Prostatitis is a disease that causes problems with urination, 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 gland consists of a gland and connective tissue. Its function is to produce fluid, which consists of partial discharge. This fluid carries the sperm during ejaculation (ejaculation) and protects the sperm on its way to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not pass for months or even years. The acute form of the disease appears suddenly and lasts a maximum of several weeks. It is usually easy to treat, but sometimes it becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure permanently. But with proper treatment, there is every chance to achieve long-term remission and significantly improve the patient's quality of life. We figured out how to understand that you have chronic prostatitis and what to do next.
What is chronic prostatitis?
In general, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Of these, non-bacterial chronic prostatitis is the most common. And he is the worst for treatment.
If the symptoms do not pass for more than 3 months, the disease is considered chronic. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its repeated course. This means that the 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. These usually include problems with urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. Moreover, the chronic form is more common than the acute form. Chronic prostatitis accounts for about 25% of referrals to a urologist.
The pathology can appear at any age, but the chronic form develops most often in men after the age of 50.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of diseases have common symptoms, but different causes.
Chronic bacterial prostatitis
The inflammatory process causes bacterial infection from the urinary tract to enter the prostate. An inciting factor can be: an acute form of prostatitis, UTI (urinary tract infection), STI. The causative agent of the inflammatory process in the prostate is Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic non-bacterial prostatitis (chronic pelvic pain syndrome)
Researchers have not identified the causes of chronic pelvic pain syndrome. With this form, there is no infection in the prostate gland. In this case, it is not known exactly what caused the concern. This is likely due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- the patient already had prostatitis and chronic pain remained despite treatment;
- urine entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- stress
Symptoms of chronic prostatitis
With chronic prostatitis, symptoms bother the patient for a long time - several months or even years. The disease is characterized by a repetitive course, that is, problems appear and disappear.
Common symptoms of infectious and non-infectious prostatitis include:
- urinary disorders: frequent and sudden urges, difficulty urinating, pain;
- pain in the penis, testicles, pelvis, lower back;
- pain during intercourse;
- pain during ejaculation (ejaculation);
- decrease in sexual desire (libido);
- fever, chills;
- nausea, vomiting
The disease also affects the general condition of the patient. Some people experience irritability, increased fatigue, lethargy and anxiety.
If you have these symptoms, see a urologist. Some of them may indicate other more serious diseases that require immediate medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you should make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and urinary system in both men and women.
The initial consultation consists of several stages:
- Don't date.
The urologist will ask you about the reason for your visit, your previous illnesses, and the medications you are taking 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. The 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 done immediately at the appointment, some later.
Diagnosis usually involves laboratory and instrumental studies.
Laboratory research methods
- General urinalysis
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).
It helps to assess the state of the prostate gland. An increase in the level of PSA indicates an inflammatory process in the prostate gland or neoplasms. - Microscopy of prostate secretion
Prostatic secretion is a fluid produced by the prostate gland. The composition of secretion also changes with organ changes. For example, during an 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. - Prostate secretions are collected by prostate massage. Massage can be combined with 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 carefully insert an ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate gland.
- MRI (magnetic resonance imaging) of the pelvis. It helps to assess the state of the prostate tissue. It may be necessary to see foci of inflammation of the prostate gland 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 a few simple recommendations:
- Before using for intimate hygiene, you should not use special products, just warm water is enough.
- Do not go to the toilet 2 hours before coming to the clinic. Later, at your appointment, you can have immediate tests or an ultrasound if needed.
- If you take any medications regularly, write down their names in your diary or notes on 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 way to get rid of prostatitis. Different treatments are indicated for different forms and manifestations of the disease.
To determine the type of chronic prostatitis, you need to undergo diagnostics. Based on its results, the doctor will prescribe a therapy that will be effective 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 is aimed at combating a certain symptom.
Recommendations for outpatient treatment
Lifestyle changes:
- Dietary restrictions
Alcohol, coffee, spicy and sour foods should be avoided. These products irritate the bladder and worsen the patient's condition. - Hot sitz baths, hot showers
Water procedures will help reduce the manifestations of the disease. - More water
Drink enough fluids. More frequent trips to the toilet will help remove pathogenic bacteria from the bladder. - Cushions for chairs
When sitting, put a soft pillow under it. - Physical activity
Regular walks and exercise will help reduce pain and relieve congestion. - Regular sex life
Sexual activity is helpful in preventing constipation.
The methods listed will complement your prescribed therapy, but do not replace it.
Drug treatment
- Antibiotics. Antibacterial therapy is indicated for the infectious form. Medicines destroy the bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, therefore, before prescribing, it is necessary to study prostate secretions and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary tract disorders. Medicines relax the organs of the urinary system, which relieves symptoms. Most often, alpha blockers are used for non-infectious chronic prostatitis, but they can also be prescribed for the infectious form of the inflammatory process to improve the patient's well-being.
- NSAIDs (non-steroidal anti-inflammatory drugs). It is prescribed to relieve pain and reduce swelling of the prostate gland.
- Muscle relaxants. It is used when it is necessary to eliminate the spasm of the pelvic muscles.
- Antidepressants. It is indicated for depression that can develop due to stress and prolonged pain.
- Medicines for the treatment of erectile dysfunction. It is used if prostatitis causes problems in your sex life.
- Laxatives. They can diagnose it if symptoms include pain during bowel movements.
Treatment with herbal remedies
Herbal remedies.Herbal medicines do not work as a primary treatment. They can be used additionally to reduce inflammation of the prostate. For this purpose, drugs are prescribed with the substance quercetin found in vegetables, fruits and berries.
Non-drug treatment
- Physiotherapy and prostate massage. The methods are used to relax the muscles of the pelvic floor, relieve pain and prevent congestion. For a therapeutic effect, the patient undergoes a massage course consisting of several sessions. Massage is contraindicated in the development of complications of the pathology: abscess, stones in the tissues of the prostate gland.
- Bladder catheterization. It may be necessary if you have bladder problems.
- Psychotherapy. Due to chronic pain, patients with prostatitis may develop depression and anxiety disorders. Psychological problems have a negative impact on the patient's well-being and worsen the pain syndrome. In such cases, consultation with a psychotherapist will help.
- Biofeedback programs. It can help reduce pelvic floor muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be necessary if complications develop.
Types of operations:
- TUR (transurethral resection) of the prostate.It is indicated for the appearance of stones in the tissues of the prostate gland
- Prostatectomy. Removal of the prostate gland is performed in some cases when there is an abscess (accumulation of pus) or serious disorders of the bladder.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the muscles of the pelvic floor and relieve symptoms related to urination. How to do the exercises:
- Sit comfortably.
- Squeeze your pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
- Relax your muscles.
- Repeat this 10-15 times.
- You can gradually increase the number of repetitions and tense the muscles for a longer time.
- You should do 2-3 approaches a day.
Changes can be observed only with regular exercise.
Treatment prognosis
Permanent treatment of chronic prostatitis is very difficult. In some cases, the disease is incurable, but there is always a chance to achieve long-term remission and return the patient to the previous quality of life. For 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). Entering the bloodstream of bacteria. It can be the result of bacterial forms of pathology. Bacteremia develops suddenly and may lead to sepsis. This situation is life-threatening.
- Epididymitis (inflammation of the epididymis). The disease can cause severe pain in the scrotum.
- Prostate abscess (collection of pus in the tissue). In the case of an abscess, surgery is performed to clean and empty the purulent focus, rarely the prostate can be removed.
- Infinity. If there is a lack of sperm due to an inflammatory process in the prostate gland, there may be problems with conception.
- Spread of infection to spine and pelvis
- Depressive disorder. Chronic pathologies increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and emotional state.
The following are important to prevent prostatitis:
- Use barrier contraception (condoms): STIs increase the risk of developing prostatitis.
- If you are over 40, see a urologist every year
- If you have symptoms of a UTI, contact your doctor immediately