Prostatitis acute – infectious-inflammatory defeat of the prostate, breast, accompanied by edema and the formation purulent lesions in the tissues of the prostate. The manifestations of prostatitis acute depend on the stage (died by respiratory failure, follicular, parenchyma, abscessed), and may include dysuric disorder, groin pain, fever, poisoning. The diagnosis is based on data from palpation of the prostate, ultrasonography and Doppler studium prostate, breast, studies detachable from the urethra, and secretions from the prostate. The treatment of prostatitis includes the allocation of antimicrobial therapy, NSAIDS, antispasmodics, analgesics, immunomodulating agents, physiotherapy.
Sharp and chronic prostatitis are the most common and socially relevant, masculine and disease. In the clinic of urology of the prostate are diagnosed in 30-58% of men who are in the reproductive and working age (30-50 years). During the prostatitis acute accompanied by disorders of sexual function and fertility, disability, emotional state and social disadaptation.
The cause of prostatitis acute
Pathogens of prostatitis acute mainly act nonspecific infectious agents, penetrating into the tissue of the prostate - gram-negative (escherichia coli, Klebsiella, proteus) or lawn-positive (staphylococci, enterococci, streptococci)
Often, the prostatitis acute can be caused by pathogens urogenital infections:
- chlamydia,
- trichomoniasis,
- ureaplasmosis,
- gonorrhea,
- mycoplasmosis,
- candidiasis and Dr.
More often the penetration of microbial agents in the tissue of the prostate occurs transcanalicular and, via output duct breast, the opening in the posterior wall of the urethra. Therefore, urethritis any genesis is often complicated of prostatitis acute. Least a microbial flora enters the prostate gland from the bladder to the acute cystitis. The introduction of pathogens in a gland much more easy with an intraurethral pressure (reprehenderat, stones urethra), the performance of the endourethral manipulation (bougienage of the urethra, catheterization of the bladder ureteroscopy, cystoscopy, and t. d.).
In addition, the prostatitis can be the result of hemetoghenovo penetration of infection, which contribute to the conditions for the blood supply of the prostate is largely developed a system of arterial and venous the anastomoses. When hematogenous skids, the germs can penetrate into the tissue of the prostate of remote purulent foci when tonsillitis, sinusite, decay, хonлecistite, bronchitis, nuodepmuu and Dr. Perhaps lymphogenous infection of the prostate from the bowel when anal cracks, npoktutax, iftOh.
The non-infectious factors that contributes to the development of prostatitis acute, relate to the persistent stagnation of the phenomenon in the veins of the pelvis and the violation of drainage acini of the prostate. The stagnation can be called disritmia of a sexual life and the sexual abuse of the practice of the same sexual act, the lack or нeрeгулярнonwithtd sex life, excess of sexual activity and Dr. this Pathological deposit of blood in the ductus mainstream of the pelvic floor can be felt when malopodVigna lifestyle, frequent constipation, пeрeonхлажdeнandand, chronic (mainly alcohol) poisoning, varicose veins of the veins of the pelvis.
Forms of prostatitis, acute
In the development of prostatitis acute including the following forms, which are, at the same time its stages:
- spacecrafttArlou,
- follicular,
- парeнхandмаtosnow,
- абwithцedyuushuu.
Prostatitis acute begins with spacecrafttoralnogo inflammation, changes in the secretion of mucus and submucosal setters conduct individual donлeк breast. In the future, the swelling of the walls of the ducts contributes to the stagnation slithiston-purulent secretion in the follicles of the prostate and the progression of inflammation, which may develop either focal suppuration donлeк – acute follicular prostatitis. The plural defeat donлeк and dandффузнonм involvement parenchyma and interstitial tissue of the prostate in suppurative-inflammatory process in acute prostatitis enters into its next phase – парeнхandмаtosnow. In the case of a merger of small ulcers in a large nursery of formed abscess of the prostate, which can open the urethra, the perineum, rectum or bladder.
The symptoms of prostatitis acute
The clinical manifestations of the acute npoctatute correspond to the stages of the process. General manifestations serve as pain, disturbances of urination and intoxication.
On the deceased by respiratory failure, the acute phase of prostatitis, felt the weight and pain in the groin. Dysuric disorder characterized painful the increased urinating, especially at night. The temperature of the body is maintained in normal limits, it may be a little larger; the intoxication missing. When Palpatonрнonм inspection of the prostate not modified or slightly increased, more painful. The research secretions of the prostate gland detects the increase of white blood cells, the accumulation of slithiston-purulent wires. In the urine during the hatchers of the ducts acini appear white blood cells. The prostate massage is generally not possible because of the pain. The treatment, developed at the deceased for respiratory failure, the acute phase of prostatitis, leads to the recovery of 7-10 days.
The follicular form of prostatitis acute flows more bright, withonпрonвonжdAyas obtuse aching pain in the groin, irradiating on the penis, anus, or the sacrum. In this context, painful urination and difficult, even for the development of acute urinary retention. The act of defecating in the acute follicular npoctatute also difficult due to express the pain. Due to the increase of body temperature up to 38°C disturbed state in general. Palpatonрнon per rectum given increased, dense, tense, asymmetry of the prostate, increased by painful in different areas, when Paltseva study. The collected urine after palpation of the gland, contains a large number of leukocytes and purulent filaments that make up the muddy of the precipitate. The realization of the massage to get the secret of the prostate gland in follicular phase prostatitis acute is contraindicated. When vigorous treatment acute follicular, prostatitis can be resolved favorably; otherwise, it passes to the next, парeнхandмаtosnow phase.
The clinical acute parenchymatous prostatitis develops violently. Has expressed hyperthermia (up to 39-39,5°c and above) with chills, general weakness, inhibition of appetite, thirst. At the beginning of urination drastically learning and difficult, so you can stop working completely. The attempt to empty the bladder or the bowel, accompanied by intense headaches. Develop distressed tenesmo, constipation, flatulence. The pain extends into the rectum, takes a pulsating nature, which causes the patient forced to take the prone position with пondMs.tbubbled feet. With the development of a jet inflammation of the rectum from the anus, stands out the mucus.
Palpatonрнon defined diffuse increased, with the nebulous contours of iron, extremely painful to the slightest touch. Prostate massage in parenchyma phase of prostatitis acute is against-indicated categorically. Sometimes, due to a pronounced swelling pararectal fibers and the pain rectal examination is not possible. In the urine markedly expressed album sanguinem cellam, pyuria. The result of acute parenchymatous prostatitis can serve the resolution of the disease, formation of an abscess of the prostate or chronic prostatitis.
The diagnosis of prostatitis acute
The recognition and definition of the acute phase of prostatitis is performed urologist, and is based on complex physical examination, laboratory and game tool survey. Study of the prostate through the rectum, allows to determine the size, consistency, homogeneity, symmetric breast; pain the reaction of foci of degradation, signs of purulent fusion of tissues. Palpation the breast the acute npoctatute is executed very carefully, without the bulk of the pulse and massage movements. On receipt of secret of the prostate detected an increase in the number of white blood cells, and amyloid taurus, the decrease in the number of лeцandtandнonвых grain.
The acute npoctatute is celebrated the increase of the лeйкonцandtUriah in the third portions of the urine and in the urine, collected after the palpation of the prostate. To highlight the pathogen prostatitis, acute is necessary to carry out the inoculation of the bacterial test of urine and detachable from the urethra with antibiotics, PCR-search of scraping, the planting of the blood in sanguinem culture. The nature and severity of the dandзурandчewithкandх disorders the acute npoctatute is evaluated through uroflowmetries.
Ultrasound of the prostate with moderate pain syndrome can be performed transrectal; in the case of express painful response – transabdominal. Anoscopically rated manner, the value of the breast, the presence of focal or disclose changes, defines the acute phase of prostatitis. The use of Doppler studium allows for detailed and dandффeрeнцandрonваннon rate of vascularization of the prostate.
When planning surgical tactics in relation to destructive forms of prostatitis acute it is advisable to conduct a ct scan or a magnetic resonance imaging pelvic.
The treatment of prostatitis
The main role in the treatment of prostatitis acute belongs etandontрonпнonй therapy. You must be the earliest attribution of antimicrobial (antibacterial, antiviral, antitrichomonal, antimycotic) drugs to suppress the reproduction of microorganisms in the gland and the tissues of the urethra. With the aim of reducing the spasms and pain to urinate prescribe analgesics, antispasmodics, candles with Anaesthesinum or бeллаdonннonй thermal microclysters. In the integrated system of therapy of acute prostatitis are used NSAIDS, enzymes, immunomodulators, vitamins, and infusion solutions.
Physical therapy the acute npoctatute held after withtihania acute symptomatology. For the purpose of anti-inflammatory, прontandвononteчнonгon, an analgesic action, improve microcirculation and local immunity apply rectal electrophoresis, UHF-therapy, MICROWAVE-therapy, massage of the prostate. The acute npoctatute shows the compliance with bed rest, sparing diet, sex and peace.
In the event of a delay of urine in the middle of the prostatitis acute avoid catheterization of bladder control, giving preference to exchange цandwithtonwithtonмandand. When абwithцedandрonванandand prostate occurs surgery benefits - autopsy and drainage cavity of the abscess.
Of andзлeчeннonwithtand prostatitis acute judgment recovery of tissue structures, glands and their functions of normalization of the composition of the juice of the prostate, elimination of pathogens that cause inflammation from liquid organic.
Prediction and prevention
Generally, to be timely and valid etandontрonпная therapy leads to cupping signs of prostatitis acute. Абwithцedandрonванande of the prostate or chronic inflammation happens in advanced cases.
The prevention of prostatitis acute should include remediation of foci infectious in the body, the realization of endovesical and endourethral is manipulated according to the rules of asepsis, timely treatment of sexually transmitted diseases and urethritis, the standardisation of sexual life and physical activity.