Prostatitis (inflammation of the prostate gland) can occur in various forms. Most often, men suffer from acute inflammation of the prostate gland (prostate). If this disease occurs more often or if it is not treated sufficiently, it can develop into chronic prostatitis in the course of time. Typical signs are burning and pulling pain when urinating, fever and chills.
What is prostatitis?
The male prostate is responsible for producing some of the sperm. However, like any other organ, it can become inflamed:
This is called prostatitis, or prostatitis in technical terms. In a broader sense, it is also used to refer to any other inflammation of the pelvic floor to which no other cause can initially be attributed. Typical symptoms include difficulty and pain urinating, increased urination, and severe pain after ejaculation.
Causes
Acute prostatitis is the body’s response to bacterial infections. In most cases, it involves intestinal bacteria of the E. coli species, which can be detected in large amounts in the urine of affected men. Other, but rarer, triggers are chlamydia or various mycoplasmas. When bacterial prostatitis has become chronic, other bacteria usually also play a role. For example, Mycobacterium tuberculosis has been identified as a possible trigger, although genital tuberculosis must have preceded it. Less commonly, viruses or fungi are associated with chronic prostatitis. In most cases, the cause is due to the fact that the triggers of the previous acute disease remained in the urethra and, after the healing of the first episode of infection, re-entered by this route the prostate, which was still weakened. Abacterial prostatitis is by far the most common manifestation. It differs little from bacterial inflammation, but has other causes. Possibilities range from neuronal disorders to autoimmune reactions. Although it is discussed that bacteria that are difficult to detect could act as the causative agent, there is no proof of this.
Symptoms, complaints, and signs
Acute prostatitis usually begins with a general feeling of illness. The patient feels tired and weary, and fever with chills develops. Urination causes burning pain, much like that of cystitis. The urinary stream may be restricted by the swollen prostate. Because little urine can be passed when going to the toilet, the patient often has the urge to urinate. Furthermore, there is pain in the perineal area, which can radiate to the penis, testicles, bladder and groin. Pain may also occur during defecation and sexual intercourse, especially at or after ejaculation. As a complication of acute inflammation, purulent encapsulation (abscess) in the prostate is possible. It must be surgically opened and cleared out. Chronic inflammation of the prostate causes less severe symptoms. There is no fever and chills. The most severe symptom is a feeling of pressure in the perineum or abdomen. The ejaculate may be brownish in color due to traces of blood. Blood in the urine is also possible. In the chronic form, the man also often feels more severe pain at or during ejaculation. In addition, libido or potency disorders may occur. If the inflammation is not treated, it can spread to surrounding organs, such as the testicles or epididymis.
Disease progression
In acute prostatitis, prostatic abscess or urinary retention may occur as complications during the course of the disease. If a chronic form of prostatitis has already occurred, new infections can occur again and again, so that treatment can become very lengthy and complicated.
Complications
Recognized and treated in time, acute prostatitis heals in most cases within a short time without consequences. Occasionally, the triggering bacteria enter the testicles and can cause epididymitis there. A further complication can be a prostate abscess, in which pathogens encapsulate in the prostate and cause a massive purulent inflammation.This can be accompanied by fever, chills and severe pain in the affected area. A prostate abscess is usually opened surgically without delay, as the focus of the pus can otherwise break through into the urinary bladder, the urethra or the rectum. Furthermore, as a consequence of prostatitis, disturbances in urination are possible, which can extend to complete urinary retention – in this case, urination must be performed with the aid of a catheter. A rare but life-threatening complication is blood poisoning (urosepsis), in which bacteria enter the bloodstream and spread throughout the body. If not treated quickly, vital organs fail. Acute prostatitis that is inadequately treated with antibiotics often progresses to chronic prostatitis: In this case, the infection flares up again and again and must be treated with medication. Discontinuing the antibiotic too early carries the risk of developing resistance, in which the causative bacteria no longer respond to the active ingredient.
When should you see a doctor?
Symptoms such as burning during urination, frequent urination, and an uncomfortable feeling in the lower abdomen indicate prostatitis. A doctor’s consultation is necessary if the symptoms do not subside within two to three days. If general symptoms such as fever or malaise occur, it is best to consult the family doctor immediately. Sometimes the signs of illness occur in connection with a bacterial infection or tuberculosis of the genital organs. In this case, the relevant specialist should be consulted. The same applies if the health problems appear in the context of a chlamydia infection. Away from the family doctor, one should go to a urologist with an inflammation of the prostate. In the case of organic causes, the specialist responsible in each case must be consulted so that treatment can be started quickly. If no physical cause is found, the condition may be psychological. The patient should see a psychologist or psychotherapist insofar as mental health is poor or there are other reasons to suspect a psychological trigger.
Treatment and therapy
Acute prostatitis is initially treated with antibiotics. Depending on the pathogen, various preparations come into question. The chronic form is also treated with antibiotics, but different drugs are used. To combat chronic bacterial inflammation of the prostate, gentler agents are required, as the administration of antibiotics can extend over 4-6 weeks. In addition, alpha blockers are often prescribed or prostate massages are performed to help limit the painful symptoms. Abacterial prostatitis is more difficult to treat. In this case, it must first be determined whether or not it is an inflammation. In some cases, the pain may be due to an unhealthy tension of the muscles of the pelvic floor and may affect the prostate only among other things, or sometimes not at all. The administration of antibiotics has been shown to be helpful in preventing bacterial infection of the weakened area. However, quercetin, alpha-1 blockers, or mepartricin play the main role in drug treatment.
Prevention
Prostatitis can hardly be effectively prevented, since it originates from internal processes in the body over which the individual has little influence. Basically, thorough personal hygiene and adherence to hygienic principles help to prevent the pathogens of inflammation from entering the body through the urethra. Chronification of prostatitis can be prevented by having the acute form treated immediately by a doctor. Antibiotics must be taken until the last tablet of the package or as directed by the doctor, otherwise the bacterial population cannot be completely killed. If symptoms recur or there is little improvement, the doctor must be seen again immediately.
Follow-up care
Follow-up care for prostatitis takes place a few days after recovery. When the patient no longer has pain and does not notice any other unusual symptoms, the urologist in charge is consulted. The follow-up includes a physical examination and a patient interview. During the physical examination, the physician checks the bladder region. Typical symptoms such as inflammation of the epididymis or fever are clarified.If symptoms persist, a blood test may be necessary. During the patient interview, other typical symptoms are clarified that are difficult for the doctor to see during the physical examination. These include the typical pain during urination and general potency problems. Insofar as no abnormalities are detected, treatment can be completed. A prescribed antibiotic must be phased out. If necessary, the physician will prescribe another lighter medication or refer the patient to an alternative physician. Follow-up of prostatitis is done by the urologist who has already provided treatment. It is a one-time examination aimed at clarifying the symptoms. If the patient has fully recovered, no further visits to the doctor are necessary. Before discharge, the physician can inform the patient about preventive measures to avoid recurrence of prostatitis.
Here’s what you can do yourself
Very often, bacterial prostatitis is triggered by pathogens that ascend from the urinary tract to the prostate and kidneys. For this reason, countermeasures should be taken immediately at the first sign of urinary tract disease. The best way for patients to help themselves is to flush their urinary tract thoroughly to flush out the germs and keep the concentration of bacteria as low as possible. This should be done by drinking plenty of water or unsweetened herbal or fruit tea. In pharmacies and drugstores there is also special bladder tea, which not only flushes the urinary tract, but also has a pain-relieving effect. In naturopathy, pumpkin seeds and drops and tablets based on them are also used. If it is chronic prostatitis, the patient can improve his chances of recovery by protecting himself from hypothermia. This can be achieved by wearing clothing appropriate to the weather, warm underwear and avoiding cold sitting surfaces. Warm sitz baths can also relieve tension and thus ease pain. In addition, the patient can learn and apply relaxation techniques such as yoga or tai chi, which also have a beneficial effect on chronic tension pain in the pelvic region. If the patient also suffers from erectile dysfunction, he should definitely point this out to his attending physician and not remain silent out of shame, as this makes diagnosis and therapy more difficult.
