Many men suffer from chronic prostatitis but attribute the symptoms to other diseases or waste time with ineffective treatments. From our article you will learn complete information about this male problem: causes, exact symptoms and methods of diagnosis, various methods of treatment.
Despite all the successes of modern medicine, the diagnosis of such a disease as chronic prostatitis causes some difficulties. This negatively affects the effectiveness of its treatment.
What is chronic prostatitis
In the ICD-10 (International Classification of Diseases, 10th revision), there is no such disease as "chronic prostatitis". In addition, there is no single and generally accepted feature of this pathology. In urological practice it is customary to use the classification developed by the AHI (American Institute of Health). It defines the categories of prostate diseases. What can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses, 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 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 family performance and relationships. Patients' quality of life is reduced to the same extent as people who have had a heart attack or who suffer from angina pectoris.
According to various sources, every 3rd or 4th man is diagnosed with prostatitis. And most often this is not the initial or acute stage of the disease, but an already formed and ongoing long-term process - chronic.
Not so long ago it was believed that this pathology was inherent mainly in older men. But the statistics have disproved this notion. Today it is known that chronic prostatitis is a disease of men of childbearing age who are sexually active.
More than 30% of patients go to a specialist with ailments characteristic of the chronic form of 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 diverse. Of all the variety of negative factors that affect a man's health, it is difficult to isolate exactly those that provoked the development of the disease. Often it is a set of situations and circumstances that accompany a man's life.
The main causes of chronic abacterial prostatitis are the following:
- arrhythmia (irregularity) of sexual intercourse;
- hypodynamy, typical of overweight people;
- prolonged stressful conditions;
- the predominance of high-fat foods in the diet;
- negative impact on the body in dangerous industries.
Chronic bacterial prostatitis is the result of not fully cured bacterial prostatitis. Or the man ignored the ailments and didn't ask for help from a urologist. Therefore, no treatment was given.
Chronic prostatitis of the abacterial type develops due to exposure to infectious agents against the background of a decrease in immunity. As a rule, such patients are diagnosed with diseases of the endocrine system.
The factors provoking the development of chronic bacterial prostatitis are:
- surgery on the prostate (if antibiotic therapy was not performed before the operation);
- refusal to use contraceptives;
- lack of habit of keeping one's body clean.
Symptoms of chronic prostatitis
Today there are many fictions about chronic prostatitis. For this reason, any temporary violations of sexual function are attributed to this disease. You can often hear the opinion that a decrease in sexual desire and erectile dysfunction is due to prostatitis, and if a man is aged, then chronic prostatitis.
This is not true, as sexual dysfunction has many other causes and the main symptom of chronic prostatitis is pain. All other signs can be considered concomitant 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 myosfacial trigger zones near the prostate, which appear as a result of injuries and surgery. Pain in these areas can be considered a symptom of inflammation of the prostate.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and small pelvis emerge, lasting at least 3 months. The pain is localized near the prostate, radiating 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 a decrease in sexual desire, erectile dysfunction. These symptoms are also characteristic of other diseases of the urogenital area. Therefore, they cannot be said to be the hallmarks of chronic prostate disease.
An important symptom is orgasm fading. If the patient began to notice that the acuity of sensations during ejaculation had disappeared, this is an occasion for a more attentive attitude to her health and a signal to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urinary tube increases, and a deterioration in the quality of urination occurs. Patients with chronic prostatitis notice a frequent need to urinate at night. The process of urine excretion is accompanied by a burning sensation, pain, pain. There is often urinary incontinence.
The signs of chronic prostatitis can be expressed in whole or in part. Much depends on the state of health of the patient, the presence or absence of other diseases. Chronic prostatitis is characterized by a wavy course, with an increase and decrease in symptoms. In this disease, the inflammatory process is not acute.
Chronic Prostatitis Diagnosis
With severe symptoms, diagnosing chronic prostatitis is easy. But this disease is often asymptomatic, which complicates its detection. For diagnostic purposes, a whole range of studies are performed.
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 subjective feelings of the patient can be ascertained. Not all men are able to give a correct assessment of their erectile function, the quality of orgasm and other details of their sexual life. Patient-filled questionnaires provide the specialist with the information needed to make a diagnosis. In urological practice, the NIH-CPS scale is often used.
To differentiate chronic prostatitis from other diseases, a neurological examination is performed. In the list of diagnostic methods used, the 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 bacterial. 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 are performed on the secretion of urine and prostate.
If, after a period of 10 days after the DRE, the PSA test showed an excess of the prostate specific antigen level of 4. 0 ng / ml, this is a reason to refer the patient for a biopsy in order to rule out a oncological process.
The following search methods are recommended:
- scraping from the urethra;
- general and biochemical analysis of urine;
- LHC culture of prostatic secretion.
Instrumental research methods
TRUS (transrectal ultrasound diagnosis) is performed using equipment equipped with an instrument that is inserted into the patient's rectum. If an irregularly shaped hypoechoic area is detected, there is every reason to suspect a malignant neoplasm. In chronic prostatitis, scars, compaction of the structure of the glandular tissue, changes in the seminal vesicles can be observed.
UDI is the primary method of functional diagnostics. It allows you to find out the nature of urination, signs of stagnation of urine, its composition. The study includes several tests: uroflowmetry, cystometry, measurement of the residual volume of urine, evaluation of the pressure inside the bladder and the rate of urine outflow.
Tomography (computer or magnetic resonance imaging) is needed to rule out benign and malignant neoplasms. These research methods are highly informative and help assess the condition of the prostate tissues.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach. One dose of the drug is not enough. Physiotherapeutic procedures, therapeutic exercises are required. In general, chronic prostatitis is difficult to cure, requires a radical lifestyle review, changes in habits and, in some cases, a 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 bacterial in nature, prostate congestion played an important role in its formation. A viscous secret deposited 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 is solved by changing the lifestyle and including physiotherapy exercises in the daily program.
Exercise complexes have been developed that are suitable for different life situations:
- for those men who are forced to sit most of the time (drivers, employees, 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 rest.
Course treatment methods:
- 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.
- The pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers. NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, a combination of microelements have proven their effectiveness.
- Physiotherapeutic methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Massage is another effective method of influencing the prostate. Opens the ducts, 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 surgery.
- Psychological counseling.
Treatment of chronic prostatitis
With long-term exposure (at least one month) to the prostate, there is no guarantee of 100% cure. Priorities for herbal preparations, immunocorrection, change of household habits:
- Phytotherapeutic 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 glandular tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Drugs that improve immunity not only help to cope with prostatitis, but also correct the negative effect of antibiotics that disrupt 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 minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, semi-hot or herbal micro-enemas.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates abundant urine output, prevents symptoms of intoxication, the development of ascending cystitis, pyelonephritis.
- For constipation, laxatives of plant origin are used.
- The urologist, psychologist, together with the patient, develops an individual long-term program of the daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- In case of resistance of the chronic process to ongoing therapy, blocking the outflow of urine, surgical intervention is prescribed: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). Practiced in exceptional cases, fraught with impotence, urinary incontinence. Young people do not undergo surgery, as this can cause infertility.
Recommendations for outpatient treatment
The patient must avoid situations in which he can suffer injury 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 work is sedentary, 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 extremely important to eliminate the stagnation of the secret in the prostate.
It is recommended to limit to the minimum doses or completely eliminate the use of alcohol.
Treatment with drugs
In chronic prostatitis, outpatient treatment is predominantly performed. If the disease process persists and remission cannot be achieved with this method, hospitalization is recommended. In a hospital, under the supervision of medical staff, there are many more opportunities to comply with 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 contribute to the normalization of hormonal levels and eliminate the symptoms of pathology. 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 a preliminary laboratory study of prostate secretion.
There is no universal drug for the suppression and destruction of pathogenic microflora. What works for one patient may not work for another. For this reason, there are a lot of negative reviews about the 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 bacterial form of prostatitis. Such therapy is carried out for preventive purposes. According to indications, treatment with penicillin drugs is connected.
After the completion of antibiotic therapy, treatment with hormonal drugs begins.
With intraprostatic reflux, it is necessary to take a-blockers.
Pain relievers are effective in relieving pain.
Treatment with herbal remedies
Many doubt that chronic prostatitis can be cured with herbal remedies. The answer to this question has been obtained from many years of using these health enhancing agents 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 the function of urination is normalized. The components that make up herbal remedies perform this task. They help reduce the frequency of impulses, eliminate the syndrome of a slow jet.
Phytocollections, which include pumpkin extract or pumpkin seeds, are recommended for patients with chronic prostatitis. The latter have a unique chemical composition and act in three directions simultaneously:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered the main method of treatment. These curative agents are considered to be concomitant drug therapy.
Non-drug treatment
Non-drug methods of therapy allow you to act directly on the prostate, increase the concentration of drugs in its tissues, help eliminate congestion.
For this purpose, the following methods are used: ultrasonic rectal exposure;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus. On the device it is possible to set the required temperature for a particular type of exposure. To increase the concentration of the drug in the prostate it is necessary to heat 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, the following processes occur in the prostate gland:
- activation of redox reactions;
- improves blood microcirculation;
- new capillaries are formed;
- pathogenic microflora is suppressed;
- the cell division process is activated, which contributes to tissue regeneration.
During the research period on the effects of laser therapy on patients with prostatitis, a side effect, but positive for the purpose of treatment, was noted. In those who completed the course, potency increased, erectile dysfunction was eliminated and vitality was restored. To achieve this, it is necessary to use a beam with a certain wavelength. In general, low-intensity laser radiation is used for the treatment of chronic prostatitis.
Patients can, on their own initiative, undergo a course of laser therapy, unless 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 free him from prostolytes, transurethral resection is used.
Surgery is performed under the supervision of TRUS.
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 the blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate violations of the patency of the secret. For this purpose, an incision is 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 a number of effective exercises to stimulate the prostate, which helps eliminate congestion. This complex was developed for patients with hip joint problems. Practice has shown that these exercises are beneficial for those diagnosed with prostatitis. Classes can be held at a convenient time, the completion of the complex will take no more than 15 minutes.
Exercise 1
- Lying on an exercise mat, he stretches both arms upward.
- They bend their knees and pull them towards themselves, simultaneously spreading them in different directions.
- Raise your pelvis as far as possible.
- Repeat 10-12 times.
Exercise n. 2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise # 3
- Lie on your stomach.
- Raise 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 obtaining a high therapeutic effect.
Treatment prognosis
Few men manage to completely cure chronic prostatitis. Inflammation of the prostate often enters a long-term remission phase. But when the conditions arise for the activation of the pathology, a relapse occurs. The exacerbation begins with the onset of pain in the prostate. They are often accompanied by urinary disorders. At the first symptoms of 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 studies on the state of the prostate, do an analysis for PSA. With systematic monitoring of the state of the gland, it is possible to timely identify the processes that provoke a relapse 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 for preventing exacerbations of the disease. It is recommended to balance the diet, excluding from it fatty and spicy foods. The reception of phytopreparations and traditional medicine must be agreed with the attending physician. With this approach, you can minimize the risk of exacerbation of chronic prostatitis.
Prevention
To prevent the occurrence of an unpleasant disease for men, it is necessary to eliminate the provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Do not catch cold.
- Drink at least 1. 5-2 liters of water per day.
- Strengthen immunity, walk a lot, harden.
- Engage in physical education and sports, attend fitness clubs.
- Avoid stressful situations.
- Have a regular sex life with a regular partner.