Many men suffer from chronic prostatitis but attribute the symptoms to other conditions or waste time with ineffective treatments. In 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, the diagnosis of a disease such as chronic prostatitis causes certain difficulties. This negatively affects the effectiveness of your treatment.
What is chronic prostatitis
In the ICD-10 (International Classification of Diseases, 10th revision), the disease "chronic prostatitis" does not exist. There is also no single and generally accepted feature of this pathology. In urological practice, the classification developed by the AHI (American Institute of Health) is commonly used. It defines the categories of prostate diseases. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To make these diagnoses, the following symptoms are needed: Prolonged pain (at least 3 months) in the perineum. Thus, chronic prostatitis can be called a long-lasting inflammatory process, which results in changes in the structure of the prostate 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 in people who have had a heart attack or who suffer from angina pectoris.
According to various sources, every 3rd or 4th man is diagnosed with prostatitis. And most of the time this is not the initial or acute stage of the disease, but an already formed and long-term continuous process - chronic.
Not so long ago, it was considered that this pathology is inherent mainly in older men. But statistics refuted that notion. Today it is known that chronic prostatitis is a disease of men of childbearing 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. 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 man's life.
The main causes of chronic abacterial prostatitis are as follows:
- 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 cured bacterial prostatitis. 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, these 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 performed before the operation);
- refusal to use contraceptives;
- lack of habit of keeping the 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 merit of prostatitis, and if a man is elderly, 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 concomitant and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome, as the symptoms of these diseases are quite similar. This is due to the formation of myofacial trigger zones close to 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 emerge, with a minimum duration of 3 months. The pain is located in the vicinity of the prostate, radiating to the sacrum, rectum, scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical activity, being "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 area. Therefore, it cannot be said that they are the hallmarks of chronic prostate disease.
An important symptom is the fading of the orgasm. If the patient began to notice that the acuity of sensations during ejaculation had disappeared, this is an occasion for a more attentive attitude to his health and a signal to visit a urologist.
The structure of the inflamed prostate becomes denser, pressure in the urinary tube increases, and the quality of urination deteriorates. Patients with chronic prostatitis notice a frequent urge to urinate at night. The process of urine excretion is accompanied by a burning sensation, pain, pain. There is often urinary incontinence.
Signs of chronic prostatitis can be expressed fully or partially. Much depends on the patient's health status, the presence or absence of other diseases. Chronic prostatitis is characterized by a wavy 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 range of studies are carried out.
The Association of Urologists has developed questionnaires, thanks to which it is possible to identify asymptomatic chronic prostatitis. The questions are phrased in such a way that the patient's subjective feelings can be verified. Not every man is able to correctly assess his erectile function, the quality of orgasm and other details of his sex life. Questionnaires completed by patients provide the specialist with the information necessary 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 state of the patient's immunity.
Laboratory research methods
If you suspect chronic prostatitis, first find out what its nature is: bacterial or abacterial. In the first case, it is necessary to determine the pathogen or pathogens, to find out which drugs they are sensitive to. For this, laboratory tests of urine and prostatic secretion are performed.
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 reason to refer the patient for a biopsy to exclude an oncological process.
The following search methods are recommended:
- urethral scraping;
- general and biochemical analysis of urine;
- LHC culture of prostatic secretion.
Instrumental research methods
TRUS (transrectal ultrasound diagnosis) is performed with 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, compaction of the glandular tissue structure, changes in the seminal vesicles can be observed.
IDU 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: uroflowmetry, cystometry, measurement of residual urine volume, assessment of pressure inside the bladder and urine output velocity.
Tomography (computer or MRI) is required to exclude benign and malignant neoplasms. These research methods are highly informative and help to assess the condition of prostate tissues.
Chronic prostatitis treatment
The treatment of chronic prostatitis requires an integrated approach. One dose of medication is not enough. Physiotherapeutic procedures, therapeutic exercises are necessary. In general, chronic prostatitis is difficult to treat, requiring a radical overhaul of lifestyle, changes in habits and, in some cases, changing jobs. Urologists insist that only a set of measures will help to completely get rid of this disease or guarantee a long-term remission.
Regardless of whether the disease is bacterial or abacterial in nature, congestion in the prostate played an important role in its formation. A viscous secret deposited in the gland ducts is a favorable environment for the development of pathogenic and opportunistic microorganisms. Therefore, the main attention should be directed towards 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 obliged to be seated 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 need to decide on a serious review of your attitude towards 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 alleviates the manifestations of inflammation.
- Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microclysters with warm solutions of analgesics. 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 phase of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Massage is another effective method of influencing the prostate. Opens the ducts, normalizes the blood circulation of the scrotum, small pelvis.
- Acute retention of renal filtrate can be corrected by catheterization, cystostomy with trocar.
- The purulent process involves surgical intervention.
- Psychologist consultations.
Chronic prostatitis treatment
With a long-term course (at least one month) of exposure to the prostate, there is no 100% guarantee of cure. Priority for herbal preparations, immunocorrection, change in household habits:
- Phytogenic 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.
- Immunity-enhancing drugs not only help to deal with prostatitis, but also correct the negative effect of antibiotics that disrupt immune system function.
- 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. This stimulates the production of abundant urine, prevents the 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 ongoing therapy, 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, fraught 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 may have 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, then every 2-3 hours it is necessary to do warm-ups, squats, leg swings, jogging in place.
It is necessary to try to normalize sex life, which is extremely important to eliminate the stagnation of the secret in the prostate.
It is recommended to limit to minimal doses or completely eliminate the use of alcohol.
drug treatment
In chronic prostatitis, outpatient treatment is predominantly performed. If the pathological process persists and remission cannot be achieved by this method, hospitalization is recommended. In a hospital, under the supervision of the medical staff, there are many more opportunities to comply with 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 hormone levels and eliminate the symptoms of the 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 given 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 about the drugs advertised for the treatment of chronic prostatitis.
The drugs recommended for antibacterial therapy are fluoroquinolones. Most bacteria are sensitive to them.
Antibiotics can also be included in the treatment plan for patients with the abacterial form of prostatitis. Such therapy is carried out for preventive purposes. According to indications, treatment with penicillin drugs is connected.
After completion of antibiotic therapy, treatment with hormonal drugs begins.
With intraprostatic reflux, it is necessary to take a-blockers.
Analgesics are effective for pain relief.
Treatment with herbal medicines
Many doubt whether chronic prostatitis can be cured with herbal remedies. The answer to this question has been gleaned from many years of using these health-enhancing 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 to reduce the frequency of impulses, eliminate the syndrome of a slow jet.
Patients with chronic prostatitis are recommended for phytocollections, which include pumpkin extract or pumpkin seeds. The latter have a unique chemical composition and act in three directions at the same time:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood circulation in Organs pelvic organs.
Taking herbal medicines cannot be considered the main method of treatment. These healing agents are considered as concomitant drug therapy.
non-drug treatment
Non-drug therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues, help to eliminate congestion.
For this, the following methods are used: rectal ultrasonic exposure;
Microwave hyperthermia is performed using a rectal probe that is 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 requires heating to 38-40°C. To obtain 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 take place in the prostate:
- 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 period of research on the effects of laser therapy in patients with prostatitis, a side effect, but positive for treatment purposes, was noted. 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-level laser radiation is used to treat chronic prostatitis.
Patients may, on their own initiative, undergo a course of laser therapy, if not prescribed by the treating 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 tissues of the gland. To free it from the prostoliths, transurethral resection is used.
Surgery is performed under the control of TRUS.
If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If, in combination with this pathology, sclerosis of the bladder neck 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 permeability of the secret. For this, 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 in stimulating the prostate, which helps to eliminate congestion. This complex was developed for patients with hip joint problems. Practice has shown that these exercises are helpful 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 up.
- They bend their knees and pull them towards themselves, simultaneously spreading them in different directions.
- Lift your pelvis as high as you can.
- 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 and 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 are able to completely cure chronic prostatitis. Prostate inflammation usually enters a long-term remission stage. But when conditions arise for the activation of the pathology, a relapse occurs. The exacerbation begins with the onset of prostate pain. 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. Just as often, they carry out studies of the state of the prostate, do an analysis for PSA. With the systematic monitoring of the state of the gland, it is possible to timely identify the processes that cause a relapse of the disease. But even with a long remission, there is no guarantee that it will not be violated.
The patient must follow the recommendations to avoid exacerbations of the disease. It is recommended to balance the diet, excluding from it fatty and spicy foods. The reception of phytopreparations and traditional medicines must 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 get cold.
- Drink at least 1. 5-2 liters of water a day.
- Strengthen immunity, walk a lot, toughen up.
- Practice physical education and sports, attend gyms.
- Avoid stressful situations.
- Practice regular sex life with a regular partner.