Many men suffer from chronic prostatitis, but they associate the symptoms with other diseases or waste time on ineffective treatment.From our article, you will learn comprehensive information about this men's 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 certain difficulties.This also has a negative effect on the effectiveness of the 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 for this pathology.In urological practice, it is customary to use the classification developed by AHI (American Institute of Health).It defines the category of prostate disease.Those who can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To make this diagnosis, the following symptoms are required: long-term pain (at least 3 months) in the perineal area.Therefore, chronic prostatitis can be called a long-term inflammatory process, the result of which is a change in the structure of the prostate gland and its dysfunction.But other prostate diseases also lead to 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 patient's quality of life decreases to the same extent as people who have a heart attack or suffer from angina pectoris.
According to data from various sources, every 3rd or 4th man is diagnosed with prostatitis.And 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 was characteristic mainly of older men.But statistical data refutes this opinion.Today it is known that chronic prostatitis is a disease of men of fertile age who are sexually active.
More than 30% of patients consult a specialist with complaints characteristic of chronic prostatitis.Often, at the time of a 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 the various negative factors that affect a man's health, it is difficult to choose exactly those that trigger 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;
- physical inactivity, which is typical for overweight people;
- long-term stressful conditions;
- predominance of foods rich in fat in the diet;
- negative effects on the body in hazardous industries.
Chronic bacterial prostatitis is the result of bacterial prostatitis that does not heal completely.Or the man ignores the disease and does not seek help from a urologist.Therefore, no treatment is carried out.
Chronic prostatitis of the abacterial type 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.
Factors that trigger the development of chronic bacterial prostatitis are:
- surgical operation on the prostate (if antibacterial therapy is not performed before the operation);
- refusal to use contraceptives;
- lack the habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many myths about chronic prostatitis.For this reason, any temporary disturbance in sexual function is associated with this disease.You can often hear the opinion that decreased libido and erectile dysfunction are caused by prostatitis, and if an older man, then for chronic prostatitis.
This is not true, because sexual dysfunction has many other causes, and the main symptom of chronic prostatitis is pain.All other signs can be considered equivalent 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 a myofacial trigger zone near the prostate, which appears as a result of injuries and surgical interventions.Pain in this area 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, come to the fore.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, being on your feet for a long time), pain increases.
The hallmark of this 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 characteristic of chronic prostate disease.
An important symptom is the fading of orgasm.If the patient begins to notice that the intensity of sensations during ejaculation has disappeared, this is a reason for a more attentive attitude towards his health and a signal about the need to visit a urologist.
The structure of the inflamed prostate becomes more dense, the pressure on the urinary tube increases, and the quality of urine deteriorates.Patients with chronic prostatitis note a frequent urge to urinate at night.The process of urine excretion is accompanied by burning, burning, and pain.Urinary incontinence is common.
Signs of chronic prostatitis can be fully or partially expressed.Much depends on the patient's health status and the presence or absence of other diseases.Chronic prostatitis is characterized by a wave-like course, with waxing and waning symptoms.With this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
With the presence of clear symptoms, it is not difficult to diagnose chronic prostatitis.But this disease is often asymptomatic, which complicates its detection.For diagnostic purposes, various studies are conducted.
The Society of Urologists has developed a questionnaire that can help identify asymptomatic chronic prostatitis.The questions are formulated in such a way that the patient's subjective feelings can be explained.Not every man can give a correct assessment of his erectile function, quality of orgasm and other details of sexual life.Questionnaires filled out by patients provide specialists with the information needed to make a diagnosis.In urological practice, the NIH-CPS scale is most often used.
To distinguish chronic prostatitis from other diseases, a neurological examination is performed.The list of diagnostic methods used includes an explanation of the patient's immunity status.
Laboratory research methods
If chronic prostatitis is suspected, first of all they know its nature: bacterial or abacterial.In the first case, it is necessary to identify the pathogen or pathogens and find out which drugs they are sensitive to.To do this, laboratory tests of urine and prostate secretions are performed.
If, after a period of 10 days 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 research methods are recommended:
- scraping from the urethra;
- general and biochemical urine analysis;
- LHC culture of prostate secretions.
Instrumental research methods
TRUS (transrectal ultrasound) is performed using equipment equipped with instruments that are inserted into the patient's rectum.If a hypoechoic area with an irregular shape is detected, there is reason to suspect a malignant neoplasm.With chronic prostatitis, scarring, compaction of the glandular tissue structure, and changes in the seminal vesicles can be observed.
UDI is the primary method of functional diagnostics.It allows you to know the nature of urine, signs of urine stagnation, and its composition.This study includes several tests: uroflowmetry, cystometry, measurement of the amount of residual urine, assessment of pressure in the bladder and the rate of urine outflow.
Tomography (computed or magnetic resonance imaging) is necessary to exclude benign and malignant neoplasms.This research method is very informative and helps to assess the state of the prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach.Taking medicine alone 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, job changes.Urologists insist that only one set of measures will help get rid of the disease completely or ensure long-term remission.
Regardless of whether the disease is bacterial or abacterial, congestion in the prostate plays a major role in its formation.Viscous secretion stored in the ducts of the gland is a good environment for the development of pathogenic and opportunistic microorganisms.Therefore, the main attention should be directed to eliminate stagnation.
This issue can be resolved by changing lifestyle and including physical therapy classes in the daily schedule.
Training complexes have been developed that are suitable for different life situations:
- for men who have to sit most of the time (drivers, office workers, managers);
- for overweight people;
- for those who don't have time to exercise.
Having thought about how to treat chronic prostatitis, you should decide to seriously reconsider your attitude to your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet, and sexual rest.
Course treatment method:
- 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.
- Pain syndrome is eliminated with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers.NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, and combinations of microelements have proven their effectiveness.
- Physiotherapy methods are only possible in the subacute stage of the disease.They improve microcirculation and improve 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 renal filtrate retention can be corrected by catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist consultation.
Treatment of chronic prostatitis
With long-term effects, the course (at least a month) on the prostate, there is no 100% guarantee of recovery.Priority is given to herbal medicines, immunocorrection, changing household habits:
- Herbal preparations are widely used in urological practice.They can accumulate at the site of the most active pathological processes, protect cells from oxidation, eliminate free radicals, and prevent the proliferation of glandular tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of the microbe to the drug.
- Drugs that improve immunity not only help to overcome prostatitis, they also correct the negative effects of antibiotics that interfere with the functioning of the immune system.
- The pain syndrome is relieved with 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 bath or microenemas with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.This stimulates the production of copious amounts of urine, preventing hangover symptoms, the development of ascending cystitis, and pyelonephritis.
- For constipation, herbal laxatives are used.
- Urologists and psychologists, together with patients, develop individual long-term programs of daily routine, necessary rest, diet, dosed physical activity, and sexual activity.
- If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of all affected tissue (transurethral removal 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 surgery because it can cause infertility.
Recommendations for outpatient treatment
The patient must avoid situations where he may experience injury to the pelvic organs.
It is necessary to avoid any pressure on the prostate: do not ride a bicycle, do not do strength training, do not carry loads.
If the work is inactive, every 2-3 hours you need to warm up by doing squats, leg swings, and running in place.
You need to try to normalize your sex life, which is very important to eliminate the stagnation of secretions in the prostate.
It is recommended to limit alcohol consumption to a minimum dose or completely eliminate alcohol consumption.
Treatment with drugs
For chronic prostatitis, outpatient treatment is mainly carried out.If the pathological process continues and it is not possible to achieve remission using this method, hospitalization is recommended.In the hospital, under the supervision of medical staff, there are more opportunities to adhere to the regimen and monitor changes in the patient's condition.
Chronic prostatitis in men develops against the background of endocrine disorders.In this case, the drugs 5-alpha reductase inhibitors and alpha 1-blockers are recommended.They help normalize hormone levels and eliminate pathological symptoms.For this purpose, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach includes taking medications such as:
Treatment methods for chronic bacterial prostatitis
Chronic bacterial prostatitis is treated with antibiotics.The most effective drug for a particular patient is determined using preliminary laboratory studies of prostate secretions.
There is no universal drug to suppress and destroy the pathogenic microflora.What helps one patient may not help another.For this reason, there are many negative reviews about 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 abacterial prostatitis.This therapy is carried out for preventive purposes.According to the indications, treatment with penicillin drugs is included.
After the completion of antibacterial therapy, treatment with hormonal drugs begins.
For intraprostatic reflux, it is necessary to take α-blockers.
For pain, painkillers are effective.
Treatment with herbal medicine
Many people doubt whether chronic prostatitis can be cured with the help of herbal medicine.The answer to this question is obtained through many years of use of this healing agent in urological practice.
Today the following treatment complex is recommended:
All these drugs have a good effect on the function of the male genitourinary system.Effective treatment of chronic prostatitis is possible provided that urinary function is normalized.The components included in the herbal medicine perform this task.They help reduce the frequency of urges and eliminate sluggish flow syndrome.
For chronic prostatitis patients, herbal mixtures containing pumpkin extract or pumpkin seeds are recommended.The latter has a unique chemical composition and acts in three directions at once:
- normalize metabolism;
- strengthens the walls of blood vessels;
- activates blood circulation in the pelvic organs.
Taking herbal medicine should not be considered as the main method of treatment.These health-improving agents are considered in tandem with drug therapy.
Treatment is not medicine
Non-drug therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues, and help relieve congestion.
For this purpose, the following techniques are used: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe 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 to 38-40 ° C is required.To get an antibacterial effect – 40-45°C.
Today, non-drug treatments focus on laser therapy.The possibilities of this technique are vast.Under the influence of the 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 period of research on the effect of laser therapy on prostatitis patients, side effects, but positive for the purpose of treatment, have been observed.Those who complete the course increase potency, eliminate erectile dysfunction, and restore vitality.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 can, on their own initiative, undergo a course of laser therapy if it is not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not pose a threat to the patient's life, but can significantly reduce its quality.The most serious complication of this disease is the formation of stones in the glandular tissue.To free it from prostatolith, transurethral resection is used.
Surgical intervention is carried out 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.
When the seminal and excretory ducts are blocked, endoscopic surgery is indicated to eliminate the obstruction of secretion patency.For this purpose, incisions are made into the seminal vesicles and excretory ducts.In the case of an abscess, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis
There are several exercises that are effective in stimulating the prostate, which helps relieve congestion.This complex was developed for patients suffering from hip joint problems.Practice has shown that this exercise is also useful for those diagnosed with prostatitis.Classes can be run at a convenient time;complex will take no more than 15 minutes to complete.
Exercise No.1
- Lying on the gymnastic mat, stretch both arms upwards.
- Bend your knees and pull them towards you, simultaneously spreading them in different directions.
- Raise the pelvis as much as they can.
- Repeat 10-12 times.
Exercise No.2
- Standing on the mat, do a deep squat.
- 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 for obtaining a high therapeutic effect.
Treatment prognosis
Few men can cure chronic prostatitis completely.Prostate inflammation often goes into long-term remission.But when conditions arise for pathological activation, relapse occurs.Severity begins with the occurrence of pain in the prostate.Often they are accompanied by urinary disorders.At the first symptom of a 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 an examination of the state of the prostate and take a PSA test.By systematically monitoring the condition of the glands, the process that triggers the recurrence of the disease can be identified in time.But even with long-term remission there is no guarantee that it will not be disturbed.
Patients must follow the recommendations to avoid worsening of the disease.It is recommended to balance your diet by excluding fatty and spicy foods.The use of herbal medicine and traditional medicine must be agreed with the attending physician.With this approach, the risk of exacerbation of chronic prostatitis can be minimized.
Prevention
To prevent the occurrence of unpleasant diseases for men, you need to eliminate provoking factors and follow simple rules:
- Live a healthy lifestyle, abandon bad habits.
- Don't be too cold.
- Drink at least 1.5-2 liters of water a day.
- Strengthen your immune system, walk more, strengthen your body.
- Engage in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a normal sex life with a normal partner.