Prostate tuberculosis: causes and treatment features

• Tuberculosis is an infectious pathological process that can involve tissues of almost any organ system.
• The high risk of infection of the genitourinary system is explained primarily by the excellent conditions for the reproduction and activity of bacteria and the abundant blood supply in these tissues.
• In men, the prostate gland is often affected with the development of prostate tuberculosis.

Causes of the disease

The cause of tuberculosis is infection with a pathogenic microorganism of the genus Mycobacterium, namely Mycobacterium tuberculosis, and much less commonly, Mycobacterium bovis.

This bacterium is immobile and does not form spores, but at the same time it is characterized by amazing viability.

Due to the presence of a protective cell wall, it is able to survive in a strongly acidic environment, when heated above 90 ° C, and in dry form remains viable for more than 3 years. The main route of infection is contact with a patient with active tuberculosis.

In 90-95% of cases, mycobacterium damage to prostate tissue occurs against the background of existing pulmonary tuberculosis. The infection travels through the bloodstream (hematogenous route) or the lymphatic system (lymphogenous route) to the prostate, where a pathological tuberculosis focus develops.

Along with the prostate gland, other genitourinary organs (seminal tubules, seminal vesicles) are infected; isolated lesions of the prostate are much less common.

It is also possible for mycobacteria to spread through the placental bloodstream, that is, intrauterine infection. As a result, a congenital form of pathology develops.

Symptoms of tuberculosis in men

This type of specific prostatitis most often affects men at the age of maximum sexual activity - 20-50 years. Therefore, the social significance of the disease is high, taking into account its high prevalence among infectious pathologies of the genitourinary system.

In the initial stage, the disease usually does not have pronounced symptoms and goes unnoticed by the infected person.

Further damage to prostate tissue is usually accompanied by the following symptoms:

Painful symptoms are associated with structural and functional disorders directly in the prostate tissue. In its stroma, pathological foci of inflammation are formed, turning into granulomas.

In the absence of adequate treatment, a necrotic process begins - tissue death and the formation of tuberculous cavities (cavities inside the gland) in their place. Prostate tuberculosis has a slow, sluggish course.

Is the disease contagious?

Tuberculosis is a highly contagious disease.

Active spreaders of infections are patients affected by the pulmonary form of tuberculosis.

If the infection is localized only in the prostate gland, the risk of infection is much lower, but potentially possible.

In the active stage of the disease, the patient is a source of virulent bacteria that can enter the body of a healthy person through a damaged mucous membrane. Infection through sexual or nutritional routes is possible.

Possible complications and consequences

The most common complication is infertility, associated with a decrease in the quality and quantity of sperm, and erectile dysfunction.

When neighboring organs of the reproductive system (vas deferens, testes) are involved in the infectious process, an excretory form of infertility develops, characterized by a violation of the removal of sperm from the place of their formation due to obstruction of the vas deferens with scar tissue.

Structural and functional disorders in the absence of effective therapy progress to the formation of fistulas, abscesses and scars, first at the site of the primary lesion, then in nearby organs. This is accompanied by disturbances in urination and defecation, and in some cases, generalization of infection.

Other possible consequences:

• pyelonephritis;
• prostate atrophy;
• chronic renal failure;
• the appearance of neoplasms;
• high risk of secondary infection due to general weakening of the body.

Diagnostic methods

If prostate tuberculosis is suspected, a certain set of measures is carried out to examine the body. The doctor palpates the prostate through the rectum.

A sign of infection by mycobacteria is the detection of dense tubercles in the thickness of the gland, however, when the infection is localized deep in the prostate tissue, palpation diagnosis is difficult.

Prostate palpation

The next stage of the examination is the collection of clinical tests, during which samples of prostate secretion, urine, and semen are examined. During a bacterioscopic examination for prostate tuberculosis, tests are examined for the presence of mycobacteria. Their detection is a reliable specific sign of the disease.

Such types of instrumental research as ultrasound and plain radiography have high diagnostic value. The use of radiopaque agents during examination helps to increase the accuracy of diagnosis.

The images clearly show structural changes characteristic of tuberculosis infection: heterogeneity of gland tissue, granulomas, and, in advanced cases, cavities.

Ultrasound allows you to more accurately assess the risk of tuberculosis spreading or destructive inflammation to neighboring organs.

Treatment of prostate tuberculosis

Treatment of any form of tuberculosis is complex and takes quite a long time.

The choice of therapy method and the preparation of a set of treatment measures is carried out by a doctor based on the individual clinical situation, the form and severity of the disease, and the presence of concomitant diseases.

Existing treatment methods:

Drug therapy

1. The basic component in the treatment of prostate tuberculosis are antibacterial drugs.
2. The proper effect of antibiotics can only be obtained when taken together with immunomodulatory and certain hormonal anti-inflammatory drugs.
3. An important point in treatment is vitamin therapy, a balanced high-calorie diet, and giving up bad habits.

Chemotherapy

• The mycobacterium has high gene polymorphism, in other words, it is capable of forming strains that are resistant to one or another type of antibiotic.
• For this reason, the patient is prescribed simultaneous administration of at least three antimicrobial drugs.
• The duration of chemotherapy with anti-tuberculosis drugs ranges from three to four months in mild forms of the disease and up to one and a half to two years in advanced stages.

In the first stages of treatment, inpatient monitoring of the patient is sometimes necessary.

Surgical treatment methods

Depending on the stage and activity of the pathological process, surgical intervention can be gentle or radical (prostatectomy).

Most often, transural resection is performed to remove part of the gland, as this is one of the least traumatic methods. The operation is performed endoscopically, that is, no incisions are made during it; access to the affected tissues is through the urethra.

Folk remedies

Some traditional medicine recipes help increase the effectiveness of the main prescribed treatment and alleviate some symptoms.

It is recommended to use infusions of sage, nettle, and cinquefoil. These herbs help reduce inflammation and painful reactions, and help cell regeneration.

It is important to remember that the use of traditional medicine is allowed only as a possible addition to an already drawn up treatment program and only after prior consultation with a doctor.

Prognosis and prevention

The prognosis for the patient's life with adequate therapy is favorable. To obtain lasting positive treatment results, timely correct diagnosis and the earliest possible prescription of antimicrobial therapy are necessary.

Video on the topic

1. About tuberculosis of the genital organs and bladder in the video:
3. The main rule for the prevention of prostate tuberculosis is a timely visit to a doctor (urologist, phthisiatrician) if any suspicious and unusual symptoms from the genitourinary system are detected, especially if you have had tuberculosis in the past, and without fail - after contact with a patient in the active stage of the disease.

Source: https://prostata.guru/prostata/tuberkulez.html

Prostate tuberculosis: causes, diagnosis and treatment

Prostate tuberculosis is a disease of the genitourinary system in which the prostate gland is affected by Mycobacterium tuberculosis with the development of inflammation and the further formation of cavities, tubercles and purulent decay of the organ. Tuberculosis can occur directly in the prostate (primary) or bacteria can enter the organ, for example, from the lungs - this is secondary tuberculosis.

The prostate gland is affected by Mycobacterium tuberculosis with the formation of cavities and purulent foci

Mechanism of the disease

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Mycobacterium tuberculosis can penetrate the organ hematogenously - with the flow of lymph and blood, regardless of where the gate of infection was located - be it the lungs, the mucous membrane of the eye or a wound. Since the prostate gland is well supplied with blood, secondary tuberculosis most often occurs here. But tuberculous prostatitis can also be primary, since it is not always (about 30%) accompanied by lung disease. In this case, the surrounding organs are most often drawn into the inflammatory process - the seminal tubercles, kidneys, epididymis and the testicle itself.

In the initial stages, the inflammatory process proceeds almost unnoticed, since at this time the bacteria “change” the state of the organ - inflammation forms tubercles, cavities (cavities), there is a gradual blockage of the excretory ducts, inflammation and purulent decay of the glandular epithelium.

Symptoms

General signs

Symptoms of tuberculous prostatitis in the initial stage are minor:

• mild pain in the scrotum, rectum and perineum;
• minor urinary disorders - urinary retention, nighttime urge to go to the toilet.

With the development of prostate tuberculosis, discharge with blood and pus appears

With further development of the disease and spread of the inflammatory process to other organs of the genitourinary system, the following symptoms may appear:

• the appearance of blood and pus in the urine and semen;
• severe pain in the perineum, lower back, rectum;
• severe urinary disorders - pain during urination, frequent urge to go to the toilet, inability to completely empty the bladder;
• in 80% of cases nephrotuberculosis develops, in 30% - tuberculosis of the testicle and epididymis;
• significant deterioration in sexual life.

The symptoms of prostate tuberculosis are very similar to ordinary bacterial prostatitis and benign prostatic hyperplasia, so careful diagnosis is required to rule out these diseases.

Sexual function disorder

With the disease, sexual life suffers significantly. Since inflammatory processes affect other organs of the genitourinary system, after some time problems of a sexual and reproductive nature appear:

• erection weakens and becomes painful;
• sexual desire decreases until it disappears completely;
• orgasm becomes less colorful or disappears altogether;
• fertility decreases - sperm become inactive, the number of active individuals in the ejaculate decreases;
• During sexual intercourse, pain is felt, sex ceases to bring pleasure.

Diagnostics

Diagnosis of prostate tuberculosis must necessarily include several research methods - to accurately exclude chronic bacterial prostatitis and prostate adenoma, as well as to assess the condition of other organs of the genitourinary system. Today, urologists use the following methods:

1. Three-glass urine sample . This study should be performed before digital examination of the prostate. You need to urinate into three containers with one stream of urine, while the first will reflect the condition of the urethra, the second - the bladder and kidneys, and the third - the prostate. In this way, you can not only assess the condition of the prostate, but also identify disorders in the functioning of the kidneys.
2. Finger examination (see here). The doctor performs a digital examination of the prostate followed by collection of secretions. Massage is an important stage of the study - due to purulent plugs, the infected secretion may not get into the ejaculate, so the secretion must be squeezed out mechanically.
   

   The prostate is examined with a finger, a sample of the secretion is taken

3. Bacteriological study of prostate secretion . The resulting secretion is examined using light microscopy and sown on a nutrient medium - thus, the pathogen and sensitivity to antibiotics are determined.
4. Ultrasound of the kidneys and prostate . Using this method, you can detect kidney damage, which is not typical for chronic bacterial prostatitis, and also evaluate the condition of the prostate.
5. Ascending urethrography . This study allows us to identify cavernous changes in the prostate (the indication for this method is the recurrent course of the disease).
6. Spermogram . Used to detect mycobacteria in semen, as well as pus and blood.

Treatment

Prostate tuberculosis is difficult to treat, so the course lasts from 6 (for acute form) to 12 months (for chronic form) and includes at least 3 antibiotics, vitamins, pathogenetic drugs:

The course of treatment for prostate tuberculosis is from 6 months to 1 year

• Antibiotic therapy . Depending on the regimen (newly diagnosed disease, relapse, multiple organ damage), the doctor prescribes from 2 to 9 drugs under strict supervision. If for some reason the course of medication is interrupted or the course is not completed, the mycobacterium may develop multi-resistance - after which further treatment can be considered ineffective.
• Vitamins . It is mandatory to take a complex of vitamins, especially group B, since anti-tuberculosis drugs destroy them (see “Vitamins for prostate health”).
• Pathogenetic drugs . These are drugs that improve the general condition of the body, relieve inflammation, improve metabolism, have a diuretic effect, dilute prostate secretions, etc.

Treatment is also complemented by a high-protein diet; during therapy it is advisable to give up bad habits - smoking and alcohol. Strict adherence to the doctor’s orders is the key to recovery. Even if relief occurs, you cannot stop taking antibiotics - after this, the mycobacterium may become insensitive.

Prostate tuberculosis is a disease that can affect every man, regardless of age and social status. If you have any symptoms that may indirectly indicate the presence of any inflammatory process in the prostate gland, it is better not to hesitate, but to immediately contact a urologist. After all, the future health of the entire genitourinary system, as well as sexual life, may depend on this.

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Source: http://MenQuestions.ru/urologiya/tuberkulez-prostaty.html

Prostate tuberculosis and treatment methods

Tuberculosis is considered a dangerous and common disease, in which the pathogen can be localized not only in the lungs, but also in the prostate gland. In this case, a man may not be aware of the problem at all until the pathological process spreads to nearby organs.

Let's consider what symptoms tuberculous prostatitis can manifest and why it is dangerous. We will also talk about methods of diagnosing and treating the disease.

Causes of prostate tuberculosis

The causative agent of the disease is Koch's bacillus, a bacterium that enters a man's body through the respiratory system and develops primarily in the lungs. From this organ, the pathogen can enter the genitourinary system through the blood and infect the testicles, their appendages or the bladder. The prostate is hit relatively rarely.

The risk of contracting prostate tuberculosis increases if the following factors are present:

• human immunodeficiency virus (HIV);
• taking glucocorticosteroid drugs;
• long-term chronic diseases;
• immunosuppressive therapy;
• constant contact with a sick person.

In most cases, the tuberculosis bacillus enters the genitourinary system from the primary focus - from the lungs or bones. Much less often, the bacterium ends up in the prostate after entering the urethra, and even less often from other organs of the reproductive system.

With a strong immune system, the Koch bacillus can “hidden” and not manifest itself in any way for years, but if the immune system is weakened, tuberculosis will begin.

Symptoms of tuberculosis of the prostate

Once in the prostate gland, Koch's bacillus begins vital activity, as a result of which granulomas are formed in the tissues of the organ - zones of the inflammatory process. Therefore, doctors often talk about granulomatous prostatitis.

As the pathology progresses, inflammation invades more and more new areas of the prostate, in which cavities and areas of necrosis form. In the future, the formation of fibrous tissue or stones is possible - calculous prostatitis with calcifications develops.

At the time of granulomatous inflammation, the man does not notice any health problems. The doctor will not find any pathology if he only palpates the prostate - there will be no enlargement or pain. However, as cavities, fistulas form and the bladder or urethra becomes involved in the inflammatory process, unpleasant symptoms of tuberculous prostatitis begin:

• pain in the perineum, often of a pressing nature;
• reduction in ejaculate volume;
• urinary retention or frequent urination;
• burning in the urethra during urination;
• blood or pus in the urine.

A sick man may lose weight and complain of poor appetite and irritability. During the day he is plagued by constant weakness, low performance, and at night increased sweating and insomnia. The quality of life, including intimate life, is steadily declining.

In the initial stage, the prostate affected by tuberculosis will be painless on palpation and there will be no pain. As inflammation progresses, signs of fluctuation and pain may occur. These symptoms indicate both severe inflammation and an abscess. At the final stage of tuberculosis, the prostate decreases in volume, becomes dense, and the structure of its surface is disrupted.

In the latter case, there is a high probability of developing peritonitis, which may be followed by death.

Methods for diagnosing tuberculous prostatitis

To make a correct diagnosis, you need to comprehensively examine the man. Anamnesis and the results of a rectal digital examination of the prostate are important.

You can’t do without laboratory research methods:

• tuberculin test (Mantoux reaction) - the technique allows you to detect the immune response to tuberculin and draw conclusions about the presence of Koch's bacillus;
• general analysis of urine and blood;
• urine culture test, the result of which, when using automated systems, can be obtained within 2-3 days;
• semen analysis - with prostate tuberculosis, a decrease in prostate volume and sperm count is possible; in many men, leukocytes are detected;
• sperm culture to detect acid-fast bacteria;
• PCR diagnostics for quick results;
• smear microscopy.

Instrumental diagnostics are also important. Thus, in half of men with suspected prostate tuberculosis, chest x-ray reveals foci of tuberculosis in the lungs. As in the case of chronic or congestive prostatitis, one cannot do without TRUS of the prostate gland. Using the technique, it is possible to detect pathological foci in the posterior part of the prostate gland.

Sometimes the resulting image can be interpreted as adenocarcinoma. In this case, a biopsy is performed followed by examination of the material in the laboratory.

If a purulent course or the presence of an abscess is suspected, the patient may be referred to a CT or MRI of the prostate. Using these methods, it is possible to obtain more detailed data, determine the boundaries of the abscess, the presence and direction of fistulas and pustules, and record the involvement of other organs of the genitourinary system in the pathological process.

Principles of treatment of prostate tuberculosis

Prostate tuberculosis is a serious disease that requires long-term and complex therapy. In particularly difficult cases, surgical intervention may be recommended, but more often doctors cope with conservative methods.

Drug treatment

Treatment of tuberculous prostatitis with medications can last up to six months, and it will require simultaneous use of several drugs, otherwise Koch's bacillus cannot be defeated. Therapy can be carried out on an outpatient basis - hospitalization is needed only if there are purulent complications.

For the treatment of prostate tuberculosis the following may be prescribed:

• Ethambutol;
• Prothionamide;
• Isoniazid;
• Rifamlicin;
• Pyrazinamide.

The drugs can negatively affect the kidneys and liver, so additional supportive therapy will be required. If there are already dysfunctions of these organs, the doctor calculates a lower dosage taking into account the state of health.

Sometimes after treatment various complications may appear. In this case, it is important not to interrupt therapy, otherwise hospitalization may be required for medical supervision.

The number of operations related to tuberculosis in the prostate gland is gradually decreasing.

This is explained by the increasing effectiveness of drug therapy and the increasing responsibility of men who consult a doctor in a timely manner.

Removal of the prostate is advisable only in cases of impaired urine outflow caused by organ atrophy and in cases where drug therapy does not give the desired result.

To remove the organ, the TURP technique—transurethral resection of the prostate—is increasingly being used. This is a highly precise and effective type of surgical treatment in which the integrity of the skin and muscles is not compromised - instruments are inserted through the urethra. The manipulations are quite painful, so operations are performed under general anesthesia or epidural anesthesia.

To control the manipulations, an endoscopic device equipped with a portable video camera is inserted into the urethra. The image is displayed on the monitor screen, so the doctor can control the location of the instruments and excise pathologically altered tissue with high precision.

At the final stage, a catheter is inserted into the urethra, through which blood and accumulated fluid are evacuated outside the body. If there are no complications, the catheter is removed on the second or third day.

Surgery cannot be avoided in cases of prostate abscess development. In this case, it is drained, and the drained purulent masses are sent for laboratory testing. To perform the operation, transurethral, ​​transrectal or perineal access can be used. Its choice depends on the localization of the pathological process.

These methods are well tolerated by most patients, last about an hour, and have few complications. So there is nothing to worry about.

Conclusion

Prostate tuberculosis is rarely an independent disease; often it is a secondary process - a complication of pulmonary or bone tuberculosis. A weak immune system and frequent contact with sick people increases the risk of developing the disease.

At the initial stages, the process is invisible, so timely examination is important. Medical or surgical treatment, folk remedies and anti-inflammatory suppositories do not help.

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Source: https://prostatits.ru/oslozhneniya/tuberkulez-prostaty.html

Prostate tuberculosis: causes, symptoms and methods of treating the disease

The scourge of today's generation is the various forms of tuberculosis, which are spreading and increasing at lightning speed every year. Prostate tuberculosis is a dangerous disease.

This is a serious illness of the genitourinary system, which occurs against the background of tuberculosis of other organs. Prostate tuberculosis (tuberculous prostatitis) is less common than tuberculosis of the epididymis or seminal vesicles.

In any case, the disease requires immediate medical intervention to avoid dire consequences.

Clinical picture of prostate tuberculosis

Any tuberculosis, be it pulmonary, genitourinary system or bones and joints, is caused by Koch's bacillus. This harmful bacterium enters the human body through the respiratory tract, settles inside the weakened body and takes on a hidden form. This is her cunning. Sometimes the disease can be asymptomatic for a long time, which aggravates the situation.

Koch stick

When an infection enters the prostate gland, small granules are formed in it - foci of tuberculosis.

At first they are located exclusively inside the prostate, and then begin to come out in the form of fibrosis or sand, calcification. If the disease becomes advanced, suppuration and tissue death begin.

Tuberculosis abscesses are not uncommon, which are dangerous because they can break into the abdominal cavity or rectum.

In the final stages, the infection may spread throughout the body. Some organs are so affected by a harmful microbe that a huge cavity appears in it.

Prostate tuberculosis belongs to the category of such diseases. It is almost impossible to detect it in time. The absence of symptoms can create a false picture of complete health.

Doctors have discovered an interesting pattern: most men suffering from pulmonary tuberculosis are affected by prostate tuberculosis. There is no clinical picture of the disease.

At an early stage of the disease, it is almost impossible to diagnose it by palpation.

Causes of prostate tuberculosis

The prostate can come under attack from pathogenic bacteria, including Koch's bacillus, due to various factors:

• genitourinary tract infection that has “descended” to the prostate gland;
• the urethra became the focus of tuberculosis, which then spread further;
• if there is already a focus of tuberculosis in the lungs or bone tissues, the infection spreads through the bloodstream;

Scientists have proven that infection through the blood is the most common cause of prostate tuberculosis.

Prostate tuberculosis

A number of circumstances can provoke the disease or accelerate its course:

1. long-term use of drugs from the group of adrenal hormones - glucocorticosteroids.
2. treatment with drugs that suppress some serious immune conditions, such as autoimmune diseases.
3. human immunodeficiency virus disease and other immune diseases.

Symptoms of prostate tuberculosis

The danger of this disease is the absence of symptoms at the initial stage of the disease. Unpleasant bells begin when neighboring organs are affected by infection. The following symptoms may indicate developing prostate pathology:

• fistulas in the perineum;
• cavities in the prostate that can be detected during an ultrasound;
• mild pain in the scrotum;
• frequent urination;
• constant urge to urinate;
• urinary incontinence;
• burning and stinging when urinating;
• blood in urine;
• in difficult cases - difficulty urinating;
• pain in the lumbar region is observed in 60% of sick men;
• 40% of patients complain of pain in the perineum;
• during a rectal examination, the doctor may detect areas of fluid accumulation in the prostate;
• decreased potency;
• painful ejaculation;
• increasing pain in the anus during bowel movements;
• purulent discharge in the urine;
• decreased sperm volume and quality;
• in the later stages of tuberculosis, the prostate shrinks, sharply decreasing in size, and palpation reveals a hardened organ.

The patient's general condition deteriorates sharply, appetite decreases, night sweats, anemia, sudden weight loss, weakness and fatigue appear.

At the initial stage of prostate tuberculosis there are no symptoms of the disease!

If several symptoms of prostate tuberculosis appear, you must immediately consult a doctor for timely treatment.

Methods for diagnosing prostate tuberculosis

Before the doctor makes the correct diagnosis, the patient must undergo a wide range of studies aimed at confirming or refuting the preliminary conclusion.

Only a set of signs of the disease, confirmed by tests, can indicate the presence of a problem. The prostate gland is a rather difficult-to-reach organ for various studies.

Diagnostics is carried out using the following methods.

1. Taking a “three-glass” urine test, the main condition for collection of which is a continuous flow of urine for all three containers.
2. Rectal method.
3. Taking prostate secretions.
4. General urine analysis after prostate massage.
5. Taking a tuberculin test or Koch provocative test.
6. General blood analysis.
7. Sperm analysis. In patients with tuberculosis, semen volumes are reduced, sperm counts are reduced, and leukocytes appear in the later stages of the disease.
8. PCR sample. Allows you to identify the cause of the disease within 6 hours after taking the biomaterial. In this case, the doctor will promptly prescribe treatment.
9. Transrectal ultrasound examination of the prostate.
10. Prostate biopsy. It is prescribed when areas with reduced density are detected on ultrasound, which indicates a pathology of organ development.
11. Urethrogram. Prescribed only to patients with diagnosed narrowing of the lumen of the urinary canal.
12. MRI and computed tomography. These examinations help identify foci of abscess in the prostate gland and its spread to neighboring tissues.

Magnetic resonance imaging (MRI)

Treatment of prostate tuberculosis

If the disease is confirmed, treatment is immediately prescribed. It takes a lot of time, about a year, and is carried out according to a clearly defined scheme, including taking 3-4 drugs at once.

In case of a benign course of the disease, treatment is carried out at home. If the patient does not take a health problem seriously or there are side effects from medications, treatment in a hospital setting is recommended.

Antibacterial therapy is prescribed as standard, then second-line drugs that actively work against tuberculosis viruses are added.

In extreme cases, doctors decide on surgical treatment of prostate tuberculosis. As a rule, the indication for surgery is the detection of abscess foci that can break into the abdominal cavity or rectum.

The main treatment goes into maintenance therapy to avoid relapse of the disease. It lasts about three years.

The diagnosis can be removed only after comprehensive treatment and repeated basic tests.

Unfortunately, prostate tuberculosis is much more difficult to treat than tuberculosis of other organs. Experts explain this by saying that the drugs simply do not reach the target of treatment in the required dose.

Prostate tuberculosis is a serious disease, but not hopeless. Timely consultation with a doctor will help cope with this disease.

Originally posted 2017-03-31 19:57:57.

Source: https://tutux.ru/prostata/tuberkulez-prostaty/

Prostate tuberculosis: causes, symptoms and treatment of prostate tuberculosis

• Urologist-andrologist 1st category Denis Georgievich
• 35271
• Update date: December 2019

Tuberculous prostatitis or prostate tuberculosis is one of the most dangerous and difficult to diagnose pathologies found in men. The development of inflammation in the prostate gland is caused by the penetration of Koch's bacillus into the organ. The disease progresses slowly; at the initial stage, symptoms may be completely absent.

Causes of the disease

Tuberculosis is a dangerous disease that can affect not only the lungs, but also other internal organs. Prostate tuberculosis is not considered a rare disease; in approximately 13% of cases of infection with extrapulmonary tuberculosis, this form of pathology is diagnosed.

The cause of the disease is infection of the prostate with Koch's bacillus. The bacterium penetrates the prostate gland in three ways:

• hematogenous spread of bacteria;
• descending route of infection, from the genitourinary system;
• infection through the urethral canal.

Causes of prostate tuberculosis – Koch bacillus entering the gland

The spread of bacteria through the bloodstream is a hematogenous route of infection of the prostate. The rod enters the organ from infected lungs, with pulmonary tuberculosis, or bone tissue, with the corresponding form of the disease.

The bacterium spreads quite easily through the urethral canal. At the same time, it can enter the urethra both from the kidneys, when this organ is infected, and from any other sources of infection. The bacterium descends through the urethra into the prostate gland and causes the development of a dangerous disease.

However, direct spread of infection is very rare. In most cases, the bacterium enters the prostate gland through the hematogenous route, moving to the prostate from infected organs.

The development of secondary tuberculosis in the prostate against the background of lung damage is observed in 30% of cases of this disease, which is due to good blood supply to the prostate gland.

In almost every third person with pulmonary tuberculosis, the infection spreads to the prostate

Development of the disease and symptoms

Prostate tuberculosis develops in several stages. The difficulty of treating this disease lies in the fact that the pathology in the initial stages does not have pronounced symptoms, which makes it difficult to make a timely diagnosis.

At the initial stage, the pathology proceeds unnoticed, but it is during this period that pathological changes occur in the glandular tissue due to the activity of the pathogenic bacterium. Prostate tuberculosis begins with the appearance of tubercles in the tissue of the organ.

After some time, the tubercles merge, forming large foci of infiltration. The next stage of the disease is purulent tissue damage followed by the development of necrosis. Large cavities filled with pus, or cavities, form in the organ.

After their removal, dense scars remain in the prostate, which leads to disruption of the functionality of the organ.

In some cases, there is a risk of developing an abscess in the prostate tissue.

Symptoms of prostate tuberculosis in the initial stages of the disease are mild and manifest as pain in the pelvis and perineum. There may be minor urinary disturbances - frequent urge, the need to strain the muscles to empty the bladder.

As the pathological process increases, the symptoms worsen. Signs of the disease in later stages:

• acute pain in the perineum;
• pain in the rectum, which increases many times during defecation;
• frequent urge to urinate with inability to completely empty the bladder;
• burning in the urethra after passing urine.

As a rule, at the beginning of the development of the tuberculosis process, the symptoms are moderately expressed, but the symptoms of prostate tuberculosis in the later stages repeat the symptoms of all forms of bacterial prostatitis.

Symptoms are significantly worse at night, due to increased swelling. This is manifested by a frequent urge to urinate, which disturbs the patient's sleep. Many men complain of a feeling of pressure in the rectum.

Symptoms of prostate tuberculosis are similar to those of other types of bacterial prostatitis

Diagnostics

To make a diagnosis, the same methods are used as for suspicion of any other form of prostatitis:

• organ palpation;
• Ultrasound and TRUS of the prostate;
• study of the composition of prostatic secretion.

Prostate tuberculosis requires caution during palpation and other examinations that are performed through the rectum. This is due to the risk of damage to cavities filled with pus. However, during palpation, tubercles and cavities are clearly felt, which makes it possible to accurately confirm the diagnosis.

TRUS shows the presence of changes in the organ, including sclerotic disorders in the prostate tissue. Additionally, an analysis of prostate secretions is prescribed, which allows identifying Koch's bacillus.

However, the bacterium may not be detected in the prostate secretion if only organ tissue is involved in the pathological process. In this case, an accurate diagnosis is possible by puncture of the prostate gland.

Treatment of the disease

Prostate tuberculosis is a dangerous pathology that requires long-term complex treatment. Since Koch's bacillus is resistant to antibiotic monotherapy, a special treatment regimen is practiced, including the use of special medications.

There is no universal treatment regimen; drugs are selected individually in each case. Typically, therapy is carried out with several antibacterial drugs of the first group of tuberculosis treatment. If the disease is detected for the first time, two to five medications are prescribed. In case of relapse of prostate tuberculosis, the number of prescribed antibacterial drugs can reach up to 9.

The treatment regimen includes an impressive list of medications

Long-term therapy with potent antibacterial drugs significantly weakens the immune system. Some medications used to treat tuberculous prostatitis destroy B vitamins, so vitamin-mineral complexes are often prescribed to compensate for the deficiency of these substances.

Additionally, various medications with general strengthening effects are prescribed. This is necessary to improve metabolic processes, normalize immunity and prostate function, minimize possible complications and disorders of the prostate, which are difficult to treat.

The length of antibiotic treatment depends on how effective the treatment is. On average, drug therapy takes about six months, but can be extended up to a year. For recurrent prostate tuberculosis, treatment can take several years, with consistent changes in the treatment regimen and replacement of antibacterial drugs with drugs with another active ingredient.

Surgical treatment is considered ineffective and is practiced only in exceptional cases. An operation is performed to remove cavities and purulent cavities that lead to the formation of scars in the prostate.

Possible risks and complications

Any prostatic disease, including prostate tuberculosis, negatively affects a man’s sexual function, causing erectile dysfunction and decreased libido. Depending on the duration of the disease, such disorders may be irreversible.

Prostate tuberculosis entails changes in the composition of prostatic secretions and seminal fluid. Spermatozoa lose motility, their number decreases and infertility develops. The inability to conceive a child is one of the most common complications of the disease.

Purulent cavities in the prostate leave behind scars and scars, or areas of sclerotic changes. This leads to changes in the density of the prostate gland and disruption of its functions, which can negatively affect the functioning of the entire genitourinary system.

Since the inflammation site contains Koch's bacillus, there is a risk of infection of other organs with tuberculosis. Due to the peculiarities of localization, the risk of infection primarily threatens the kidneys.

If a prostate abscess is suspected, the patient is hospitalized and undergoes surgery, during which the abscess is opened and the cavity is cleaned out.

Self-medication for prostate tuberculosis is unacceptable.

An incorrectly selected regimen of antibacterial therapy leads to the fact that the bacteria that provoked the development of the pathological process develops resistance to the action of antibiotics.

With tuberculosis, this is fraught with the transition of the disease to a form that cannot be treated. As a result, the duration of therapy will be increased several times and the course of treatment can take up to several years.

When treating prostate tuberculosis, it is necessary to accurately follow all the doctor’s recommendations, take the pills hourly and under no circumstances interrupt the course of therapy on your own.



Until August 10, the Institute of Urology together with the Ministry of Health is conducting the program “Russia without prostatitis .” Within which the drug Predstanol is available at a discounted price of 99 rubles. , to all residents of the city and region!

Source: https://ProstatitNo.ru/prostatit/tuberkulez-prostaty/