Prostatitis

23 May 2026

Prostatitis is a condition in which the prostate becomes inflamed.Prostatitis, whose symptoms are most often found in men of childbearing age (20-40 years), is diagnosed on average in 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 from a photograph, because it does not have any visible manifestations.In order to quickly notice the first symptoms, you need to listen to your own health.

General description

The prostate, affected by the disease in question, is an exclusively male organ;therefore, prostatitis can only develop in men.If we consider a similar area in women, and it is the distal third of the urethra, or urethra, then here are the Skene glands.These glands are essentially analogous to the prostate and if their inflammation develops, symptoms can resemble those of prostatitis.

The prostate itself resembles a glandular-muscular organ located near the bladder.Thanks to this, the process of urination is controlled, in addition, it is thanks to the presence of the prostate that a certain secret is released, which makes the semen liquid.

Very 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 affected pathogens.Basically, these are pathological agents that permanently reside on the surface of the skin or in the environment of the digestive tract.In this case, a certain combination of factors can provoke 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 of microbial agents penetrating the prostate, or causes disruption of blood supply to the 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, even if none of them is proven at the moment.For example, some experts believe that in this form the disease can develop against the background of real neurogenic disorders, while another part, on the contrary, focuses on the immune nature of the disease in this form.This is only part of the existing theories regarding 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, this factor is not the main one here, acting rather as a secondary and important factor 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, under the influence of which the chronic form of inflammation is maintained even when there is no question of bacterial invasion.

Prostatitis: symptoms

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

During this time, before the start of such a stage as blockage of the excretory ducts, as a rule, a lot of time passes, in some cases this time is calculated in months, in others even in years.The process progresses gradually, the patient may not notice anything special, especially since the production of secretions by the prostate does not stop.Another thing is that when these microabscesses are formed, this is already accompanied by the appearance of not very pleasant symptoms, manifesting themselves in varying degrees of intensity.

As the first of these symptoms, patients note difficulty urinating.Due to the fact that the prostate enlarges against the background of the inflammatory process, the urethra is compressed to a certain 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 subject to disruption and orgasm is weakened.

There are also other signs of prostatitis, including:

the appearance of a burning sensation in the urethra and perineum;
persistent and frequent urge to urinate;
the appearance of discomfort during bowel movements;
“floaters” in urine;
the appearance of stretched urethral discharge during defecation;
the appearance of prolonged nocturnal erections;
intermittent and difficult urination;
ejaculation too rapid;
increased general fatigue;
decrease in power;
manifestation of orgasm in an erased form;
expectation of 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 all appear overnight.The disease is characterized by a highly variable pattern of manifestation, this applies to different variants in each patient and at different 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 “out of the blue”.We are mainly talking about pathogens, already mentioned above.In the meantime, it was this factor that caused the formation of an erroneous 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 for this disease.At the same time, any chronic infectious disease can provoke the development of prostatitis;it can be any type, whether it is sinusitis, tonsillitis, cholecystitis or any other disease.In this case, the pathogen can enter the prostate through the bloodstream, which is characterized by a fairly powerful blood supply (otherwise its functionality would be called into question).

There is a certain group at risk of prostatitis, in particular the following people:

people whose professional activity falls under the “sedentary” work criterion;
people with a sedentary lifestyle;
people who have already been diagnosed with a specific genitourinary infection;
people for whom the problem of chronic constipation is relevant;
people who practice promiscuity;
people whose family relationships do not meet the order's criterion;
people who abuse alcohol.

Men are often diagnosed with “abacterial prostatitis”, “prostatitis in the prostatosis stage”.If a man is diagnosed with prostatosis, we can say that at this stage there is nothing to be particularly concerned about.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 stagnation phenomena mentioned above are already taking place, but there is no inflammation as such yet, it is prostatosis.If such an option as abacterial prostatitis is considered, then here 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 peculiarity 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 can be explained by its often long and progressive evolution.Complete recovery due to the treatment administered to the disease or spontaneous disappearance of the pathological process is estimated in isolated cases during the initial acute phase.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 seeking medical help is excluded, can provoke the development of an abscess in the prostate, that is, the cause of the development of focal purulent inflammation in it.This is accompanied by an increase in temperature (between 39 and 40 degrees), which at the same time becomes eventful, that is, its differences exceed one degree.Patients also suffer from high fever, which periodically gives way to chills.The pain in the perineum becomes so intense that it is difficult to urinate, while defecation becomes almost impossible due to the pain.After a while, swelling develops in the prostate, which causes acute retention of urination.Meanwhile, it is rarely acute prostatitis, which manifests itself against the background of chronic spread of the pathological process - unless, at his own risk, a man “endures and endures”.

Returning to chronic prostatitis, we can say that it is characterized by the undulation of its own course, that is, periodically the symptoms of the chronic form of prostatitis appear more intensely and periodically they are practically not felt.Because of this type of change, many patients choose a wait-and-see approach.During this time, as noted above, the inflammatory process can worsen and spread more and more.When it spreads, even pyelonephritis can develop.Meanwhile, complications of prostatitis in most cases are due to diseases such as vesiculitis, in which the inflammatory process affects the seminal vesicles, as well as epididymo-orchitis, in which the testicles and appendages become inflamed.Due to the transfer of the disease in a similar form of spread, the development of infertility in a man can be indicated.Infertility treatment is a long and complex process and, in some cases, completely impossible.The listed characteristics mainly relate to the development of a chronic form of prostatitis, due to the specific etiology of its appearance (in particular, we are talking about STDs).

Diagnosis

Examining patients to identify their specific type of prostate pathology can be carried out in different ways.Meanwhile, in each specific case, an individual approach to the problem in question is important, on the basis of which it is already possible to determine the diagnostic option to obtain sufficient information about the disease.

To begin with, the doctor conducts an investigation of the patient's complaints, studies the medical history, if any, based on this, and then draws a preliminary conclusion and determines the principles of an individual diagnostic algorithm.We would like to add that the first consultation with a urologist (that is, the specialist to whom you should contact if worrying symptoms of prostatitis appear) is not definitive and reliable for making a diagnosis, since the first examination is only an opportunity for the doctor to determine what further diagnostic measures are necessary.

Given the sensitivity of the problem, men are interested in what questions a urologist asks if they suspect prostatitis.In particular, he will ask about current problems with urination, as well as how the patient himself assesses his own sexual function (i.e. are there any changes, what exactly has changed, since what period).Additionally, the doctor will ask you what diseases you are currently suffering from, etc.

This is followed by an examination, including an external examination, rectal examination, laboratory and instrumental examination.During an external examination, the doctor examines the man's genitals, determining if there are rashes, irritation, discharge, etc.

Then, after an external examination, the doctor goes to the next step which is the rectal exam.A rectal exam allows you to determine the general contours of the prostate, its consistency, its limits, etc.

After that, you will need to obtain the results of instrumental and laboratory diagnostics.Instrumental diagnosis is called TRUS, which in its expanded form means transrectal ultrasound.This is the most accurate method for identifying diseases in a man compared to standard ultrasound.

As for laboratory tests, they include a smear, urinalysis, prostate secretion test, PCR (a laboratory test to detect sexually transmitted infections).

Based on the current classification of methods for diagnosing prostatitis, only a microscopic examination of the secretion obtained from the prostate gland, as well as any topical diagnostic option that allows detecting the presence of an inflammatory process in the lower genital tract, can be considered a necessary option.Other types of diagnostic methods act only as clarification methods;they are necessary for differential diagnosis and identification of existing complications of the underlying disease.In addition, it is important to remember that in case of overdiagnosis, this stage itself becomes longer and the symptoms only worsen.That is, here, as in any other matter, the principle of “golden mean” is appropriate.

Treatment of prostatitis

The treatment of prostatitis today is a serious problem, although this does not mean that a doctor cannot help and the disease should be left to chance.Indeed, it is not always possible to completely recover from prostatitis, but it is possible to eliminate the symptoms of the disease, as well as achieve long-term sustainable remission.Depending on how seriously a man takes the doctor's recommendations, the duration of remission periods for him.

At its core, the treatment of prostatitis may contain a number of measures, including methods of antibacterial therapy, prostate massage, immunotherapy, physiotherapy and general correction of the patient's lifestyle.It is only on the basis of a set of these measures that the desired result can be achieved;In general, the disease is difficult to treat and therefore cannot be ignored.

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, including the following:

the ability of the components of the proposed drug to penetrate the secretion and tissues 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 have no activity against Gram-negative bacteria, namely they are the main etiological agents in the examination of the acute form of prostatitis).

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

Prostate massage

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

restoration of duct permeability;
improvement of muscle tone and blood circulation in the prostate;
increased penetration of used antibiotics into glandular tissue;
the possibility of activating inactive microorganisms, thereby improving the results of the sale of antibacterial drugs.

How does prostate massage take place?Of course, to begin with, it is important to establish a certain contact of trust between doctor and patient;this will guarantee greater relaxation of the patient, which will allow the necessary manipulations to be carried out 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 (this gel sometimes has an analgesic effect).Then, with his free hand, he spreads the buttocks to a width such that he can palpate the anal sphincter using the index finger.The natural reaction to such contact is muscle contraction.Then, after relaxing them, the index finger is inserted into the bulb 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.A massage can be considered successful when it is possible to obtain at least 4 drops of secretion secreted by the prostate.

The most popular recognized method used in the treatment of chronic prostatitis is to use massage according to the Manila protocol.In this case, massage is performed three times a week, a dynamic microbiological study is also carried out and antibiotics are taken.

Immunotherapy

This direction in the treatment of prostatitis is often extremely necessary, because in case of prolonged manifestation of inflammation associated with previously incorrect antibacterial treatment, the possibility of a negative impact on the general state of the immune system cannot be excluded.Treatment of prostatitis requires not only eliminating the infection of the gland and, in fact, inflammation, but also preventing the 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 have to consult an immunologist and, most likely, carry out some tests.

Physiotherapy

For prostatitis, this direction of treatment can be implemented in a wide variety of impact options, however, regardless of the specific solution, the impact is focused on improving blood circulation in the pelvic organs, thereby increasing the overall effectiveness of the implementation of antibacterial therapy measures.Physiotherapy can use ultrasound waves, electromagnetic waves, laser therapy, increasing temperature directly in the rectum, etc.If there is no possibility of physical therapy, the doctor may recommend microenemas with warm water and certain medications.

Lifestyle correction

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

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