Many men suffer from chronic prostatitis, but attribute the symptoms to other illnesses or waste time with ineffective treatment. From our article you will get complete information about this male problem: causes, exact symptoms and diagnostic methods, various treatment methods.
Despite all the successes of modern medicine, the diagnosis of such a disease as chronic prostatitis causes certain difficulties. This negatively affects the effectiveness of your 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 and generally accepted characteristic of this pathology. In urological practice, it is customary to use the classification developed by the AHI (American Institute of Health). Define the categories of prostate diseases. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- abacterial chronic prostatitis.
To make these diagnoses, the following symptoms are required: Prolonged pain (at least 3 months) in the perineum. Therefore, chronic prostatitis can be called a long-term inflammatory process, which provokes changes in the structure of the prostate gland and its dysfunction. But other prostate diseases also lead to such sad results. 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 relationships in the family. The quality of life of patients is reduced to the same extent as in people who have suffered a heart attack or suffer from angina pectoris.
According to various sources, one in three or four men is diagnosed with prostatitis. And, in most cases, this is not the initial or acute stage of the disease, but an already formed and long-term ongoing process - chronic.
Not so long ago it was considered that this pathology is inherent mainly in older men. But the statistics refute this notion. Today it is known that chronic prostatitis is a disease of men of childbearing age who are sexually active.
More than 30% of patients come to a specialist with complaints characteristic of the chronic form of prostatitis. Often, at the time of visiting the doctor, the disease is complicated by concomitant pathologies: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very different. Of all the variety of negative factors that affect a man's health, it is difficult to isolate exactly those that provoked the development of the disease. Often this is a complex of situations and circumstances that accompany the life of a man.
The main causes of chronic abacterial prostatitis are the following:
- dysrhythmia (irregularity) of sexual intercourse;
- hypodynamia, which is typical for overweight people;
- prolonged stressful conditions;
- the predominance of high-fat foods in the diet;
- negative impact on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely healed bacterial prostatitis. Or the man ignored the ailments and did not seek help from a urologist. Therefore, no treatment was administered.
Chronic prostatitis of the abacterial type develops due to exposure to infectious agents against the background of decreased immunity. As a rule, these patients are diagnosed with diseases of the endocrine system.
Factors provoking the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibiotic therapy was not performed before the operation);
- refusal to use contraceptives;
- lack of habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many fictions about chronic prostatitis. For this reason, any temporary violation of sexual function is attributed to this disease. The opinion can often be heard that a decrease in sexual desire and erectile dysfunction is the merit of prostatitis, and if a man ages, then 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 concomitant and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome, since the symptoms of these diseases are very 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 taken as a symptom of inflammation of the prostate.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and small pelvis, lasting at least 3 months, stand out. The pain is localized in the vicinity of the prostate, radiating to the sacrum, rectum, scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical activity, being "on your feet" for a long time), the pain intensifies.
A characteristic symptom of the disease is premature ejaculation. Patients have a decrease in sexual desire, erectile dysfunction. These symptoms are also characteristic of other diseases of the urogenital area. Therefore, it cannot be said that they are the characteristics of chronic prostatic disease.
An important symptom is the disappearance of the orgasm. If the patient began to notice that the sharpness of sensations during ejaculation had disappeared, this is an occasion for a more attentive attitude to her health and a signal to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urinary tube increases, and there is a deterioration in the quality of urination. Patients with chronic prostatitis notice a frequent urge to urinate at night. The process of excretion of urine is accompanied by a burning sensation, pain, pain. There is often urinary incontinence.
Signs of chronic prostatitis can be fully or partially expressed. Much depends on the state of health of the patient, the presence or absence of other diseases. Chronic prostatitis is characterized by an undulating course, with waxing and waning of symptoms. In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of severe symptoms, the diagnosis of chronic prostatitis is easy. But this disease is usually asymptomatic, which complicates its detection. For diagnostic purposes, a whole series of studies is carried out.
The Association of Urologists has developed questionnaires, thanks to which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated in such a way that the patient's subjective feelings can be ascertained. Not all men can give a correct assessment of their erectile function, quality of orgasm and other details of sexual life. The questionnaires completed by the patients provide the specialist with the information necessary to make a diagnosis. In urological practice, the NIH-CPS scale is most often used.
To differentiate chronic prostatitis from other diseases, a neurological examination is performed. In the list of diagnostic methods used, the determination of the patient's immunity status.
Laboratory research methods.
If you suspect chronic prostatitis, first find out what its nature is - bacterial or abacterial. In the first case, it is necessary to determine the pathogen or pathogens, to know which drugs they are sensitive to. For this, laboratory tests of urine secretion and prostate are performed.
If after a period of 10 days after DRE, the PSA test showed an excess of prostate-specific antigen level of 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 of the urethra;
- general and biochemical analyzes of urine;
- LHC culture of prostate secretion.
Instrumental research methods
TRUS (diagnostic transrectal ultrasound) is performed using equipment equipped with an instrument that is inserted into the patient's rectum. If an irregularly shaped hypoechoic area is found, there is every reason to suspect a malignancy. In chronic prostatitis, scars, compaction of the glandular tissue structure, changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnosis. It allows you to find out the nature of urination, the signs of stagnation of urine, its composition. The study includes several tests: uroflowmetry, cystometry, measurement of the residual volume of urine, assessment of the pressure inside the bladder and the speed of urine output.
Tomography (computer 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 tissues.
Treatment of chronic prostatitis
The treatment of chronic prostatitis requires an integrated approach. One dose of medication is not enough. Physiotherapeutic procedures, therapeutic exercises are necessary. In general, chronic prostatitis is difficult to treat, requiring a radical review of lifestyle, changes in habits and, in some cases, a change of job. Urologists insist that only a set of measures will help to completely eliminate this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or abacterial in nature, congestion in the prostate played a significant role in its formation. A viscous secret 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 directed to the elimination of stagnation.
The problem is solved by changing the lifestyle and including physical therapy exercises in the daily schedule.
Complexes of exercises have been developed that are suitable for different life situations:
- for those 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 exercise.
Thinking about how to treat chronic prostatitis, you need to decide on a serious review of your attitude to your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet, and sexual rest.
Course treatment methods:
- The most effective in the treatment of prostatitis is etiotropic therapy. If the basis of prostatitis is infection, a course of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
- Pain syndrome is relieved by analgesics, antispasmodics, rectal suppositories, microclysters with warm solutions of analgesics. NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, a combination of microelements have proven themselves.
- Physiotherapeutic methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Massage is another effective method to influence the prostate. Opens the ducts, normalizes the blood circulation of the scrotum, small pelvis.
- Acute retention of renal filtrate can be corrected by catheterization, trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist consultations.
Treatment of chronic prostatitis
With a long-term course (at least a month) of exposure to the prostate, there is no 100% guarantee of cure. Priority for herbal preparations, immunocorrection, change of domestic habits:
- Phytopreparations are widely used in urological practice. They can accumulate at the site of the most active disease process, protect cells from oxidation, scavenge free radicals, and prevent the growth of glandular tissue.
- Antibacterial therapy is selected individually, depending on the sensitivity of microbes to drugs.
- Immunity-enhancing drugs not only help to cope with prostatitis, but also correct the negative effect of antibiotics that disrupt the function of the immune system.
- Pain syndrome stops with the appointment of alpha-blockers, muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secret from the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths, or herbal microclysters.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates abundant urine output, prevents symptoms of intoxication, the development of ascending cystitis, pyelonephritis.
- Plant-based laxatives are used for constipation.
- The urologist, psychologist, together with the patient, develops an individual long-term program of daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- In case of resistance of the chronic process to the ongoing therapy, blocking the flow of urine, surgical intervention is prescribed: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy ). Practiced in exceptional cases, charged with impotence, urinary incontinence. Young people do not undergo surgery, as this can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations in which the pelvic organs may be injured.
It is necessary to exclude any load on the prostate: do not ride a bike, do not do strength exercises, do not carry heavy loads.
If the work is sedentary, then every 2-3 hours it is necessary to do warm-ups, do squats, swing your legs, run on the spot.
It is necessary to try to normalize sexual life, which is extremely important in order to eliminate the stagnation of the secret in the prostate.
It is recommended to limit the use of alcohol to the minimum doses or completely eliminate it.
drug treatment
In chronic prostatitis, outpatient treatment is predominantly performed. If the disease process persists and remission cannot be achieved by this method, hospitalization is recommended. In a hospital, under the supervision of medical staff, there are much more opportunities to adhere to 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 contribute to the normalization of hormonal levels and eliminate the symptoms of pathology. For these purposes, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach includes taking medications such as:
Methods of treatment of chronic bacterial prostatitis.
Chronic bacterial prostatitis is treated with antibiotics. The most effective drug for a particular patient is determined by a preliminary laboratory study of prostatic secretion.
There is no universal drug for the suppression and destruction of pathogenic microflora. What works for one patient may not work for another. For this reason, there are many negative reviews about drugs advertised for the treatment of chronic prostatitis.
The recommended drugs for antibacterial therapy are the fluoroquinolones. Most bacteria are sensitive to them.
Antibiotics can also be included in the treatment plan for patients with abacterial prostatitis. Such therapy is carried out for preventive purposes. According to the indications, treatment with penicillin preparations is connected.
After completion of antibiotic therapy, treatment with hormonal drugs begins.
With intraprostatic reflux, it is necessary to take blockers to.
Analgesics are effective in relieving pain.
Treatment with herbal remedies
Many doubt that chronic prostatitis can be cured with herbal remedies. The answer to this question was obtained after many years of use of these health-improving agents in urological practice.
Today the following medical complexes are recommended:
All these drugs have a beneficial effect on the work of the male genitourinary system. Effective treatment of chronic prostatitis is possible if the function of urination is normalized. The components that make up herbal remedies perform this task. They help reduce the frequency of impulses, eliminate the syndrome of a slow jet.
Phytocollections, which include pumpkin extract or pumpkin seeds, are recommended for patients with chronic prostatitis. The latter have a unique chemical composition and act in three directions at once:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment. These curative agents are considered as concomitant drug therapy.
Non-pharmacological treatment
Non-drug methods of therapy allow you to act directly on the prostate, increase the concentration of drugs in its tissues and help eliminate congestion.
For these purposes, the following methods are used: rectal ultrasonic exposure;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus. On the device, you can set the temperature required for a particular type of exposure. To increase the concentration of the drug in the prostate it is necessary to heat to 38-40°C. To obtain an antibacterial effect - 40-45 ° C.
Today, non-pharmacological treatment focuses on laser therapy. The possibilities of this technique are vast. Under the influence of a laser, the following processes occur in the prostate gland:
- activation of redox reactions;
- improves blood microcirculation;
- new capillaries are formed;
- pathogenic microflora is suppressed;
- the process of cell division is activated, which contributes to tissue regeneration.
During the investigation period on the effects of laser therapy in patients with prostatitis, a side effect, but positive for treatment purposes, was noted. In those who completed the course, potency increased, erectile dysfunction was eliminated, and vitality was restored. To achieve this result, it is necessary to use a beam with a certain wavelength. In general, low level laser radiation is used to treat chronic prostatitis.
Patients can, on their own initiative, undergo a course of laser therapy, if 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 tissues of the gland. To free it of prostoliths, transurethral resection is used.
The surgery is carried out under the control of TRUS.
If complications such as sclerosis of the prostate occur, transurethral electrosurgery is performed. If, in combination with this pathology, sclerosis of the neck of the bladder is observed, a partial resection of the prostate is performed.
With the blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate violations of the patency of the secret. To do this, an incision is made in the seminal vesicles and excretory ducts. With an abscess, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis.
There are a number of exercises that are effective in stimulating the prostate, which helps eliminate congestion. This complex was developed for patients with hip joint problems. Practice has shown that these exercises are useful for those who are diagnosed with prostatitis. Classes can be held at a convenient time, the complex will take no more than 15 minutes to complete.
Exercise 1
- Lying on a gym mat, stretch both arms up.
- They bend their knees and pull them towards themselves, at the same time extending them in different directions.
- Raise your pelvis as high as you can.
- Repeat 10-12 times.
Exercise 2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise 3
- Lie on your stomach.
- Lift one leg and 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 manage to completely cure chronic prostatitis. Prostate inflammation often goes into a long-term remission stage. But when conditions arise for the activation of pathology, a relapse occurs. Exacerbation begins with the appearance of pain in the prostate. They are often accompanied by urinary disorders. At the first symptoms of relapse, you should seek help from a specialist.
Patients are advised to visit a urologist regularly, at least once every six months. Just as often, they conduct studies of the state of the prostate, conduct a PSA analysis. With systematic monitoring of the state of the gland, it is possible to timely identify the processes that provoke a relapse of the disease. But even with a long remission, there is no guarantee that it will not be violated.
The patient must follow the recommendations to prevent exacerbations of the disease. It is recommended to balance the diet, excluding fatty and spicy foods. Reception of phytopreparations and traditional medicine must be agreed with the attending physician. With this approach, you can minimize the risk of exacerbation of chronic prostatitis.
Prevention
In order to prevent the occurrence of an unpleasant disease for men, it is necessary to eliminate the provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't get cold.
- Drink at least 1. 5-2 liters of water a day.
- Strengthen immunity, walk a lot, harden.
- Participate in physical education and sports, attend fitness clubs.
- Avoid stressful situations.
- Have a regular sex life with a regular partner.