Prostatitis is a disease that causes problems with urination, sexual dysfunction, pain in the perineum and lower abdomen. The cause of these symptoms is inflammation of the prostate gland.
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, which partly consists of ejaculate. This fluid transports 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 can take months or even years. The acute form of the disease appears suddenly and lasts for a maximum of 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 figured out how to understand 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 non-bacterial (chronic pelvic pain syndrome), asymptomatic. Of these, chronic non-bacterial prostatitis is the most common. And he's the worst to deal with.
A disease is considered chronic if symptoms do not disappear for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another 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 bother the patient for a long time.
The bacterial and non-bacterial forms have common symptoms. These generally include problems with urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. Furthermore, the chronic form is much more common than the acute form. The reason for around 25% of visits to the urologist is related to chronic prostatitis.
The pathology can appear at any age, but the chronic form develops more frequently in men after 50 years of age.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of illnesses have common symptoms but different causes.
Chronic bacterial prostatitis
When in prostate secretion during analysisuncoveredleukocytes and pathogens
The inflammatory process causes a bacterial infection from the urinary tract to enter the prostate. The provoking factor can be: acute form of prostatitis, UTI (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)
When in prostate secretion during analysisnot detectedleukocytes and pathogens
Researchers have not established the causes of chronic pelvic pain syndrome. With this form, there is no prostate infection. What causes disturbances in this case is not known exactly. There is an assumption that this may be due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- the patient already had prostatitis and chronic pain remained despite treatment;
- urine entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- stress
Chronic prostatitis symptoms
With chronic prostatitis, 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 region, lower back;
- pain during sexual 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 have these signs, see 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 developing potentially fatal complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, it is necessary to make an appointment with a urologist. This doctor specializes in diagnosing and treating the male reproductive system and urinary system in men and women.
The initial consultation includes several steps:
- Making history.
The urologist will ask about the reason for your visit, previous illnesses, and medications you have taken now and in the past. - Examination of genital organs
- Digital rectal exam.
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 done immediately at the appointment, others later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urine analysis
Allows you to see signs of infection. This may be indicated by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate specific antigen)
Helps assess the condition of the prostate. An elevated PSA level indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostate secretion
Prostate secretion is a fluid produced by the prostate gland. With changes in the organ, the composition of the secretion also changes. For example, during an inflammatory process, white blood cells increase and a high level of pathogenic bacteria may indicate a bacterial infection in the prostate. Microscopic examination of the fluid will help see these changes. - Prostate secretions are collected through prostate massage. Massage can be combined with a digital rectal exam.
Instrumental research methods
- Cystoscopy. Examination of the inner surface of the bladder using an endoscope - a thin, flexible tube with a camera. The device is inserted into the bladder through the urethra. The study allows you to see problems in the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). For the exam, the specialist will carefully insert 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 observe foci of prostate inflammation and rule out prostate cancer.
There is no special preparation for a consultation with a urologist. But to make the consultation as effective as possible, follow some simple recommendations:
- For intimate hygiene, you should not use special products before use, just warm water is enough.
- Do not go to the bathroom 2 hours before your clinical appointment. Then, at the appointment, if necessary, you can immediately take tests or have an ultrasound.
- If you take any medications regularly, write their names down in your diary or in notes on your phone.
- Take the results of previous studies with you so that the specialist has a complete picture of the disease.
- Make a list of questions you want to ask the doctor at your appointment.
Treatment of chronic prostatitis
There is no universal method for getting rid of prostatitis. For different forms and manifestations of the disease, different treatments are indicated.
To determine the type of chronic prostatitis, it is necessary to make a diagnosis. Based on the results, the doctor will prescribe a therapy that will give specific results for your case.
Unlike the acute form, chronic prostate inflammation cannot be cured forever. The doctor's goal is to achieve long-term remission and reduce symptoms.
Bacterial form: Treatment will include antibiotic therapy and other methods to alleviate symptoms.
Non-bacterial form: Treatment is symptomatic. In other words, each method aims to combat a specific symptom.
Recommendations for outpatient treatment
Lifestyle changes:
- Dietary 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 will help reduce the manifestations of the disease. - More water
Drink plenty of fluids. More frequent trips to the bathroom help eliminate pathogenic bacteria from the bladder. - Chair cushions
When sitting, place a soft pillow beneath you. - Physical activity
Regular walking and exercise helps reduce pain and eliminate congestion. - Normal sex life
Sexual activity is helpful in preventing congestion.
The listed methods will complement the prescribed therapy, but will not replace it.
Drug treatment
- Antibiotics. Antibacterial therapy is indicated for the infectious form. The medicines destroy bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, therefore, before prescribing, it is necessary to conduct a study of prostate secretions and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary disorders. The medications relax the organs in the urinary system and relieve symptoms. Most often, alpha blockers are used for chronic non-infectious prostatitis, but to improve the patient's well-being they can also be prescribed for an infectious form of the inflammatory process.
- NSAIDs (nonsteroidal anti-inflammatory drugs). Prescribed to relieve pain and reduce prostate swelling.
- Muscle relaxants. Used when you need to relieve pelvic muscle spasm.
- Antidepressants. Indicated for depression, which can develop due to stress and prolonged pain.
- Medications for the treatment of erectile dysfunction. Used if prostatitis causes problems in your sex life.
- Laxatives. They may prescribe it if symptoms include pain during bowel movements.
Treatment with herbal remedies
Herbal remedies.Herbal medicines do not work as the main method of treatment. They can be used as a supplement to reduce prostate inflammation. For this, medications with 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 course consisting of several sessions. Massage is contraindicated in the development of pathological complications: abscess, stones in the prostate tissues.
- Bladder catheterization. It may be necessary if you have bladder problems.
- Psychotherapy. Due to chronic pain, prostatitis patients may develop depression and anxiety disorders. Psychological problems have a negative impact on the patient's well-being and worsen the pain syndrome. In these cases, consulting a psychotherapist can help.
- Biofeedback programs. It can help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be needed if complications arise.
Types of operations:
- TUR (transurethral resection) of the prostate.Indicated for the appearance of stones in prostate tissues
- Prostatectomy. Removal of the prostate, in some cases, is carried out in case of abscess (accumulation of pus) or serious disorders in the functioning of the bladder.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and alleviate symptoms associated with urinary 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.
- Gradually you can increase the number of repetitions and tense your muscles for longer.
- You should do 2-3 approaches per day.
Changes can only be noticed with regular exercise.
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 return the patient to their previous quality of life. To do this, it is important to carry out a complete diagnosis to determine the form of the disease. If the cause of the inflammatory process is an infection, antibacterial therapy will help. And for chronic non-infectious prostatitis - well-chosen symptomatic therapy.
Complications of chronic prostatitis may include:
- Bacteremia (bacterial blood poisoning). Bacteria entering the bloodstream. It may be a consequence of bacterial forms of pathology. Bacteremia develops suddenly and can lead to sepsis. This condition is fatal.
- Epididymitis (inflammation of the epididymis). The disease can cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in tissue). In case of abscess, surgery is performed to clean and drain the purulent focus; in rare cases, the prostate may be removed.
- Infertility. Problems with conception may occur when there is a lack of sperm due to an inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bone
- 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.
To prevent prostatitis it is important:
- Use barrier contraception (condoms): STIs are a factor that increases the risk of developing prostatitis
- Visit a urologist annually if you are over 40
- If you have symptoms of a UTI, contact your doctor immediately