Prostatitis is a disease that causes urinary problems, 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 below the male bladder and in front of the rectum. The prostate consists of glandular and connective tissue. Its function is to produce fluid, which is partly made up of ejaculation. This fluid carries the sperm during ejaculation (ejaculation) and protects the sperm as they travel to the female 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 easily treated, but sometimes becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure permanently. But with the right treatment, there is every chance to achieve long-term remission and significantly improve the patient's quality of life. We know 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 bacterial, chronic (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Of these, non-bacterial chronic prostatitis is the most common. And he is the worst to treat.
A disease is considered chronic if the symptoms do not disappear for more than 3 months. However, they develop slowly and are less obvious than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its recurrent course. This means that symptoms may disappear for a while and then reappear. Without treatment, this condition can bother the patient for a very long time.
Bacterial and non-bacterial forms have common symptoms. They usually include urinary problems, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. In addition, the chronic form is more common than the acute form. Because about 25% of visits to urologists are related to chronic prostatitis.
Pathology can appear at any age, but the chronic form most often develops in men after 50 years.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. This type of disease has common symptoms but different causes.
Chronic bacterial prostatitis
The inflammatory process causes bacterial infection from the urinary tract to enter the prostate. Possible provoking factors: 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 identified the cause of chronic pelvic pain syndrome. With this form, there is no infection in the prostate gland. What caused the disorder in this case is not known exactly. There are assumptions that this may be due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- patients already have prostatitis and chronic pain persists despite treatment;
- urine enters the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- pressure
Symptoms of chronic prostatitis
With chronic prostatitis, symptoms bother the patient for a long time - for several months or even years. The disease is characterized by a recurrent course, that is, the problem appears and disappears.
Infectious and non-infectious prostatitis have common symptoms and include:
- urinary disorders: frequent and sudden urge, difficulty urinating, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during sexual intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- nausea and vomiting
This 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 immediate medical attention. If treatment is delayed, there is a risk of life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you need to make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and the urinary system in men and women.
Initial consultation includes several stages:
- History taking.
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 the genitals
- Digital rectal examination.
During the procedure, the urologist inserts a finger into the patient's anus to feel the surface of the prostate gland. This test allows you to determine the size of the prostate and check for swelling and tenderness. - Other studies.
The doctor may prescribe one or more diagnostic procedures, some of which can be performed immediately at the appointment, some later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urine analysis
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)
Helps assess the condition of the prostate gland. A high PSA level indicates an inflammatory process in the prostate or a neoplasm. - Microscopy of prostate secretions
Prostatic secretions are fluids produced by the prostate gland. With changes in the organ, the composition of secretions also changes. For example, during the 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 liquid will help to see these changes. - Prostatic secretions were 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 insert the ultrasound probe carefully into the rectum. TRUS shows structural and functional changes in the prostate.
- MRI (magnetic resonance imaging) of the pelvis. Helps assess the condition of the prostate tissue. It may be necessary to see the focus of prostate inflammation 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; just warm water is enough.
- Do not go to the toilet 2 hours before your clinic visit. Then, at your appointment, if necessary, you can immediately take a test or undergo an ultrasound.
- If you regularly take any medicines, write down their names in your diary or a note in 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 various forms of the disease and manifestations, different treatments are indicated.
To determine the type of chronic prostatitis, you need to undergo diagnostics. Based on the results, the doctor will prescribe a therapy that will give specific results 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 specific symptoms.
Recommendations for outpatient treatment
Lifestyle change:
- Diet restrictions
It is worth giving up alcohol, coffee, spicy and sour foods. This product irritates the bladder and worsens the patient's condition. - Take a warm bath, take a warm bath
Water procedures will help reduce the manifestation of the disease. - More water
Drink enough fluids. More frequent trips to the toilet will help remove pathogenic bacteria from the bladder. - Pillows for chairs
When sitting, place a soft pillow under you. - Physical activity
Regular walking and exercise will help reduce pain and relieve congestion. - Fixed sex life
Sexual activity is useful to avoid congestion.
The methods listed will complement the therapy prescribed to you, but do not replace it.
Drug treatment
- Antibiotics. Antibacterial therapy is indicated for infectious forms. Medicines destroy the bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, you need to undergo a study of prostate secretions and determine the type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary problems. Medicines relax the organs of the urinary system and this relieves symptoms. Most often, alpha blockers are used for non-infectious chronic prostatitis, but to improve the patient's well-being they can also be prescribed for infectious forms of the inflammatory process.
- NSAIDs (nonsteroidal anti-inflammatory drugs). Prescribed to relieve pain and reduce swelling of the prostate gland.
- Relax the muscles. Used when you need to relieve pelvic muscle spasms.
- Antidepressant. Indicated for depression, which can develop due to prolonged stress and pain.
- Medicines for the treatment of erectile dysfunction. Used if prostatitis is causing problems in your sex life.
- laxative. They may prescribe it if symptoms include pain during bowel movements.
Treatment with herbal medicine
Herbal medicines.Herbal medicine does not work as a primary treatment method. They can be used as supplements to reduce prostate inflammation. For this purpose, drugs are prescribed with quercetin, a substance found in vegetables, fruits and berries.
Treatment is not medicine
- Physiotherapy and prostate massage. These methods are used to relax the pelvic floor muscles, relieve pain and prevent congestion. For a therapeutic effect, the patient undergoes a course of several sessions of massage. Massage is contraindicated in the development of pathological complications: abscesses, stones in the tissue of the prostate gland.
- Bladder catheterization. May be needed if you have problems with your bladder.
- Psychotherapy. Due to chronic pain, prostatitis patients may experience 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 program. Can help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be needed if complications develop.
Type of operation:
- TUR (transurethral resection) of the prostate.Indicated for the appearance of stones in the tissue of the prostate gland
- Prostatectomy. Removal of the prostate gland in some cases is carried out in the event of an abscess (accumulation of pus) or serious disorders in bladder function.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and reduce symptoms related to urinary disorders. How to do the exercise:
- Sit comfortably.
- Tighten your pelvic muscles for 5 seconds. To do this, imagine you are trying to stop urinating.
- Relax your muscles.
- Repeat this 10-15 times.
- Gradually you can increase the number of repetitions and tense the muscles for a longer time.
- You need to do 2-3 approaches a day.
Changes can only be seen with regular exercise.
Treatment prognosis
It is very difficult to cure chronic prostatitis forever. In some cases, the disease cannot be cured, but there is always a chance to achieve long-term remission and return the patient to the previous quality of life. To do this, it is important to undergo a comprehensive diagnosis to determine the form of the disease. If the cause of the inflammatory process is an infection, antibacterial therapy will help. And for non-infectious chronic prostatitis - well-chosen symptomatic therapy.
Complications of chronic prostatitis may include:
- Bacteremia (bacterial blood poisoning). Bacteria enter the bloodstream. May be the result of a form of bacterial pathology. Bacteremia develops suddenly and can cause sepsis. This condition is life threatening.
- Epididymitis (inflammation of the epididymis). This disease can cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in the tissue). In the case of an abscess, surgery is performed to clean and drain the purulent focus; in rare cases, the prostate can be removed.
- Infertility. Problems with conception can occur when there is a lack of sperm due to the inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bones
- Depressive disorder. Chronic pathology increases the risk of depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in men's quality of life and emotional state.
To avoid prostatitis it is important:
- Use barrier contraception (condoms): STIs are factors that increase the risk of prostatitis
- Visit a urologist every year if you are over 40 years old
- If you have symptoms of a UTI, call your doctor right away