Prostatitis is a disease that causes problems with urination, sexual dysfunction, and pain in the perineum and lower abdomen. The cause of these symptoms is inflammation of the prostate.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located under the man's bladder and in front of the rectum. The prostate consists of glandular and connective tissue. Its function is to produce fluid, partly composed of ejaculate. This fluid transports the sperm during ejaculation (ejaculation) and protects the sperm on their way to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not disappear for months or even years. The acute form of the disease occurs suddenly and lasts a maximum of several weeks. The condition is usually easy to treat, but can sometimes become chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure permanently. However, with proper treatment, there is every chance of long-term remission and a significant improvement in the patient's quality of life. We figured out how to recognize that you have chronic prostatitis and what to do next.
What is chronic prostatitis?
In total, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic nonbacterial (chronic pelvic pain syndrome) and asymptomatic. The most common of these is nonbacterial chronic prostatitis. And he is the worst to treat.
A disease is considered chronic if the symptoms do not disappear for more than 3 months. However, they develop slowly and are less pronounced than the acute form.
Another characteristic feature of chronic prostate inflammation is its recurrent course. This means that symptoms may disappear for a while and then reappear. Without treatment, this condition can affect the patient for a very long time.
The bacterial and nonbacterial forms share common symptoms. These typically include problems with urination, sexual function, and perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases among men. In addition, the chronic form is significantly more common than the acute form. The reason for about 25% of visits to the urologist is chronic prostatitis.
The pathology can occur at any age, but the chronic form most often develops in men after 50 years of age.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or nonbacterial. These types of diseases have common symptoms but different causes.
Chronic bacterial prostatitis
If in the prostate secretion during the analysisdiscoveredLeukocytes and pathogens
The inflammatory process causes a bacterial infection to move from the urinary tract to the prostate. The provoking factor can be: acute form of prostatitis, urinary tract infection (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 nonbacterial prostatitis (chronic pelvic pain syndrome)
If in the prostate secretion during the analysisnot recognizedLeukocytes and pathogens
Researchers have not clarified the causes of chronic pelvic pain syndrome. In this form there is no infection of the prostate. It is not exactly known what causes disruptions in this case. It is suspected that this could be due to several factors:
- Stagnation due to sedentary work, lack of exercise, irregular sex life;
- The patient already had prostatitis and chronic pain persisted despite treatment.
- Urine enters 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 bother the patient for a long period of 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 urge to urinate, difficulty urinating, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during sexual intercourse;
- pain during ejaculation;
- decreased sexual desire (libido);
- fever, chills;
- Nausea, vomiting
The disease also affects the general condition of the patient. Some people experience irritability, increased fatigue, lethargy and anxiety.
If you have these signs, consult a urologist. Some of them may indicate other, more serious illnesses that require urgent medical attention. If treatment is delayed, there is a risk of life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you need to make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and urinary system in men and women.
The initial consultation includes several phases:
- historiography.
The urologist will ask you about the reason for your visit, any previous illnesses and any medications you are currently taking and have taken in the past. - Examination of the sexual 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 may prescribe one or more diagnostic procedures, some of which can be performed immediately at the appointment and others later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urinalysis
Allows you to detect signs of infection. This can be indicated by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate-specific antigen)
Helps assess the condition of the prostate. An increased PSA value indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostate secretion
Prostatic secretion is a fluid produced by the prostate. With changes in the organ, the composition of the secretion also changes. For example, during an inflammatory process there is an increase in white blood cells, and a high proportion of pathogenic bacteria can indicate a bacterial infection of the prostate. Microscopic examination of the fluid helps detect these changes. - Prostate secretion is collected using prostate massage. The massage can be combined with a digital rectal examination.
Instrumental research methods
- cystoscopy. Examination 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 identify problems with the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). For the examination, the specialist carefully inserts an ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
- MRI (magnetic resonance imaging) of the pelvis. Helps assess the condition of prostate tissue. It may be necessary to identify foci of prostate inflammation and rule out prostate cancer.
There is no special preparation for an appointment with a urologist. However, to make the consultation as effective as possible, follow a few simple recommendations:
- You should not use any special products for intimate hygiene before use, just warm water is sufficient.
- Do not go to the toilet 2 hours before your clinic visit. Then, at your appointment, you can have tests or an ultrasound scan immediately if necessary.
- If you take medications regularly, write down their names in your diary or notes in your phone.
- Take the results of previous studies with you so that the specialist can see a complete picture of the disease.
- Make a list of questions you would like to ask the 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 need to undergo diagnostics. Based on the results, the doctor will prescribe therapy that will produce results specific to your case.
In contrast to the acute form, chronic inflammation of the prostate cannot be cured permanently. The doctor's goal is to achieve long-term remission and relieve symptoms.
Bacterial form: Treatment includes antibiotic therapy and other methods to relieve symptoms.
Nonbacterial form: Treatment is symptomatic. That is, each method is aimed at combating a specific symptom.
Recommendations for outpatient treatment
Lifestyle Changes:
- Diet restrictions
It is worth giving up alcohol, coffee, spicy and sour foods. These products irritate the bladder and worsen the patient's condition. - Warm sitz baths, warm showers
Water treatments will help reduce the manifestations of the disease. - More water
Drink enough fluids. More frequent trips to the toilet help flush out disease-causing bacteria from the bladder. - Cushions for chairs
Place a soft pillow under you when sitting. - Physical activity
Regular walks and exercise help relieve pain and eliminate congestion. - Regular sex life
Sexual activity is helpful in preventing congestion.
The methods listed complement the therapy prescribed for you, but do not replace it.
Medication
- Antibiotics. In the infectious form, antibacterial therapy is indicated. The drugs destroy bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics. Therefore, before prescribing, you need to conduct an examination of prostate secretions and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary tract problems. The medication relaxes the organs of the urinary system and thus relieves the symptoms. Most often, alpha-blockers are used for non-infectious chronic prostatitis, but they can also be prescribed for an infectious form of the inflammatory process to improve the patient's well-being.
- NSAIDs (nonsteroidal anti-inflammatory drugs). Prescribed to relieve pain and reduce swelling of the prostate.
- Muscle relaxants. Used when you need to relieve spasms of the pelvic muscles.
- Antidepressants. Indicated for depression, which may develop due to stress and persistent pain.
- Medications used to treat erectile dysfunction. Used when prostatitis causes problems in your sex life.
- laxative. You may prescribe it if symptoms include pain during bowel movements.
Treatment with herbal remedies
Herbal remedies.Herbal medicines are not the main method of treatment. They can be used as a supplement to relieve prostate inflammation. For this purpose, medications containing quercetin, a substance found in vegetables, fruits and berries, are prescribed.
Non-drug treatment
- 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 undergoes a massage in several sessions. Massage is contraindicated in the development of pathological complications: abscess, stones in the tissue of the prostate.
- Bladder catheterization. May be necessary if you have problems with your bladder.
- psychotherapy. Due to chronic pain, patients with prostatitis may experience depression and anxiety disorders. Psychological problems negatively affect the patient's well-being and aggravate the pain syndrome. In such cases, consulting a psychotherapist can help.
- Biofeedback programs. Can help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be necessary if complications arise.
Types of operations:
- TUR (transurethral resection) of the prostate.Indicated when stones appear in the prostate tissue
- Prostatectomy. In some cases, the prostate gland is removed if there is an abscess (collection of pus) or serious problems with bladder function.
Exercises to treat chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and relieve symptoms of urinary tract problems. 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 use the muscles for longer.
- You should do 2-3 approaches per day.
Changes are only noticeable with regular exercise.
Treatment prognosis
It is very difficult to permanently cure chronic prostatitis. In some cases, the disease is incurable, but there is always the possibility of achieving long-term remission and returning the patient to the previous quality of life. For this purpose, a thorough diagnosis to determine the form of the disease is important. If the cause of the inflammatory process is infection, antibacterial therapy will help. And with non-infectious chronic prostatitis – well-chosen symptomatic therapy.
Complications of chronic prostatitis may include:
- Bacteremia (bacterial blood poisoning). Bacteria enter the bloodstream. May 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 (collection 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 if there is a lack of sperm due to an inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bones
- depression. Chronic pathologies increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a deterioration in a man's quality of life and emotional state.
To prevent prostatitis, it is important:
- Use barrier contraceptives (condoms): STIs are a factor that increases the risk of prostatitis
- Visit a urologist annually if you are over 40
- If you have symptoms of a urinary tract infection, contact your doctor immediately