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 diagnostic methods, various treatment methods.
Despite all the successes of modern medicine, diagnosing a disease such as chronic prostatitis causes some difficulties.This also 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 establish these diagnoses, the following symptoms are required: long-term pain (at least 3 months) in the perineal area.Thus, chronic prostatitis can be called a long-term inflammatory process, the consequence of which are 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 suffer from angina pectoris.
According to data from 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-term process - chronic.
Not so long ago, it was generally accepted that this pathology is characteristic mainly of elderly men.But statistical data refuted this opinion.Today it is known that chronic prostatitis is a disease of men of reproductive age who are sexually active.
More than 30% of patients consult a specialist with complaints characteristic of chronic 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.From the variety of negative factors that affect a man's health, it is difficult to single out 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;
- physical inactivity, which is typical for overweight people;
- long-term stressful conditions;
- predominance of foods rich in fat in the diet;
- negative impact on the body in hazardous industries.
Chronic bacterial prostatitis is the result of bacterial prostatitis not completely cured.Or the man ignored the diseases and did not seek help from a urologist.Therefore, no treatment was performed.
Chronic abacterial prostatitis develops due to exposure to infectious agents against the background of decreased 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 antibacterial therapy was not carried out before the operation);
- refusal to use contraception;
- lack of habit to keep your body clean.
Symptoms of chronic prostatitis
Today there are many myths about chronic prostatitis.For this reason, any temporary disturbance in sexual function is attributed to this disease.You can often hear the opinion that decreased sexual desire and erectile dysfunction are due to prostatitis, and if an elderly man, then from 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 mistaken for a symptom of prostate inflammation.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and pelvis, lasting at least 3 months, stand out.The pain is localized near the prostate, radiating to the sacrum, rectum and scrotum.With prolonged exposure to negative factors (carrying heavy objects, excessive physical activity, standing for a long time), the pain intensifies.
A characteristic sign of the disease is premature ejaculation.Patients experience decreased sexual desire and erectile dysfunction.These symptoms are also characteristic of other genitourinary diseases.Therefore, it cannot be said that they are distinctive signs of chronic prostate disease.
An important symptom is the fading of orgasm.If the patient begins to notice that the severity of sensations during ejaculation has disappeared, this is a reason for a more attentive attitude to his health and a signal for the need to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure in the urinary tube increases and the quality of urination worsens.Patients with chronic prostatitis notice a frequent urge to urinate at night.The process of urine secretion is accompanied by a burning sensation, stinging and pain.Urinary incontinence often occurs.
Signs of chronic prostatitis can be fully or partially expressed.Much depends on the patient's state of health and the presence or absence of other diseases.Chronic prostatitis is characterized by a wave-like course, with symptoms of waxing and fading.With this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of pronounced symptoms, it is not difficult to diagnose chronic prostatitis.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 that can help identify asymptomatic chronic prostatitis.The questions are formulated in such a way that the patient's subjective feelings can be clarified.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 completed by the patient 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.The list of diagnostic methods used includes clarifying the patient's immunity status.
Laboratory research methods
If chronic prostatitis is suspected, first of all they find out what is its nature: bacterial or bacterial.In the first case, it is necessary to identify the pathogen or pathogens and find out to which the drugs are sensitive.To do this, laboratory tests of urine and prostate secretions are performed.
If after a 10-day period after DRE, the PSA test shows that the level of prostate-specific antigen exceeds 4.0 ng/ml, this is a reason to refer the patient for a biopsy to exclude 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) is performed using equipment equipped with an instrument that is inserted into the patient's rectum.If an irregularly shaped hypoechoic area is detected, there is every reason to suspect a malignant neoplasm.With chronic prostatitis, scarring, compression of the glandular tissue structure, and 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 and 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 (computerized imaging 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.Just taking medicine is not enough.Physiotherapy procedures and therapeutic exercises are necessary.In general, chronic prostatitis is difficult to treat and requires a radical revision of lifestyle, changes in habits and in some cases, a change of job.Urologists insist that only a series of measures will help to completely eliminate this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or bacterial in nature, congestion in the prostate has played a major role in its formation.The 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 can be resolved by changing lifestyle and including physical therapy classes 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 people with excess body weight;
- for those who do not have time to exercise.
Thinking about how to treat chronic prostatitis, you should decide to seriously review your attitude to your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special diet, without salt and sexual rest.
Course treatment methods:
- The most effective treatment for 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, microclyses with warm sedative solutions.NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
- Physiotherapy methods are possible only in the subacute phase of the disease.They improve microcirculation and increase immunity: UHF, microwaves, electrophoresis, laser, magnetic therapy.
- Massage is another effective method to influence the prostate.It opens the channels, normalizes blood circulation in the scrotum and pelvis.
- Acute retention of renal filtrate can be corrected with trocar catheterization and cystostomy.
- The purulent process involves surgical intervention.
- Consultations with a psychologist.
Treatment of chronic prostatitis
With a long-term effect (at least one month) on the prostate, there is no 100% guarantee of recovery.Priority goes to herbal medicines, correction of immunity, 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 proliferation of glandular tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Medicines that increase immunity not only help to cope with prostatitis, they also correct the negative effects of antibiotics that disrupt the function of the immune system.
- The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secretions of the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or herbal microclymas.
- In severe cases, intravenous fluids with diuretics are indicated.This stimulates the abundant production of urine, prevents the symptoms of intoxication, the development of growing cystitis and pyelonephritis.
- For constipation, herbal laxatives are used.
- The urologist and psychologist together with the patient develop an individual long-term program of daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- If the chronic process is resistant to therapy and urine output is blocked, surgical intervention is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissue (prostatectomy).Practiced in exceptional cases, it is fraught with impotence and urinary incontinence.Young people do not undergo the operation because it can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations in which he may suffer injuries to the pelvic organs.
It is necessary to avoid any stress on the prostate: do not ride a bicycle, do not do strength exercises, do not carry weights.
If the work is sedentary, every 2-3 hours you should warm up by doing squats, leg swings and jogging in place.
You should try to normalize your sex life, which is extremely important to eliminate the stagnation of secretions in the prostate.
It is recommended to limit alcohol consumption to minimum doses or to completely eliminate alcohol consumption.
Treatment with medications
For 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 many more opportunities for compliance with the regimen and monitoring of 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 help to normalize 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 secretions.
There is no universal drug to suppress and destroy pathogenic microflora.What helps one patient may not help 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 abacterial prostatitis.This therapy is carried out for preventive purposes.According to indications, treatment with penicillin drugs is included.
After the end of antibacterial therapy, treatment with hormonal drugs begins.
For intraprostatic reflux, taking α-blockers is necessary.
For pain, pain relievers are effective.
Treatment with herbal medicines
Many people doubt whether chronic prostatitis can be cured with the help of herbal medicines.The answer to this question was obtained from the many years of use of these healing agents in urological practice.
Today, the following treatment complexes are recommended:
All these drugs have a beneficial effect on the functioning of the male genitourinary system.Effective treatment of chronic prostatitis is possible provided that the urinary function is normalized.The components included in herbal medicines perform this task.They help reduce the frequency of urges and eliminate slow current syndrome.
For patients with chronic prostatitis, herbal mixtures containing pumpkin extract or pumpkin seeds are recommended.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 health-enhancing agents are considered adjunctive to 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 and help eliminate congestion.
The following techniques are used for these purposes: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus.The device can be used to set the required temperature for a specific type of exposure.To increase the concentration of the drug in the prostate, heating of 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;
- blood microcirculation improves;
- new capillaries are formed;
- pathogenic microflora is suppressed;
- The process of cell division is activated, which promotes 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.Those who completed the course increased potency, eliminated erectile dysfunction and restored vitality.To achieve this result, it is necessary to use a beam with a specific 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 it has not been 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 prostatitis, transurethral resection is used.
The surgical intervention is performed under the control of TRUS.
If complications such as prostate sclerosis occur, transurethral electrosurgery is performed.If sclerosis of the bladder neck is observed in combination with this pathology, partial resection of the prostate is performed.
When the seminal and excretory ducts are blocked, endoscopic operations are indicated to eliminate the obstruction of secretion permeability.For this purpose, an incision is made in the seminal vesicles and excretory ducts.In case of 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 in stimulating the prostate, which helps relieve congestion.This complex was created for patients with hip joint problems.Practice has shown that these exercises are also 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 no. 1
- Lying on an exercise mat, stretch both arms up.
- Bend your knees and pull them towards you, simultaneously spreading them in different directions.
- Lift the pelvis as high as they can.
- Repeat 10-12 times.
Exercise no. 2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise no. 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 can 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.An aggravation 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 perform examinations of the state of the prostate and do a PSA test.By systematically monitoring the state of the gland, the processes that provoke a relapse of the disease can be identified in time.But even with long-term remission there is no guarantee that it will not be interrupted.
The patient should follow the recommendations to prevent the worsening of the disease.It is recommended to balance your diet by excluding fatty and spicy foods.The use of herbal medicines and traditional medicine must be agreed with the attending physician.With this approach, the risk of exacerbation of chronic prostatitis can be minimized.
Preventing
To prevent the occurrence of a disease that is unpleasant for men, you need to eliminate the provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't get too cold.
- Drink at least 1.5-2 liters of water a day.
- Strengthen your immune system, walk a lot, get stronger.
- Engage in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice regular sex life with a regular partner.