Prostatocystitis: clinic and treatment

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

Disease refers to the simultaneous (not necessarily simultaneously occurring) inflammation of the bladder and prostate gland. Prostatocystitis is a purely male disease, it can be acute and chronic. In the chronic form, the symptoms are not so pronounced.

Symptoms

All signs of prostatocystitis are composed of the phenomena of prostatitis and cystitis. The difference in different people lies both in the features of the course of the disease, and in the features of the anatomical and morphological characteristics.

However, all symptoms of prostate cystitis are similar in nature and can be grouped into several categories.

1. Dysuric phenomena. All symptoms of this group are associated with one or another violation of the processes of urination.
2. Pain syndrome. This includes all the unpleasant sensations in the lower abdomen (they can be given to the lower back, groin), constant, accompanying urination, arising after.
3. Physical changes in urine (not always characteristic).
4. Sexual disorders. Such as erectile dysfunction, pain during intercourse, decreased sperm fertility up to infertility.
5. Pollakiuria. This is an increase in the frequency of urination. The person begins to go to the toilet more often. In this case, a portion of urine remains within the normal range. But this symptom is characteristic only of those cases when pathogens penetrate from the urethra into the prostate. In this situation, the bladder is the first to be inflamed.

As inflammation develops in the prostate gland, the amount of urine portion becomes smaller while urinary frequency persists. This is due to the edema of the prostate, as a result of which the lumen of the urethra is squeezed. Finally, the patient develops nocturia - the predominance of nocturnal diuresis over daytime. The patient often goes to the toilet at night.

Pain syndrome can have 3 variants. Painful urination, pain before and / or after urination above the bosom, constant pain in the lower abdomen.

Painful urination is a common symptom of urethritis, an inflammation of the urethra. As an independent disease, it is rare. Usually accompanied by cystitis and prostatocystitis. Therefore, patients distinguish it as one of the signs of disease.

Severe pain before and after urination is characteristic of acute cystitis. If the painful sensations are expressed before the emptying of the bladder, then this indicates inflammation of the deep parts of the muscle wall and even around the cystic tissue. This phenomenon is extremely rare. More often pain is noted at the end of urination. They arise as a result of the contact of the inflamed walls of the bladder.

Pains of a constant nature in the lower parts, often spreading. They are noted with the phenomena of prostatitis, when the inflamed gland enlarges and stretches its own capsule.

Changes in urine are expressed as follows:

• the appearance of a sediment (usually white flocculent);
• turbidity;
• the acquisition of a reddish tint.

The first two signs appear due to an increase in leukocyturia (the number of leukocytes excreted in the urine). This phenomenon always occurs with inflammation. The reddish tint is associated with the appearance of red blood cells. Their presence is most often characteristic (in the light of prostatocystitis) for inflammation of the prostate gland.

Male sexual dysfunction is a direct result of inflammation of the prostate gland. All of them are manifested as a result of disruption of its normal functioning. The secret of the testicles during ejaculation does not mix with the contents of the prostate gland (due to the absence of the latter). Or, because of the rather scarce secretion of the prostate, the ejaculate is not diluted enough. In any case, the ejaculate remains thick, making it difficult to move. Hence the painful intercourse, which gradually leads to a decrease in erection.

Causes of pathology

All causes of the development of pathology are divided into 2 unequal groups.

1. External. They are disease factors in 80-90% of all prostatocystitis cases.
2. Internal. Their share accounts for the remaining 10-20% of cases.

External causes include urinary tract infections. And all, without exception, penetrate in an ascending way. That is, from the urethra.

The first three causative agents of prostatocystitis that enter the ascending route include:

• Trichomonas;
• neisseria gonorrhea;
• fungi of the genus Candida (causative agents of thrush).

Naturally, the highest risk of getting acute prostatocystitis is in men who have promiscuous sex, who have unprotected sex with different sexual partners. The rest of the pathogens account for a much smaller percentage. But they all combine by the mechanism of penetration.

Pathogens quickly penetrate the bladder cavity from the urethra. However, natural defense mechanisms interfere with gaining a foothold and giving rise to the inflammatory process: the aggressiveness of urine, the mucous layer of the inner walls of the bladder and the fluidity of its contents. Therefore, the most rational is to populate the vas deferens, and only then spread to the bladder, urinary tract, and prostate gland. In this way, the causative agents of trichomoniasis, gonorrhea (fungi are secondary infections that come to the "ready-made place").

The group of internal causes is also associated with microorganisms. But they, as a rule, are brought in with the blood flow or activated by their own flora. Both cases are impossible without weakening the functioning of the defense system. Therefore, the reasons leading to a decrease in immunity (both general and local) are considered factors in the development of prostatocystitis. These are smoking, alcohol abuse, drug addiction, substance abuse, prolonged and uncontrolled intake of antibacterial drugs, chronic diseases of internal organs.

Treatment by therapeutic methods

Treatment of prostatocystitis should always begin with the elimination of the direct factor of the pathology. And since 99, 99% are microorganisms, all therapeutic regimens include antimicrobial drugs. Their choice is determined by the pathogen and the individual characteristics of the organism.

With the gonorrheal nature of the disease, combinations of cephalosporins are used (it is desirable to use drugs of 3-4 generations) with macrolides or doxycycline. This circumstance is explained by two reasons. First, the risk of developing drug resistance of the pathogen is minimized. Secondly, both of the latter drugs are active against chlamydia. And cases of a combination of gonorrhea and chlamydia are quite frequent.

With a purely chlamydial infection, antibiotics of the following groups are indicated:

• macrolides (azithromycin is currently considered the best);
• tetracyclines (doxycycline);
• fluoroquinolones (ciprofloxacin, levofloxacin).

True, the latter are considered as an alternative for intolerance to macrolides and / or tetracyclines. If there is reliable data on a fungal infection, the patient is shown a course of antifungal drugs (miconazole, nystatin, fluconazole).

Simultaneously with the intake of antimicrobial drugs, it is recommended to use the means of symptomatic therapy:

• Alpha-blockers (tamsulosin, terazosin, doxazosin, etc.). They relax the smooth muscles of the prostate, bladder neck and post-static part of the urethra;
• Immonomodulators. They prove to be most effective in weakening the defenses. The most popular in the treatment of prostatocystitis include drugs based on galavita, echinocea;
• Pain relievers. Treatment is prescribed only in the presence of pain syndrome. You can take any portable drugs. But the best are non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, nise), katadolone.

Preventive actions

In order to prevent diseases, a number of rules are recommended that are common for any infections of the genitourinary system.

1. Sexual hygiene and hygiene of relationships (casual unprotected sex increases the risk of developing prostate cystitis by 80-85%!).
2. Healthy lifestyle. Quitting smoking, drugs, alcohol abuse.
3. Timely and adequate treatment of any infections.
4. Avoiding hypothermia of the genitourinary organs.

For everyone who has suffered from prostate cystitis, these tips are doubly recommended. In addition, a regular preventive examination by a urologist is required.