maximum length, width and thickness are 3. 5 cm, 4 cm and 2 cm respectively.
3. Magnetic resonance imaging (MRI)- This method allows you to study the structure, density, condition and even blood flow of the prostate in detail; sometimes, additional contrast material is injected intravenously to better understand the situation. This test can also be used to differentiate between prostatitis and tumors. The MRI machine is a large cylinder surrounded by magnets into which the medical table carrying the patient slides, like a tunnel. For 10-12 hours before surgery, patients should wear loose-fitting clothing (without hardware) and avoid eating large amounts of food. Watches, jewelry and any other metal objects must be removed before the inspection. MRI diagnostic methods are contraindicated if the patient has metal-containing implants or cardiac devices. To perform this procedure, a transrectal sensor is most often used (although it is also possible without it), having previously cleaned the rectum with an enema. The nurse inserts the sensor and secures it with a special disposable cuff. The patient should lie as still as possible throughout the examination (approximately 30 minutes). The procedure is painless.

4. Cystoscopy- A cystoscope is used to examine the mucous membrane of the urethra and bladder - A long, narrow catheter with a light bulb and a camera at the end is used under local anesthesia. This surgery is performed after the bladder is full. The duration of a cystoscopy is approximately 15 minutes. This method allows you to evaluate the condition of your urinary tract and rule out other conditions that may be causing urinary problems.
5. prostate biopsy- This is a necessary procedure if, after a thorough examination, the doctor suspects a malignant process in the prostate. Must be ruled out or confirmed before a treatment strategy can be selected. The procedure is performed on an outpatient basis, in which a needle is inserted into the patient's rectum and a sample of prostate tissue is collected. A local anesthetic is injected into the anus, and then, once the anesthetic has taken effect, an ultrasound probe with a needle attachment is inserted into the intestine. Under ultrasound guidance, the surgeon determines where the material needs to be "pinched off" for analysis. Typically, there are up to 18 different points on the organ. The biopsy will not cause pain; there may be only mild discomfort after the anesthesia wears off.

If a patient has recurring urinary tract infections and prostatitis, the specialist will order a complete examination of the genitourinary system to detect anatomical abnormalities.

Differential diagnosis

The symptoms of acute prostatitis may resemble inflammation of the bladder or urethra. In all cases, symptoms include painful urination and frequent urination. But acute prostatitis is characterized by clear symptoms of systemic intoxication and urine and secretions mixed with pus. A palpatory examination of the prostate can be painful and may reveal enlargement of the gland, which is not the case with cystitis or urethritis.

Doctors say inflammation of the prostate does not increase the risk of prostate cancer.

Complex anogenital symptoms and vegetative genitourinary syndrome in young men should be differentiated from chronic inflammation of the prostate. These diseases can only be distinguished by analyzing the prostate secretions for the presence of bacteria. In men over 45 years of age, it is necessary to exclude tumors and prostate adenomas, which, unlike prostatic inflammation, are usually asymptomatic in the initial stages. For a more detailed analysis, the urologist will perform a PSA test and then, if necessary, a biopsy.Prostatitis can be an acute bacterial disease that is usually easily treated with antibiotics, or it can be a recurring, chronic condition that requires ongoing medical monitoring and control. In each case, only specialists in the fields of urology and andrology can correctly diagnose the disease.