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 methods of diagnosis, various methods of treatment.
Despite all the successes of modern medicine, the diagnosis of a disease such 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 characteristic of this pathology. In urological practice, it is customary to use the classification developed by AHI (American Institute of Health). It defines the categories of prostate diseases. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses, the following symptoms are required: prolonged pain (at least 3 months) 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 family relationships. The quality of life of patients decreases to the same extent as in people who have had a heart attack or who suffer from angina pectoris.
According to various sources, every third or fourth 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-term process - chronic.
Not so long ago it was considered that this pathology is natural mainly in elderly men. But the statistics disproved this notion. 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 visiting 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. 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 a person's life.
The main causes of chronic bacterial prostatitis are as follows:
- dysrhythmia (irregularity) of sexual relations;
- hypodynamia, which is typical for overweight people;
- prolonged stressful conditions;
- predominance of food rich in fat in the diet;
- negative impact on the body in hazardous industries.
Chronic bacterial prostatitis is the result of bacterial prostatitis that has not completely healed. Or the man ignored the diseases and did not seek help from a urologist. Therefore, no treatment was given.
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 that provoke 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 to keep the body clean.
Symptoms of chronic prostatitis
Today there is a lot of fiction about chronic prostatitis. For this reason, any temporary violation of sexual function is attributed to this disease. You can often hear the opinion that the decrease in sexual desire and erectile dysfunction is due to 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.
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 myofacial 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 prostate inflammation.
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 near the prostate, radiating to the sacrum, rectum, scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical activity, standing "on your feet" for a long time), the pain intensifies.
A characteristic symptom of the disease is premature ejaculation. Patients have decreased sexual desire, erectile dysfunction. These symptoms are also characteristic of other diseases of the urogenital area. Therefore, it cannot be said that they are a hallmark 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 has disappeared, this is a case 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 tube increases and there is a deterioration in the quality of urination. Patients with chronic prostatitis note the frequent need to urinate at night. The process of urine secretion 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 number of studies are performed.
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 subjective feelings of the patient can be ascertained. Not every man is able to give an accurate assessment of his erectile function, the quality of orgasm and other details of his sexual life. Questionnaires filled out by patients provide the specialist with the necessary information 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, determination of the patient's immune 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, the determination of the pathogen or pathogens is required to find out which drugs are sensitive. For this, laboratory analyzes of urine and prostate secretion are performed.
If, after a 10-day period after DRE, the PSA test showed an excess of the prostate-specific antigen level from 4. 0 ng / ml, this is a reason to refer the patient for a biopsy to rule out an oncological process.
The following search methods are recommended:
- itching from the urethra;
- general and biochemical analysis of urine;
- LHC culture of prostatic secretion.
Instrumental research methods
TRUS (transrectal ultrasound diagnostics) 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 malignant neoplasm. In chronic prostatitis, scarring, compression of the tissue structure of the glands, changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnostics. This allows you to discover the nature of urination, signs of urine stagnation, its composition. The study includes several tests: uroflowmetry, cystometry, measurement of the residual volume of urine, evaluation of the pressure inside the bladder and the rate of urine output.
Tomography (computed 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 prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach. One dose of medication is not enough. Physiotherapy 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 in work. Urologists insist that only a series of measures will help to completely eliminate this disease or to ensure a long-term remission.
Regardless of whether the disease is bacterial or bacterial in nature, congestion in the prostate played a major role in its formation. A 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 the elimination of stagnation.
The issue is resolved by changing the lifestyle and including physical therapy exercises in the daily schedule.
Exercise complexes 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 should 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 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 sedative solutions. NSAIDs may be used.
- Immunostimulators, immunomodulators, enzymes, vitamin complexes, a combination of microelements have proven their effectiveness.
- Physiotherapy methods are possible only in the subacute phase of the disease. They improve microcirculation, increase immunity: UHF, microwaves, electrophoresis, laser, magnetotherapy.
- Massage is another effective method to influence the prostate. It opens the channels, 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.
- Consultations with a psychologist.
Treatment of chronic prostatitis
With a long-term exposure (at least a month) to the prostate, there is no 100% guarantee of recovery. Priority for herbal preparations, immunocorrection, change of household habits:
- 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, remove free radicals and prevent the growth of glandular tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Medicines for increasing immunity not only help to cope with prostatitis, they also correct the negative effect of antibiotics that disrupt the function 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" secretion of the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm baths or herbal microclysters.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates abundant urine output, prevents the symptoms of intoxication, the development of growing cystitis, pyelonephritis.
- Herbal laxatives are used for constipation.
- The urologist, the 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 continuous 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). It is practiced in exceptional cases, filled 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 he can get injuries to 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, doing squats, leg movements, jogging in place.
It is necessary to try to normalize sexual life, which is extremely important to eliminate the stagnation of secretion in the prostate.
Limitation to minimum doses or complete elimination of alcohol use is recommended.
Treatment with medications
In chronic prostatitis, outpatient treatment is mainly carried out. If the pathological process continues and it is not possible to achieve remission with this method, hospitalization is recommended. In a hospital, under the supervision of medical personnel, there are much more opportunities 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 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 using a preliminary laboratory study of prostate secretion.
There is no universal medicine for 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 therapy are fluoroquinolones. Most bacteria are sensitive to them.
Antibiotics may also be included in the treatment plan for patients with the bacterial form of prostatitis. Such therapy is carried out for preventive purposes. According to indications, treatment with penicillin preparations is related.
After the end of antibiotic therapy, treatment with hormonal drugs begins.
With intraprostatic reflux, it is necessary to take α-blockers.
Painkillers are effective in relieving pain.
Treatment with herbal medicines
Many doubt whether chronic prostatitis can be cured with herbal medicines. The answer to this question was obtained from the 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 urination function is normalized. The components that make up herbal remedies perform this task. They help reduce the frequency of urges, 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:
- normalization of 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 healing agents are considered adjunctive drug therapy.
Non-drug treatment
Drug-free therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues, help eliminate congestion.
The following methods are used for these purposes: rectal ultrasound exposure;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus. In the device, you can set the required temperature for a particular type of exposure. To increase the concentration of the drug in the prostate, heating to 38-40°C is required. To get an antibacterial effect - 40-45 ° C.
Today, non-drug treatment focuses on laser therapy. The possibilities of this technique are wide. 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 research period of the effects of laser therapy on prostate patients, a side effect, but positive for treatment purposes, was observed. 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-intensity laser radiation is used to treat chronic prostatitis.
Patients, on their own initiative, can 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 it can significantly reduce its quality. The most serious complication of this disease is the formation of stones in the tissue of the gland. To free it from prostoliths, transurethral resection is used.
The surgery is performed under TRUS control.
If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If sclerosis of the bladder neck is observed in combination with this pathology, a partial resection of the prostate is performed.
With blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate violations of the permeability 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 exercises that are effective for stimulating the prostate, which helps eliminate congestion. This complex has been developed for patients with hip joint problems. Practice has shown that these exercises are useful for those diagnosed with prostatitis. Classes can be held at a convenient time, the complex will take no more than 15 minutes to complete.
Exercise number 1
- Lying on an exercise mat, stretch both arms up.
- They bend their knees and pull them towards themselves, simultaneously spreading them in different directions.
- Raise the pelvis as much as possible.
- Repeat 10-12 times.
Exercise number 2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise number 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 to obtain a high therapeutic effect.
Treatment prognosis
Few men manage to completely cure chronic prostatitis. Prostate inflammation often goes into a phase of long-term remission. But when the conditions are created for the activation of the pathology, a relapse occurs. The deterioration begins with the appearance of pain in the prostate. They are often associated with 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 conduct studies of the state of the prostate, take an analysis for PSA. With systematic monitoring of the state of the gland, it is possible to identify in time the processes that provoke a return of the disease. But even with a long apology, there is no guarantee that it will not be violated.
The patient should follow the recommendations to prevent the worsening of the disease. It is recommended to balance the diet, excluding fatty and spicy foods from it. 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 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 be cold.
- Drink at least 1. 5-2 liters of water per day.
- Strengthen immunity, walk a lot, strengthen.
- Engage in physical education and sports, participate in fitness clubs.
- Avoid stressful situations.
- Practice regular sex life with a regular partner.