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, different treatment methods.
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 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: long-lasting (at least 3 months) pain in the perineal area.Therefore, chronic prostatitis can be called a long-term inflammatory process, the consequence of which is 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 quality of life of patients 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 third or fourth man is diagnosed with prostatitis.And most often it is not about the initial or acute phase of the disease, but about an already formed and long-term process - chronic.
Not so long ago, it was generally accepted that this pathology is characteristic mainly of older men.But statistics refute this opinion.Today it is known that chronic prostatitis is a disease of men of reproductive age who are sexually active.
More than 30% of patients consult a specialist with complaints characteristic of chronic 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.Of the various negative factors that affect a man's 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 man's life.
The main causes of chronic abacterial prostatitis are as follows:
- arrhythmia (irregularity) of sexual intercourse;
- physical inactivity, which is typical for 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.Therefore, no treatment was carried out.
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 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, any temporary disturbances of sexual function are attributed to this disease.One can often hear the opinion that reduced libido and erectile dysfunction are the result of prostatitis, and if it is an older man, 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 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 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.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and pelvis, which last 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 on your feet for a long time), the pain intensifies.
A characteristic sign of the disease is premature ejaculation.Patients have reduced sexual desire and erectile dysfunction.These symptoms are also characteristic of other genitourinary diseases.Therefore, it cannot be said that they are signs of chronic prostate disease.
An important symptom is the weakening of orgasm.If the patient begins to notice that the heaviness of the sensation during ejaculation has disappeared, this is a reason for a more attentive attitude towards his health and a signal of 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 notice a frequent need to urinate at night.The process of passing urine is accompanied by a burning sensation, stinging and pain.Urinary incontinence is common.
Signs of chronic prostatitis can be expressed completely or partially.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 symptoms of waxing and waning.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 makes it difficult to detect.A whole series of studies is carried out for diagnostic purposes.
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, quality of orgasm and other details of sexual life.Questionnaires filled out by the patient 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.The list of diagnostic methods used includes clarification of the patient's immunity status.
Laboratory research methods
If chronic prostatitis is suspected, first of all they find out its nature: bacterial or abacterial.In the first case, it is necessary to identify the pathogen or pathogens and find out which drugs they are sensitive to.To achieve this, laboratory tests of urine and prostate secretions are performed.
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 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) 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, scarring, compaction 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 find out the nature of urination, signs of urine stagnation and its composition.The study includes several tests: uroflowmetry, cystometry, measurement of the remaining 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.Just taking medication 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, 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 secretion 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 can be solved by changing your lifestyle and including physical therapy classes in your 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 people with excess body weight;
- for those who do not have time for exercises.
Thinking about how to treat chronic prostatitis, you must 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.
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, microenemas and warm solutions of painkillers.NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
- Physiotherapy methods are possible only in the subacute phase of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
- Massage is another effective method of influencing the prostate.It opens 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.
- Psychologist consultations.
Treatment of chronic prostatitis
With long-term, course (at least one month) effect on the prostate, there is no 100% guarantee of cure.The priority is herbal medicines, immunocorrection, change of household 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 gland tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Medicines that strengthen immunity not only help in the fight against prostatitis, but also correct the negative effects of antibiotics that disrupt the function of the immune system.
- The pain syndrome is alleviated by using 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 reduce congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitting baths or microenemas with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.It stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis and 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.
- If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of the entire affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy).Practiced in exceptional cases, it is full of impotence and 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 avoid any stress on the prostate: do not ride a bicycle, do not do strength exercises, do not carry weights.
If the job is sedentary, every 2-3 hours you have to warm up with squats, leg swings and running in place.
You must try to normalize your sex life, which is extremely important to eliminate stagnation of secretions in the prostate.
It is recommended to limit the consumption of alcohol to minimum doses or completely exclude the consumption of alcohol.
Drug treatment
Chronic prostatitis is usually 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 follow 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 help normalize hormone levels and eliminate 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 for patients with abacterial prostatitis.This therapy is carried out for preventive purposes.According to indications, treatment with penicillin drugs is included.
After the end of the antibacterial therapy, treatment with hormonal drugs begins.
For intraprostatic reflux, it is necessary to take α-blockers.
Painkillers are effective for pain.
Treatment with herbal medicines
Many people doubt that 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 medicinal agents 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 provided that urinary function is normalized.The components included in herbal medicines perform this task.They help to reduce the frequency of urges and eliminate slow flow syndrome.
Herbal mixtures containing pumpkin extract or pumpkin seeds are recommended for patients with chronic prostatitis.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 health-enhancing agents are considered to be used concurrently with drug therapy.
Treatment without drugs
Medicine-free therapy methods allow you to act directly on the prostate, increasing the concentration of drugs in its tissues and helping to remove congestion.
For these purposes, the following techniques are used: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus.The device can be used to adjust 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;
- blood microcirculation improves;
- new capillaries are formed;
- pathogenic microflora is suppressed;
- The process of cell division is activated, which promotes tissue regeneration.
During the research period of the effects of laser therapy on patients with prostatitis, a side effect was observed, but positive for treatment purposes.Those who completed the course increased potency, eliminated erectile dysfunction and regained vitality.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 it 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 gland tissues.In order to get rid of prostatolith, transurethral resection is used.
Surgical intervention 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.
When the seminal and excretory ducts are blocked, endoscopic operations are indicated in order to remove the obstruction of secretion passage.For this purpose, an incision is made on 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 in stimulating the prostate, which helps relieve congestion.This complex was developed for patients with hip joint problems.Practice has shown that these exercises are also useful for people diagnosed with prostatitis.Classes can be held at a convenient time;It takes no more than 15 minutes to complete the complex.
Exercise no.1
- Lying on the gym mat, extend both arms upwards.
- Bend your knees and pull them towards you while spreading them in different directions.
- Lift your pelvis as high as you 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, 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 can 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.They perform prostate condition examinations and PSA tests with the same frequency.By systematically monitoring the state of the gland, the processes that cause the recurrence 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 must follow the recommendations to prevent the disease from worsening.It is recommended that you balance your diet by excluding fatty and spicy foods.The use of herbal medicines and traditional medicine must 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 remove provoking factors and follow simple rules:
- Lead a healthy lifestyle, discard 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, get stronger.
- Do physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.