Prostatitis is a disease that causes urination problems, sexual dysfunction, pain in the perineum and lower abdomen. The cause of these symptoms is inflammation of the prostate gland.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located under the male bladder and in front of the rectum. The prostate consists of a gland and connective tissue. Its function is to produce fluid, which is partly made up of ejaculate. This fluid carries the sperm during ejaculation (ejaculation) and protects the sperm as they travel to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not go away for months or even years. The acute form of the disease appears suddenly and lasts a few weeks at most. It is usually easy to treat, but sometimes it becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure permanently. But with proper treatment, there is every chance to achieve long-term remission and significantly improve the patient's quality of life. We found out how to know that you have chronic prostatitis and what to do next.
What is chronic prostatitis?
In general, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. The most common of them is non-bacterial chronic prostatitis. And it is the worst treatment.
The disease is considered chronic if the symptoms do not disappear for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its repeated course. This means that the symptoms may disappear for a while and then reappear. Without treatment, this condition can bother the patient for a very long time.
Bacterial and non-bacterial forms have common symptoms. They usually involve urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. Moreover, the chronic form is much more common than the acute form. About 25% of visits to a urologist are related to chronic prostatitis.
Pathology can appear at any age, but the chronic form most often develops in men after 50 years.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of diseases have common symptoms, but different causes.
Chronic bacterial prostatitis
The inflammatory process causes bacterial infection from the urinary tract to enter the prostate. The provoking factor can be: acute form of prostatitis, urinary tract infection, STD. Prostate inflammatory process causative agents are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic non-bacterial prostatitis (chronic pelvic pain syndrome)
Researchers have not identified the causes of chronic pelvic pain syndrome. In this form, there is no infection in the prostate gland. What causes the violations in this case is not known exactly. There is an assumption that this may be due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- The patient already had prostatitis and chronic pain remained despite treatment;
- Urine entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to trauma or surgery;
- stress
Symptoms of chronic prostatitis
In case of chronic prostatitis, symptoms bother the patient for a long time - for several months or even years. The disease is characterized by a recurrent course, that is, problems appear and disappear.
Infectious and non-infectious prostatitis have common symptoms and include:
- Urinary disorders: frequent and sudden urge, difficulty urinating, pain;
- pain in the penis, testicles, pelvis, lower back;
- pain during intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- Nausea, vomiting
The disease also affects the general condition of the patient. Some people experience irritability, increased fatigue, lethargy and anxiety.
If you have these signs, consult a urologist. Some of them may indicate other more serious diseases that require immediate medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, it is necessary to visit a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and the genitourinary system in both men and women.
The initial consultation includes several stages:
- history taking.
The urologist will ask you about the reason for your visit, any previous illnesses and medications you have taken now and in the past. - Examination of the genitals
- Digital rectal examination.
During the procedure, the urologist inserts a finger into the patient's anus to feel the surface of the prostate gland. The test allows you to determine the size of the prostate and check swelling and sensitivity. - Other studies.
The doctor may prescribe one or more diagnostic procedures, some of which may be done immediately at the appointment, others later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General analysis of urine
Allows you to see signs of infection. This may indicate pathogenic bacteria in the general analysis. - Blood test for PSA (prostate-specific antigen)
Helps to assess the state of the prostate gland. An elevated PSA level indicates an inflammatory process of the prostate or neoplasms. - Microscopy of prostate secretion
Prostatic secretion is a fluid produced by the prostate gland. With changes in the body, the composition of the secretion also changes. For example, during an inflammatory process, white blood cells will increase and high levels of pathogenic bacteria may indicate a bacterial infection of the prostate. Microscopic examination of the fluid can help you see these changes. - Prostatic secretions are collected using prostate massage. Massage can be combined with digital rectal examination.
Instrumental research methods
- Cystoscopy. Examination of the inner surface of the bladder using an endoscope - a thin flexible tube with a camera. The device is inserted into the bladder through the urethra. The study allows you to see problems with the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). For the examination, the specialist will carefully insert an ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
- Pelvic MRI (magnetic resonance imaging). Helps to assess the state of the prostate tissue. It may be necessary to see foci of prostate inflammation and rule out prostate cancer.
There is no special preparation for visiting a urologist. But in order for the consultation to be as effective as possible, follow some simple recommendations:
- Before use for intimate hygiene, you should not use special products, only warm water is enough.
- Do not go to the toilet 2 hours before visiting the clinic. Then, at your appointment, if necessary, you can immediately undergo tests or undergo an ultrasound.
- If you take any medications regularly, write down their names in your diary or notes on your phone.
- Take the results of previous studies with you so that the specialist can see a complete picture of the disease.
- Make a list of questions you want to ask your doctor during your appointment.
Treatment of chronic prostatitis
There is no universal method to get rid of prostatitis. For different forms and manifestations of the disease, different treatments are indicated.
To determine the type of chronic prostatitis, you need to undergo diagnostics. Depending on its results, the doctor will prescribe a therapy that will give you results specifically in your case.
Unlike the acute form, chronic inflammation of the prostate cannot be cured forever. The doctor's goal is to achieve long-term remission and reduce symptoms.
bacterial form: Treatment includes antibiotic therapy and other methods to relieve symptoms.
non-bacterial form: Treatment is symptomatic. That is, each method is aimed at combating a specific symptom.
Recommendations for outpatient treatment
Lifestyle changes:
- Diet restrictions
It is worth giving up alcohol, coffee, spicy and sour food. These products irritate the bladder and worsen the patient's condition. - Warm dining baths, warm showers
Water procedures will help to reduce the manifestation of the disease. - more water
Drink enough fluids. More frequent visits to the toilet will help flush out pathogenic bacteria from the bladder. - Cushions for chairs
Place a soft pillow under you when sitting. - Physical activity
Regular walking and exercise can help reduce pain and swelling. - regular sex life
Sexual activity is helpful in preventing swelling.
The listed methods will complement the therapy prescribed for you, but will not replace it.
drug treatment
- Antibiotics. Antibacterial therapy is indicated for the infectious form. Medicines destroy the bacteria that cause inflammation of the prostate. Different types of pathogenic microorganisms require different antibiotics, therefore, before the appointment, you need to study the prostate secretion and determine their type. In the treatment of the chronic form, antibiotics are prescribed for several months.
- alpha blockers. Helps urinary disorders. Medicines relax the organs of the genitourinary system and this relieves the symptoms. Most often, alpha blockers are used in non-infectious chronic prostatitis, but to improve the patient's well-being, they can also be prescribed for the infectious form of the inflammatory process.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). It is prescribed to relieve pain and reduce swelling of the prostate gland.
- Muscle relaxants. It is used when it is necessary to remove the spasm of the pelvic muscles.
- Antidepressants. It is indicated for depression that can develop due to stress and long-term pain.
- Drugs for the treatment of erectile dysfunction. It is used if prostatitis causes problems in your sex life.
- Laxatives. They may prescribe it if symptoms include pain during bowel movements.
Treatment with herbal remedies
Herbal remedies.Herbal medicines do not work as the main method of treatment. They can be used as a supplement to reduce prostate inflammation. For this purpose, medicines are prescribed together with quercetin, a substance found in vegetables, fruits and berries.
Non-drug treatment
- Physiotherapy and prostate massage. The methods are used to relax the muscles of the pelvic floor, relieve pain and prevent swelling. For a therapeutic effect, the patient undergoes a massage course of several sessions. Massage is contraindicated in the development of complications of the pathology: abscess, stones in the tissues of the prostate gland.
- Bladder catheterization. It may be necessary if you have bladder problems.
- Psychotherapy. Due to chronic pain, patients with prostatitis may develop depression and anxiety disorders. Psychological problems have a negative impact on the patient's well-being and worsen the pain syndrome. In such cases, consulting a psychotherapist will help.
- Biofeedback programs. May help reduce pelvic floor muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be needed if complications develop.
Types of operations:
- TUR (transurethral resection) of the prostate.It is indicated for the occurrence of stones in the tissues of the prostate gland
- Prostatectomy. In some cases, removal of the prostate gland is performed in case of abscess (accumulation of pus) or serious bladder dysfunction.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help in the treatment of chronic prostatitis. They strengthen the muscles of the pelvic floor and alleviate the symptoms associated with urinary disorders. How to do the exercises:
- Sit comfortably.
- Tighten the pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
- Relax your muscles.
- Repeat this 10-15 times.
- Gradually, you can increase the number of repetitions and tense the muscles for longer.
- You should do 2-3 approaches a day.
Changes are noticeable only with regular exercise.
treatment prognosis
Chronic prostatitis is very difficult to cure permanently. In some cases, the disease is incurable, but there is always a chance to achieve long-term remission and return to the patient's previous quality of life. For this, it is important to undergo a thorough diagnosis to determine the form of the disease. If the cause of the inflammatory process is an infection, antibacterial therapy will help. And in non-infectious chronic prostatitis - well-chosen symptomatic therapy.
Complications of chronic prostatitis may include:
- Bacteremia (bacterial blood poisoning). Bacteria in the blood. May be the result of bacterial forms of pathology. Bacteremia develops suddenly and can lead to sepsis. This condition is life-threatening.
- Epididymitis (inflammation of the epididymis). The disease can cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in the tissue). In the case of an abscess, an operation is performed to clean and drain the purulent focus, in rare cases it is possible to remove the prostate.
- Infertility. Problems with conception can arise due to the inflammatory process of the prostate during the lack of sperm.
- Spread of infection in spine and pelvic bones
- Depressive disorder. Chronic pathologies increase the risk of developing depression.
- erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and his emotional state.
To prevent prostatitis, it is important to:
- Use barrier contraception (condoms): STIs are a factor that increases the risk of developing prostatitis.
- See a urologist every year if you are over 40
- If you have symptoms of a UTI, see your doctor right away