Many men suffer from chronic prostatitis but attribute the symptoms to other diseases or waste time on ineffective treatment.In our article you will learn comprehensive information about this men's problem: causes, exact symptoms and methods of diagnosis, various methods of treatment.
Despite all the successes of modern medicine, the diagnosis of a disease such as chronic prostatitis presents certain difficulties.This also negatively affects the effectiveness of his treatment.
What is chronic prostatitis?
In the ICD-10 (International Classification of Diseases, 10th Revision) there is no disease like “chronic prostatitis”.There is also no single, generally recognized feature of this pathology.In urological practice, it is customary to use the classification developed by the AHI (American Institute of Health).It defines categories of prostate diseases.Conditions that can be described as “chronic” include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To make 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 consequences.Therefore, diagnosing chronic prostatitis is difficult.
Epidemiology
Prostatitis is one of the most common diseases among men.It has a significant impact on performance and family relationships.The quality of life of patients decreases to the same extent as people who have suffered a heart attack or suffer from angina pectoris.
According to various sources, every third or fourth man is diagnosed with prostatitis.And most often it is not about the initial or acute stage of the disease, but about an already formed and long-term process - chronic.
Not so long ago it was widely believed that this pathology was characteristic mainly of older men.But statistical data refuted this opinion.Today it is known that chronic prostatitis is a disease of sexually active men of childbearing age.
More than 30% of patients consult a specialist with complaints characteristic of chronic prostatitis.At the time of a visit to the doctor, the disease is often complicated by concomitant diseases: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very different.From the multitude of negative factors affecting a man's health, it is difficult to single out exactly those that provoked the development of the disease.Often it is a complex of situations and circumstances that accompany a man's life.
The main causes of chronic abacterial prostatitis are as follows:
- Dysrhythmia (irregularity) during sexual intercourse;
- physical inactivity, which is typical for overweight people;
- long-term stressful conditions;
- the predominance of high-fat foods in the diet;
- negative effects on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely healed bacterial prostatitis.Or the man ignored the complaints and did not seek 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 reduced immunity.As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors provoking the development of chronic bacterial prostatitis are:
- surgical interventions on the prostate (unless antibacterial therapy was carried out before the operation);
- refusal to use contraceptives;
- lack of habit of keeping your body clean.
Symptoms of chronic prostatitis
Today there are many myths about chronic prostatitis.For this reason, all temporary disorders of sexual function are attributed to this disease.You often hear the opinion that reduced libido and erectile dysfunction are due to prostatitis, and if it is an older man, then to 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 largely similar.This is due to the formation of myosfacial trigger zones near the prostate that occur as a result of injuries and surgical procedures.Pain in these areas can be mistaken for a symptom of prostate inflammation.
When diagnosing the disease, the focus is on complaints of pain and discomfort in the perineum and pelvis, which last for at least 3 months.The pain is localized near the prostate and radiates to the sacrum, rectum and scrotum.With prolonged exposure to negative factors (carrying heavy objects, excessive physical activity, standing for a long time), the pain increases.
A characteristic sign of the disease is premature ejaculation.Patients suffer from reduced sexual desire and erectile dysfunction.These symptoms are also characteristic of other genitourinary diseases.Therefore, they cannot be said to be a hallmark of chronic prostate disease.
An important symptom is the cessation of orgasm.If the patient notices that the severity of sensations during ejaculation has disappeared, this is a reason for a more attentive approach to 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 worsens.Patients with chronic prostatitis note a frequent urge to urinate at night.The process of excreting urine is accompanied by burning, stinging and pain.Urinary incontinence is common.
Signs of chronic prostatitis can be fully or partially expressed.Much depends on the patient's health and the presence or absence of other diseases.Chronic prostatitis is characterized by a wave-like course with waxing and waning symptoms.In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
If symptoms are pronounced, the diagnosis of chronic prostatitis is not difficult.However, this disease is often asymptomatic, making it difficult to recognize.A whole range of studies are 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 feeling can be clarified.Not every man is able to correctly assess his erectile function, the quality of orgasm and other details of sexual life.Questionnaires filled out by the patient provide the specialist with the information necessary to make a diagnosis.The NIH-CPS scale is most commonly used in urological practice.
To differentiate chronic prostatitis from other diseases, a neurological examination is carried out.The diagnostic methods used also include clarifying the patient's immunity status.
Laboratory research methods
If chronic prostatitis is suspected, the first step is to find out what nature it is: 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.For this purpose, laboratory tests of urine and prostate secretion are carried out.
If the PSA test 10 days after DRE shows that the level of prostate specific antigen exceeds 4.0 ng / ml, this is a reason to refer the patient for a biopsy to exclude an oncological process.
The following research methods are recommended:
- Scratching from the urethra;
- general and biochemical urine analysis;
- 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 a hypoechoic area of irregular shape 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 urinary stagnation and its composition.The study includes several tests: uroflowmetry, cystometry, measurement of residual urine volume, assessment of pressure in the bladder and urine outflow rate.
Tomography (computed or magnetic resonance imaging) is required to rule out benign and malignant neoplasms.These research methods are extremely informative and help to assess the condition of prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach.Taking medication alone is not enough.Physiotherapeutic procedures and therapeutic exercises are necessary.In general, chronic prostatitis is difficult to treat and requires a radical change in lifestyle, a change in habits and, in some cases, a change of job.Urologists insist that only a number of measures can help completely eliminate this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or nonbacterial in nature, prostate obstruction plays an important role in its development.The viscous secretion deposited in the gland ducts is a favorable environment for the development of pathogenic and opportunistic microorganisms.Therefore, the main focus should be on eliminating stagnation.
The problem can be solved by changing lifestyle and including physiotherapy classes in the daily schedule.
Exercise complexes have been developed that are suitable for different life situations:
- for men who have to sit most of the time (drivers, office workers, managers);
- for people who are overweight;
- for those who don't have time for exercises.
After thinking about treating chronic prostatitis, you need to 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.
Methods of course treatment:
- The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, treatment with antimicrobial agents that relieve the inflammatory symptoms is the priority.
- Pain syndrome is relieved by analgesics, antispasmodics, rectal suppositories and microenemas with warm analgesic solutions.NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
- Physiotherapeutic methods are only possible in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
- Another effective method of influencing the prostate is massage.It opens the ducts and normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
- The purulent process requires surgical intervention.
- Psychologist consultations.
Treatment of chronic prostatitis
With a long-term (at least a month) effect on the prostate, there is no 100% guarantee of healing.Priority is given to herbal medicines, immune correction and changing household habits:
- Herbal preparations are often 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 glandular tissue.
- Antibacterial therapy is selected individually based on the sensitivity of microbes to drugs.
- Drugs that strengthen immunity not only help to cope with prostatitis, they also correct the negative effects of antibiotics that disrupt the functioning of the immune system.
- The pain syndrome is alleviated by administering alpha blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove the “extra” secretion of the gland through the urethra, improving blood circulation and minimizing congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or microenemas with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.This stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- Herbal laxatives are used for constipation.
- The urologist and the psychologist work with the patient to develop an individual long-term program consisting of a 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 all affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissue (prostatectomy).It is practiced in exceptional cases and is associated with impotence and urinary incontinence.Young people do not undergo surgery because it can lead to infertility.
Recommendations for outpatient treatment
The patient must avoid situations in which injury to the pelvic organs may occur.
It is important to avoid any strain on the prostate: do not ride a bike, do any strength exercises, or carry weights.
If the work is sedentary, you need to do warm-up exercises every 2-3 hours by doing squats, leg swings and running in place.
You need to try to normalize your sex life, which is extremely important to eliminate stagnation of secretions in the prostate.
It is recommended to limit alcohol consumption to minimal doses or to avoid alcohol consumption altogether.
Treatment with medication
Chronic prostatitis is mainly treated on an outpatient basis.If the pathological process persists and remission cannot be achieved using this method, hospitalization is recommended.In a hospital, under the supervision of medical staff, there are much more opportunities to adhere to the regime and monitor changes in the patient's condition.
Chronic prostatitis in men develops against the background of endocrine disorders.In this context, drugs such as 5-alpha-reductase inhibitors and alpha-1 blockers are recommended.They help to normalize 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:
Treatment methods for bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics.The most effective drug for a particular patient is determined based on a preliminary laboratory examination of prostate secretions.
There is no universal drug to suppress and destroy pathogenic microflora.What helps one patient may not help 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 it.
For patients with nonbacterial prostatitis, antibiotics may also be included in the treatment plan.This therapy is carried out preventively.Depending on the indication, treatment with penicillin drugs is included.
After completing antibacterial therapy, treatment with hormonal drugs begins.
In cases of intraprostatic reflux, α-blockers must be taken.
Painkillers are effective against pain.
Treatment with herbal remedies
Many people doubt that chronic prostatitis can be cured with the help of herbal remedies.The answer to this question was gained through the long-term use of these remedies in urological practice.
Today the following treatment complexes are recommended:
All of these drugs have a positive effect on the functioning of the male urogenital system.Effective treatment of chronic prostatitis is possible provided that urinary function is normalized.This task is carried out by the components contained in herbal medicines.They help reduce the frequency of urges and eliminate Sluggish Stream Syndrome.
For patients with chronic prostatitis, herbal mixtures containing pumpkin extract or pumpkin seeds are recommended.The latter have a unique chemical composition and act in three directions at the same time:
- 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 health-promoting active ingredients are considered to accompany drug therapy.
Non-drug treatment
Non-drug therapy methods allow you to act directly on the prostate, increasing the concentration of drugs in its tissues and helping to eliminate congestion.
For this purpose, 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 set the temperature required for a specific type of exposure.To increase the concentration of the drug in the prostate, warming to 38-40 ° C is required.To achieve an antibacterial effect – 40-45°C.
The focus of non-drug treatment today is on laser therapy.The possibilities of this technology are diverse.Under the influence of a laser, the following processes occur in the prostate:
- 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 research into the effects of laser therapy on patients with prostatitis, a beneficial side effect for treatment purposes was identified.Those who completed the course increased potency, eliminated erectile dysfunction and restored vitality.To achieve this result, it is necessary to use a beam with a specific wavelength.In general, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can undergo laser therapy on their own initiative, provided it is not prescribed by the treating doctor.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not pose a threat to the patient's life, but can significantly reduce his quality of life.The most serious complication of this disease is the formation of stones in the glandular tissue.To rid it of prostatoliths, a transurethral resection is performed.
The surgical procedure is carried out under TRUS control.
If complications such as prostate sclerosis occur, transuretal electrosurgery is performed.If sclerosis of the bladder neck is observed in combination with this pathology, partial resection of the prostate is performed.
In case of blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate the patency of the secretion.For this purpose, an incision is made in the seminal vesicles and ducts.If there is an abscess, complete removal of the gland is possible.
Exercises to treat chronic prostatitis
There are a number of exercises that effectively stimulate the prostate to help relieve constipation.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 conducted at a convenient time;The complex will take no more than 15 minutes to complete.
Exercise #1
- Lying on an exercise mat, stretch both arms upwards.
- Bend your knees, pull them towards you and at the same time spread them in different directions.
- Raise the pelvis as much as possible.
- Repeat 10-12 times.
Exercise #2
- Stand on the mat and 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 these exercises, all movements should be smooth.This is the main requirement for achieving a high therapeutic effect.
Treatment prognosis
Few men can completely cure chronic prostatitis.Inflammation of the prostate often goes into a stage of long-term remission.However, when conditions arise for the activation of the pathology, a relapse occurs.An exacerbation begins with the appearance of pain in the prostate.They are often accompanied by urinary tract problems.At the first symptoms of a relapse, you should contact a specialist.
Patients are recommended to visit a urologist regularly, at least once every six months.They carry out examinations of the condition of the prostate and do a PSA test at the same frequency.Systematic monitoring of the condition of the gland makes it possible to detect processes provoking a relapse of the disease in a timely manner.But even in long-term remission, there is no guarantee that disorders will not occur.
The patient must follow recommendations to prevent exacerbation of the disease.It is recommended to keep your diet balanced and exclude fatty and spicy foods.The use of herbal remedies and traditional medicine must be coordinated with the treating doctor.This approach can minimize the risk of exacerbation of chronic prostatitis.
Prevention
To prevent the occurrence of a disease unpleasant for men, you need to eliminate provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't get too cold.
- Drink at least 1.5-2 liters of water per day.
- Strengthen your immune system, walk a lot, strengthen yourself.
- Do sports and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a steady partner.