Many men suffer from chronic prostatitis, but they attribute the symptoms to other illnesses or waste time with ineffective treatments. In our article you will learn full information about this male problem: causes, exact symptoms and diagnostic methods, various methods of treatment.
Despite all the successes of modern medicine, there are certain difficulties in diagnosing a disease such as chronic prostatitis. This negatively affects the effectiveness of its treatment.
What is chronic prostatitis
In ICD-10 (International Classification of Diseases, 10th Revision), there is no disease such as "chronic prostatitis". Nor is there a single, generally accepted characteristic of this pathology. In urological practice, it is customary to use the classification developed by the AHI (American Institute of Health). It defines the categories of prostate diseases. Those that qualify as "chronic" include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To make these diagnoses, the following symptoms are necessary: prolonged pain (at least 3 months) in the perineum. Thus, chronic prostatitis can be called a long-term inflammatory process, which leads to 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 within 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 3 or 4 men is diagnosed with prostatitis. And most often this is not the initial or acute stage of the disease, but an already formed, long-term continuous process - chronic.
Not so long ago, this pathology was considered to be inherent mainly in older men. But statistics have refuted this idea. Today it is known that chronic prostatitis is a disease of men of reproductive age who are sexually active.
More than 30% of patients turn to a specialist with complaints characteristic of the chronic form of prostatitis. Often, at the time of the visit to 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. From the whole variety of negative factors affecting the health of a man, it is difficult to isolate exactly those that provoked the development of the disease. It is often a set of situations and circumstances that accompany the life of a man.
The main causes of chronic abacterial prostatitis are:
- dysrhythmia (irregularity) of sexual intercourse;
- hypodynamia, typical of 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 a decrease in immunity. As a rule, such patients are diagnosed with diseases of the endocrine system.
The factors provoking the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibiotic therapy was not carried out before the operation);
- refusal to use contraceptives;
- lack of habit of keeping 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. You can often hear the opinion that a decrease in sexual desire and erectile dysfunction is the merit of prostatitis, and if a man is elderly, then chronic prostatitis.
This is not true, because sexual dysfunction has many other causes, and the main symptom of chronic prostatitis is pain. All other signs can be considered concomitant and indirect.
Often, chronic prostatitis is confused with pelvic pain syndrome, as the symptoms of these diseases are largely similar. This is due to the formation of myosfacial trigger zones near the prostate, which appear as a result of injuries and surgical interventions. Pain in these areas can be considered a symptom of prostate inflammation.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and small pelvis, lasting at least 3 months, are highlighted. The pain is localized in the vicinity of the prostate, radiating towards the sacrum, the rectum, the scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical activity, "standing" 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 region. Therefore, it cannot be said that they are hallmarks of chronic prostate disease.
An important symptom is the disappearance of orgasm. If the patient began to notice that the sharpness of sensations during ejaculation disappeared, this is an opportunity for a more attentive attitude to his health and a signal to consult a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urinary tube increases, and the quality of urination deteriorates. Patients with chronic prostatitis note 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 expressed in whole or in part. It all depends on the patient's state of health, the presence or absence of other diseases. Chronic prostatitis is characterized by an undulating course, with an increase and decrease in 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 often asymptomatic, which complicates its detection. For diagnostic purposes, a whole series of studies are carried out.
The Association of Urologists has developed questionnaires with which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated in such a way that the subjective feelings of the patient can be determined. Not every man is able to give a correct assessment of his erectile function, quality of orgasm and other details of sex life. The questionnaires completed by the patients provide the specialist with the information necessary to establish 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. In the list of diagnostic methods used, the determination of the state of the patient's immunity.
Laboratory research methods
If you suspect chronic prostatitis, find out first about its nature: bacterial or abacterial. In the first case, it is necessary to determine the pathogen(s), in order to know which drugs they are sensitive to. For this, laboratory tests on urine and prostate secretion are carried out.
If, after a period of 10 days after DRE, the PSA test showed an excess of the level of prostate specific antigen from 4. 0 ng/ml, it is a reason to refer the patient for a biopsy in orderto exclude an oncological process.
The following search methods are recommended:
- scratching of the urethra;
- general and biochemical analysis of urine;
- LHC culture of prostatic secretion.
Instrumental research methods
TRUS (Transrectal Ultrasound Diagnosis) is performed using equipment with an instrument inserted into the patient's rectum. If an irregularly shaped hypoechoic area is found, there is every reason to suspect a malignant tumor. In chronic prostatitis, scarring, compaction of the structure of the glandular tissue, 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, signs of stagnation of urine, its composition. The study includes several tests: urinary flowmetry, cystometry, measurement of the residual volume of urine, evaluation of the pressure inside the bladder and the speed of urine flow.
Tomography (computer or magnetic resonance) is necessary to exclude benign and malignant neoplasms. These research methods are very informative and help to assess the condition of the tissues of the prostate.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach. One dose of medicine is not enough. Physiotherapeutic procedures, therapeutic exercises are necessary. In general, chronic prostatitis is difficult to treat, requires a radical revision of lifestyle habits, changes in habits, and in some cases, a change of profession. Urologists insist that only a set of measures will help to completely get rid of this disease or ensure long-term remission.
Whether the disease is bacterial or abacterial in nature, prostate congestion has played a major 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 physiotherapy exercises in the daily schedule.
Complexes of exercises have been developed that are suitable for different life situations:
- 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 exercise.
Thinking about how to deal with chronic prostatitis, you need to decide on a serious overhaul of your attitude to your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.
Course processing methods:
- Etiotropic therapy is the most effective in the treatment of prostatitis. If the basis of prostatitis is an infection, a course of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
- The pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microclysters with warm solutions of painkillers. NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, a combination of microelements have proven their effectiveness.
- Physiotherapeutic methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwaves, electrophoresis, laser, magnetic therapy.
- Massage is another effective method of influencing the prostate. It 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 long-term exposure (at least a month) to the prostate, there is no guarantee of 100% cure. Priority to herbal preparations, immunocorrection, change in lifestyle:
- Phyto preparations are widely used in urological practice. They are able to accumulate at the site of the most active pathological process, protect cells from oxidation, eliminate 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 functioning of the immune system.
- The pain syndrome is stopped by 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, hot sitz baths or herbal microclysters.
- In severe cases, intravenous fluids with diuretics are indicated. It stimulates the production of abundant urine, prevents symptoms of intoxication, the development of ascending cystitis, pyelonephritis.
- For constipation, laxatives of plant origin are used.
- 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 current treatment, blocking the outflow 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, heavy with impotence, urinary incontinence. Young people do not undergo surgery, as it can lead to infertility.
Recommendations for outpatient treatment
The patient should avoid situations in which he can injure his pelvic organs.
It is necessary to exclude any load on the prostate: do not ride a bicycle, 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, squats, leg swings, running in place.
It is necessary to try to normalize sex life, which is extremely important in order to eliminate the stagnation of the secret in the prostate.
It is recommended to limit to minimum doses or completely eliminate alcohol consumption.
Treatment with drugs
In chronic prostatitis, mainly outpatient treatment is carried out. If the pathological process persists and it is not possible to achieve remission by this method, hospitalization is recommended. In a hospital, under the supervision of medical personnel, there are many more opportunities to comply with the diet 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, such drugs 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 using a preliminary laboratory study of prostate 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 of drugs advertised for the treatment of chronic prostatitis.
The drugs recommended for antibacterial treatment are fluoroquinolones. Most bacteria are sensitive to it.
Antibiotics may also be included in the treatment plan for patients with an abacterial form of prostatitis. Such therapy is carried out for preventive purposes. According to indications, treatment with penicillin preparations is bound.
After antibiotic therapy is completed, treatment with hormonal drugs begins.
In case of intraprostatic reflux, it is necessary to take a-blockers.
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 has been obtained by many years of use of these health enhancing agents in urological practice.
Today, the following medical complexes are recommended:
All of 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 cravings, eliminate the syndrome of a slow jet.
Patients with chronic prostatitis are recommended phytocollections, which include pumpkin extract or pumpkin seeds. These 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 the main method of treatment. These healing agents are considered concomitant drug therapy.
Non-drug treatment
Non-drug methods of therapy allow you to act directly on the prostate, increase the concentration of drugs in its tissues, help eliminate congestion.
For these purposes, the following methods are used: rectal exposure to ultrasound;
Microwave hyperthermia is performed using a rectal probe 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 38-40°C. To achieve an antibacterial effect - 40-45 ° C.
Today, non-drug treatments focus on laser therapy. The possibilities of this technique are wide. Under the influence of a laser, the following processes occur in the prostate:
- activation of redox reactions;
- improves blood microcirculation;
- new capillaries form;
- pathogenic microflora is suppressed;
- the process of cell division is activated, which contributes to the regeneration of tissues.
During the period of research on the effects of laser therapy on patients with prostatitis, a side effect, but positive for the purposes of treatment, was found. 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 of a certain wavelength. In general, low intensity laser radiation is used to treat chronic prostatitis.
Patients can, on their own initiative, undergo laser treatment, 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 tissues of the gland. In order to free it from the prostoliths, a transurethral resection is used.
The surgery is performed under the supervision of TRUS.
If complications such as prostate sclerosis 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. For this purpose, 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 effective exercises to stimulate the prostate, which helps clear congestion. This complex was developed for patients with problems with hip joints. 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 upwards.
- They bend their knees and pull them towards them, simultaneously pushing them apart in different directions.
- Raise the pelvis as far as they can.
- Repeat 10 to 12 times.
Exercise #2
- Standing on the mat, do deep squats.
- Repeat 10 to 12 times.
Exercise #3
- Lie on your stomach.
- Raise one leg, then the other.
- Repeat 10 to 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 phase. But when the conditions arise for the activation of the pathology, a relapse occurs. Exacerbation begins with the appearance of pain in the prostate. Often they are accompanied by urinary disorders. At the first symptoms of relapse, you should seek help from a specialist.
Patients are recommended to visit a urologist regularly, at least once every six months. With the same frequency, they carry out studies on the state of the prostate, carry out an analysis of PSA. 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 she will not be violated.
The patient should 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 should be agreed with the attending physician. With this approach, you can minimize the risk of exacerbation of chronic prostatitis.
Prevention
To prevent the appearance of an unpleasant disease for men, it is necessary to eliminate the provoking factors and follow simple rules:
- Lead a healthy life, give up bad habits.
- Don't be cold.
- Drink at least 1. 5-2 liters of water a day.
- Strengthen immunity, walk a lot, harden.
- Engage in physical education and sports, attend fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.