Prostatitis

23 May 2026

Prostatitis is a disease in which the prostate gland becomes inflamed.Prostatitis, the symptoms of which are most often found in men of reproductive 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, since the disease has no visible manifestations.In order to notice the first symptoms in a timely manner, you should listen to your own health.

General description

The prostate gland, which is affected by the disease in question, is an exclusively male organ; accordingly, prostatitis can develop exclusively only in men.If we consider a similar area in women, and this is the distal third of the urethra, or urethra, then here they have Skene’s glands.These glands are essentially analogues of the prostate, and if their inflammation develops, the symptoms may resemble those of prostatitis.

The prostate itself looks like a glandular-muscular organ located near the bladder.Due to it, the process of urination is controlled, in addition, it is due to the presence of the prostate that a certain secret is released, which makes the sperm liquid.

Quite 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 relevant pathogens.Basically, these are pathological agents that constantly reside on the surface of the skin or in the environment of the digestive tract.In this case, a certain combination of factors can cause the development of prostatitis.

The causes of prostatitis include a variety of factors.So, this may be untimely emptying of the bladder, the presence of diseases of the genitourinary system, constant hypothermia, irregular sex life, a sedentary lifestyle, bad habits, etc. The relevance of this type of factor either causes the possibility of microbial agents entering the prostate gland, or causes disruption of the blood supply to those organs that are located in the pelvis, or leads to the development of stagnant processes.All this leads to the proliferation of microorganisms, as well as to 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, although none of them has been proven at the moment.For example, some experts believe that in this form the disease can develop against the background of actual 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 us dwell on the acute and chronic forms of the disease.Acute prostatitis is based on the influence of a bacterial factor.As for chronic prostatitis, here this factor is not the main one, acting rather as a secondary factor and important in its impact only at the beginning of the disease.Over time, the pathogenetic mechanism can be supplemented by a neurogenic, autoimmune factor, or an allergic factor, due to 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, this 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.In addition, microliths also form; 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.

Meanwhile, before the onset 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 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 when these microabscesses form, this is already accompanied by the appearance of not very pleasant symptoms, manifested in varying degrees of intensity.

As the first of these symptoms, patients note some 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, in particular these include:

the appearance of a burning sensation in the urethra and perineum;
persistent and frequent urge to urinate;
the appearance of discomfort during bowel movements;
“floating threads” in urine;
the appearance of urethral stretching discharge during defecation;
the appearance of prolonged night erections;
intermittent and difficult urination;
too rapid ejaculation;
increased general fatigue;
decreased potency;
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 very variable pattern of its manifestation, this applies to different variants in each individual patient, and to different periods of time during its course.

When considering the symptoms, it would be useful to return to the causes.Naturally, the inflammatory process will not appear “out of the blue.”We are mainly talking about pathogenic agents, which have already been mentioned above.Meanwhile, 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 cause the development of prostatitis; it can be any type, be it 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 in question).

There is a certain risk group for prostatitis, in particular the following people fall into it:

persons whose professional activity falls under the criterion of “sedentary” work;
persons with a sedentary lifestyle;
persons who have previously been diagnosed with a particular genitourinary infection;
persons for whom the problem of chronic constipation is relevant;
persons who are promiscuous;
persons whose family relationships do not fall under the criterion of orderliness;
persons who abuse alcohol.

Often men are diagnosed with “abacterial prostatitis”, “prostatitis in the stage of prostatosis”.If a man is diagnosed with prostatosis, we can say that at this stage there is nothing particularly to worry about.Meanwhile, you will have to make certain adjustments to your lifestyle.In other words, what we are talking about here is that the stagnation phenomena discussed above are already taking place, but there is no inflammation as such yet, this concerns 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 distinctive feature of prostatitis is that it practically does not manifest itself in acute form.In other words, when it manifests itself, it is already a chronic process, which is explained by its often long and gradual development.Complete recovery due to treatment provided to the disease or due to the spontaneous disappearance of the pathological process is estimated in isolated cases during the initial acute stage.The disease is characterized, as already noted, by its extremely slow course, the manifestations of symptoms generally have a smoothed form.

Prostatitis: consequences

Acute prostatitis, if its manifestations are ignored and if seeking medical help is excluded, can cause the development of an abscess in the prostate gland, that is, the cause of the development of purulent focal inflammation in it.This is accompanied by an increase in temperature (within 39-40 degrees), which at the same time becomes hectic, that is, its differences exceed one degree.Patients also experience high fever, which periodically gives way to chills.The pain in the perineum becomes so severe that it makes it difficult to urinate, while defecation becomes almost impossible due to the pain.After some time, swelling develops in the prostate gland, which, in turn, causes acute retention of urination.Meanwhile, it rarely comes to acute prostatitis, which manifests itself against the background of a chronic spread of the pathological process - unless, at his own peril and 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.Meanwhile, as indicated above, the inflammatory process can worsen, spreading further and further.When it spreads, even pyelonephritis can develop.Meanwhile, complications of prostatitis in most cases come down 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.As a result of transferring the disease in a similar form of its spread, one can indicate the development of infertility in a man.Treatment of infertility is a long and complex process, and, in some cases, completely impossible.The listed features mainly fall under the development of a chronic form of prostatitis, due to the specific etiology of its occurrence (in particular, we are talking about STDs).

Diagnosis

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

To begin with, the doctor carries out a survey on the patient’s complaints, studies the medical history, if any, based on this, a preliminary conclusion is subsequently made, and the principles of an individual diagnostic algorithm are determined.We would like to add that the first consultation with a urologist (namely, this is the specialist you should go to if disturbing symptoms of prostatitis appear) is not final and reliable in making a diagnosis, because the first examination is only an opportunity for the doctor to determine what further diagnostic measures are needed.

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 associated with urination, as well as how the patient himself evaluates his own sexual function (that is, are there any changes, what exactly has changed, since what period).Additionally, the doctor will ask what diseases you currently have, etc.

This is followed by an examination, in particular an external examination, a rectal examination, laboratory and instrumental examination.During an external examination, the doctor examines the man’s genitals, determining whether there are accompanying rashes, irritation, discharge, etc.

Then, after an external examination, the doctor moves on to the next stage, which is a rectal examination.A rectal examination makes it possible to determine the general contours of the prostate, its consistency, boundaries, etc.

After this, you will need to obtain results from instrumental and laboratory diagnostics.Instrumental diagnostics is called TRUS, which in 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, this includes a smear, urine test, 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 of the topical diagnostic options that can detect the presence of an inflammatory process in the lower genital tract, can be considered as a necessary option.Other types of diagnostic methods act only as clarifying methods; they are necessary for differential diagnosis and for identifying existing complications of the underlying disease.In addition, it is important to remember that with overdiagnosis, this stage itself is lengthened, and the symptoms only get worse.That is, here, as in any matter, the principle of the “golden mean” is appropriate.

Treatment of prostatitis

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 and sustainable remission.Depending on how seriously a man takes the doctor’s recommendations, how long the periods of remission will be for him.

At its core, the treatment of prostatitis may contain a number of measures, in particular, methods of antibacterial therapy, prostate massage, immunotherapy, physiotherapy and general correction of the patient’s lifestyle.Only on the basis of a set of these measures can the desired result be achieved; in general, the disease is difficult to treat, so it cannot be ignored.

Antibacterial therapy

This type of therapy is considered as the basis of conservative treatment.The basis for the choice of antibacterial drugs is a number of factors, in particular these:

the ability of the components of the proposed drug to enter the secretion and tissue of the prostate to create a concentration exceeding the MIC values of the pathogens;
features of the spectrum of antimicrobial activity (for example, the use of macrolide antibiotics determines the possibility of their good penetration into prostate tissue, while they do not have any activity against gram-negative bacteria, namely, they are the main etiological agents in considering the acute form of prostatitis).

What is noteworthy is that acute prostatitis, when compared 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 that are 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 the drugs in this group is that as the inflammation subsides, the degree of their penetration into the prostate 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 as 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 patency;
improvement of muscle tone and blood circulation in the prostate gland;
increased penetration of antibiotics used into the gland tissue;
the possibility of activating microorganisms that are in an inactive state, thereby enhancing the results from the sale of antibacterial drugs.

How is prostate massage performed?To begin with, of course, it is important to establish a certain trusting contact between the doctor and the patient; this will ensure greater relaxation of the patient, which, in turn, will make it possible to carry out the necessary manipulations 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 (sometimes this gel has an analgesic effect).Next, with his free hand, he spreads the buttocks to such a width that will make it possible to palpate the anal sphincter using the index finger.The natural reaction to such contact is muscle contraction.Next, after relaxing them, the index finger is inserted into the ampulla 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 called 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 using massage according to the Manila Protocol.In this case, the massage is performed three times a week, a microbiological dynamic study is also carried out, and antibiotics are taken.

Immunotherapy

This direction in the treatment of prostatitis is often extremely necessary, because with prolonged manifestation of inflammation in combination with previously incorrect antibacterial treatment, the possibility of a negative impact on the general condition of the immune system cannot be ruled out.Treatment of prostatitis requires not only eliminating the infection from the gland and, in fact, inflammation, but also preventing the re-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 need to consult an immunologist, and also, 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 ultrasonic waves, electromagnetic waves, laser therapy, increasing the temperature directly in the rectum, etc. If there are no opportunities for 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 factors predisposing to 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 wakefulness/sleep schedule, a nutritious balanced diet, walking, eliminating bad habits.

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