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 get comprehensive information about this men's 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 has a negative effect on the effectiveness of its treatment.
What is chronic prostatitis?
In ICD-10 (International Classification of Diseases, version 10) there is no such disease as "chronic prostatitis".There is no single, generally accepted characteristic of this pathology.In urological practice, it is customary to use the classification developed by AHI (American Institute of Health).This defines the categories of prostate diseases.Those that may be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses, the following symptoms are required: long-term (at least 3 months) pain in the perineal area.Thus, chronic prostatitis can be called a long-term inflammatory process, the result of which is changes in the structure of the prostate gland and its dysfunction.But other prostate diseases also lead to such sad consequences.Therefore, the diagnosis of chronic prostatitis is difficult.
Epidemiology
Prostatitis is one of the most common diseases in men.It significantly affects performance and family relationships.The quality of life of patients decreases to the same extent as people who have had a heart attack or suffer from angina pectoris.
According to information 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.
Some time ago, it was recognized that this pathology is mainly characteristic of older men.But statistics refuted this idea.Today it is known that chronic prostatitis is a disease of sexually active men of reproductive age.
More than 30% of patients turn to a specialist with complaints characteristic of chronic prostatitis.Often, during the 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 diverse.It is difficult to separate the various negative factors that affect a person's health from those that lead to the development of the disease.Often it is a complex of situations and circumstances that accompany a person's life.
The main causes of chronic abacterial prostatitis are as follows:
- dysrhythmia (irregularity) of sexual intercourse;
- physical inactivity characteristic of overweight people;
- long-term stressful conditions;
- predominance of fat-rich foods in the diet;
- adverse effect on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely treated bacterial prostatitis.Or the man ignored the diseases and did not seek help from a urologist.Therefore, no treatment was performed.
Abacterial chronic prostatitis develops due to exposure to infectious agents against the background of reduced immunity.As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors leading to the development of chronic bacterial prostatitis:
- surgical operations on the prostate (if antibacterial therapy is not carried out before the operation);
- refusal to use contraception;
- lack of habit of keeping your body clean.
Symptoms of chronic prostatitis
Today there are many myths about chronic prostatitis.For this reason, any temporary disorders in sexual function are attributed to this disease.You can often hear the idea that decreased libido and erectile dysfunction are caused by prostatitis, and in older men, 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 accompanying and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome, because the symptoms of these diseases are basically 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 mistaken for a sign of inflammation of the prostate gland.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and pelvic area lasting at least 3 months come to the fore.The pain is localized near the prostate, spreads to the sacrum, rectum and testicle.When exposed to negative factors for a long time (carrying heavy objects, excessive physical activity, standing for a long time), the pain intensifies.
A characteristic symptom of the disease is premature ejaculation.Sexual desire and erectile dysfunction decrease in patients.These symptoms are also characteristic of other genitourinary diseases.Therefore, it cannot be said that they are a symptom 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 disappears, this is a reason for a more attentive attitude to his health and a signal of the need to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urethra increases, and the quality of urine deteriorates.Patients with chronic prostatitis report a frequent urge to urinate at night.The process of urination is accompanied by a burning sensation, stinging and pain.Frequent urinary incontinence occurs.
Symptoms of chronic prostatitis can be expressed completely or partially.Much depends on the patient's state of health and the presence or absence of other diseases.Chronic prostatitis is characterized by a wave-like course, with signs of waxing and waning.The inflammatory process with this disease is not acute.
Diagnosis of chronic prostatitis
When there are clear symptoms, the diagnosis of chronic prostatitis is not difficult.However, 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 that can help identify asymptomatic chronic prostatitis.Questions are formulated to clarify the patient's subjective feelings.Not every man can correctly assess his erectile function, orgasm quality and other details of sexual life.Questionnaires filled out by the patient provide the specialist with the information needed to make a diagnosis.NIH-CPS scale is most commonly used in urological practice.
A neurological examination is performed to distinguish chronic prostatitis from other diseases.The list of diagnostic methods used includes clarification of the patient's immunity status.
Laboratory research methods
If you suspect chronic prostatitis, first of all they find out what its nature is: bacterial or bacterial.In the first case, it is necessary to identify the pathogen or pathogens and find out which drugs they are sensitive to.For this, laboratory examinations of urine and prostate secretion are performed.
If the PSA test 10 days after DRE shows a prostate-specific antigen level of more than 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 urine analysis;
- LHC culture of prostate secretion.
Instrumental research methods
TRUS (transrectal ultrasound) is performed using equipment equipped with an instrument that is inserted into the patient's rectum.If a hypoechoic area of an irregular shape is detected, there is every reason to suspect a malignant neoplasm.With chronic prostatitis, scarring, compression of the glandular tissue structure, and changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnostics.This allows you to study the nature of urine, the symptoms of urine stagnation and its composition.The study includes several tests: uroflowmetry, cystometry, measurement of the volume of residual urine, assessment of the pressure inside the bladder and the rate of urine output.
Tomography (computed or magnetic resonance imaging) is necessary to exclude benign and malignant neoplasms.These research methods are highly informative and help to assess the condition of the prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires a complex approach.Just taking medicine is not enough.Physiotherapy procedures and therapeutic exercises are necessary.In general, the treatment of chronic prostatitis is difficult and requires a radical revision of lifestyle, change of habits, and in some cases, change of workplace.Urologists insist that only a complex of measures will help to completely get rid of this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or not, blockages in the prostate gland have played a major role in its development.Viscous secretion accumulated 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 problem can be solved by changing the lifestyle and incorporating physical therapy classes into the daily schedule.
Complexes of exercises suitable for different life situations have been developed:
- for men who have to sit often (drivers, office workers, managers);
- for overweight people;
- for those who don't have time to exercise.
Thinking about how to treat 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.
Course treatment methods:
- The most effective treatment of prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, a course of antimicrobial agents that eliminate the manifestations of inflammation is a priority.
- Pain syndrome is eliminated with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers.NSAIDs can be used.
- The combination of immunostimulants, immunomodulators, enzymes, vitamin complexes and trace elements has proven its effectiveness.
- Physiotherapy methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave oven, electrophoresis, laser, magnetic therapy.
- Massage is another effective way to affect 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 advice.
Treatment of chronic prostatitis
There is no 100% guarantee of treatment with a long-term, course (at least one month) effect on the prostate gland.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 process, protect cells from oxidation, remove free radicals and prevent the proliferation of glandular tissue.
- Antibacterial therapy is selected individually based on the sensitivity of microbes to drugs.
- Medicines that strengthen immunity not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the function of the immune system.
- The pain syndrome is relieved by taking alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secretion of the gland through the urethra, improve blood circulation and minimize blockage.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, hot sitz baths or microenemas with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.It stimulates the production of abundant urine, prevents the symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- Herbal laxatives are used for constipation.
- Together with the patient, the urologist and psychologist develop an individual long-term program of daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- If the chronic process is resistant to therapy and the flow of urine is blocked, surgical intervention is prescribed: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy).It is applied in exceptional cases, it is fraught with impotence and urinary incontinence.Young people are not operated on because it can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations that could injure the pelvic organs.
Any stress on the prostate should be avoided: do not ride a bicycle, do strength training, do not carry weights.
If the job is sedentary, you should warm up every 2-3 hours by squatting, swinging your legs and running in place.
To eliminate stagnation of secretions in the prostate, it is extremely important to try to normalize your sex life.
It is recommended to limit alcohol consumption to a minimum dose or completely eliminate alcohol consumption.
Treatment with drugs
Chronic prostatitis is mainly treated on an outpatient basis.If the pathological process continues and remission cannot be achieved using this method, hospitalization is recommended.In a hospital, under the supervision of medical staff, there are more opportunities 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 normalize hormonal levels and eliminate the symptoms of pathology.For these purposes, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach includes taking medications such as:
Methods of treatment of bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics.The most effective drug for a particular patient is determined using a preliminary laboratory study of prostate secretion.
There is no universal drug to suppress and destroy 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 may 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 preparations is included.
After the antibacterial therapy is completed, treatment with hormonal drugs begins.
It is necessary to take α-blockers for intraprostatic reflux.
Painkillers are effective for pain.
Treatment with herbal remedies
Many people doubt that chronic prostatitis can be treated with the help of herbal remedies.The answer to this question was obtained as a result of many years of use of these therapeutic agents in urological practice.
Today, the following treatment complexes are recommended:
All these drugs have a beneficial effect on the activity of the male genitourinary system.Effective treatment of chronic prostatitis is possible with normalization of urinary function.The components included in herbal medicines perform this task.They help reduce the frequency of urges and eliminate sluggish flow syndrome.
Herbal mixtures containing pumpkin extract or pumpkin seeds are recommended for patients with chronic prostatitis.The latter has a unique chemical composition and acts in three directions at once:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment.These health-enhancing agents are taken at the same time as drug therapy.
Non-drug treatment
Non-drug therapy methods allow you to act directly on the prostate, increasing the concentration of drugs in its tissues and helping to eliminate the blockage.
The following methods are used for these purposes: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe inserted into the patient's anus.The device can be used to determine the required temperature for a specific type of exposure.To increase the concentration of the drug in the prostate, it is necessary to heat it to 38-40 ° C.To achieve 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 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 studies on the effect of laser therapy on patients with prostatitis, side effects, but positive for the treatment, were noted.Those who completed the course increased potency, eliminated erectile dysfunction and regained vitality.To achieve this result, it is necessary to use a beam with a certain wavelength.In general, low-intensity laser radiation is used in the treatment of chronic prostatitis.
Patients can undergo a course of laser therapy on their own initiative, if not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not threaten 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.Transurethral resection is used to free it from prostatoliths.
Surgical intervention is performed under TRUS control.
If complications such as sclerosis of the prostate gland 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.
When the seminal and excretory ducts are blocked, endoscopic operations are indicated to eliminate the obstruction of the excretory opening.For this purpose, an incision is made in the seminal vesicles and excretory ducts.In the case of 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 relieve congestion.This complex is designed for patients with hip joint problems.Experience has shown that these exercises are also useful for those diagnosed with prostatitis.Classes can be held at a convenient time;completion of the complex will not take more than 15 minutes.
Exercise number 1
- Lying on the gym mat, raise both arms up.
- Bend your knees and pull them towards you, spreading them in different directions at the same time.
- Raise the bowl as high as they can.
- Repeat 10-12 times.
Exercise number 2
- While standing on the floor, do deep squats.
- 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 completely cure chronic prostatitis.Inflammation of the prostate often goes into a long-term remission phase.However, when the conditions for the activation of the pathology are created, relapse occurs.Exacerbation begins with the occurrence of pain in the prostate.Often they are accompanied by urinary tract disorders.At the first signs of relapse, you should seek help from a specialist.
Patients are advised to regularly visit a urologist at least once every six months.At the same frequency, they conduct an examination of the state of the prostate and conduct a PSA test.By systematically monitoring the condition of the gland, it is possible to identify the processes that lead to the relapse of the disease in time.But even with long-term remission, there is no guarantee that it will not be broken.
The patient should follow the recommendations to prevent exacerbation of the disease.It is recommended to balance your diet by excluding fatty and spicy foods.The use of herbal remedies and traditional medicine should 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 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 too cold.
- Drink at least 1.5-2 liters of water a day.
- Strengthen your immune system, walk a lot, get tough.
- Do physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Have regular sex with a regular partner.