Many men suffer from chronic prostatitis, but they 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 methods of diagnosis, various methods of treatment.
Despite all the successes of modern medicine, the diagnosis of such a disease as chronic prostatitis causes certain difficulties. This negatively affects the effectiveness of its 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, the classification developed by AHI (American Institute of Health) is usually used. . It defines categories of prostate diseases. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- Chronic bacterial prostatitis.
To establish this diagnosis, the following symptoms are required: long-lasting (at least 3 months) pain in the perineum. Thus, chronic prostatitis can be called a long-term inflammatory process, which results in a change in the structure of the prostate gland and a violation of its function. But other prostate diseases also cause such unfortunate consequences. 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 activities and relationships in the family. Patients' quality of life is reduced in the same way as in people who have had a heart attack or suffer from angina pectoris.
According to various sources, every 3rd-4th man is diagnosed with prostatitis. And most often it is not the initial or acute stage of the disease, but an already established and long-term ongoing process - chronic.
Not so long ago, it was believed that this pathology is inherent mainly in older men. But statistics refuted this opinion. Today it is known that chronic prostatitis is a disease of sexually active men of childbearing age.
More than 30% of patients with complaints characteristic of the chronic form of prostate refer to a specialist. Often during a visit to 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. Of all the negative factors that affect men's health, it is difficult to single out exactly those that caused the development of the disease. Often it is a complex of situations and circumstances that accompany a man's life.
The main causes of chronic bacterial prostatitis are:
- Dysrhythmia of intercourse (irregular);
- hypodynamia, which is characteristic of overweight people;
- Prolonged stressful conditions;
- Predominance of foods rich in fats in the diet;
- Negative effects 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 consult a urologist. Therefore, no treatment was performed.
Bacterial type chronic prostatitis develops against the background of decreased immunity due to exposure to infectious agents. As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors provoking the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibiotic therapy was not carried out before the operation);
- refusal to use contraceptives;
- Lack of the habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many fictions about chronic prostatitis. For this reason, any temporary disorder of sexual function is attributed to this disease. You will often hear the opinion that decreased sexual desire and erectile dysfunction are due to prostatitis, and if a man is old, then chronic prostatitis.
This is not true, since sexual dysfunction has many other causes, and the main symptom of chronic prostatitis is pain. All other signs can be considered accompanying and indirect.
Often, chronic prostatitis is confused with pelvic pain syndrome, because the symptoms of these diseases are largely similar. This is due to the formation of myofascial trigger zones near the prostate, which appear as a result of injuries and surgical interventions. Pain in these areas can be considered a symptom of prostate inflammation.
When diagnosing the disease, complaints about pain and discomfort in the perineum and small pelvis that last at least 3 months come to the fore. The pain is localized in the prostate area, radiates to the palate, rectum, scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical exertion, "standing on your feet" for a long time), the pain intensifies.
A characteristic symptom of the disease is premature ejaculation. Patients have decreased sexual desire, erectile dysfunction. These symptoms are characteristic of other diseases of the urogenital area. Therefore, it cannot be said that they are characteristic signs of chronic prostate disease.
An important symptom is the disappearance of orgasm. If the patient notices that the sharpness of sensations during ejaculation has disappeared, this is a case of a more attentive attitude to his health and a signal to visit a urologist.
The structure of the inflamed prostate becomes dense, the pressure on the urethra increases and the quality of urination deteriorates. Patients with chronic prostatitis report a frequent urge to urinate at night. The process of passing urine is accompanied by a burning sensation, pain, pain. Urinary incontinence is often observed.
Signs of chronic prostatitis can be expressed fully or partially. Much depends on the patient's state of health, the presence or absence of other diseases. Chronic prostatitis is characterized by a wavy course, increasing and decreasing symptoms. In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
Chronic prostatitis is easy to diagnose when severe symptoms are present. But this disease is often asymptomatic, which makes it difficult to detect. A number of studies are conducted for diagnostic purposes.
The Association of Urologists has developed questionnaires, thanks to which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated in such a way that it is possible to determine the subjective feelings of the patient. Not all men can correctly assess their erectile function, orgasm quality and other details of their sexual life. Questionnaires filled in by patients provide the specialist with the necessary information to make a diagnosis. In urological practice, the NIH-CPS scale is most often used.
In order to differentiate chronic prostatitis from other diseases, a neurological examination is performed. In the list of used diagnostic methods, determination of the patient's immunity status.
Laboratory research methods
If you suspect chronic prostatitis, first find out what its nature is: bacterial or bacterial. In the first case, it is necessary to determine the pathogen or pathogens, to find out which drugs they are sensitive to. Laboratory tests of urine and prostate secretion are performed for this.
If, after a 10-day period after DRE, the PSA test showed an excess of the prostate-specific antigen level from 4. 0 ng/ml, this is a reason to send the patient for a biopsy to rule out an oncological process.
The following research methods are recommended:
- scraping from the urethra;
- general and biochemical analysis of urine;
- LHC culture of prostatic secretion.
Instrumental research methods
TRUS (transrectal ultrasound) is performed with instruments equipped with equipment that are inserted into the patient's rectum. If a hypoechoic area of irregular shape is found, there is every reason to suspect a malignant neoplasm. In chronic prostatitis, scars, compaction of glandular tissue structure, and changes in seminal vesicles can be observed.
UDI is the main method of functional diagnostics. This allows you to find out the nature of urine, signs of urine stagnation, its composition. The study includes several tests: uroflowmetry, cystometry, measurement of the residual volume of urine, assessment of the pressure inside the bladder and the rate of urine flow.
Tomography (computed or magnetic resonance) is necessary to exclude benign and malignant neoplasms. These research methods are very informative and help to assess the state of prostate tissues.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach. One dose of medicine is not enough. Physiotherapy procedures, therapeutic exercises are necessary. In general, treatment of chronic prostatitis is difficult, requires a radical revision of lifestyle, change of habits and in some cases change of job. Urologists claim that only a combination of measures will help to completely get rid of this disease or achieve long-term remission.
Regardless of whether the disease is bacterial or bacterial in nature, swelling of the prostate gland played a major role in its formation. The viscous secret deposited in the ducts of the gland is a favorable environment for the development of pathogenic and opportunistic microorganisms. Therefore, the main focus should be on eliminating stagnation.
The issue is resolved by changing the lifestyle and incorporating physical therapy exercises into the daily schedule.
Exercise complexes have been developed that are suitable for different life situations:
- For men who are forced to sit most of the time (drivers, office workers, managers);
- for overweight people;
- For those who don't have time to exercise.
Thinking about the treatment of chronic prostatitis, you should decide to seriously reconsider your attitude to health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual abstinence.
Treatment course methods:
- Etiotropic therapy is the most effective in the treatment of prostatitis. If the basis of prostatitis is an infection, the priority is a course of antimicrobial drugs that relieve the manifestations of inflammation.
- The pain syndrome is relieved by warm solutions of painkillers, antispasmodics, rectal suppositories, microclysters. Non-steroidal anti-inflammatory drugs can be used.
- Immunostimulators, immunomodulators, enzymes, vitamin complexes, a combination of microelements have proven their effectiveness.
- Physiotherapy methods are possible only in the sub-acute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Another effective method of affecting the prostate is massage. It opens the ducts, normalizes the blood circulation of the scrotum, small pelvis.
- Acute retention of renal filtrate can be corrected by catheterization, trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist consultations.
Treatment of chronic prostatitis
With long-term exposure to the prostate (at least one month), there is no 100% guarantee of cure. Prioritizing herbal preparations, immunocorrection, changing household habits:
- Phyto preparations are widely used in urological practice. They can 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, depending on the sensitivity of microbes to drugs.
- Immune-enhancing drugs not only help to deal with prostatitis, but also correct the negative effects of antibiotics, which disrupt the function of the immune system.
- The pain syndrome is stopped by prescribing alpha-blockers, muscle relaxants.
- Prostate massage allows you to mechanically remove the "excess" secret of the gland through the urethra, improve blood circulation and minimize swelling.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm baths or herbal microclysters.
- In severe cases, intravenous fluids of diuretics are indicated. It stimulates the abundant excretion of urine, prevents the symptoms of intoxication, the development of ascending cystitis, pyelonephritis.
- Herbal laxatives are used for constipation.
- Together with the patient, the urologist, psychologist develops an individual long-term program of daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- In case of chronic process resistance to current therapy, urinary outflow obstruction, surgical intervention is prescribed: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). They practice in exceptional cases, with impotence, urinary incontinence. Young people are not operated because it can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations where he can damage 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 sitting, every 2-3 hours it is necessary to warm up, do squats, swing the leg, run on the spot.
It is necessary to try to normalize sexual life, which is extremely important to eliminate the stagnation of the secret in the prostate.
It is recommended to limit to minimum doses or completely eliminate alcohol consumption.
Treatment with drugs
In case of chronic prostatitis, ambulatory treatment is mainly carried out. If the pathological process continues and remission cannot be achieved by this method, hospitalization is recommended. In the hospital, under the supervision of medical staff, there is much more opportunity to follow 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 help to normalize the hormonal level and eliminate the symptoms of pathology. Drugs such as finasteride and terazosin are prescribed for these purposes.
An integrated approach includes taking such medications as:
Methods of treatment of bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics. The most effective drug for a specific patient is determined using a preliminary laboratory study of prostate secretion.
There is no universal drug for suppressing and destroying pathogenic microflora. What works for one patient may not work for 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 may also be included in the treatment plan for patients with bacterial prostatitis. Such therapy is carried out for preventive purposes. According to indications, treatment with penicillin drugs is related.
After the end of antibiotic therapy, treatment with hormonal drugs begins.
During intraprostatic reflux, it is necessary to take α-blockers.
Pain relievers are effective in relieving pain.
Treatment with herbal remedies
Many people doubt whether chronic prostatitis can be cured with herbal remedies. The answer to this question was obtained as a result of many years of use of these health-improving agents in urological practice.
Today, the following medical complexes are recommended:
All these drugs have a positive effect on the male reproductive system. Effective treatment of chronic prostatitis is possible if urinary function is normalized. The components of herbal remedies perform this task. They help reduce the frequency of urges, eliminate the sluggish jet syndrome.
Phytocollections that include pumpkin extract or pumpkin seeds are recommended for patients with chronic prostatitis. The latter have a unique chemical composition and act simultaneously in three directions:
- normalization of metabolism;
- strengthening the walls of blood vessels;
- Activates blood circulation in pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment. These treatment agents are considered as adjunctive drug therapy.
Non-drug treatment
Non-narcotic methods of therapy allow you to act directly on the prostate, increase the concentration of drugs in its tissues, help eliminate swelling.
The following methods are used for these purposes: rectal ultrasound exposure;
Microwave hyperthermia is performed using a rectal probe, which is inserted into the patient's anus. You can set the temperature required for a specific type of exposure on the device. To increase the concentration of the drug in the prostate, it is necessary to heat it to 38-40°C. To get an antibacterial effect - 40-45 ° C.
Today, non-drug treatment is focused on laser therapy. The possibilities of this technique are wide. Under the influence of the laser, the following processes occur in the prostate gland:
- activation of redox reactions;
- improves blood microcirculation;
- new capillaries are formed;
- Pathogenic microflora is suppressed;
- The process of cell division is activated, which promotes tissue regeneration.
During the study period of the effects of laser therapy on patients with prostatitis, side effects were noted, but positive for treatment purposes. For 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 of a certain wavelength. In general, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can take a course of laser therapy on their own initiative, 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 gland tissues. Transurethral resection is used to free it from prostatitis.
The operation is performed under TRUS control.
If complications such as sclerosis of the prostate occur, transurethral electrosurgery is performed. If sclerosis of the bladder neck is observed along with this pathology, a partial resection of the prostate is performed.
With the blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate the violation of the permeability of the secret. For this purpose, an incision is made in the seminal vesicles and excretory ducts. With 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 to eliminate swelling. This complex was created for patients with hip joint problems. Practice has shown that these exercises are useful for those diagnosed with prostatitis. Lessons can be held at a convenient time, the complex will take no more than 15 minutes to complete.
Exercise #1
- Lying on the gym mat, stretch both arms up.
- They bend their knees and pull them towards themselves, spreading them in different directions at the same time.
- Lift the pelvis as far as they 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 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 manage to completely cure chronic prostatitis. Prostate inflammation often goes into a long remission stage. But when conditions arise for the activation of the pathology, a relapse occurs. Aggravation begins with the appearance of prostate pain. They are often accompanied by urinary disorders. At the first symptoms of relapse, you should consult a specialist.
Patients are advised to visit a urologist regularly, at least once every six months. With the same frequency, they conduct research on the state of the prostate, take an analysis for PSA. By systematic monitoring of the condition of the gland, it is possible to detect the processes that provoke the recurrence of the disease. But even in the case of a long remission, there is no guarantee that it will not be broken.
The patient should follow the recommendations to prevent the aggravation of the disease. It is recommended to balance the diet, to exclude fatty and spicy foods from it. Taking phytopreparations and traditional medicine should 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 provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- do not get cold.
- Drink at least 1. 5-2 liters of water a day.
- Strengthening immunity, walking a lot, hardening.
- Engage in physical education and sports, attend fitness clubs.
- Avoid stressful situations.
- Practice having a regular sex life with a regular partner.