Prostatitis is a disease that causes urination problems, 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 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 transports the sperm during ejaculation (ejaculation) and protects the sperm as they travel to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and does not go away for months or even years. The acute form of the disease appears suddenly and lasts at most several weeks. It is usually easy to treat, but sometimes it becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure forever. But with proper treatment, there is every chance of achieving long-term remission and significantly improving the patient's quality of life. We found out how to understand that you have chronic prostatitis and what to do.
What is chronic prostatitis
In total, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Among these, non-bacterial chronic prostatitis is the most common. And he is the worst to handle.
A disease is considered chronic if the symptoms do not go away for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic of chronic inflammation of the prostate is a recurrent course. This means that the symptoms may disappear for a while and then reappear. Without treatment, this condition can bother the patient for a very long time.
Bacterial and non-bacterial forms share common symptoms. They usually cause urinary problems, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. In addition, the chronic form is much more common than the acute form. About 25% of urologist visits are caused by chronic prostatitis.
The pathology can appear at any age, but the chronic form most often develops after the age of 50 in men.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of diseases have common symptoms, but their causes are different.
Chronic bacterial prostatitis
As a result of the inflammatory process, a bacterial infection enters the prostate from the urinary tract. The provoking factor can be: acute form of prostatitis, UTI (urinary tract infection), STI. The causative agents of the inflammatory process of the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic non-bacterial prostatitis (chronic pelvic pain syndrome)
Researchers have not established the causes of chronic pelvic pain syndrome. With this form, there is no infection in the prostate gland. It is not known exactly what causes the disturbances in this case. It can be assumed that there may be 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 entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- tension
Symptoms of chronic prostatitis
In the case of chronic prostatitis, the symptoms bother 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:
- urinary disorders: frequent and sudden urges, difficulty urinating, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during 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 notice these symptoms, see a urologist. Some of them may indicate other more serious diseases that require urgent 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, you should consult a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and urinary system in both men and women.
The initial consultation consists of several stages:
- History collection.
The urologist will ask about the reason for your visit, your previous illnesses, and your current and past medications. - Examination of the genitals
- 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, some later.
Diagnosis usually involves laboratory and instrumental tests.
Laboratory research methods
- General urinalysis
Allows detection of 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 tumors. - Microscopic examination of prostate secretion
Prostatic secretion is the fluid produced by the prostate gland. With the changes in the organ, the composition of the secretion also changes. For example, during an inflammatory process, white blood cells increase, and high levels of pathogenic bacteria may indicate a bacterial infection of the prostate. Microscopic examination of the fluid helps to see these changes. - Prostatic secretions are 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 makes it possible to detect urinary tract problems.
- TRUS (transrectal ultrasound of the prostate). For the examination, the specialist carefully places an 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 condition of the prostate tissue. It may be necessary to look at foci of prostatitis and rule out prostate cancer.
There is no special preparation for the urologist appointment. But in order for the consultation to be as effective as possible, follow some simple recommendations:
- For intimate hygiene, do not use special products before use, just warm water is enough.
- Do not go to the toilet 2 hours before visiting the clinic. Then, if necessary, you can immediately perform an examination or undergo an ultrasound.
- If you take any medication regularly, write its name in your diary or note it on your phone.
- Take the results of previous examinations with you so that the specialist can see a complete 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 way to get rid of prostatitis. Different treatments are prescribed for different forms and manifestations of the disease.
To determine the type of chronic prostatitis, diagnostics must be performed. Based on your results, the doctor prescribes a therapy that is especially effective for you.
Unlike the acute form, chronic inflammation of the prostate cannot be cured forever. The doctor's goal is to achieve long-term remission and reduce symptoms.
Bacterial form: Treatment includes antibiotic therapy and other methods to relieve symptoms.
It is not a bacterial form: Treatment is symptomatic. In other words, each method is aimed at overcoming 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. - Hot sitz baths, hot showers
Water procedures help to reduce the manifestations of the disease. - More water
Drink enough fluids. Going to the toilet more often helps to flush pathogenic bacteria from the bladder. - Cushions for chairs
Place a soft pillow under you while sitting. - Physical activity
Regular walks and exercise will help reduce pain and relieve congestion. - Regular sex life
Sexual activity is helpful in preventing congestion.
The listed methods supplement the therapy prescribed for you, but do not replace it.
Drug treatment
- Antibiotics. Antibacterial therapy is recommended for the infectious form. Medicines kill the bacteria that cause prostatitis. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, it is necessary to examine the secretions of the prostate and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. It helps with urinary tract disorders. Medicines relax the organs of the urinary system and this relieves symptoms. Most often, alpha-blockers are used for non-infectious chronic prostatitis, but in order 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 swelling of the prostate.
- Muscle relaxants. It can be used to relieve spasms in the pelvic muscles.
- Antidepressants. It is indicated for depression, which can develop due to stress and long-lasting pain.
- Medicines for the treatment of erectile dysfunction. It can be used if prostatitis causes problems in your sex life.
- Laxatives. They may prescribe it if symptoms include pain during bowel movements.
Treatment with herbs
Herbal remedies.Herbal medicines do not work as the main method of treatment. They can be used as a supplement to reduce prostatitis. Medicines are prescribed for this purpose with quercetin, a substance found in vegetables, fruits and berries.
It is not a drug treatment
- Physiotherapy and prostate massage. The methods are used to relax the muscles of the pelvic floor, relieve pain and prevent congestion. In order to achieve a therapeutic effect, the patient undergoes a massage course consisting of several sessions. Massage is contraindicated in the development of complications of the pathology: abscess, stones in the tissues of the prostate gland.
- Bladder catheterization. It may be necessary if you have problems with your bladder.
- Psychotherapy. Due to chronic pain, prostatitis patients may develop depression and anxiety disorders. Psychological problems negatively affect the patient's well-being and worsen the pain syndrome. In such cases, a consultation with a psychotherapist helps.
- Biofeedback programs. It can help reduce tension in the pelvic floor muscles.
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.It is indicated for the appearance of stones in the tissues of the prostate gland
- Prostatectomy. In some cases, removal of the prostate gland is performed in case of an abscess (accumulation of pus) or a serious disorder of the bladder.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the muscles of the pelvic floor and relieve 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 stretch the muscles for longer periods of time.
- You need to do 2-3 approaches per day.
Changes can only be noticed with regular movement.
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 long-term remission and restore the patient's previous quality of life. For this, it is important to carry out a thorough diagnosis to determine the form of the disease. If the cause of the inflammatory process is an infection, then antibacterial therapy will help. And in the case of non-infectious chronic prostatitis - a 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 the 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 tissues). In the case of an abscess, surgery is performed to clean and drain the pus, and in rare cases, the prostate can be removed.
- Infertility. Conception problems can occur if there is a lack of sperm due to the inflammatory process of the prostate.
- Spread of the infection to the spine and pelvis
- 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 emotional state.
In order to prevent prostatitis, it is important to:
- Use barrier-free contraception (condoms): Sexually transmitted infections are factors that increase the risk of developing prostatitis
- If you are over 40, see a urologist annually
- If you experience symptoms of a urinary tract infection, contact your doctor immediately