Many men suffer from chronic prostatitis, but they attribute the symptoms to other diseases or waste time on ineffective treatment.From our article you will learn comprehensive information about this male problem: causes, exact symptoms and diagnostic methods, various treatment methods.
Despite all the successes of modern medicine, diagnosis of such a disease as chronic prostatitis causes certain difficulties.This also negatively affects the effectiveness of its treatment.
What is chronic prostatitis?
In ICD-10 (International Classification of Diseases, 10th revision) there is no such disease as "chronic prostatitis".There is also no single, generally accepted characteristic of this pathology.In urological practice, the classification developed by AHI (American Institute of Health) is usually used.It defines categories of prostate diseases.What can be described as "chronic" includes:
- chronic bacterial prostatitis;
- Chronic bacterial prostatitis.
To establish this diagnosis, the following symptoms are required: Long-lasting (at least 3 months) pain in the perineum area.Thus, chronic prostatitis can be called a long-term inflammatory process, the result of which is changes in the structure of the prostate gland and its dysfunction.But other prostate diseases also cause such sad consequences.Therefore, the diagnosis of chronic prostatitis is difficult.
Epidemiology
Prostatitis is one of the most common diseases in men.It has a significant impact on performance and family relationships.Patients' quality of life is reduced in the same way as in people who have a heart attack or suffer from angina pectoris.
According to various sources, every 3rd or 4th man is diagnosed with prostatitis.And most often it is not the initial or acute stage of the disease, but an already established and long process - chronic.
Not so long ago, it was generally accepted that this pathology is mainly characteristic of older men.But statistical data refuted this opinion.Today it is known that chronic prostatitis is a disease of sexually active men of childbearing age.
More than 30% of patients with complaints characteristic of chronic prostatitis refer to a specialist.Often during a visit to the doctor, the disease is complicated by accompanying pathologies: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very different.From the variety of negative factors that affect men's health, it is difficult to single out exactly what caused the development of the disease.Often it is a complex of situations and circumstances that accompany a man's life.
The main causes of chronic bacterial prostatitis are:
- Dysrhythmia of intercourse (irregular);
- physical inactivity, which is characteristic of overweight people;
- long stressful conditions;
- Predominance of foods rich in fats in the diet;
- Negative effects on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely cured bacterial prostatitis.Or the man ignored the diseases and did not consult a urologist.Therefore, no treatment was performed.
Bacterial type chronic prostatitis develops against the background of reduced immunity due to exposure to infectious agents.As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors provoking the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibacterial therapy was not carried out before the operation);
- refusal to use contraception;
- Lack of the habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many myths about chronic prostatitis.For this reason, any temporary disturbance of sexual function is attributed to this disease.You will often hear the opinion that decreased libido and erectile dysfunction are caused by prostatitis, and if it is an older man, then by chronic prostatitis.
This is not true, since sexual dysfunction has many other causes, and the main symptom of chronic prostatitis is pain.All other signs can be considered accompanying and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome, as the symptoms of these diseases are largely similar.This is due to the formation of myofascial trigger zones near the prostate, which appear as a result of injuries and surgical interventions.Pain in these areas can be mistaken for a symptom of prostate inflammation.
When diagnosing the disease, complaints of pain and discomfort in the perineum and pelvis, lasting at least 3 months, come to the fore.The pain is localized near the prostate, radiates to the vagina, rectum and scrotum.With prolonged exposure to negative factors (carrying heavy objects, excessive physical exertion, standing for a long time), the pain intensifies.
A characteristic sign of the disease is premature ejaculation.Patients have decreased sexual desire and erectile dysfunction.These symptoms are also characteristic of other diseases of the reproductive system.Therefore, it cannot be said that they are characteristic signs of chronic prostate disease.
An important symptom is the disappearance of orgasm.If the patient begins to notice that the severity of sensations during ejaculation has disappeared, this is a reason for a more attentive attitude to his health and a signal for the need to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urethra increases and the quality of urination worsens.Patients with chronic prostatitis report a frequent urge to urinate at night.The process of urinating is accompanied by a burning sensation, tingling and pain.Urinary incontinence is common.
Signs of chronic prostatitis can be expressed fully or partially.Much depends on the patient's state of health and the presence or absence of other diseases.Chronic prostatitis is characterized by a wave-like course, with waxing and waning symptoms.In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of pronounced symptoms, it is not difficult to diagnose chronic prostatitis.But this disease is often asymptomatic, which makes it difficult to detect.A number of studies are conducted for diagnostic purposes.
The Urological Association has developed questionnaires to help identify asymptomatic chronic prostatitis.The questions are formulated in such a way that the patient's subjective feelings can be clarified.Not all men can correctly assess their erectile function, orgasm quality and other details of their sexual life.Questionnaires filled in by the patient provide the specialist with the necessary information to make a diagnosis.In urological practice, the NIH-CPS scale is most often used.
In order to differentiate chronic prostatitis from other diseases, a neurological examination is performed.The list of used diagnostic methods includes finding out the patient's immunity status.
Laboratory research methods
If chronic prostatitis is suspected, they first find out what its nature is: bacterial or bacterial.In the first case, it is necessary to identify the causative agent or pathogens and find out which drugs they are sensitive to.For this, laboratory tests of urine and prostate secretion are performed.
If the PSA test 10 days after the DRE shows a prostate-specific antigen level greater than 4.0 ng/mL, this is a reason to refer the patient for a biopsy to rule out an oncological process.
The following research methods are recommended:
- scraping from the urethra;
- general and biochemical analysis of urine;
- LHC culture of prostatic secretions.
Instrumental research methods
A TRUS (transrectal ultrasound) is performed with instruments that are inserted into the patient's rectum.If a hypoechoic area of irregular shape is detected, there is every reason to suspect a malignant neoplasm.In chronic prostatitis, scarring, compaction of the glandular tissue structure, and changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnostics.This allows you to find out the nature of urination, signs of urine stagnation and its composition.The study includes several tests: uroflowmetry, cystometry, residual urine volume measurement, bladder pressure assessment, and urine flow rate.
Tomography (computed tomography or magnetic resonance imaging) is necessary to exclude benign and malignant neoplasms.These research methods are very informative and help to assess the state of the prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach.Taking medication alone is not enough.Physiotherapy procedures and therapeutic exercises are necessary.In general, the treatment of chronic prostatitis is difficult and requires a radical revision of lifestyle, change of habits and, in some cases, change of job.Urologists claim that only a combination of measures will help to completely get rid of this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or bacterial in nature, swelling of the prostate gland played a major role in its formation.The viscous secretion deposited in the ducts of the gland is a favorable environment for the development of pathogenic and opportunistic microorganisms.Therefore, the main attention should be paid to eliminating stagnation.
The problem can be solved by changing your lifestyle and incorporating physical therapy classes into your daily schedule.
Complexes of exercises suitable for different life situations have been developed:
- for men who are forced to sit most of the time (drivers, office workers, managers);
- For overweight people;
- For those who don't have time to do exercises.
After thinking about the treatment of chronic prostatitis, you should decide to seriously reconsider your attitude towards your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual abstinence.
Treatment course methods:
- The most effective treatment of prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, the priority is a course of antimicrobial drugs that relieve the manifestations of inflammation.
- The pain syndrome is relieved by warm solutions of painkillers, antispasmodics, rectal suppositories, and microneedling.Nonsteroidal anti-inflammatory drugs may be used.
- Immunostimulators, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
- Physiotherapy methods are possible only in the sub-acute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Another effective method of affecting the prostate is massage.It opens the ducts, normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist consultations.
Treatment of chronic prostatitis
With a long-term course (at least one month) effect on the prostate, there is no 100% guarantee of cure.Priority is given to herbal medicines, immunocorrection, changing household habits:
- Herbal preparations are widely used in urological practice.They can accumulate at the site of the most active pathological process, protect cells from oxidation, remove free radicals and prevent the proliferation of glandular tissue.
- Antibacterial therapy is selected individually, depending on the sensitivity of microbes to drugs.
- Medicines that strengthen immunity not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the function of the immune system.
- The pain syndrome is relieved by taking alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove the "excess" secretion of the gland through the urethra, improve blood circulation and minimize swelling.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or micro-elema with herbs.
- In severe cases, intravenous fluids of diuretics are indicated.It stimulates the abundant production of urine, prevents the symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- Herbal laxatives are used for constipation.
- Together with the patient, the urologist and psychologist work out an individual long-term program of daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of all damaged tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy).In exceptional cases, it is full of impotence and urinary incontinence.Young people are not operated because it can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations in which the pelvic organs may be damaged.
It is necessary to avoid any stress on the prostate: do not ride a bicycle, do not do strength exercises, do not carry weights.
If the job is stationary, you should warm up every 2-3 hours with squats, leg swings, and running on the spot.
You should try to normalize your sex life, which is very important to eliminate the stagnation of prostate secretion.
It is recommended to limit alcohol consumption to minimum doses or completely eliminate alcohol consumption.
Treatment with drugs
In case of chronic prostatitis, ambulatory treatment is mainly carried out.If the pathological process continues and remission cannot be achieved by this method, hospitalization is recommended.In the hospital, under the supervision of medical staff, there is much more opportunity to observe the regimen and monitor changes in the patient's condition.
Chronic prostatitis in men develops against the background of endocrine disorders.In this regard, 5-alpha reductase inhibitors and alpha 1-blockers are recommended.They help to normalize the hormonal level and eliminate the symptoms of pathology.Drugs such as finasteride and terazosin are prescribed for these purposes.
An integrated approach includes taking such medications as:
Methods of treatment of bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics.The most effective drug for a specific patient is determined using a preliminary laboratory study of prostate secretion.
There is no universal drug to suppress and destroy pathogenic microflora.What works for one patient may not work for another.For this reason, there are many negative reviews of drugs advertised for the treatment of chronic prostatitis.
The drugs recommended for antibacterial therapy are fluoroquinolones.Most bacteria are sensitive to them.
Antibiotics may also be included in the treatment plan for patients with bacterial prostatitis.This therapy is carried out for preventive purposes.According to indications, treatment with penicillin drugs is included.
After the end of antibacterial therapy, treatment with hormonal drugs is started.
For intraprostatic reflux, it is necessary to take α-blockers.
Painkillers are effective for pain.
Treatment with herbal remedies
Many people doubt whether chronic prostatitis can be cured with the help of herbal remedies.The answer to this question was obtained as a result of many years of use of these drugs in urological practice.
Today, the following treatment complexes are recommended:
All these drugs have a positive effect on the functioning of the male reproductive system.Chronic prostatitis can be effectively treated by normalizing urinary function.The components contained in herbal medicines perform this task.They help reduce the frequency of urges and eliminate sluggish flow syndrome.
Herbal mixtures containing pumpkin extract or pumpkin seeds are recommended for patients with chronic prostatitis.The latter have a unique chemical composition and act simultaneously in three directions:
- normalization of metabolism;
- strengthening the walls of blood vessels;
- Activates blood circulation in pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment.These health-enhancing agents are considered adjunctive to drug therapy.
Non-drug treatment
Non-drug therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues and help eliminate swelling.
The following techniques are used for these purposes: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus.The device can be used to set the temperature required for a specific type of exposure.To increase the concentration of the drug in the prostate, it is necessary to heat it to 38-40°C.To get an antibacterial effect - 40-45°C.
Today, non-drug treatment is focused on laser therapy.The possibilities of this technique are wide.Under the influence of the laser, the following processes occur in the prostate gland:
- activation of redox reactions;
- blood microcirculation improves;
- new capillaries are formed;
- Pathogenic microflora is suppressed;
- The process of cell division is activated, which promotes tissue regeneration.
During the period of research on the effects of laser therapy on patients with prostatitis, side effects were noted, but for positive therapeutic purposes.Those who completed the course had increased potency, eliminated erectile dysfunction and restored vitality.To achieve this result, it is necessary to use a beam with a specific wavelength.In general, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can take a course of laser therapy on their own initiative, if it is not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not pose a threat to the patient's life, but can significantly reduce its quality.The most serious complication of this disease is the formation of stones in the gland tissues.Transurethral resection is used to free it from prostatitis.
Surgical intervention is performed under TRUS control.
In case of complications similar to prostate sclerosis, transurethral electrosurgery is performed.If sclerosis of the bladder neck is observed along with this pathology, a partial resection of the prostate is performed.
When the seminiferous and excretory ducts are blocked, endoscopic operations are indicated to eliminate the obstruction of secretion conduction.For this purpose, an incision is made in the seminal vesicles and excretory ducts.In case of abscess, it is possible to completely remove the gland.
Exercises for the treatment of chronic prostatitis
There are a number of exercises that are effective in stimulating the prostate, which helps to relieve swelling.This complex was created for patients with hip joint problems.Practice has shown that these exercises are also useful in the diagnosis of prostatitis.Lessons can be held at a convenient time;It will take no more than 15 minutes to complete the complex.
Exercise No. 1
- Lie on an exercise mat, stretch both arms up.
- Bend your knees and pull them towards you, spreading them in different directions at the same time.
- Lift the pelvis as far as they can.
- Repeat 10-12 times.
Exercise No. 2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise No. 3
- Lie on your stomach.
- Lift one leg up, then the other.
- Repeat 10-12 times.
When performing this set of exercises, all movements should be smooth.This is the main condition for obtaining a high therapeutic effect.
treatment prognosis
Few men can completely cure chronic prostatitis.Prostate inflammation often goes into a long remission stage.But when conditions arise for the activation of the pathology, a relapse occurs.Aggravation begins with the appearance of prostate pain.They are often accompanied by urinary disorders.At the first symptoms of relapse, you should consult a specialist.
Patients are advised to visit a urologist regularly, at least once every six months.Prostate condition examinations and PSA tests are performed with the same frequency.By systematic monitoring of the condition of the gland, it is possible to detect the processes that provoke the relapse of the disease.But even in the case of long-term remission, there is no guarantee that it will not be broken.
The patient should follow the recommendations to avoid exacerbation of the disease.It is recommended to balance the diet by excluding fatty and spicy foods.The use of herbal remedies and traditional medicine should be agreed with the attending physician.This approach can minimize the risk of exacerbation of chronic prostatitis.
Prevention
To prevent the occurrence of an unpleasant disease for men, you should eliminate provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't get too cold.
- Drink at least 1.5-2 liters of water a day.
- Strengthen the immune system, walk a lot, get stronger.
- Engage in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice having a regular sex life with a regular partner.