Symptoms of prostatitis symptoms and treatment

At least 1/3 of men, for once in my life have been detected bacteriuria, and 1/4 is diagnosed inflammation of the prostate. The vast majority of these cases are diagnosed and treated by General practitioners. So what's new in this issue?

Such diseases as prostatitis, is the most common urological problem in men aged up to 50 years, and the third most common disease in the elderly. It is assumed that chronic inflammation of the prostate affects the quality of human life, and in many respects comparable to coronary heart disease or Crohn's disease. Thus, the prostatitis symptoms the treatment of disease is the increased attention of the male population.

Inflammation of the prostate represent a heterogenous group of infectious and noninfectious diseases, most of which are reasons not exactly explained.

What are the prostatitis symptoms and treatment of the disease can we treat the disease with traditional methods? Let's see.

Common symptoms

How does the disease – signs and symptoms of prostatitis:

• the increase in temperature (usually below 38.5°C),
• abdominal pain,
• frequent urination,
• blood in urine,
• paroxysmal or dull pain, tension and pressure in the perineum,
• pain and burning during urination,
• backache,
• sometimes there can be discharge from the urethra,
• chronic disease is often manifested by epididymitis.

Classification and characteristics of

The symptoms of prostatitis bacterial nature are characterized by the presence of signs of inflammation of the urinary tract, the positive results of cultivation in the urine or prostatic secretions, and the presence of inflammatory cells in the secretions.

In accordance with the clinical course are acute bacterial prostatitis and chronic bacterial prostatitis. Both of these forms, however, do not constitute more than 5-10% of all cases of inflammation of the prostate. The vast majority represented by a non-bacterial nature of the disease or chronic pelvic pain syndrome in people who do not have a history of urinary tract infection, and cultivation examination of the urine and prostatic secretions are negative.

A new category is asymptomatic prostatitis, which is clinically "silent" inflammation of the prostate gland detected during the survey because of other problems, because symptoms of prostatitis in of this type do not exist.

This classification, symptoms and treatment of prostatitis can be to some extent interrelated in the decision about therapeutic methods, but in practice this relationship is often not taken into account because the physical data, the ability to respond to treatment with antibiotics and the prognosis of chronic bacterial inflammation is virtually the same as when or when non-bacterial chronic pelvic pain syndrome.

Etiology and pathogenesis

Most is known about the causes of acute bacterial prostatitis. Most often, there is a Escherichia coli (strains causing prostatitis usually Express several characteristic virulence factors – cytotoxic necrotizing factor 1, hemolysin, P fimbriae, etc.). In addition, pathogens can be bacteria of the genus Proteus and Providentia, at least – representatives of the genera Klebsiella, Pseudomonas, Serratia or Enterobacter. A primary pathogen can be enterococci, but their value is not great. Also discussed is the role of other gram-positive cocci.

Although the main etiological agents are known, the process of pathogenesis remains unclear. It is assumed that prostatitis occurs due to accidentado the spread of infection from the urethra or reflux of infected urine from the bladder into the ducts of the prostate in the posterior urethra. This interpretation is confirmed, for example, finding the same bacteria in the prostate and vaginal secretions of sexual partner, or cryptonym of bacteria in prostatitis in gay men.

Cause of chronic non-bacterial prostatitis is unknown. Chlamydia, Mycoplasma, Ureaplasma, Trichomonas, or different viruses, although they can cause inflammation of the prostate, their role in the process of chronic disease is unlikely. The use of highly sensitive detection methods in the study of tissue the prostatecancer and some cases of chronic inflammation showed the presence of low pathogenic bacteria. In older men in the prostate are formed concretions, which may contain bacteria resistant to antibiotics and cause inflammation. But no one suspected mechanism have not been studied enough filled the gap between partial observation and understanding of the causation of pathogenesis.

The prostate creates some antibacterial agents, of which the most important are polypeptides that contain zinc ("prostatic antibacterial factor"). In chronic prostatitis in the prostate gland decreases the amount of zinc, calcium, citric acid and spermine, and increased pH. However, it is unknown whether the factors inducing inflammation, or which are the consequence.

Cystitis

It is believed that circumcision reduces the risk of infections of the urogenital tract in men, but in young men, these infections are rare and without it, of course, subject to hygiene. The frequency of UTI increases with increasing age and functional disorders of the urinary tract. Bacteriuria is seen in 50% of older people. The disease is intermittent, mostly caused by prostate enlargement or dysfunction of the bladder and not by the penetration of virulent bacteria in the urinary tract. The finding of asymptomatic bacteriuria, however, says nothing about the risk of symptomatic UTI in the future.

The pathogenesis of cystitis remains unclear. The main predisposing factor is the restriction of the outflow of urine from the bladder, the pressure of the enlarged prostate, but evidence of this, remarkably little. Cystitis after instrumental investigations, most likely, is a complication caused by introduction of infection from outside. Young men sometimes uncomplicated UTIS caused by E. coli after Homo - or heterosexual contact.

Bacteriological diagnosis

Since the collection of uncontaminated urine is easier in men than in women, is considered to be an important discovery 10 bacterial colonies per 1 ml. In 95% of cases for diagnosis, it is sufficient to study a single sample of urine.

In almost half of cases of cystitis cause Escherichia coli strains, but often the occurrence of disease involved also other types of bacteria. Pathogens about 20% of cases of cystitis are considered to be gram-positive bacteria – most commonly Enterococcus faecalis, sometimes Staphylococcus epidermidis or S. aureus.

Most elderly men with recurrent bacteriuria and approximately 30% of young people with only one episode of bacteriuria intravenous urography or pyelography can detect any anatomical changes in the urinary tract, but the clinical significance of these findings is unclear. Thus, such a study is recommended for people with symptoms suggestive of pyelonephritis who do not respond to treatment with antibiotics or have a UTI again.

Treatment of prostatitis

Most studies examining the penetration of antibiotics into the prostate, were carried out on dogs. Despite the fact that this model is not completely analogous to the situation in chronic bacterial prostatitis in humans, but it allows you to learn some basic facts. For example, that the level of antibiotics in the prostate secretion, as a rule, lower than in tissue, and is better correlated with the efficacy of the treatment.

Penicillins and Cephalosporins penetrate the prostate in small amounts. Macrolides, Chloramphenicol, Tetracyclines and some penetrate into the prostate well, but, with the exception of Doxycycline, are not effective against most etiologic agents.

From the point of view of penetration into the prostate and efficiency, it is worth attention Trimethoprim, but it is often combined with Sulfamethoxazole, which in the prostate reaches a low level, the effectiveness of the drug increases.

Fluoroquinolones due to the low molecule solubility in lipids and low protein binding penetrate into the prostate well and is active against almost all the bacteria that are involved in the formation of the disease. Norfloxacin, Ciprofloxacin, Ofloxacin, Levofloxacin, Lomefloxacin and Enoxacin, tend to have higher levels in the prostate than in the plasma.

Some proven treatment regimens are shown in table:Treatment usually begins pending the outcome of bacteriological research. Sometimes during the initial empirical phase it is recommended that Trimethoprim with Sulfamethoxazole, but more recent data about the effectiveness of Fluoroquinolones in this situation are compelling. Their spectrum of activity includes not only most species of bacteria, but also Mycoplasma and chlamydia. A variety of drugs of Fluoroquinolones group seem to fit equally, but, for example, the American FDA for the treatment of bacterial prostatitis has only approved four to Norfloxacin, Ciprofloxacin, Ofloxacin and Trovafloxacin.

Acute bacterial prostatitis usually responds promptly to treatment because of intense inflammatory reaction, improves penetration of the antibiotic into the tissue. People who are not in serious condition, can be orally administered drugs that are well tolerated. To prevent the formation of abscesses, or transition to chronic inflammation, it is advisable to continue treatment for 4weeks'.

In the case of chronic prostatitis treatment involves antibiotics for 4-6 weeks. The effectiveness of therapy with the use of Trimethoprim and Sulfamethoxazole is 30-40%, when using Fluoroquinolone – 60-90%.

In the recurrence of prostatitis symptoms which re-occur, antibiotic therapy is conducted for at least 3 months. When this is insufficient, continue treatment low doses may prevent recurrence of symptomatic inflammation. Suitable modes, such as the following:

• Norfloxacin, Ciprofloxacin or Ofloxacin – 100 mg daily or 3 times a week,
• 1 tablet of Trimethoprim-Sulfamethoxazole or Nitrofurantoin 100 mg daily.

People who do not respond to treatment, it is necessary to consider the removal of prostatic calculi, possibly by transurethral prostatectomy. However, after Subtotal prostatectomy inflammation disappears, only about 30% of people, most likely, this happens because the bacteria remain on the periphery of the gland. Radical prostatectomy inflammation completely, but it is recommended only in rare cases. New methods (microwaves, cryotherapy) in terms of treatment of bacterial prostatitis has not yet been evaluated.

Treatment of non-bacterial prostatitis is symptomatic and has no fixed rules. Antibiotic treatment is successful only in some people. Four-week antibiotic therapy, effective against pathogenic and non-pathogenic normal bacteria in the urinary tract, may be introduced, but long-term and repeated administration of antibiotics is inappropriate.

It is recommended that a number of other procedures, although the requirements of the medicine based on facts, they do not respond.

These methods include the introduction of anti-inflammatory drugs, alpha-blockers, Finasteride, Allopurinol, dietary supplements containing zinc, recommendations for lifestyle changes (diet, exercise, sexual practices), prostate massage. Preliminary reports indicate that the new surgical methods with non-bacterial disease to relieve symptoms of prostatitis.

Treatment of cystitis

Young men and elderly people who have no symptoms of prostatitis, cystitis can be treated with Amoxicillin, Trimethoprim-Sulfamethoxazole, or any drug from the group Fluoroquinolones (e.g., Norfloxacin), usually 7-14 days. Treatment with a single dose or short-term (2-3 days) introduction of medicines in men is not effective. Bacteriuria in some cases persists, and is caused by the same species of bacteria, as in the first episode. This indicates a focal infection where the localization is usually located in the prostate gland.

Receiving Trimethoprim-Sulfamethoxazole for 6-12 weeks, although it is more effective than short-term treatment, but in this way able to cure only about 65% of men. The degree of success of over 90% is specified after the 4-6 weeks of the introduction of the Fluoroquinolones.

In General, UTIS in men know less than women, less studied is the non-bacterial inflammation, which is most common. Today used scheme of classification is, overall, satisfactory for diagnosis and treatment, but deepening knowledge of the pathophysiology and the effectiveness of various diagnostic and therapeutic procedures is a prerequisite for a rational approach to this group of diseases in the future.

Diagnostics

Diagnosis is based on examination of urine and semen, prostatic fluid, is smear from the urethra for the presence of microorganisms. You can also use ultrasound of the urinary tract or rectal examination of the prostate.

In acute prostatitis, blood shows increased numbers of leukocytes.

Other measures of treatment and prevention

• You must comply with drinking regime, hygienic principles during sexual intercourse, regular urination (excessive accumulation of urine in the bladder can make the condition worse).
• It is recommended to avoid prolonged sitting or staying in cold places.
• In addition, it is advisable to consider temporary sexual abstinence.

Home treatment of prostate diseases

• The most important for good function of the prostate are zinc and vitamin A. Source of zinc can be bee pollen, which can be purchased in stores for beekeepers. Be careful of pills that contain bee pollen! Read how much pollen is contained in 1 tablet. Usually, this number is 5-10%, which is a little. Bee pollen is most effective in a fermented condition. Vitamin a is found in butter, whole milk ( ideally homemade), egg yolk, cow's liver, herring and mackerel.
• For 6 weeks, drink alkaline mineral water. Can mix it with 1 teaspoon of bee pollen and to consume 2 times a day. Along with this take brewer's yeast.
• Take 3 times a day 1 teaspoon of ground Flaxseed. Or preparea healthy Breakfast, mix 1 tablespoon ground flax seeds with a Cup of fat cottage cheese.

Herbal tea

• Herbal blend for the prostate: mix equal amounts of goldenrod, fireweed small-flowered, Heather and sweet clover medical. Pour 1 tablespoon of the mixture 250 ml of boiling water, leave for 15 minutes and strain. Drink 3 times a day before meals.
• Nettle inhibits the enzyme responsible for excessive enlargement of the prostate. Nettle root is effective in the treatment of moderately enlarged prostate: 15-25 g of crushed root to put in 0.5 liters of water, boil for 10 minutes, leave to stand for 20 minutes and strain. Drink hot 3 times a day a Cup.
• Mix 30 g of goldenrod 15 g of creeping couch, 15 g nettle root, 15 g of horsetail and 10 g oregano. 2 teaspoons of the mixture pour 200 ml of water and cook for 3 minutes, leave to stand for 15 minutes and strain. Drink 3 times a day for half an hour before meals. At least 4 weeks make one month break, and then repeat the treatment.
• Prepare a mixture of equal parts of black currant leaves, leaves cranberries, BlackBerry leaves and raspberry leaves. 2 teaspoons of the mixture pour 200 ml of boiling water and steep for 10 minutes. Drink 2 times a day. This tea helps to prevent problems with urinary ways and a prostate.
• The mixture for inflammation of the prostate gland: mix 20 g goldenrod, 7 g of chamomile, 10 g of horsetail, 20 g of rosehip, 20 g of yarrow, 15 g of peppermint and 15 g of fennel seeds. A tablespoon with a slide of the mixture pour 0,5 l of boiling water, boil for 10 minutes, steep 5 minutes and strain. Drink 3 times a day 1 Cup of hot tea.
• Boil a handful of flowers of the Heather in 1 liter of water until the volume is reduced by 1/3, strain. Drink hot tea 2 cups a day.

Compresses

• At night apply a compress on the area of the prostate. To do this, use a hot gruel made from boiled seeds of fenugreek or flax.
• Between your legs you can put wrapped in a towel with a hot water bottle. Prostate needs warmth.