Many men suffer from chronic prostatitis, but they attribute the symptoms to other diseases or waste time on ineffective treatment.From our article, you can learn comprehensive information about this male problem: causes, exact symptoms and diagnostic methods, various 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 your treatment.
What is chronic prostatitis
In ICD-10 (International Classification of Diseases, 10th Revision) there is no such disease as "chronic prostatitis".There is no uniform, generally accepted characteristic of this pathology.In urological practice, the classification developed by the AHI (American Institute of Health) is used.It defines the categories of prostate diseases.Those that can be called "chronic" include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To establish this diagnosis, the following symptoms are necessary: long-lasting (at least 3 months) pain in the perineal area.Thus, chronic prostatitis can be called a long-lasting inflammatory process, the consequence of which is a change in the structure and dysfunction of the prostate gland.But other prostate diseases also lead to such sad results.Therefore, 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 patients' quality of life deteriorates to the same extent as those who have suffered a heart attack or angina pectoris.
According to data from various sources, every 3rd or 4th man is diagnosed with prostatitis.And most often this is not the initial or acute stage of the disease, but an already established and long-term process - chronic.
Not so long ago, it was generally accepted that this pathology was mainly characteristic of older men.However, statistical data refuted this opinion.It is now known that chronic prostatitis is a disease of sexually active men of childbearing age.
More than 30% of patients consult a specialist with complaints typical of chronic prostatitis.It often happens that during a visit to the doctor, the disease is complicated by simultaneous pathologies: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis vary greatly.Among the many negative factors affecting human health, it is difficult to pinpoint exactly those that triggered the development of the disease.It is often a combination of situations and circumstances that accompany a man's life.
The main causes of chronic abacterial prostatitis are:
- rhythm disorder (irregularity) of sexual intercourse;
- physical inactivity characteristic of overweight people;
- long-term stressful conditions;
- predominance of fat-rich foods in the diet;
- has a negative effect on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely healed bacterial prostatitis.Or the man ignored the diseases and did not seek help from a urologist.Therefore, no treatment was performed.
Abacterial-type chronic prostatitis develops due to exposure to infectious agents against the background of reduced immunity.Usually, such patients are diagnosed with diseases of the endocrine system.
The factors that trigger the development of chronic bacterial prostatitis are the following:
- surgical operations on the prostate (if antibacterial therapy was not performed before the operation);
- refusal to use contraception;
- lack of the habit of keeping the body clean.
Symptoms of chronic prostatitis
There are many myths circulating today about chronic prostatitis.For this reason, temporary disorders of sexual function can be attributed to this disease.You often hear the opinion that the cause of reduced libido and erectile dysfunction is prostatitis, and in older men, chronic prostatitis.
This is not true, as there are many other causes of sexual dysfunction, and the main symptom of chronic prostatitis is pain.All other signs are considered simultaneous and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome, as the symptoms of these diseases are largely similar.This is due to the formation of myofacial 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 prostatitis.
When diagnosing the disease, complaints of pain and discomfort in the perineum and pelvis lasting at least 3 months come to the fore.The pain is localized near the prostate, radiating to the sacrum, rectum and scrotum.In case of negative factors (carrying heavy objects, excessive physical activity, staying on the feet for a long time), the pain increases.
The characteristic symptom of the disease is premature ejaculation.Patients experience decreased sexual desire and erectile dysfunction.These symptoms are also typical of other urinary tract diseases.Therefore, it cannot be said that these are characteristics of chronic prostate disease.
An important symptom is the fading of orgasm.If the patient notices that the severity of the sensations during ejaculation has disappeared, this is a reason to pay more attention to his health and indicate 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 experience a frequent urge to urinate at night.The process of urinating 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 state of health and the presence or absence of other diseases.Chronic prostatitis is characterized by a wave-like course, with waxing and diminishing symptoms.With this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of specific symptoms, it is not difficult to diagnose chronic prostatitis.But this disease is often asymptomatic, which makes it difficult to recognize.A number of tests are performed 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 all men are able to correctly assess their erectile function, orgasm quality and other details of sexual life.The questionnaires filled out by the patient provide the specialist with the information necessary to make a diagnosis.In urological practice, the NIH-CPS scale is most often used.
In order to distinguish between chronic prostatitis and other diseases, a neurological examination is performed.The list of applied diagnostic methods includes clarification of the patient's immunity.
Laboratory research methods
If chronic prostatitis is suspected, the first thing to do is to find out whether 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, laboratory tests of urine and prostate secretions are carried out.
If, 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 for a biopsy to rule out an oncological process.
The following research methods are recommended:
- scraping from the urethra;
- general and biochemical urinalysis;
- LHC culture of prostatic secretion.
Instrumental research methods
TRUS (transrectal ultrasound) is performed with equipment equipped with an instrument inserted into the patient's rectum.If an irregularly shaped hypoechoic area is detected, there is every reason to suspect a malignant tumor.In the case of chronic prostatitis, scarring, compaction of the glandular tissue structure 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 examination includes a number of tests: uroflowmetry, cystometry, measurement of the volume of residual urine, assessment of the pressure inside the bladder and the rate of urine outflow.
Tomography (computed tomography or magnetic resonance imaging) is necessary to rule out benign and malignant tumors.These research methods are extremely informative and help to assess the condition of the prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach.Medication alone is not enough.Physiotherapy procedures and therapeutic exercises are necessary.In general, chronic prostatitis is difficult to treat and requires radical lifestyle changes, changes in habits and, in some cases, job changes.Urologists insist that only one set of measures will help to completely get rid of the disease or ensure long-term remission.
Regardless of whether the disease is bacterial or abacterial, prostate congestion has 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 focus should be on eliminating stagnation.
The problem can be solved by changing your lifestyle and adding exercise classes to your daily routine.
Exercise complexes have been developed that are suitable for different life situations:
- for men who are forced to sit most of the time (drivers, office workers, managers);
- for overweight people;
- for those who don't have time to do exercises.
After thinking about how to treat chronic prostatitis, you should decide to seriously rethink your approach to your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.
Course management methods:
- The most effective treatment for prostatitis is etiotropic therapy.If the prostatitis is based on an infection, the priority is a course of antimicrobial agents, which relieves the manifestations of the inflammation.
- The pain syndrome is alleviated with painkillers, antispasmodics, rectal suppositories, and microenjections with warm solutions of painkillers.NSAIDs can be used.
- The combination of immunostimulants, immunomodulators, enzymes, vitamin complexes and microelements has proven its effectiveness.
- Physiotherapy methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave oven, electrophoresis, laser, magnetic therapy.
- Massage is another effective way to influence the prostate.It opens the channels, normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
- The purulent process means surgical intervention.
- Psychologist consultations.
Treatment of chronic prostatitis
In addition to the long-term (at least one month) effect on the prostate, there is no 100% cure guarantee.Priority is given to herbal medicines, immune correction, changing 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 glandular tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Medicines that enhance immunity not only help in the treatment of prostatitis, but also correct the negative effects of antibiotics, which interfere with the functioning of the immune system.
- The pain syndrome can be alleviated by administering alpha-blockers and muscle relaxants.
- Prostate massage enables the mechanical removal of "extra" secretions from the gland through the urethra, improves blood circulation and minimizes congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz bath or microenema with herbs.
- In severe cases, intravenous fluids with diuretics are recommended.This stimulates abundant urine production, prevents the symptoms of poisoning, the development of ascending cystitis and pyelonephritis.
- In case of constipation, herbal laxatives are used.
- Together with the patient, the urologist and the psychologist work out an individual, long-term program of the daily routine, the necessary rest, diet, 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 tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy).In exceptional cases, it is common, full of impotence and urinary incontinence.Young people are not operated on because it can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations in which he may suffer injury to the pelvic organs.
Stress on the prostate should be avoided: do not cycle, do not do strength exercises, do not carry weights.
In the case of sedentary work, warm-up should be done every 2-3 hours with squats, leg swings and running in place.
You should try to normalize your sex life, which is extremely important to eliminate the stagnation of prostate secretions.
It is recommended to limit alcohol consumption to minimum doses or to eliminate alcohol consumption altogether.
Drug treatment
In case of chronic prostatitis, outpatient treatment is mainly carried out.If the pathological process persists and remission cannot be achieved with this method, hospitalization is recommended.In the hospital, under the supervision of the medical staff, there are many more opportunities to follow the regime and monitor changes in the patient's condition.
Chronic prostatitis in men develops against the background of endocrine disorders.In this regard, 5-alpha-reductase inhibitors and alpha-1 blockers are recommended.They help to normalize hormone levels and eliminate the symptoms of pathology.For this purpose, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach involves taking drugs such as:
Methods of treatment of bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics.The most effective drug for a given patient is determined by a preliminary laboratory examination of the prostate secretion.
There is no universal drug to suppress and destroy the pathogenic microflora.What helps one patient may not help another.For this reason, there are many negative opinions about drugs advertised for the treatment of chronic prostatitis.
The drugs recommended for antibacterial therapy are fluoroquinolones.Most bacteria are sensitive to them.
Antibiotics may also be included in the treatment plan for patients with abacterial prostatitis.This therapy is carried out for preventive purposes.According to the indications, treatment with penicillin drugs also belongs to this category.
Hormonal drug treatment is started after the antibacterial therapy is finished.
In case of intraprostatic reflux, taking α-blockers is necessary.
In case of pain, pain relievers are effective.
Treatment with herbs
Many people doubt whether chronic prostatitis can be cured with herbs.The answer to this question was obtained during the many years of use of these healing agents in urological practice.
Today, the following treatment complexes are recommended:
All these drugs have a beneficial effect on the functioning of the male urinary system.Effective treatment of chronic prostatitis is possible, provided that urinary tract function is normalized.This task is performed by the components found in herbal medicines.They help reduce the frequency of urges and eliminate sluggish stream syndrome.
Herbal mixtures containing pumpkin extract or pumpkin seeds are recommended for those suffering from chronic prostatitis.The latter have a unique chemical composition and act simultaneously in three directions:
- normalizes metabolism;
- strengthens the walls of blood vessels;
- activates blood circulation in the pelvic organs.
Taking herbal medicines is not considered the main method of treatment.These health-improving agents can be used simultaneously with medication.
It is not a drug treatment
Non-drug therapeutic methods allow you to develop directly on the prostate, increase the concentration of drugs in the tissues and help to eliminate congestion.
For this purpose, the following techniques are used: rectal ultrasound;
Microwave hyperthermia is performed with a rectal probe inserted into the patient's anus.The device can be used to set the temperature required for a given type of exposure.In order to increase the concentration of the drug in the prostate, it is necessary to heat it to 38-40 ° C.To achieve the antibacterial effect - 40-45°C.
Today, non-drug treatment focuses on laser therapy.The possibilities of this technique are wide.As a result of the laser, the following processes take place in the prostate gland:
- 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.
While researching the effects of laser therapy on patients with prostatitis, one side effect was noted, but positive for the treatment.Those who have completed the course have increased potency, eliminated erectile dysfunction and restored vitality.To achieve this result, a beam of a specific wavelength must be used.Low-intensity laser radiation is usually used to treat chronic prostatitis.
Patients can take part in laser treatment 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 tissues of the gland.To get rid of prostatoliths, transurethral resection is used.
The surgical intervention is performed under TRUS control.
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.
In case of blockage of the fetal and excretory ducts, endoscopic surgeries are recommended to remove the obstruction to the permeability of the secretion.For this purpose, incisions are made in the seminal vesicles and excretory ducts.In the case of an abscess, it is possible to completely remove the gland.
Exercises for the treatment of chronic prostatitis
There are several exercises that effectively stimulate the prostate, which helps relieve congestion.This complex was developed for patients with hip joint problems.Practice shows that these exercises are also useful for those diagnosed with prostatitis.Classes can be held at a convenient time;the preparation of the complex takes no more than 15 minutes.
Exercise number 1
- Lying on an exercise mat, extend both arms.
- Bend your knees and pull them towards you, spreading them in different directions at the same time.
- Raise your pelvis as high as you can.
- Repeat 10-12 times.
Exercise number 2
- While standing on the mat, perform deep squats.
- Repeat 10-12 times.
Exercise number 3
- Lie on your stomach.
- Lift one leg, then the other.
- Repeat 10-12 times.
When performing this sequence of exercises, all movements should be smooth.This is the main condition for achieving a high therapeutic effect.
Treatment prognosis
Few men are able to completely cure chronic prostatitis.Prostatitis often goes into long-term remission.But when the conditions for activating the pathology arise, a relapse occurs.Exacerbation begins with the occurrence of prostate pain.They are often associated with urinary tract disorders.At the first symptoms of a relapse, you should seek professional help.
Patients are recommended to visit the urologist regularly, at least once every six months.The state of the prostate is checked and a PSA test is performed with the same frequency.By systematically monitoring the condition of the gland, the processes that trigger the relapse of the disease can be identified in time.But even in the case of long-term remission, it cannot be guaranteed that it will not be interrupted.
The patient must follow the recommendations in order to prevent the aggravation of the disease.We recommend that you balance your diet by excluding fatty and spicy foods.The use of herbs and traditional medicine must be discussed with the attending physician.This approach minimizes the risk of exacerbation of chronic prostatitis.
Prevention
In order to prevent the occurrence of an unpleasant disease 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 a day.
- Strengthen your immune system, walk a lot, exercise.
- Participate in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice regular sex with a regular partner.