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 methods of diagnosis, 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 impact 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: prolonged pain (at least 3 months) in the perineum. Therefore, chronic prostatitis can be called a long-term inflammatory process, which results in changes 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.
Prostatitis is one of the most common diseases in men. It has a significant impact on performance and relationships in the family. The patient's quality of life is reduced to the same extent as a person having a heart attack or suffering from angina pectoris.
According to 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 ongoing process that is already formed and long-term - chronic.
Not long ago it was considered that this pathology exists mainly in older men. But statistics refute this notion. Today it is known that chronic prostatitis is a disease of men of fertile age who are sexually active.
More than 30% of patients turn to specialists with complaints characteristic of chronic prostatitis. Often, at the time of the 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 all the variety of negative factors that affect a man's health, it is difficult to isolate 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;
- hypodynamia, which is typical for overweight people;
- prolonged stressful situations;
- the preference 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 given.
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 provoke the development of chronic bacterial prostatitis are:
- surgical operation on the prostate (if antibiotic 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 is a lot of fiction about chronic prostatitis. For this reason, any temporary violation of sexual function is associated with this disease. You can often hear the opinion that decreased sexual desire and erectile dysfunction is the merit of prostatitis, and if a man is old, then 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.
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 a myofacial trigger zone near the prostate, which appears as a result of injuries and surgical interventions. Pain in this area can be considered a symptom of prostate inflammation.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and small pelvis, lasting at least 3 months, appear in front. The pain is localized around the prostate, radiating to the sacrum, rectum, scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical activity, "standing" for a long time), pain increases.
The characteristic symptom of this disease is premature ejaculation. Patients experience decreased sexual desire, erectile dysfunction. These symptoms are also characteristic of other diseases in the urogenital area. 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 sharpness of sensation during ejaculation has disappeared, this is an opportunity for a more attentive attitude towards his health and a signal to visit a urologist.
The structure of the inflamed prostate becomes more dense, the pressure on the urinary tube increases, and there is a deterioration in the quality of urine. Patients with chronic prostatitis note a frequent urge to urinate at night. The process of excretion of urine is accompanied by a burning sensation, pain, pain. Urinary incontinence is common.
Signs of chronic prostatitis can be fully or partially expressed. Much depends on the patient's state of health, the presence or absence of other diseases. Chronic prostatitis is characterized by an undulating course, with increasing and decreasing symptoms. In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
With the presence of severe symptoms, diagnosing chronic prostatitis is easy. But this disease is often asymptomatic, which complicates its detection. For diagnostic purposes, various studies are conducted.
The Association of Urologists has developed a questionnaire, thanks to which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated in such a way that the patient's subjective feelings can be ascertained. Not every man is able to 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. In the list of diagnostic methods used, the determination of the patient's immune status.
Laboratory research methods
If you suspect chronic prostatitis, first of all find out its nature: bacterial or abacterial. In the first case, it is necessary to determine the pathogen or pathogens, to find out which drugs they are sensitive to. For this, laboratory tests of urine and prostate secretions are carried out.
If, after a period of 10 days after DRE, the PSA test shows an excess level of prostate-specific antigen of 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 analysis of urine;
- LHC culture of prostate secretions.
Instrumental research methods
TRUS (transrectal ultrasound diagnostics) is performed using equipment equipped with instruments that are inserted into the patient's rectum. If an irregularly shaped hypoechoic area is found, there is reason to suspect a malignant neoplasm. In chronic prostatitis, scarring, compaction of gland tissue structure, changes in 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, its composition. This study includes several tests: uroflowmetry, cystometry, measurement of the amount of residual urine, assessment of pressure in the bladder and the speed of urine outflow.
Tomography (computer or magnetic resonance) is necessary to exclude benign and malignant neoplasms. This research method is very informative and helps to assess the condition of the prostate tissue.
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, chronic prostatitis is difficult to treat, requiring a radical study of lifestyle, changes in habits, and in some cases, changes in work. 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 the elimination of stagnation.
This issue is solved by changing the lifestyle and including physiotherapy exercises in the daily schedule.
Exercise 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.
Thinking about how to treat chronic prostatitis, you need to decide on a serious review of your attitude to your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet, and sexual abstinence.
Course treatment method:
- The most effective in the treatment of 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, microclysters with a warm painkiller solution. NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, combinations of microelements have proven their effectiveness.
- Physiotherapy methods are only possible in the subacute stage of the disease. They improve microcirculation, improve immunity: UHF, microwaves, electrophoresis, laser, magnetotherapy.
- Massage is another effective method to influence the prostate. It opens the channels, 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 consultation.
Treatment of chronic prostatitis
With a long-term course (at least a month) of exposure to the prostate, there is no 100% guarantee of recovery. Preferences for herbal preparation, immunocorrection, change of household habits:
- Phyto preparations are widely used in urological practice. They can accumulate at the site of the most active pathological processes, protect cells from oxidation, remove free radicals, and inhibit the growth of glandular tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of the microbe to the drug.
- Medicines 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 stopped with the appointment of alpha-blockers, muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secret of the gland through the urethra, improve blood circulation, and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, sitting warm water bath or herbal microclyster.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates the production of a lot of urine, prevents the symptoms of hangover, the development of ascending cystitis, pyelonephritis.
- For constipation, laxatives of plant origin are used.
- Urologists, psychologists, together with patients, develop individual long-term programs of daily routine, necessary rest, diet, sinful physical activity, and sexual activity.
- If the resistance of the chronic process to therapy persists, preventing the outflow of urine, 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, full of impotence, urinary incontinence. Young people do not undergo surgery, as this can cause infertility.
Recommendations for outpatient treatment
The patient must avoid situations where he can get injuries to the pelvic organs.
It is necessary to exclude any load on the prostate: do not ride a bicycle, do not do strength training, do not carry heavy loads.
If the work is inactive, every 2-3 hours it is necessary to warm up, do squats, leg swings, run in place.
It is necessary to try to normalize sexual life, which is very important to eliminate secret stagnation in the prostate.
It is recommended to limit to a minimum dose or completely eliminate the use of alcohol.
Treatment with drugs
In chronic prostatitis, outpatient treatment is mostly done. If the pathological process continues and it is not possible to achieve remission with 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, 5-alpha reductase inhibitors and alpha 1-blockers are recommended. They contribute to the normalization of 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:
Methods of treatment of 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 medicine for the suppression and destruction of 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 can also be included in the treatment plan for patients with abacterial prostatitis. Such therapy is carried out for preventive purposes. According to the indications, treatment with penicillin preparations is connected.
After completion of antibiotic therapy, treatment with hormonal drugs begins.
With intraprostatic reflux, it is necessary to take a blocker.
Painkillers are effective in relieving pain.
Treatment with herbal medicine
Many people doubt whether chronic prostatitis can be cured with herbal medicine. The answer to this question was obtained with many years of use of this health-improving agent in urological practice.
Today the following medical complexes are recommended:
All these drugs have a good effect on the work of the male genitourinary system. Effective treatment of chronic prostatitis is possible if urinary function is normalized. The components that make up herbal medicine perform this task. They help reduce the frequency of impulses, eliminate sluggish jet syndrome.
Patients with chronic prostatitis are recommended phytocollections, which include pumpkin extract or pumpkin seeds. 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 healing agents are considered adjunctive drug therapy.
Treatment is not medicine
Non-drug therapy methods allow you to act directly on the prostate, increasing the concentration of drugs in its tissues, helping to relieve congestion.
For this purpose, the following methods are used: rectal ultrasonic exposure;
Microwave hyperthermia is performed using a rectal probe inserted into the patient's anus. On the device, you can set the required temperature for a certain type of exposure. To increase the concentration of the drug in the prostate requires heating to 38-40°C. 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;
- improve blood microcirculation;
- new capillaries are formed;
- pathogenic microflora is suppressed;
- the process of cell division is activated, which contributes to tissue regeneration.
During the period of research on the effect of laser therapy on patients with prostatitis, side effects, but positive for the purpose of treatment, have been observed. For those who complete the course, potency increases, erectile dysfunction is eliminated, and vitality is restored. 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 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 prostol, transurethral resection is used.
Surgery is performed under TRUS control.
If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If, in combination with this pathology, sclerosis of the bladder neck is observed, a partial resection of the prostate is performed.
With blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate violations of secretory patency. For this purpose, incisions are made in the seminal vesicles and excretory ducts. With an abscess, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis
There are some effective exercises to stimulate the prostate, which help relieve congestion. This complex was developed for patients suffering from hip joint problems. Practice has shown that this exercise is useful for those diagnosed with prostatitis. Classes can be held at a convenient time, the complex will take no more than 15 minutes to complete.
- Lying on the gymnastic mat, stretch both arms up.
- They bend their knees and pull it towards themselves, simultaneously spreading it in different directions.
- Raise the pelvis as far as they can.
- Repeat 10-12 times.
- Standing on the mat, do a deep squat.
- Repeat 10-12 times.
- 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.
Some men manage to cure chronic prostatitis completely. Prostate inflammation often goes into long-term remission. But when conditions arise for pathological activation, relapse occurs. Aggravation begins with the onset 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 a study of the condition of the prostate, take an analysis for PSA. With systematic monitoring of the state of the gland, it is possible to identify in time the process that provokes the relapse of the disease. But even with a long amnesty, there is no guarantee that it will not be violated.
Patients must follow the recommendations to avoid worsening of the disease. It is recommended to balance the diet, excluding fatty and spicy foods from it. Acceptance of phytopreparation and traditional medicine should be agreed with the attending physician. With this approach, you can minimize the risk of exacerbation of chronic prostatitis.
To prevent the occurrence of unpleasant diseases for men, it is necessary to eliminate provoking factors and follow simple rules:
- Live a healthy lifestyle, abandon bad habits.
- Don't be cold.
- Drink at least 1. 5-2 liters of water a day.
- Strengthen immunity, walk a lot, harden.
- Engage in physical education and sports, attend fitness clubs.
- Avoid stressful situations.
- Practice a normal sex life with a normal partner.