Prostatitis is a disease that causes problems with urination, sexual dysfunction, pain in the perineum and lower abdomen. The cause of these symptoms is inflammation of the prostate gland.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located under a man's bladder and in front of the rectum. The prostate consists of glands and connective tissue. Its function is to produce fluid, which is partly made up of ejaculate. This fluid carries the sperm during ejaculation (ejaculation) and protects the sperm as they travel to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not go away for months or even years. The acute form of the disease appears suddenly and lasts a maximum of several weeks. It is usually easy to treat, but sometimes it becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure permanently. But with proper treatment, there is every chance to achieve long-term remission and significantly improve the patient's quality of life. We figured out how to understand that you have chronic prostatitis and what to do next.
What is chronic prostatitis?
In total, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Of these, chronic non-bacterial prostatitis is the most common. And he is the worst to deal with.
A disease is considered chronic if the symptoms do not go away for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its repeated course. This means that symptoms may disappear for a while and then reappear. Without treatment, this condition can trouble the patient for a very long time.
Bacterial and non-bacterial forms have common symptoms. They usually include problems with urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. Moreover, the chronic form is much more common than the acute form. The reason for about 25% of visits to the urologist is related to chronic prostatitis.
The pathology can appear at any age, but the chronic form most often develops in men after the age of 50.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of diseases have common symptoms, but different causes.
Chronic bacterial prostatitis
The inflammatory process causes a bacterial infection from the urinary tract to enter the prostate. The provoking factor can be: acute form of prostatitis, UTI (urinary tract infection), STI. The causative agents of the inflammatory process in the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic non-bacterial prostatitis (chronic pelvic pain syndrome)
Researchers have not determined the causes of chronic pelvic pain syndrome. With this form, there is no infection in the prostate gland. What causes concern in this case is not exactly known. There is an assumption that this may be due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- the patient already had prostatitis and chronic pain remained despite treatment;
- urine enters the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- stress
Symptoms of chronic prostatitis
With chronic prostatitis, the symptoms bother the patient for a long time - for several months or even years. The disease is characterized by a repetitive course, that is, problems appear and disappear.
Infectious and non-infectious prostatitis have common symptoms and include:
- urination disorders: frequent and sudden urges, difficulty urinating, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during sexual intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (lust);
- fever, chills;
- nausea, vomiting
The disease also affects the general condition of the patient. Some people experience irritability, increased fatigue, lethargy and anxiety.
If you have these signs, consult a urologist. Some of them may indicate other more serious illnesses that require urgent medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you should make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and the urinary system in both men and women.
The initial consultation includes several stages:
- Taking history.
The urologist will ask you about the reason for your visit, previous illnesses and medications you have taken now and in the past. - Examination of genital organs
- Digital rectal examination.
During the procedure, the urologist inserts a finger into the patient's anus to feel the surface of the prostate gland. The test allows you to determine the size of the prostate and check for swelling and tenderness. - Other studies.
The doctor can prescribe one or more diagnostic procedures, some of which can be done immediately at the appointment, some later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General analysis of urine
Allows you to see signs of infection. This can be shown by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate specific antigen)
It helps to assess the state of the prostate gland. An elevated PSA level indicates an inflammatory process in the prostate or neoplasia. - Microscopy of prostate secretion
Prostatic secretion is a fluid produced by the prostate gland. With the changes in the organ, the composition of the secretion also changes. For example, during an inflammatory process, white blood cells will increase, and a high level of pathogenic bacteria may indicate a bacterial infection in the prostate. Microscopic examination of the fluid will help to see these changes. - Prostate secretions are collected using prostate massage. Massage can be combined with a digital rectal examination.
Instrumental research methods
- Cystoscopy. Examination of the inner surface of the bladder using an endoscope - a thin flexible tube with a camera. The device is inserted into the bladder through the urethra. The study allows you to see problems with the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). For the examination, the specialist will carefully insert an ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
- MRI (magnetic resonance imaging) of the pelvis. It helps to assess the condition of the prostate tissue. It may be necessary to look for foci of inflammation of the prostate and rule out prostate cancer.
There is no special preparation for an appointment with a urologist. But to make the consultation as effective as possible, follow some simple recommendations:
- For intimate hygiene, you should not use special products before use, only warm water is enough.
- Do not go to the toilet 2 hours before visiting the clinic. Then, at your appointment, if necessary, you can immediately do tests or undergo an ultrasound.
- If you take any medications regularly, write their names in your diary or notes on your phone.
- Take the results of previous studies with you so that the specialist can see the full picture of the disease.
- Make a list of questions you want to ask the doctor at your appointment.
Treatment of chronic prostatitis
There is no universal method to get rid of prostatitis. For different forms and manifestations of the disease, different treatments are indicated.
To determine the type of chronic prostatitis, you must undergo diagnostics. Based on his results, the doctor will prescribe therapy that will give results especially in your case.
Unlike the acute form, chronic inflammation of the prostate cannot be cured forever. The doctor's goal is to achieve long-term remission and reduce symptoms.
Bacterial form: Treatment will include antibiotic therapy and other methods to relieve symptoms.
Non-bacterial form: Treatment is symptomatic. That is, each method aims to combat a specific symptom.
Recommendations for outpatient treatment
Lifestyle changes:
- Diet restrictions
It is worth giving up alcohol, coffee, spicy and sour foods. These products irritate the bladder and worsen the patient's condition. - Hot baths, hot showers
Water procedures will help reduce the manifestations of the disease. - More water
Drink plenty of fluids. More frequent trips to the toilet will help flush out pathogenic bacteria from the bladder. - Chair cushions
When you are sitting, place a soft pillow under you. - Physical activity
Regular walks and exercise will help reduce pain and relieve congestion. - Regular sex life
Sexual activity is helpful in preventing congestion.
The listed methods will complement the therapy prescribed for you, but do not replace it.
Drug treatment
- Antibiotics. Antibacterial therapy is indicated for the infectious form. The drugs destroy the bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, you should undergo a study of prostate secretions and determine their type. When the chronic form is treated, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary disorders. Medicines relax the organs of the urinary system and this relieves the symptoms. Most often, alpha blockers are used for chronic non-infectious prostatitis, but to improve the patient's well-being, they can also be prescribed for an infectious form of the inflammatory process.
- NSAIDs (non-steroidal anti-inflammatory drugs). It is prescribed to relieve pain and reduce swelling of the prostate gland.
- Muscle relaxants. It is used when you need to relieve pelvic muscle spasm.
- Antidepressants. It is indicated for depression, which can develop due to stress and prolonged pain.
- Drugs for the treatment of erectile dysfunction. It is used if prostatitis causes problems in your sex life.
- laxative. They may prescribe it if symptoms include pain during bowel movements.
Treatment with herbal medicines
Herbal remedies.Herbal medicines do not work as the main method of treatment. They can be used as a supplement to reduce prostate inflammation. For this purpose, treatments are prescribed with quercetin, a substance found in vegetables, fruits and berries.
Non-drug treatment
- Physiotherapy and prostate massage. The methods are used to relax the pelvic muscles, relieve pain and prevent blockage. For a therapeutic effect, the patient undergoes a massage course with several sessions. Massage is contraindicated in the development of complications of the pathology: abscess, stones in the tissues of the prostate gland.
- Catheterization of the bladder. It may be necessary if you have problems with your bladder.
- Psychotherapy. Due to chronic pain, prostate patients may develop depression and anxiety disorders. Psychological problems have a negative impact on the patient's well-being and worsen the pain syndrome. In such cases, consulting a psychotherapist will help.
- Biofeedback programs. It can help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be needed if complications develop.
Types of operations:
- TUR (transurethral resection) of the prostate.It is indicated for the occurrence of stones in the tissues of the prostate gland
- Prostatectomy. Removal of the prostate gland in some cases is performed in case of abscess (accumulation of pus) or serious disorders in the functioning of the bladder.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic muscles and relieve symptoms related to urinary disorders. How to do the exercises:
- Sit comfortably.
- Tighten the pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urination.
- Relax your muscles.
- Repeat this 10-15 times.
- You can gradually increase the number of repetitions and strain the muscles for a longer time.
- You should do 2-3 approaches per day.
Changes can be noticed only with regular exercise.
Treatment prognosis
It is very difficult to permanently cure chronic prostatitis. In some cases, the disease is incurable, but there is always the possibility of achieving long-term remission and returning the patient to the previous quality of life. To do this, it is important to undergo a complete diagnosis to determine the form of the disease. If the cause of the inflammatory process is infection, antibacterial therapy will help. And for chronic non-infectious prostatitis - well-chosen symptomatic therapy.
Complications of chronic prostatitis can include:
- Bacteremia (bacterial blood poisoning). Bacteria entering the bloodstream. It can be a consequence of bacterial forms of pathology. Bacteremia develops suddenly and can lead to sepsis. This condition is life threatening.
- Epididymitis (inflammation of the epididymis). The disease can cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in the tissue). In case of abscess, surgery is performed to clean and drain the purulent focus; in rare cases, the prostate may be removed.
- Infertility. Problems with conception can appear when there is a lack of sperm due to an inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bone
- Depressive disorder. Chronic pathologies increase the risk of depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and his emotional state.
To prevent prostatitis it is important:
- Use barrier contraception (condoms): STIs are a factor that increases the risk of developing prostatitis
- See a urologist every year if you are over 40
- If you have symptoms of a UTI, contact your doctor immediately