Prostatitis is a disease that causes problems with urination, sexual dysfunction, pain in the perineum and lower abdomen. The cause of these symptoms is prostate inflammation.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located below the male bladder and in front of the rectum. The prostate consists of glandular and connective tissue. Its function is to produce fluid, which is partly made up of ejaculate. This fluid carries the sperm during ejaculation (ejaculation) and protects the sperm as it travels to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not go away for months or even years. The acute form of the disease appears suddenly and lasts a few weeks at most. It is usually easily treated, but sometimes becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure forever. But with proper treatment, there is every chance of achieving a long-term remission and significantly improving the patient's quality of life. We figured out how to understand that you have chronic prostatitis and what to do next.
What is chronic prostatitis
There are four types of prostatitis in total: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Among them, non-bacterial chronic prostatitis is the most common. And he is the worst to treat.
The disease is considered chronic if the symptoms do not disappear for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its recurrent course. This means that the symptoms may disappear for a while and then reappear. Without treatment, this condition can torment the patient for a long time.
Bacterial and non-bacterial forms have common symptoms. They usually include problems with urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. Moreover, the chronic form is much more common than the acute form. The reason for about 25% of visits to the urologist is related to chronic prostatitis.
Pathology can appear at any age, but the chronic form most often develops in men after 50 years.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of diseases have common symptoms but different causes.
Chronic bacterial prostatitis
The inflammatory process causes a bacterial infection from the urinary tract to enter the prostate. The provoking factor can be: acute form of prostatitis, UTI (urinary tract infection), STI. The causative agents of the inflammatory process in the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic non-bacterial prostatitis (chronic pelvic pain syndrome)
Researchers have not determined the causes of chronic pelvic pain syndrome. In this form, there is no infection in the prostate. What causes the interference in this case is not exactly known. There is an assumption that it can be caused by several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- the patient already had prostatitis and chronic pain remained despite treatment;
- urine entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- stress
Symptoms of chronic prostatitis
With chronic prostatitis, the symptoms torment the patient for a long time - several months or even years. The disease is characterized by a relapsing course, that is, problems appear and disappear.
Infectious and non-infectious prostatitis have common symptoms and include:
- urination disorders: frequent and sudden urges, difficult urination, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during sexual intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- nausea, vomiting
The disease also affects the patient's general condition. Some people experience irritability, increased fatigue, lethargy and anxiety.
If you have these signs, see a urologist. Some of them may indicate other more serious illnesses that require immediate medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, it is necessary to make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and the urinary system in men and women.
The initial consultation includes several stages:
- History taking.
The urologist will ask you about the reason for your visit, previous illnesses and medications you have taken now and before. - Examination of the genital organs
- Digital rectal examination.
During the procedure, the urologist inserts a finger into the patient's anus to feel the surface of the prostate. The test allows you to determine the size of the prostate and check for swelling and tenderness. - Other studies.
The doctor can prescribe one or more diagnostic procedures, some of which can be done immediately at the examination, some later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urinalysis
It allows you to see signs of infection. This can be indicated by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate specific antigen)
It helps to assess the state of the prostate. An elevated PSA level indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostate secretions
Prostate secretion is a fluid produced by the prostate. With changes in the organ, the composition of secretions also changes. For example, during an inflammatory process, white blood cells will be increased, and a high level of pathogenic bacteria may indicate a bacterial infection in the prostate. Microscopic examination of the fluid will help to see these changes. - Prostate massage collects prostate secretions. Massage can be combined with a digital rectal examination.
Instrumental research methods
- Cystoscopy. Inspection of the inner surface of the bladder with an endoscope - a thin flexible tube with a camera. The device is inserted into the bladder through the urethra. The study allows you to see problems with the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). For the examination, the specialist will carefully insert the ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
- MRI (magnetic resonance imaging) of the pelvis. It helps to assess the state of the prostate tissue. It may be necessary to see foci of inflammation of the prostate and rule out prostate cancer.
There is no special preparation for the urologist examination. But in order for the consultation to be as effective as possible, follow a few simple recommendations:
- For intimate hygiene, no special products should be used before use, only warm water is sufficient.
- Do not go to the toilet 2 hours before visiting the clinic. Then, at your appointment, if necessary, you can immediately do tests or undergo an ultrasound.
- If you take any medicines regularly, write down their names in your diary or notes in your phone.
- Bring the results of previous studies with you so that the specialist can see the full picture of the disease.
- Make a list of questions you want to ask your doctor at your appointment.
Treatment of chronic prostatitis
There is no universal method to get rid of prostatitis. Different treatments are indicated for different forms and manifestations of the disease.
To determine the type of chronic prostatitis, you must undergo diagnostics. Based on his results, the doctor will prescribe a therapy that will give results specifically in your case.
Unlike the acute form, chronic prostatitis cannot be cured forever. The doctor's goal is to achieve long-term remission and reduce symptoms.
Bacterial form: Treatment will include antibiotic therapy and other methods to relieve symptoms.
Non-bacterial form: Treatment is symptomatic. That is, each method is aimed at combating a specific symptom.
Recommendations for outpatient treatment
Lifestyle changes:
- Dietary restrictions
It is worth giving up alcohol, coffee, spicy and sour food. These products irritate the bladder and worsen the patient's condition. - Hot sitz baths, hot showers
Water procedures will help reduce the manifestations of the disease. - More water
Drink enough fluids. More frequent trips to the toilet will help flush out pathogenic bacteria from the bladder. - Chair cushions
When sitting, place a soft pillow under you. - Physical activity
Regular walks and exercise will help reduce pain and relieve congestion. - Regular sex life
Sexual activity is useful for preventing congestion.
The above methods will complement the therapy prescribed for you, but not replace it.
Drug treatment
- Antibiotics. Antibacterial therapy is indicated for the infectious form. Medicines destroy the bacteria that cause inflammation of the prostate. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, you must undergo a study of prostate secretions and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. It helps with urinary disorders. Medicines relax the organs of the urinary system and this relieves the symptoms. Alpha blockers are most often used for non-infectious chronic prostatitis, but to improve the patient's well-being, they can also be prescribed for the infectious form of the inflammatory process.
- NSAIDs (non-steroidal anti-inflammatory drugs). It is prescribed to relieve pain and reduce prostate swelling.
- Muscle relaxants. It is used when you need to relieve spasm of the pelvic muscles.
- Antidepressants. Indicated for depression, which can develop due to stress and long-term pain.
- Medicines for the treatment of erectile dysfunction. It is used if prostatitis is causing problems in your sex life.
- Laxatives. They may prescribe it if symptoms include pain during bowel movements.
Treatment with herbal medicines
Herbal medicines.Herbal medicines do not work as the main method of treatment. They can be used as a supplement to reduce prostate inflammation. For this purpose, medicines are prescribed with quercetin, a substance found in vegetables, fruits and berries.
Treatment without drugs
- Physiotherapy and prostate massage. The methods are used to relax the pelvic floor muscles, relieve pain and prevent congestion. For a therapeutic effect, the patient goes through several massage sessions. Massage is contraindicated in the development of pathology complications: abscesses, stones in prostate tissues.
- Catheterization of the bladder. It may be necessary if you have bladder problems.
- Psychotherapy. Due to chronic pain, patients with prostatitis may develop depression and anxiety disorders. Psychological problems negatively affect the patient's well-being and worsen the pain syndrome. In such cases, consultation with a psychotherapist will help.
- Biofeedback programs. It can help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be needed if complications develop.
Types of operations:
- TUR (transurethral resection) of the prostate.Indicated for the appearance of stones in prostate tissues
- Prostatectomy. Removal of the prostate in some cases is performed in case of abscess (accumulation of pus) or serious disorders in the work of the urinary bladder.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the muscles of the pelvic floor and alleviate the symptoms associated with urination disorders. How to do the exercises:
- Sit comfortably.
- Tighten your pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
- Relax your muscles.
- Repeat this 10-15 times.
- You can gradually increase the number of repetitions and strain the muscles for a longer time.
- You should do 2-3 approaches per day.
Changes can be noticed only with regular exercise.
Treatment prognosis
It is very difficult to cure chronic prostatitis forever. In some cases, the disease is incurable, but there is always a chance to achieve a long-term remission and return the patient to the previous quality of life. To do this, it is important to undergo a thorough diagnosis in order to determine the form of the disease. If the cause of the inflammatory process is an infection, antibacterial therapy will help. And for non-infectious chronic prostatitis - well-chosen symptomatic therapy.
Complications of chronic prostatitis can include:
- Bacteremia (bacterial blood poisoning). Bacteria entering the bloodstream. It can be a consequence of bacterial forms of pathology. Bacteremia develops suddenly and can lead to sepsis. This condition is life-threatening.
- Epididymitis (inflammation of the epididymis). The disease can cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in the tissue). In the case of an abscess, an operation is performed to clean and drain the purulent focus, in rare cases the prostate can be removed.
- Infertility. Problems with conception can occur when there is a lack of sperm due to an inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bone
- Depressive disorder. Chronic pathologies increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and his emotional state.
It is important to prevent prostatitis:
- Use barrier contraception (condoms): STIs are a factor that increases the risk of developing prostatitis
- Visit a urologist once a year if you are over 40 years old
- If you have symptoms of a UTI, contact your doctor immediately