Often men are concerned about their health due to frequent urge to go to the toilet and pain in the pelvic organs. And not in vain, because ICD 10 classifies prostatitis as an inflammatory lesion of the prostate gland. How is it diagnosed and treated?

Classification of the disease

In Russia there is a special International Classification of Diseases, 10th revision (ICD 10). This single regulatory document was created to take into account ailments, causes of patient complaints and deaths. The next revision is scheduled for 2017. In ICD 10, under code No. 41, a disease of the genitourinary system such as prostatitis is indicated.

Due to the negative impact of this disease on the immune system and the occurrence of pain and burning sensation, the patient is prescribed antiseptic, disinfectant, immunomodulatory agents and physiotherapeutic treatment.

The international classification divides:

• acute prostatitis (No. 41.0);
• chronic prostatitis (No. 41.1);
• prostate abscess (No. 41.2);
• prostatocystitis (No. 41.3);
• other inflammatory diseases of the prostate gland (No. 41.8);
• inflammatory disease of the prostate gland, unspecified (No. 41.9).

In addition to the international one, there is an etiological classification of prostatitis (based on the origin of the disease). Thus, infectious prostatitis can be chlamydial, gardnerellosis, bacterial, viral, candidal, gonorrheal, mycoplasma, ureaplasma, trichomonas and mixed. Tonsillitis, sinusitis, and kidney diseases are also causes of this disease.

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If the disease is not caused by infection, it is called stagnant. Most often it occurs as a result of:

• hormonal-dystrophic, allergic, cold processes;
• hypothermia;
• sedentary lifestyle;
• alcohol abuse;
• frequent smoking;
• operations on the pelvic organs.

Much less commonly, prostatitis is caused by specific pathogens.

Acute form

In ICD 10, acute prostatitis has code No. 41.0. This means that it refers to acute forms of inflammatory diseases of the prostate gland caused by tissue bacterial infection. Many of these bacteria are present in the normal microflora of the body, and only when inflamed do they cause the development of an acute form of prostatitis, which requires calling an ambulance for subsequent hospitalization. An acute form of prostatitis can occur due to a complication of a prostate biopsy.

According to ICD10, men complain of increased body temperature (the results of the rectal measurement method may differ from the standard axillary one), pain in the lower back, perineum, groin area, nocturia, dysuria, frequent or incomplete urination, weakness, muscle and headache, sometimes - for constipation and painful bowel movements. Also, with prostatitis, characteristic discharge may occur.

Often, due to acute prostatitis, sepsis may begin to develop in the prostate gland, which usually leads to cystitis, pyelonephritis or blood infection. This condition is always critical and requires urgent hospitalization. Prostatitis is diagnosed in a hospital setting. First, body temperature is measured and palpation is performed in the groin area and in the area of ​​the lymph nodes.

Next, the patient must undergo the necessary blood, urine, smear, bacterioscopy and culture tests for sensitivity to antibiotics. Some patients are prescribed bacterioscopy. Instrumental diagnostic methods include transrectal ultrasound of the prostate gland, puncture of suspicious areas of the prostate gland, and computed tomography or magnetic resonance imaging of the pelvic organs. Antibiotic therapy for this form of the disease usually lasts at least 1 month.

Complex therapy includes treatment with immunomodulators like Echinacea and Galavit, tetracyclines (Doxycycline), antiseptics and disinfectants (Miramistin), antipyretics and NSAIDs. It is worth noting that in acute forms of prostatitis, the patient should drink a lot of water - this facilitates frequent flushing of the urinary tract, preventing the development of cystitis or pyelonephritis. If antibiotics alone do not help, they should be replaced, otherwise the risk of developing chronic prostatitis increases.

Bacterial and asymptomatic type

Chronic prostatitis can be bacterial or asymptomatic.

Asymptomatic prostatitis practically does not bother the patient, only his potency and urination appear in an unexpressed form.

But the bacterial form is characterized by inflammation of the prostate gland. Because of this, the patient often experiences severe pain and burning when urinating, his sex life is disrupted, and self-esteem decreases. The quality of life of a patient with chronic prostatitis also deteriorates. Some medical specialists compare such patients with patients who have suffered a myocardial infarction or patients with chronic gastrointestinal diseases.

At least 5% of men among the entire world population are diagnosed with bacterial chronic prostatitis. Moreover, the onset of the disease can be even at 20 years of age. In the International Classification of Diseases, 10th revision, chronic prostatitis is located in paragraph No. 41.1, which means that it belongs to diseases of the genitourinary system No. 00-No. 99 (namely, diseases of the genitourinary organs No. 40-No. 51).

BPH code according to ICD-10 is N 40.0. It is under this code that a condition that every 6-7 men encounter after reaching 50 years of age is included in the worldwide register of diseases. Pathology of the prostate gland includes a wide range of diseases, including malignant neoplasms and trauma. But the risk of their occurrence is significantly lower than the development of proliferation of glandular tissue of the prostate. It is worth noting that although this condition appears among other diseases, it cannot be unambiguously regarded as a pathology. There is a separate form of BPH, in which the size of the gland increases towards the rectum. In this case, there are no clinical manifestations or laboratory changes. But the compilers of ICD-10 classify this form as N 40.0.

The essence of the problem

Neoplasms in all organs can be both benign and malignant. Adenoma is, according to anatomy, a benign tumor, the growth of which depends on the hormonal background of the whole organism. Before understanding the classifications, pathogenesis, clinical picture and treatment, it is necessary to have basic information about the anatomy of the prostate gland. The following parts of the gland are distinguished: right and left lobes, isthmus. The isthmus is a section of the gland located between the lobes. Anteriorly, it is limited by the entry point of the bladder neck. At the back is the confluence of the ejaculatory ducts. The second name for the isthmus is “middle lobe.” It is true only in older men, since this area of ​​the prostate greatly enlarges with age.

The gland is located in the pelvic cavity. Encircles the upper parts of the urethra, which have just emerged from the bladder. At the back, the prostate fits tightly to the rectum.

Reasons for the development of the disease

As with most neoplasms, the cause remains an open question. It has become known that glandular hyperplasia is closely related to age (as discussed above), the level of prostate specific antigen (PSA) and the volume of the gland itself. Thus, it is necessary to understand that an increase in the size of the gland does not always describe code N 40.0. If a malignant tumor is excluded and there are symptoms characteristic of the disease, only in this case can one indicate BPH.

The theory about the influence of hormones on the growth of tissue inside the gland has the most harmonious structure and clarity of logic. With age, the intensity of production of male sex hormones - testosterone and its derivatives - decreases. Normally, even in the male body, female sex hormones - estrogens - are synthesized. As the concentration of testosterone decreases, the relative concentration of estrogens increases, which causes an inadequate response on the part of the gland cells, which leads to hyperplasia (proliferation) of the epithelium.

Manifestations of the disease

Only after any specific manifestations occur can we talk about the disease. For a more accurate diagnosis, the so-called reference symptoms were identified, which were grouped into the concept of “symptoms of the lower urinary tract”. This concept includes:

1. 1. Difficulty urinating, more often than usual, accompanied by pain (stranguria).
2. 2. Urge is an extremely strong urge to urinate that cannot be controlled by the person.
3. 3. Violation of the integrity of the urine stream during the act of urination.
4. 4. Feeling of incomplete urination.
5. 5. Mostly nocturnal urges.

There have been attempts to connect the severity of these symptoms with the size of the prostate gland, but none of them have been successful. Therefore, to diagnose the severity, in addition to standard research methods, rather unusual methods were proposed, many of which are still used today. For example, measuring the maximum urinary flow rate.

BPH can be complicated by severe conditions. The most dangerous of them include the development of ureterohydronephrosis, which can lead to chronic renal failure.

Classification of symptoms of disease progression includes the following:

1. 1. Decrease in maximum urination rate.
2. 2. An increase in the total amount of residual urine after emptying the bladder.
3. 3. Increase in prostate size over time.
4. 4. Deterioration in the results of special testing (I-PSS).
5. 5. Acute urinary retention syndrome.
6. 6. PSA growth.

Smoking and alcohol abuse somewhat worsens the course of the disease. But the degree of this deterioration is not so high. The results of studies that compared groups of patients with adenoma and diabetes mellitus and simply gland pathology turned out to be interesting. It turned out that diabetes mellitus is much more common in combination with pathological growth of glandular tissue of the prostate than on its own. It has not yet been possible to explain this.

How to detect and determine the severity of pathology?

According to international recommendations, there is a strict distinction between the persons who are assigned to one or another list of examinations. The standard diagnostic profile is designed for men over 50 years of age without risk of lower urinary tract symptoms not associated with BPH. After collecting basic information about complaints and the history of the disease, the doctor may recommend undergoing special testing (I-PSS). It is a list of special questions and answer options that can be used to determine the severity of urinary tract symptoms without resorting to special examination methods.

The next step is a physical examination. As mentioned above, the prostate is located in front of the rectum. Therefore, for the primary diagnosis of prostate cancer, a digital examination is performed through the anus. Despite some discomfort when performing it, you should not refuse it. Since using this technique it is possible to detect prostate cancer with high reliability. In addition, the doctor is required to conduct a basic neurological examination to exclude pathology of the nervous system, which can mimic the symptoms of BPH.

A practicing physician needs knowledge of the classification of diseases. For this purpose, the ICD has been developed - the international statistical classification of diseases. It is intended for purposes that are related to healthcare activities. This allows you to track statistics and analyze work, monitoring the prevalence of diseases among different age groups of the population. A practicing doctor will be able to apply international experience to prescribe adequate treatment.

Prostatitis code according to ICD

According to the hierarchical principle of construction, prostatitis has a code according to ICD 10 - N41. Depending on the process, another subcategory is added to the three-digit heading, which consists of a Latin letter and two numbers, i.e. a number appears in the encoding. In the classification of diseases, inflammatory processes of the prostate have code N41. A number is added to indicate the form of the disease.

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The acute form has code N41.O. Chronic prostatitis - the ICD 1O code is designated N41.1. Sometimes you can find the abbreviated form “mkb 10 xr prostatitis”. Inflammation of the prostate can lead to various purulent complications or other manifestations of congestion in the prostate. In this case, the following identification codes are provided:

1. for prostate abscess - N41.2;
2. with the addition of cystitis - N41.3;
3. inflammation of the prostate - N41.8;
4. inflammation of the prostate of unknown etiology - N41.9;
5. stones in the prostate - N42.0;
6. congestion and hemorrhage in the prostate - N42.1;
7. prostate atrophy - N42.2;
8. Unrefined prostate diseases - N42.9.

ICD code for prostate adenoma

Prostate adenoma is classified as a benign neoplasm. Usually, all oncological processes in the body have a different coding, but adenoma refers to gland hypertrophy and is included in the group of diseases of the male reproductive system. According to the international classification, this group includes a three-digit code from N40 to N51. Prostate adenoma has an ICD 10 code - N40. According to alphanumeric coding, the following diseases fall under N40:

1. adenofibromatous hypertrophy;
2. fibroadenoma;
3. benign enlargement;
4. benign prostatic hypertrophy;
5. blockage of the prostate ducts;
6. BPH.

Fibroids and prostate fibroids are excluded from this classification. These diseases have a different coding. Both adenoma and prostatitis according to the ICD belong to class XIV - diseases of the genitourinary system.

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Frequent urination with sharp pain in the abdomen is inflammation of the prostate gland, which affects men of 30–40 years of age. In the International Static Classification of Diseases, prostatitis has code 41. What kind of disease is this, and what types are there?

A man should pay attention to urination in several stages

Types of prostatitis according to ICD

In medical practice, there is a special reference publication - “International Classification of Diseases”, containing all the necessary information about a particular disease. Inflammation of the prostate gland has its own coding: ICD 10 prostatitis N 41 - a disease of the urinary system.

The following disease typology is used:

1. Acute prostatitis (number 0).
2. Chronic prostatitis (number 1).
3. Prostate abscess (number 2).
4. Inflammation of the prostate gland in combination with cystitis (number 3).
5. Other inflammatory diseases (number 8).
6. Unspecified prostate disease (number 9).

Based on the causes of the disease, the following types are distinguished:

1. Prostatitis associated with infection (chlamydia, gonorrhea, ureaplasma); viral (sinusitis, kidney disease); combined.
2. Congestive prostatitis - appeared due to other factors:

• hormonal imbalance;
• colds and allergies;
• hypothermia and overheating;
• passive lifestyle;
• abuse of bad habits;
• surgical intervention.

International Classification of Diseases - prostatitis

The course of the disease in acute form

In ICD 10, acute prostatitis refers to inflammatory infections, the appearance of which is provoked by harmful microorganisms that have penetrated into the tissue layer. The mechanism of development of the acute form includes direct bacterial infection, aggravating the course of the disease. Prostatitis can worsen after a biopsy analysis has been performed.

The signs that allow you to recognize an acute form of inflammation of the prostate gland are as follows:

• a significant increase in body temperature (measure axillary and rectal);
• pain in the lumbosacral segment, groin;
• spasmodic contractions during bowel movements;
• night urination is not fully mixed with blood and pus;
• general deterioration of health;
• constant migraines.

If the above symptoms are detected, you should immediately call an ambulance at home, because the man needs urgent observation in the hospital. Medical personnel diagnose the inflammatory process by visual examination, and they must measure body temperature. Additional tests are prescribed: laboratory tests of blood and urine, cytology, cultures to select antibiotic drugs. Additional methods are widely used, such as ultrasound diagnostics of the prostate, biopsy of prostate segments, computed tomography of the pelvic organs.

Prostate gland photo

Mandatory treatment for the acute form is antibiotic therapy for a period of one to one and a half months (Doxycycline). They are used for therapeutic purposes in combination with immunostimulating drugs (Echinacea tincture), bactericidal drugs (Miramistin), anti-inflammatory drugs (Diclofenac, Nimesulide).

During treatment, the patient must consume a sufficient amount of fluid so that the genitourinary system is constantly working. This will serve as a prevention for other urinary ailments and kidney disorders.

The key to a good course of therapy is the correct selection of drugs. In order to effectively prescribe medications, cultures are performed to test the body's sensitivity to antibiotics. Medicines of this type are selected individually, taking into account the characteristics of the disease.

The course of the disease in a chronic form

Chronic prostatitis code according to ICD 10 does not occur with such severe symptoms as the acute form. There are two types of the disease: bacterial and non-bacterial inflammation of the prostate.

With prostatitis caused by bacteria, the symptoms are expressed as follows:

• severe cramps and pain when urinating;
• feeling of burning and itching in the genitals;
• impairment of physical desire and erectile function;
• headache;
• spasms in the lower abdomen with shootings in the thigh and lower back;
• low level of quality of sexual intercourse.

Metastases in the prostate gland

With these signs, you should consult a doctor so that you can conduct an examination and make a diagnosis. During the examination using palpation, the doctor will determine the size of the prostate gland and, if necessary, prescribe other types of diagnostics.

Doctors are required to take urine and blood tests. Elevated leukocytes, erythrocytes and erythrocyte sedimentation rate indicate that an inflammatory process is occurring. Ultrasound diagnostics of the prostate is effective. Thanks to this method, the size and boundaries of the location of the prostate gland are clearly determined. They also resort to studying prostatic secretions, where bacteria that cause inflammation of the gland are found. The red blood cell count will exceed the norm.

The non-bacterial form is characterized by decreased sexual function and periodic pain in the abdominal area. To correctly formulate a conclusion, you also need to undergo laboratory tests, which determine a large number of leukocytes.

ICD 10 chronic prostatitis is effectively treated using complex therapy in compliance with the rules of behavior:

• exclude frequent changes of sexual partners;
• do not overcool the groin area;
• treat genitourinary diseases;
• increase physical activity;
• avoid stressful experiences;
• have an intimate life regularly.

What is prostatitis clearly?

The non-bacterial type of prostatitis is much easier to eliminate than the bactericidal form. The main place in treatment is occupied by drugs that relieve inflammation and block pain (Ketonazole, No-spa) and antibiotics (Macropen, Azithromycin). In addition, cellular strengthening medications are prescribed (“Methyluracil”, “Timalin”, “Levamisole”). The duration of treatment is from one and a half to two months.

In order to prevent disturbances of the intestinal microflora, they use drugs with prebiotics.

The complex uses prostate massage using a special finger technique. Physiotherapy sessions (warming up, therapeutic enemas) that normalize the circulatory system of the pelvic organs are considered useful.

What to eat during prostatitis?

From the very beginning of urinary disease, you need to follow a special diet that excludes alcoholic beverages, fatty foods, sweet pastries, baked goods, salty and spicy foods, tea and coffee drinks. Mushrooms, legumes, and semi-finished products are prohibited.

The menu should contain foods high in zinc: pumpkin seeds, seafood delicacies. Preference should be given to porridges with whole grain cereals, vegetables (with the exception of cabbage, as it is involved in flatulence), dried fruits and dairy products.

Surgical methods for prostate treatment

Surgery is used in cases where drug therapy has been ineffective. Basically, surgery is resorted to in situations where complications have arisen (abscesses, prostate adenoma). The modern surgical industry offers the following options for prostate removal:

• prostatectomy (whole removal of the prostate);
• resection (removal of a segment of the gland);
• cutting off the foreskin;
• puncture of a purulent formation.

To consolidate the results of curing prostatitis, you need to protect your body from provoking factors. The main condition is regular sex with one partner. At the first manifestations of inflammation of the prostate, you need to contact a urologist for examination.

The International Classification of Diseases (ICD) is a universal statistical document used by health organizations around the world. This classification is intended to structure the huge number of diagnoses made by doctors from different countries. The ICD is necessary for universalization, qualitative assessment and systematization of the work of doctors on the whole planet.

At this point in time, doctors use the international classification of the tenth revision or shorter ICD-10. It includes three volumes. The basis of this system is a combination of letters and numbers.

In total, the classification uses 25 letters of the alphabet from A to U, which correspond to 22 sections. The latter describe certain groups of diseases, similar in etiology or pathogenesis. Each diagnosis in the section has a code consisting of a letter and a number. It is worth noting that sections in the ICD are combined into headings.

Division of urinary system disorders

Diseases of the genitourinary organs are encrypted in ICD-10 under the letter N. There are 11 blocks in this class.

Organic disorders in the male reproductive system are located in this section under the numbers N40- N51 . In addition to the pathology of the prostate gland, diseases of the testicle, penis and spermatic cord are encoded there. The block of diagnoses related to the male reproductive system contains the following sections:

• Prostatic hyperplasia ( N40)
• Inflammatory diseases of the prostate ( N41)
• Other prostate processes ( N42 )
• Hydrocele and spermatocele ( N43)
• Testicular torsion ( N44)
• Orchitis and epididymitis ( N45)
• Infertility in men ( N46)
• Excessive foreskin, phimosis, paraphimosis ( N47 )
• Other pathologies of the penis ( N48 )
• Inflammatory disorders not elsewhere classified ( N49 )
• Other pathologies of the male genital organs ( N50 )
• Lesions of the male genital organs in conditions described in other sections ( N51 )

Conditions characterized by the proliferation of prostate tissue

Benign prostatic hyperplasia or adenoma is a benign tumor that grows from the glandular cells of this organ. All conditions that fall under the above criteria are located in item N40. According to the ICD, it consists of the following organic disorders:

• Prostate hypertrophy.
• Adenoma of the middle lobe.
• Adenofibromatous hypertrophy.
• Blockage of the gland duct.
• Prostate enlargement.

All diagnoses of this subgroup are united by one sign: with these disorders, the prostate gland increases in size, i.e. adenoma develops. This fact was key when classifying these pathological processes as section N40. Hypertrophy and enlargement are very similar diagnoses, since both the first and second relate to the definition of adenoma. They differ from each other only in histological characteristics (tissue structure). In adenofibromatous hypertrophy, fibrous tissue predominates.

In the anatomy of the prostate, there are three lobes: right, left and middle (isthmus). As a rule, adenoma develops in the first two. But if the doctor finds hyperplasia in the isthmus, he will make a diagnosis: adenoma of the middle lobe.

In addition to the lobes, this organ includes two ejaculatory ducts (right and left). If for some reason they become blocked, the tissue begins to grow. This gave the name to the disease shown in section N40.

It is worth noting that the percentage of diagnoses for this group of disorders increases exponentially with increasing age:

• 40-50 years – 25%
• 50-60 years - 50%
• 60-70 years old - 65%
• 70-80 years – 80%
• over 80 years – 90%

Inflammatory pathological processes in the prostate gland

This pathological group is encrypted in the international classification under the code N41. This section focuses on the following disorders:

• Acute prostatitis ( 0 )
• Chronic prostatitis ( 1 )
• Prostate abscess ( 2 )
• Prostatocystitis ( 3 )
• Other inflammatory processes of the prostate ( 8 )
• Inflammatory diseases, unspecified ( 9 )

At this point, pathological conditions are arranged according to frequency of occurrence.

Acute prostatitis in ICD-10

From all of the above it follows that this acute pathology is the most common inflammatory disease affecting the body of men. Among all urological pathologies, prostatitis accounts for about 30-60%.

The following symptoms are characteristic of this disorder: dysuric disorders, an increase in body temperature to subfebrile or febrile numbers (37.5 - 39 ℃), pain in the lower abdomen and in the rectal area, discharge from the urethra with an unpleasant odor, weakening or absence of erection penis, nervousness and a feeling of internal weakness. In this paragraph of disorders it is encrypted under the letter N and number 41 .

Chronic form of the disease in ICD-10

This process quite often affects the stronger half of humanity under the age of 50. It affects approximately 43% of men by age 80. Of the total number of diseases that affect people all over the world, this pathology makes up 9%.

Chronic prostatitis is characterized by normal temperature readings, a pulling sensation in the pubic area, a decrease in the level of pressure of the urine stream and a decrease in the duration of an erection. Its code in the international classification is N41.1 .