With the formation of a purulent focus, the patient's body temperature rises to 39-40 ° C and can acquire a hectic character. Heat periods alternate with severe chills. Sharp pain in the perineum makes it difficult to urinate and make defecation impossible. An increase in prostate edema leads to acute urinary retention. In rare cases, an abscess spontaneously opens into the urethra or rectum. When opened, purulent, cloudy urine with an unpleasant, pungent odor appears in the urethra; when opened into the rectum, feces contain pus and mucus.
Chronic prostatitis is characterized by a wave-like course with periods of prolonged remissions, during which inflammation in the prostate is latent or manifests itself with extremely meager symptoms. Patients who are not worried about anything, often stop treatment, and turn only when complications develop.
Rathe spread of infection through the urinary tract causes pyelonephritis and cystitis. The most common complication of the chronic process is inflammation of the testicles and epididymis (epididymoorchitis) and inflammation of the seminal vesicles (vesiculitis). The outcome of these diseases is often infertility.
The characteristic clinical picture simplifies the process of making a diagnosis in acute and chronic prostatitis. It is mandatory to produce: rectal examination of the prostate, sampling of the secretion of the prostate gland to determine the sensitivity of the microflora (culture of prostate secretion and bacterial culture of urine). Ultrasound of the prostate to identify structural changes (tumors, cysts, adenomas) and differentiate prostatitis from other diseases, a spermogram is performed to exclude or confirm the development of infertility.
Patients with an uncomplicated acute process are treated by a urologist on an outpatient basis. With severe intoxication, suspicion of a purulent process, hospitalization is indicated. Antibacterial therapy is in progress. The drugs are selected taking into account the sensitivity of the infectious agent. Antibiotics are widely used that can penetrate well into the tissues of the prostate (ciprofloxacin, etc.).
With the development of acute urinary retention on prostatitis fne, they resort to installing a cystostomy, and not a urethral catheter, since there is a danger of the formation of a prostate abscess. With the development of an abscess, an endoscopic transrectal or transurethral opening of the abscess is performed.
Treatment of chronic prostatitis should be comprehensive, including etiotropic therapy, physiotherapy, correction of immunity: Antibiotic therapy. The patient is prescribed long courses of antibacterial drugs (within 4-8 weeks). The selection of the type and dosage of antibacterial drugs, as well as the determination of the duration of the course of treatment is carried out individually. The drug is chosen based on the sensitivity of the microflora according to the results of urine culture and prostate secretion. Prostate massage. Massage of the gland has a complex effect on the affected organ.
During the massage, the inflammatory secretion accumulated in the prostate gland is squeezed out into the ducts, then enters the urethra and is removed from the body. The procedure improves blood circulation in the prostate, which minimizes congestion and ensures better penetration of antibacterial drugs into the tissue of the affected organ. Physiotherapy. To improve blood circulation, laser action, ultrasonic waves and electromagnetic waves are used. If it is impossible to carry out physiotherapeutic procedures, the patient is prescribed warm medicinal microclysters.
In case of chronic, long-term inflammation, a consultation with an immunologist is indicated to choose the tactics of immunocorrective therapy. The patient is given advice on lifestyle changes. Making certain changes in the lifestyle of a patient with chronic prostatitis is both curative and preventive. The patient is advised to normalize sleep and wakefulness, adjust the diet, and conduct moderate physical activity.