How is acute prostatitis diagnosed and treated?

Acute prostatitis is characterized by a pronounced clinical picture. Pathology is dangerous with a number of serious complications, so it needs timely and complex treatment. How to recognize and treat a disease is described in this article.

Acute prostatitis is an inflammatory disease, which is accompanied by pronounced painful sensations and can pose a great danger to health. For a positive prognosis of the disease, it is necessary to consult a doctor in time for the diagnosis and prescription of competent treatment.

General characteristics of the disease

Acute prostatitis is a rapidly developing inflammatory process in the prostate gland. It has four stages of development:

  1. catarrhal.At this stage, the gland swells slightly, inflammation affects only the mucous membranes of the excretory ducts of the gland. This period is the most favorable time for treatment - if you start it at this time, you can get rid of the disease in less than two weeks. The nature of the inflammation is not purulent, but the edema that appears clogs the ducts, preventing the secretion from leaving the gland. Stagnation begins.
  2. Follicular.Due to stagnation, the bacteria that have entered the organ begin their activity already inside it. Since the organ is made up of cells, grouped into lobules and separated by connective tissue, inflammation affects one part first.
  3. parenchymal.The inflammation passes from one lobule to another, there are many pustules in different parts of the gland.
  4. Purulent abscess.The pustules merge into one and a blister filled with purulent contents forms in the gland. Over time, it can burst, pus spreads, penetrating the space around the prostate and bladder, urethra or rectum. When an abscess opens, the pus does not come out completely and this becomes a new cycle in the inflammatory process.

How quickly the disease process will develop and how it will end depends on a number of factors: the reasons for the inflammation, the timeliness and adequacy of treatment.


In 90% of cases, the cause of acute inflammation of the prostate is an infectious lesion. The causative agents can be one or more types of bacteria and viruses:

  • Gonococci are one of the most dangerous bacteria, they quickly initiate purulent processes.
  • Trichomonas is the leader among sexually transmitted microorganisms. Penetrates into the intercellular space of the gland, so it requires a long stubborn treatment.
  • Chlamydia - in addition to toxicity, they are able to glue erythrocytes, increasing their sedimentation rate and preventing blood circulation in the affected area. They penetrate deeper than Trichomonas.
  • Staphylococci, the golden appearance is particularly common. It can survive in any tissue and organ, causes suppuration and makes the blood thicker.
  • Ureaplasma is a cross between single cells and viruses. It can enter the prostate from the urinary tract or through unprotected intercourse.
  • Escherichia coli is a gram-negative bacterium, a frequent causative agent of acute inflammation. It enters the body due to inadequate hygiene when preparing food.

This is not a complete list of bacteria and viruses that can cause acute inflammation of the prostate gland.

Often the reason lies not only in infections that can live in the body for a long time with almost no symptoms. They begin to develop rapidly when there are factors that contribute to this:

  • Regular or occasional hypothermia. The cold weakens the body's defenses and it is more difficult for them to contain pathogenic bacteria, especially if hypothermia is associated with daily work.
  • Irregular sex life. The stagnation of the secretion of the gland (which is an integral part of the sperm) favors the multiplication of bacteria.
  • Infections in progress. These can be infections that result from unprotected sex or bacteria that have caused mild inflammation of the urinary tract. The consequences of a purulent sore throat not completely healed in the form of streptococci can also provoke inflammation. Caries can also cause prostatitis.
  • Weakened immunity. If, due to illness or an uncontrolled intake of antibiotics, the body's defenses become insufficient, the bacteria will certainly manifest themselves.
  • Failure to comply with the rules of personal hygiene.

Symptoms of acute prostatitis

Symptoms depend on the stage of the disease.

During the period of catarrhal prostatitis, there is a slight discomfort and a feeling of heaviness in the perineum, the urge to use the toilet at night becomes more frequent. Urination is accompanied by burning and pain. The gland itself is normal or noncritically enlarged, palpation examination causes pain. The temperature remains normal or rises slightly. No intoxication, general well-being.

The follicular period has multiple manifestations. The pain grows, becomes constant, sometimes sharply radiates to the penis, sacrum or rectum. Urine retention appears, as urination is difficult due to acute pain. Defecation is also accompanied by severe pain.

The temperature rises to 38 degrees and remains at this level. The prostate gland greatly increases in size, has a dense consistency, is tense, touching it in some places causes acute pain.

groin pain with acute prostatitis

Parenchymal prostatitis is very difficult. Appetite disappears, chills appear, general weakness. The frequent urge to go to the toilet with a short urination is replaced by acute urinary retention. Attempting to empty the bladder or bowel becomes nearly impossible due to the unbearable pain. It is aggravated by constipation and a full bladder, spreads over the entire perineum, a slight relief can only come in the prone position with the legs folded.

The temperature exceeds 39 degrees. Inflammation begins to spread to other organs, mucus is secreted from the rectum. The prostate gland is indistinct, enlarged and painful. Palpation may not be possible due to edema.

The formation of an abscess is accompanied by the localization of the acute pain point - where the abscess appeared. The passage of urine, feces and gas is extremely difficult, accompanied by severe throbbing pain that spreads to the intestines. The temperature is maintained above 39. 5 degrees, chills, fever, and sometimes a delusional state appears.

Then, unexpectedly, relief comes: the pain passes, the temperature drops. However, this does not mean that the patient has recovered - the fact is that the abscess has burst and now urgent procedures are needed to cleanse the body of pus, because the negative consequences can be very different.


The diagnosis is made on the basis of an evaluation of the patient's complaints, analysis of urine, blood and prostatic secretions. In addition, they use the method of digital rectal diagnostics, ultrasound and CT.

The severity of urinary disorders is assessed by uroflowmetry.

A general urinalysis allows you to identify the disease in the early stages, when the characteristic symptoms are still absent. The alkaline acid index itself indicates the development of inflammation.

Bacteriological examination of urine allows you to determine the nature of inflammation and its causes. Changes in the color, odor, or consistency of urine are not considered absolute evidence of acute prostatitis.

A complete blood count is the basis in the study of the disease. The characteristic indicators of acute prostatitis are low hemoglobin levels (normal 130 g / l), high levels of urea and creatinine, as well as the level of leukocytes and the rate of erythrocyte sedimentation. Protein should not be normal, as well as a high level of leukocytes - there should be no more than 5 units.

Specific PSA analysis allows you to identify not only inflammation, but also malignant formation.

PCR research allows you to quickly identify any genital infections that often cause acute prostatitis.

Ultrasound allows you to determine the size of the prostate gland, its edges, the presence of point and diffuse changes. If an abscess has formed, this study can determine its size and location. If possible, the study is carried out transrectally; if the pain and swelling do not allow, the study of the gland is carried out from the side of the abdomen.

Sometimes ultrasound is performed with the observation of the change in the frequency of the sound reflected by the organ. This allows you to assess the blood supply to the prostate - vascularity, which can be increased or weakened depending on the type of inflammation and its stage. It allows to distinguish a cancerous tumor from acute prostatitis.

If the doctor determines that surgery is needed, he will order CT or MRI to examine the details of the inflammatory process.

MRI for the diagnosis of acute prostatitis

Treatment of acute prostatitis

Disease therapy is always complex, including the intake of different drugs, procedures and diet. The treatment can last about 2 months.

The main task of the doctor is to eliminate the cause of the inflammation, which often consists of infection. For this, antibiotics are prescribed (alone or in combination). The choice of a drug depends on several factors:

  • the sensitivity of the pathogen;
  • concomitant diseases of the patient;
  • mode of action of the drug.

Self-diagnosis and therapy are not possible - an effective drug is selected on the basis of laboratory tests

To combat the causative agents of an acute inflammatory process, third-generation fluoroquinolones and cephalosporins are often used. For the treatment of acute prostatitis, the bactericidal effect of the antibiotic is of paramount importance.

Depending on the stage and condition of the patient, the dosage and form of release of the drug are selected: the more the situation is neglected, the higher the dose and the more important it is that the drug reaches its destination faster, therefore, the drugs under form of injections are preferable to tablets.

It is necessary to normalize the outflow of urine and secretions. If urinary retention has turned into an acute form, a trocar epicystomy is prescribed - a puncture of the bladder, followed by the introduction of a thin tube.

If such drastic measures are not required, non-steroidal anti-inflammatory drugs are prescribed to restore normal urination, which remove swelling and pain. Medicines are prescribed in the form of tablets, injections or rectal suppositories.

If acute prostatitis has turned into an abscess, treatment depends on what stage it is in. The infiltration phase is treated with active therapy with antibiotics and immunostimulants. A blockade with painkillers is given to help the patient overcome the pain.

If an abscess has formed, treatment is possible only with the help of surgical intervention: the purulent bladder is opened, washed and drainage is installed. After the operation, therapy is prescribed to combat microbes and intoxication.

Treatment of acute prostatitis is not limited to the relief of symptoms. The course of antibiotics should be drunk to the end, and not until the pain subsides.

After the seizure itself has been removed, it's time for physiotherapy. It includes UHF and microwave procedures, electrophoresis and prostate massage. The goal is to relieve swelling (if left), improve the outflow of glandular secretions in order to avoid congestion.

It is important to stick to the diet during the course of treatment. You must refuse the following products:

  • alcoholic drinks, coffee, fried and salty - contributes to the appearance of congestion;
  • white cabbage, apples, legumes and raw vegetables - cause swelling, as a result of which the pelvic organs, including the prostate, are compressed;
  • acidic drinks, offal - irritate the urinary tract.

The diet should include grains, stewed vegetables, dairy products, and cooked fruit. All this contributes to the normal functioning of the intestine. It is necessary to observe the drinking regime, drink at least 2 liters of liquids (water, fruit drinks, juices) per day. The more often the urinary tract becomes red, the lower the risk of inflammation.

Vitamin complexes and peptides should be drunk to improve tissue regeneration and the rapid restoration of normal gland functioning.

pills for the treatment of acute prostatitis

The favorable course of treatment is judged by the restoration of the tissues of the gland, the normalization of the chemical indications of prostatic secretions, the absence of pathogens in the analyzes and the general well-being of the patient.

Prognosis and complications

The earlier the treatment was started, the faster and easier it is to get rid of acute prostatitis. Complication is each subsequent stage of the disease, the chronic course of the disease, the spread of inflammation to other organs, infertility, sepsis. If the disease has begun, it may be necessary to remove the gland itself.

With timely treatment, at the end of the course of therapy, all body functions are restored, working capacity is fully restored.


Preventive measures include the absence of unprotected sexual intercourse (to exclude sexually transmitted diseases), thorough hygiene and timely treatment of inflammatory processes in the urinary tract. It is necessary to maintain immunity, do not start decayed teeth and carefully treat any infectious diseases.

You should also exclude factors that contribute to the development of the disease. For this you need:

  • having a regular sex life with a partner;
  • avoid hypothermia (both permanent and one-time);
  • give up alcohol, smoking and a sedentary lifestyle;
  • regularly undergo a routine examination by a urologist;
  • do not self-medicate at the first signs of inflammatory processes;
  • stick to a balanced diet;
  • take vitamins, especially during periods of the spread of infectious diseases.

Acute inflammation of the prostate appears due to infections that develop under favorable circumstances. Treatment is carried out with antibiotics, anti-inflammatory drugs, pain relievers and vitamins. During the therapy period, it is important to follow a diet and eating regimen.