Many men suffer from chronic prostatitis, but 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 methods of diagnosis, various methods of treatment.
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 his 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 feature of this pathology. In urological practice, it is customary to use the classification developed by AHI (American Institute of Health). Defines the categories of prostate diseases. What can be described as "years" include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses the following symptoms are required: prolonged (at least 3 months) pain in the perineum. Thus, chronic prostatitis can be called a long-term inflammatory process, which results in 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. Patients' quality of life is reduced to the same extent as for people who have had a heart attack or suffer from angina pectoris.
According to various sources, every 3rd or 4th man is diagnosed with prostatitis. And most often this is not the initial or acute stage of the disease, but an already formed and long-standing process - years.
Not so long ago it was believed that this pathology is inherent mainly in elderly men. But the statistics disproved that 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 accompanying pathologies: erectile dysfunction, cystitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very different. From all the variety of negative factors that affect a man's health, it is difficult to isolate exactly those that caused the development of the disease. Often this is a complex of situations and circumstances that accompany a man's life.
The main causes of chronic bacterial prostatitis are the following:
- dysrhythmia (irregularity) of sexual intercourse.
- weakness, which is characteristic of overweight people.
- prolonged stressful conditions;
- the prevalence of high-fat foods in the diet;
- negative effects on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely treated bacterial prostatitis. Or the man ignored the ailments and did not seek help from a urologist. Therefore, no treatment was given.
Chronic bacterial prostatitis develops due to exposure to infectious agents in the context of a decrease in immunity. As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors that cause the development of chronic bacterial prostatitis are:
- prostate surgery (if antibiotic treatment was not carried out before the operation);
- refusal to use contraceptives.
- lack of habit of keeping one's body clean.
Symptoms of chronic prostatitis
Today there are many fictions about chronic prostatitis. For this reason, any temporary violations of sexual function are attributed to this disease. You can often hear the opinion that a decrease in sexual desire and erectile dysfunction is the advantage of prostatitis, and if a man is old, then chronic prostatitis.
This is not true, as sexual dysfunction has many other causes and the main symptom of chronic prostatitis is pain. All other signs can be considered accompanying 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 myofacial trigger zones near the prostate, which appear as a result of injuries and surgeries. Pain in these areas can be taken as 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, come to the fore. The pain is located in the prostate area, radiating to the sacrum, rectum, scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical activity, prolonged exposure to 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, they cannot be said to be the hallmarks of chronic prostate disease.
An important symptom is the fading of orgasm. If the patient began to notice that the sharpness of sensations during ejaculation had disappeared, this is an opportunity for a more attentive attitude to his health and a signal to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure in the urinary tract increases, and the quality of urination deteriorates. Patients with chronic prostatitis note a frequent urge to urinate at night. The process of excreting urine is accompanied by a burning sensation, pain, pain. Urinary incontinence is often present.
Signs of chronic prostatitis can be fully or partially expressed. Much depends on the patient's state of health, the presence or absence of other diseases. Chronic prostatitis is characterized by an undulating course, with increasing and decreasing 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 is carried out.
The Association of Urologists has developed questionnaires, thanks to which it is possible to detect asymptomatic chronic prostatitis. The questions are phrased in such a way that the patient's subjective feelings can be ascertained. Not every man is able to correctly assess his erectile function, orgasm quality and other details of sex life. The questionnaires filled out by the patients provide the specialist with the necessary information for the 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 of all find out what its nature is: bacterial or bacterial. In the first case, it is necessary to identify the pathogen or pathogens, to find out which drugs they are sensitive to. For this, laboratory tests of urine and prostate secretion are carried out.
If, after a period of 10 days after the DRE, the PSA test showed an excess of the prostate-specific antigen level of 4. 0 ng / ml, this is a reason to refer the patient for a biopsy in order to rule out an oncological process.
The following research methods are recommended:
- scraping from the urethra;
- general and biochemical analysis of urine.
- Prostate secretion LHC culture.
Instrumental research methods
TRUS (rectal ultrasound) is performed using equipment equipped with an instrument that is 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, compression of the structure of the glandular tissue, changes in the seminal vesicles may be observed.
UDI is the primary method of functional diagnosis. It allows you to find out the nature of urination, signs of urine stagnation, its composition. The study includes various tests: urometry, cystometry, measurement of the residual volume of urine, evaluation of the pressure inside the bladder and the velocity of urine outflow.
Tomography (computed or magnetic resonance) is necessary to rule out benign and malignant neoplasms. These research methods are extremely informative and help to assess the condition of the prostate tissues.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires a comprehensive approach. One dose of medicine is not enough. Physiotherapy procedures and therapeutic exercises are necessary. In general, chronic prostatitis is difficult to treat, requiring a radical revision 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 get rid of this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or bacterial in nature, congestion in the prostate gland played an important role in its formation. A viscous secret deposited in the ducts of the gland is a favorable environment for the growth of pathogenic and opportunistic microorganisms. Therefore, the main attention should be given to eliminating stagnation.
The issue is resolved by changing lifestyle and incorporating physical therapy exercises into the daily program.
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 deal with chronic prostatitis, you need to decide on a serious revision of your attitude to your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.
Course Therapy Methods:
- The most effective in the treatment of prostatitis is etiotropic therapy. If the basis of prostatitis is an infection, a series of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
- The pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers. NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, combination of trace elements have proven their effectiveness.
- Physiotherapy methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave oven, electrophoresis, laser, magnetotherapy.
- Massage is another effective method of influencing the prostate. It opens the pores, normalizes the blood circulation of the scrotum, the small pelvis.
- Acute renal infiltrate retention can be corrected by catheterization, trocar cystostomy.
- The purulent process involves surgery.
- Psychologist consultations.
Treatment of chronic prostatitis
With a long course (at least one month) exposure to the prostate, there is no 100% guarantee of cure. Priority for herbal preparations, immunocorrection, change of household habits:
- Herbal 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, remove free radicals and prevent the growth of gland tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Medicines that strengthen immunity not only help to deal with prostatitis, but also correct the negative effect of antibiotics that disrupt the functioning of the immune system.
- The pain syndrome is interrupted by the appointment of alpha-blockers, muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secret of the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or herbal microenemas.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates the abundant production of urine, prevents the symptoms of intoxication, the development of ascending cystitis, pyelonephritis.
- Laxatives of herbal origin are used for constipation.
- The urologist, psychologist, together with the patient, develops an individual long-term program of daily routine, necessary rest, diet, physical activity in dose and sexual activity.
- In case of resistance of the chronic process to continued treatment, obstruction of the outflow of urine, surgery is prescribed: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). It is practiced in exceptional cases, full of impotence, urinary incontinence. Young people do not undergo surgery, as this can cause infertility.
Recommendations for outpatient treatment
The patient must avoid situations in which he may injure the 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, every 2-3 hours it is necessary to warm up, do squats, leg swings, running in place.
It is necessary to try to normalize the sexual life, which is extremely important to eliminate the stagnation of the secret in the prostate.
Limitation to minimum doses or complete elimination of alcohol use is recommended.
Drug treatment
In chronic prostatitis, outpatient treatment is mainly done. If the pathological process persists and it is not possible to achieve remission with this method, hospitalization is recommended. In a hospital, under the supervision of medical staff, there are much more opportunities to comply with the regimen and monitor changes in the patient's condition.
Chronic prostatitis in men develops in the context of endocrine disorders. In this regard, 5-alpha reductase inhibitors and alpha-1-inhibitors 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.
A comprehensive approach includes taking medications such as:
Methods of treatment of bacterial chronic 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 medicine to suppress and destroy the pathogenic microflora. What works for one patient may not work for another. For this reason, there are many negative reviews about advertised drugs 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. Such treatment is carried out for preventive purposes. According to indications, treatment with penicillin preparations is associated.
After the antibiotic treatment is completed, the treatment with hormonal drugs is started.
With endoprostatic reflux, it is necessary to take α-blockers.
Painkillers are effective in relieving pain.
Herbal treatment
Many doubt whether chronic prostatitis can be cured with herbal medicines. The answer to this question was obtained with many years of use of these health-improving factors in urological practice.
Today, the following medical complexes are recommended:
All these drugs have a beneficial effect on the work of the male urogenital system. Effective treatment of chronic prostatitis is possible if the function of urination is normalized. The ingredients that make up herbal medicines perform this task. They help reduce the frequency of impulses, eliminate the syndrome of a sluggish jet.
For patients with chronic prostatitis, herbal preparations are recommended, which include pumpkin extract or pumpkin seeds. The latter have a unique chemical composition and act in three directions simultaneously:
- normalization of metabolism;
- strengthening the walls of blood vessels.
- activates blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment. These therapeutic agents are considered concurrent drug therapy.
Non-pharmacological treatment
Drug-free treatment methods 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 ultrasound exposure.
Microwave hyperthermia is performed using a rectal catheter inserted into the patient's anus. On the device, you can set the temperature required for a certain type of exposure. To increase the concentration of the drug in the prostate, heating to 38-40°C is required. To obtain an antibacterial effect - 40-45 ° C.
Today, non-drug treatment focuses on laser therapy. The possibilities of this technique are great. 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.
- the pathogenic microflora is suppressed.
- the process of cell division is activated, which contributes to tissue regeneration.
During the research period on the effects of laser treatment in patients with prostatitis, a side effect was observed, but positive for the purposes of the treatment. In those who completed the course, potency increased, erectile dysfunction was eliminated, and vitality was restored. To achieve this effect, 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, on their own initiative, undergo laser treatment, if not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis is not a threat to the patient's life, but it 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 from the stones, a transurethral resection is used.
Surgery is performed under TRUS guidance.
If complications such as prostate induration occur, transurethral electrosurgery is performed. If, in combination with this pathology, a hardening of the bladder neck is observed, a partial resection of the prostate is performed.
With obstruction 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, it is possible to completely remove the gland.
Exercises for the treatment of chronic prostatitis
There are a number of exercises that are effective for 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 diagnosed with prostatitis. Lessons can be done at a convenient time, the complex will not take more than 15 minutes to complete.
Exercise 1
- Lie on an exercise mat, stretch both arms up.
- They bend their knees and pull them towards them, simultaneously spreading them in different directions.
- Lift the pelvis as far as they can go.
- 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, 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 the pathology, a relapse occurs. The flare-up 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. With the same frequency, they conduct studies on the state of the prostate, do an analysis for PSA. By systematically monitoring the condition of the gland, it is possible to identify the processes that cause the recurrence of the disease in time. But even with a long recession, there's no guarantee it won't be breached.
The patient must follow the recommendations to prevent exacerbations of the disease. It is recommended to balance the diet, excluding fatty and spicy foods from it. The reception of herbal preparations 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 causative factors and follow simple rules:
- Follow a healthy lifestyle, give up bad habits.
- Don't catch a cold.
- Drink at least 1. 5-2 liters of water a day.
- Boost immunity, walk a lot, toughen up.
- Engage in physical education and sports, attend gyms.
- Avoid stressful situations.
- Have a regular sex life with a regular partner.