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 methods of diagnosis, different 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 his 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, it is customary to use the classification developed by AHI (American Institute of Health). Defines the categories of prostate diseases. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To establish this diagnosis, the following symptoms are required: prolonged (at least 3 months) pain in the perineum. Thus, chronic prostatitis can be called a long-term inflammatory process that results in changes in the structure of the prostate and its dysfunction. But other prostate diseases also lead to such sad results. This is why the diagnosis of chronic prostatitis is difficult.
Epidemiology
Prostatitis is one of the most common diseases in men. It has a significant impact on performance and family relationships. The patients' quality of life was reduced to the same extent as in people who had a heart attack or suffered from angina pectoris.
According to various sources, every third or fourth man is diagnosed with prostatitis. And most often it is not the initial or acute stage of the disease, but an already formed and long-term process - chronic.
Not so long ago, it was thought that this pathology was characteristic mainly of older men. But statistics disproved this idea. Today it is known that chronic prostatitis is a disease of men of reproductive age who are sexually active.
More than 30% of patients turn to a specialist with complaints characteristic of the chronic form of prostatitis. Often, at the time of 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 different. From the whole range of negative factors that affect human health, it is difficult to single out exactly those that caused the development of the disease. It is often a complex of situations and circumstances that accompany a person's life.
The main causes of chronic abacterial prostatitis are as follows:
- arrhythmia (irregularity) of sexual intercourse;
- hypodynamia, typical of overweight people;
- long-term stressful conditions;
- predominance of foods rich in fat in the diet;
- negative impact on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely cured bacterial prostatitis. Or the man ignored the complaints and did not seek help from a urologist. Because of this, no treatment was given.
Chronic abacterial 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 that cause 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 habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many fictions about chronic prostatitis. For this reason, any temporary impairment of sexual function is attributed to this disease. One can often hear the opinion that the reduction of sexual desire and erectile dysfunction is due to prostatitis, and if the man is old, then it is 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 mostly similar. This is due to the creation of myofascial trigger zones near the prostate, which appear as a result of injuries and surgical interventions. Pain in these areas can be understood as a symptom of prostate inflammation.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and small pelvis, which last at least 3 months, come to the fore. The pain is localized near the prostate, radiates to the sacrum, rectum, scrotum. With prolonged exposure to negative factors (carrying heavy loads, excessive physical activity, being "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 also characteristic of other diseases of the urogenital area. Therefore, it cannot be said that they are signs of chronic prostate disease.
An important symptom is the weakening of orgasm. If the patient has begun 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 denser, the pressure on the urethra increases, and the quality of urination deteriorates. Patients with chronic prostatitis notice a frequent need to urinate at night. The process of passing urine is accompanied by a burning sensation, pain, pain. Urinary incontinence is often present.
Signs of chronic prostatitis can be expressed completely or partially. 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
In the presence of severe symptoms, diagnosing chronic prostatitis is easy. But this disease is often asymptomatic, which makes it difficult to detect. A whole series of studies is carried out 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 the patient's subjective feelings can be determined. 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 the specialist with the information needed to make a diagnosis. In urological practice, the NIH-CPS scale is most often used.
In order to distinguish 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 of all find out what its nature is: bacterial or abacterial. In the first case, it is necessary to determine the pathogen or pathogens, in order to determine which drugs they are sensitive to. For this, laboratory tests of urine and prostate secretions are carried out.
If, 10 days after DRE, the PSA test showed an excess level of prostate-specific antigen of 4. 0 ng/ml, this is a reason to refer the patient to 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 diagnostics) is performed using equipment equipped with an instrument that is inserted into the patient's rectum. If an irregularly shaped hypoechoic area is found, there is every reason to suspect a malignant neoplasm. With chronic prostatitis, scars, compaction of the glandular tissue structure, and changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnostics. It allows you to find out the nature of urination, 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 urinary bladder and the rate of urine outflow.
Tomography (computer or magnetic resonance) is necessary to exclude benign and malignant neoplasms. These research methods are very informative and help to assess the state 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, it requires a radical rethinking of lifestyle, change of habits, and in some cases, change of job. Urologists insist that only a series of measures will help to completely get rid of this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or abacterial in nature, congestion in the prostate played a major role in its development. 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 attention should be focused on eliminating stagnation.
The problem is solved by changing the way of life and including physiotherapy exercises 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.
Thinking about how to treat chronic prostatitis, you need to decide on a serious review of your attitude towards your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.
Treatment course methods:
- The most effective treatment for prostatitis is etiotropic therapy. If the underlying cause of prostatitis is an infection, the priority is a course of antimicrobial agents that alleviate the manifestations of inflammation.
- The pain syndrome is alleviated with analgesics, antispasmodics, rectal suppositories, microclysters with warm solutions of painkillers. NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, a combination of microelements have proven their effectiveness.
- Physiotherapy methods are possible only in the subacute phase of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Massage is another effective method of influencing 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 consultations.
Treatment of chronic prostatitis
With long-term (at least one month) exposure to the prostate, there is no 100% guarantee of cure. Priority herbal preparations, immunocorrection, change of household habits:
- Phyto 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 growth of gland tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Medicines to strengthen immunity not only help to solve prostatitis, but also correct the negative effect of antibiotics that disturb the function of the immune system.
- The pain syndrome is stopped by 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 reduce congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, sitting hot baths or herbal microclysters.
- In severe cases, intravenous fluids with diuretics are indicated. It stimulates copious excretion of urine, prevents symptoms of intoxication, development of ascending cystitis, pyelonephritis.
- Herbal laxatives are used for constipation.
- Together with the patient, the urologist and psychologist create an individual long-term program of daily routine, necessary rest, nutrition, dosed physical activity and sexual activity.
- In the case of resistance of the chronic process to current therapy, blocking of urine outflow, 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 used in exceptional cases, filled with impotence, urinary incontinence. Young people do not undergo surgery, because it can cause infertility.
Recommendations for outpatient treatment
The patient must avoid situations in which he may suffer injuries to 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 job is sitting, every 2-3 hours you need to warm up, do squats, swing your legs, run in place.
It is necessary to try to normalize sexual life, which is extremely important for removing the stagnation of the secret in the prostate.
It is recommended to limit to minimum doses or completely exclude the use of alcohol.
Drug treatment
Chronic prostatitis is mostly treated on an outpatient basis. If the pathological process persists 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 many 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 sense, 5-alpha reductase inhibitors and alpha 1-blockers are recommended. They contribute to the normalization of the hormonal level and remove the symptoms of pathology. Medicines such as Finasteride and Terazosin are prescribed for these purposes.
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 by a preliminary laboratory study of prostate secretions.
There is no universal remedy 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 advertised drugs 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 of patients with abacterial prostatitis. Such therapy is carried out for preventive purposes. According to the indications, treatment with penicillin preparations is associated.
After the antibiotic therapy is completed, treatment with hormonal drugs begins.
In case of intraprostatic reflux, it is necessary to take α-blockers.
Painkillers are effective for pain relief.
Treatment with herbal medicines
Many doubt that chronic prostatitis can be cured with herbal remedies. The answer to this question was obtained through the long-term use of these means to improve health in urological practice.
Today, the following medical complexes are recommended:
All these drugs have a beneficial effect on the work of the male genitourinary system. Effective treatment of chronic prostatitis is possible if urination function is normalized. The components that make up herbal medicines perform this task. They help reduce the frequency of urges, eliminate the sluggish jet syndrome.
Patients with chronic prostatitis are recommended phytocollections, which include pumpkin extract or pumpkin seeds. The latter have a unique chemical composition and act 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 healing agents are considered concurrent drug therapy.
Treatment without drugs
Medicine-free therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues, and help remove congestion.
The following methods are used for these purposes: rectal ultrasound exposure;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus. On the device, you can 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 therapy focuses on laser therapy. The possibilities of this technique are wide. Under the influence of the laser in the prostate, the following processes occur:
- activation of redox reactions;
- improves 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 effects of laser therapy on patients with prostatitis, a side effect was observed, but positive for treatment purposes. In 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 undergo laser therapy on their own initiative, 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 it 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 get rid of protoliths.
The operation is performed under the control of TRUS.
If complications such as prostate 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.
With the blockage of the seminal and excretory ducts, endoscopic operations are indicated to remove violations of the patency of the secret. For this purpose, an incision is made in the seminal vesicles and 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 for stimulating the prostate, which helps to clear the blockage. This complex was developed for patients with hip joint problems. Practice has shown that these exercises are useful for those diagnosed with prostatitis. Classes can be held at a convenient time, the complex will last no more than 15 minutes.
Exercise #1
- Lying on the gym mat, extend both arms upwards.
- They bend their knees and pull them towards them, simultaneously spreading them in different directions.
- Lift your pelvis as high as you 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, then the other.
- Repeat 10-12 times.
When performing this set of exercises, all movements should be smooth. This is the main condition for achieving a high therapeutic effect.
Treatment prognosis
Few men manage to completely cure chronic prostatitis. Prostate inflammation often goes into a phase of long-term remission. But when the conditions for the activation of the pathology appear, relapse occurs. Exacerbation begins with the appearance of pain in the prostate. They are often accompanied by urinary disorders. At the first symptoms of relapse, you should seek the help of a specialist.
Patients are recommended to visit a urologist regularly, at least once every six months. With the same frequency, they conduct studies on the state of the prostate, take a PSA analysis. With systematic monitoring of the condition of the gland, it is possible to timely identify the processes that cause the recurrence of the disease. But even with a long remission, there is no guarantee that it will not be violated.
The patient must follow the recommendations to prevent the disease from worsening. It is recommended to balance the diet, excluding fatty and spicy food. The reception of phytopreparations and traditional medicine should be arranged with the attending physician. With this approach, you can minimize the risk of exacerbation of chronic prostatitis.
Prevention
To prevent the appearance of an unpleasant disease for men, it is necessary to eliminate provoking factors and follow simple rules:
- Lead a healthy lifestyle, discard bad habits.
- Don't be cold.
- Drink at least 1. 5-2 liters of water a day.
- Strengthen immunity, walk a lot, harden up.
- Do physical education and sports, attend fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.