Many men suffer from chronic prostatitis, but 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 diagnostic methods, various methods of treatment.
Despite all the successes of modern medicine, diagnosing a disease such as chronic prostatitis causes certain difficulties.This also negatively affects the effectiveness of his treatment.
What is chronic prostatitis
In the ICD-10 (International Classification of Diseases, 10th revision) there is no such disease as "chronic prostatitis".Also, 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).It defines categories of prostate diseases.Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
The following symptoms are necessary to establish these diagnoses: prolonged (at least 3 months) pain in the perineal area.Thus, chronic prostatitis can be called a prolonged inflammatory process, the result of which are changes in the structure of the prostate gland and its dysfunction.But other prostate diseases also lead to such 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 work and family relationships.Patients' quality of life decreases to the same extent as for people who have had a heart attack or suffer from angina pectoris.
According to data from various sources, every 3rd or 4th man is diagnosed with prostatitis.And most often this is not an initial or acute stage of the disease, but an already formed and long-lasting process - chronic.
Not so long ago, it was generally accepted that this pathology was characteristic mainly of elderly men.But the statistics disproved this opinion.Today it is known that chronic prostatitis is a disease of men of childbearing age who lead a sexual life.
More than 30% of patients turn to a specialist with complaints characteristic of chronic prostatitis.Often, during 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.From the variety of negative factors affecting human health, it is difficult to single out exactly those that provoked the development of the disease.Often it is a complex of situations and circumstances accompanying a person's life.
The main causes of chronic abacterial prostatitis are the following:
- dysrhythmia (irregularity) of intercourse;
- lack of physical activity, characteristic of overweight people;
- long-term stressful conditions;
- the predominance of foods rich in fat in the diet;
- negative impact on the body in hazardous productions.
Chronic bacterial prostatitis is the result of incompletely healed bacterial prostatitis.Or the man ignored the ailments and did not seek help from a urologist.Therefore, no treatment was performed.
Chronic prostatitis of abacterial type develops due to exposure to infectious agents against the background of reduced immunity.As a rule, diseases of the endocrine system are diagnosed in such patients.
The factors that provoke the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibacterial therapy was 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, all temporary disorders of sexual function are attributed to this disease.You can often hear the opinion that decreased libido and erectile dysfunction are due to prostatitis, and if it is an older man, then to 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 collateral 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 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 symptom of prostate inflammation.
When diagnosing 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, standing for a long time), the pain intensifies.
A characteristic sign of the disease is premature ejaculation.Patients experience decreased sexual desire and erectile dysfunction.These symptoms are also characteristic of other diseases of the genitourinary system.Therefore, it cannot be said that they are hallmarks of chronic prostate disease.
An important symptom is the fading of orgasm.If the patient begins to notice that the severity of sensations during ejaculation has disappeared, this is a reason to pay more attention to his health and signal the need to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urethra increases and the quality of urination deteriorates.Patients with chronic prostatitis note a frequent urge to urinate at night.The process of passing urine is accompanied by burning, stinging and pain.Urinary incontinence often occurs.
Signs of chronic prostatitis can be expressed in whole or in part.Much depends on the patient's state of health and the presence or absence of other diseases.Chronic prostatitis is characterized by an undulating course, with waxing and waning of symptoms.In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of pronounced symptoms, it is not difficult to diagnose chronic prostatitis.But this disease is often asymptomatic, which complicates its detection.For diagnostic purposes, a whole range of research is conducted.
The Association of Urologists has developed questionnaires that can help identify asymptomatic chronic prostatitis.The questions are formulated in such a way that the patient's subjective feelings can be clarified.Not every man is able to give a correct assessment of his erectile function, the quality of orgasm and other details of sexual life.Questionnaires filled out by the patient provide the specialist with the necessary information to make the 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 clarification of the patient's immune status.
Laboratory research methods
If chronic prostatitis is suspected, its nature is first established: bacterial or abacterial.In the first case, it is necessary to identify the pathogen or pathogens and to find out which drugs they are sensitive to.For this purpose, laboratory tests of urine and prostatic secretion are carried out.
If, after 10 days after DRE, the PSA test shows that the level of prostate-specific antigen exceeds 4.0 ng / ml, this is a reason for the patient to be referred 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 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 with an irregular shape is found, there is every reason to suspect a malignant neoplasm.In chronic prostatitis, scarring, thickening of the structure of the glandular tissue and changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnostics.It allows you to understand the nature of urination, signs of urine stagnation and its composition.The examination includes several tests: uroflowmetry, cystometry, measurement of residual urine volume, assessment of bladder pressure and urine outflow rate.
Tomography (computed or magnetic resonance) is necessary to exclude benign and malignant neoplasms.These research methods are very informative and help to assess the condition of the prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach.Taking medication 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 a change of work.Urologists insist that only a set of measures will help to completely get rid of this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or non-bacterial in nature, congestion in the prostate plays a major role in its formation.The viscous secretion deposited in the ducts of the gland is a favorable environment for the development of pathogenic and opportunistic microorganisms.That is why the main focus should be on removing stagnation.
The problem can be solved by changing the lifestyle and including physiotherapy courses in the daily schedule.
Complexes of exercises have been developed that are suitable for different life situations:
- for those 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.
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 methods:
- The most effective treatment for prostatitis is etiotropic therapy.If the underlying cause of prostatitis is an infection, a course of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
- The pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, micro-enemas with warm solutions of painkillers.NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of trace elements have proven their 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 method of affecting the prostate.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.
- Consultations with a psychologist.
Treatment of chronic prostatitis
With long-term, course (at least one month) effect on the prostate, there is no 100% guarantee of cure.Priority is given to herbal medicines, immunocorrection, change of daily habits:
- Herbal preparations are widely used in urological practice.They are able to 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 increase 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 the administration of 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 congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or micro enemas with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.This stimulates the copious excretion of 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 the psychologist develop an individual long-term program for 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 resection of the prostate) or complete removal of the gland with surrounding tissue (prostatectomy).It is 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 should avoid situations in which he may suffer injuries to the pelvic organs.
It is necessary to avoid any stress on the prostate: do not ride a bicycle, do not do strength exercises, do not carry weights.
If the work is sedentary, every 2-3 hours you need to warm up by doing squats, leg swings and jogging in place.
You should try to normalize your sex life, which is extremely important to eliminate the stagnation of secretions in the prostate.
It is recommended to limit the consumption of alcohol to minimum doses or completely eliminate the use of alcohol.
Drug treatment
In case of chronic prostatitis, outpatient treatment is mainly carried out.If the pathological process continues and it is not possible to achieve remission with this method, hospitalization is recommended.In a hospital, under the supervision of medical personnel, there are many more opportunities to observe the regime and monitor changes in the patient's condition.
Chronic prostatitis in men develops against the background of endocrine disorders.In this regard, drugs 5-alpha reductase inhibitors and alpha 1-blockers are recommended.They help to normalize hormonal levels and eliminate the symptoms of pathology.For these purposes, drugs such as finasteride and terazosin are prescribed.
The integrated approach includes taking drugs such 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 examination of the prostate secretion.
There is no universal drug to suppress and destroy the pathogenic microflora.What works for one patient may not work for another.For this reason, there are many negative reviews of advertised drugs for the treatment of chronic prostatitis.
The recommended drugs 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 with a preventive purpose.As indicated, treatment with penicillin drugs is included.
After completion of antibacterial therapy, treatment with hormonal drugs is started.
In case of intraprostatic reflux, it is necessary to take α-blockers.
In pain, painkillers are effective.
Treatment with herbal preparations
Many people doubt whether chronic prostatitis can be cured with the help of herbal medicines.The answer to this question was obtained through the long-term use of these remedies in urological practice.
Today, the following treatment complexes are recommended:
All these drugs have a beneficial effect on the functioning of the male genitourinary system.Effective treatment of chronic prostatitis is possible when urinary function is normalized.The components included in herbal medicines perform this task.They help reduce the frequency of urges and eliminate slow jet syndrome.
For patients with chronic prostatitis, herbal mixtures containing pumpkin extract or pumpkin seeds are recommended.The latter have a unique chemical composition and act simultaneously in three directions:
- normalizes metabolism;
- strengthening the walls of blood vessels;
- activation of blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment.These health-enhancing agents are considered adjunctive to drug therapy.
Non-drug treatment
Non-drug therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues and help eliminate congestion.
The following techniques are used for these purposes: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus.The device can be used to set the temperature required for a certain 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 a laser in the prostate gland, the following processes take place:
- 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.
In the period of research on the effects of laser therapy in patients with prostatitis, a side effect was noted, but positive for the purposes of treatment.Those who have completed the course increase potency, eliminate erectile dysfunction and restore vitality.To achieve this result, it is necessary to use a beam of a certain wavelength.Generally, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can, on their own initiative, undergo a course of laser therapy, if this 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 it can significantly reduce its quality.The most serious complication of this disease is the formation of stones in the tissues of the gland.To get rid of prostatoliths, transurethral resection is used.
The operative intervention is performed under the control of TRUS.
If complications such as prostatic 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.
In the case of obstruction of the seminal and excretory ducts, endoscopic operations are indicated to remove the blockage of the passage of the secretion.For this purpose, an incision is made on 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 a number of exercises that are effective in stimulating the prostate, which helps relieve congestion.This complex was developed for patients with problems with the hip joint.Practice shows that these exercises are also useful for people diagnosed with prostatitis.Classes can be held at a convenient time;the complex will take no more than 15 minutes to complete.
Exercise No. 1
- Lie on an exercise mat, stretch both arms up.
- Bend your knees and pull them towards you, spreading them in different directions at the same time.
- Lift the pelvis as high as they can.
- Repeat 10-12 times.
Exercise No. 2
- Standing on the mat, 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.Prostatitis often goes into a stage of long-term remission.But when conditions arise to activate the pathology, a relapse occurs.Exacerbation begins with the appearance of pain in the prostate.Often they are accompanied by urination disorders.At the first symptoms of a relapse, you should seek help from a specialist.
Patients are advised to visit a urologist regularly, at least once every six months.With the same frequency, they conduct examinations of the state of the prostate and do a PSA test.Through systematic monitoring of the state of the gland, processes that provoke a relapse of the disease can be identified in a timely manner.But even with long-term remission, there is no guarantee that it will not be disturbed.
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 medicines 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 appearance of a disease that is unpleasant for men, you need to eliminate the provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't get too cold.
- Drink at least 1.5-2 liters of water a day.
- Strengthen your immune system, walk a lot, toughen up.
- Engage in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.