Many men suffer from chronic prostatitis, but attribute the symptoms to other illnesses or waste time with ineffective treatments.In our article you will 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 also no single, generally accepted characteristic of this pathology.In urological practice, the classification developed by the AHI (American Institute of Health) is usually used.Defines categories of prostate diseases.Those that might be described as “chronic” include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses, the following symptoms are necessary: prolonged pain (at least 3 months) in the perineal region.Thus, chronic prostatitis can be called a long-lasting 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 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 quality of life of patients decreases to the same extent as in people who have had a heart attack or suffer from angina pectoris.
According to data from various sources, every third or fourth man is diagnosed with prostatitis.And most often this is not the initial or acute stage of the disease, but an already formed and long-term - chronic process.
Not so long ago, it was generally accepted 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 men of childbearing age and sexually active.
More than 30% of patients consult a specialist with complaints characteristic of chronic prostatitis.Often, at the time of medical consultation, the disease is complicated by concomitant pathologies: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very different.From the variety of negative factors affecting human health, it is difficult to single out exactly those that provoked the development of the disease.Often this is a complex of situations and circumstances that accompany a man's life.
The main causes of chronic bacterial prostatitis are the following:
- dysrhythmia (irregularity) of sexual intercourse;
- physical inactivity, typical of overweight people;
- long-term stressful conditions;
- the predominance of foods rich in fat in the diet;
- negative impact on the body in hazardous industries.
Chronic prostatitis of the bacterial type is the result of incompletely cured bacterial prostatitis.Or the man ignored the ailments and did not seek help from a urologist.Therefore, no treatment was performed.
Chronic prostatitis of the abacterial type develops due to exposure to infectious agents against the background of decreased immunity.As a rule, these patients are diagnosed with diseases of the endocrine system.
Factors provoking the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibacterial therapy was not carried out before the operation);
- refusal to use contraception;
- lack of habit of keeping the body clean.
Chronic prostatitis symptoms
Today there are many myths about chronic prostatitis.For this reason, any temporary disturbances in sexual function are attributed to this disease.You can often hear the opinion that decreased libido and erectile dysfunction are due to prostatitis, and if you are an older man, chronic prostatitis.
This is not true, as sexual dysfunction has many other causes and the main symptom of chronic prostatitis is pain.All other signs can be considered concomitant and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome, since the symptoms of these diseases are very similar.This is due to the formation of myosfacial trigger zones near the prostate, which arise as a result of injuries and surgical interventions.Pain in these areas may be mistaken for a symptom of prostate inflammation.
When diagnosing the disease, complaints of pain and discomfort in the perineum and pelvis come to light, lasting at least 3 months.The pain is located near the prostate, radiating 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 intensifies.
A characteristic sign of the disease is premature ejaculation.Patients experience decreased sexual desire and erectile dysfunction.These symptoms are also characteristic of other genitourinary diseases.Therefore, it cannot be said that they are characteristics of chronic prostate disease.
An important symptom is the disappearance of orgasm.If the patient begins to notice that the severity of sensations during ejaculation has disappeared, this is a reason for a more attentive attitude to his health and a signal about the need to consult a urologist.
The structure of the inflamed prostate becomes denser, the pressure in the urinary tube increases and the quality of urination worsens.Patients with chronic prostatitis notice a frequent urge to urinate at night.The process of urine excretion is accompanied by a burning, stinging and pain sensation.Urinary incontinence occurs frequently.
Signs of chronic prostatitis can be expressed in full or in part.Much depends on the patient's health status and the presence or absence of other diseases.Chronic prostatitis is characterized by an undulatory course, with waxing and waning symptoms.In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of pronounced symptoms, it is not difficult to diagnose chronic prostatitis.But this disease is often asymptomatic, which makes it difficult to detect.For diagnostic purposes, a whole range of studies is carried out.
The Association of Urologists has developed questionnaires that can help identify asymptomatic chronic prostatitis.The questions are formulated so that the patient's subjective feelings can be clarified.Not every man is able to correctly assess his erectile function, the quality of orgasm and other details of his sexual life.The questionnaires completed by the patient provide the specialist with the information necessary for the diagnosis.In urological practice, the NIH-CPS scale is the most used.
To differentiate chronic prostatitis from other diseases, a neurological examination is performed.The list of diagnostic methods used includes clarifying the patient's immunity status.
Laboratory research methods
If chronic prostatitis is suspected, first find out what its nature 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, after a period of 10 days after digital rectal examination, the PSA test shows that the prostate-specific antigen level 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:
- urethra scraping;
- general and biochemical analysis of urine;
- LHC culture of prostate secretion.
Instrumental research methods
TRUS (transrectal ultrasound) is performed using 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 neoplasm.In 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 diagnosis.Allows you to find out the nature of urination, signs of urine stagnation and its composition.The study includes several tests: uroflowmetry, cystometry, measurement of residual urine volume, assessment of pressure inside the bladder and urine output rate.
Tomography (computed or magnetic resonance imaging) is necessary to exclude benign and malignant neoplasms.These research methods are highly 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 required.In general, chronic prostatitis is difficult to treat and requires a radical review of lifestyle, changes in habits and, in some cases, a change of job.Urologists insist that only a set of measures will help to completely eliminate the disease or ensure long-term remission.
Regardless of whether the disease was bacterial or non-bacterial in nature, prostate congestion played an important role in its formation.The viscous secretion deposited in the gland's ducts is a favorable environment for the development of pathogenic and opportunistic microorganisms.Therefore, the main attention should be focused on eliminating stagnation.
The problem can be solved by changing your lifestyle and including physiotherapy classes in your daily schedule.
Exercise complexes suitable for different life situations have been developed:
- for those 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 exercise.
Having thought about how to treat chronic prostatitis, you need to decide to seriously reconsider your attitude towards your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet, and sexual rest.
Clear treatment methods:
- The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, a series of antimicrobial agents are a priority, which alleviate the manifestations of inflammation.
- Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, 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 phase of the disease.Improve microcirculation and increase immunity: UHF, microwaves, electrophoresis, laser, magnetic therapy.
- Massage is another effective method of influencing the prostate.Opens the ducts, normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected by catheterization and cystostomy with a trocar.
- The purulent process involves surgical intervention.
- Consultations with a psychologist.
Treatment of chronic prostatitis
With a long-term (at least a month) effect on the prostate, there is no 100% guarantee of a cure.Priority goes to herbal medicines, immunocorrection, changing domestic 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.
- Immunity-enhancing drugs not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the functioning of the immune system.
- The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove “extra” secretion from the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, hot sitz baths or microenemas with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.This stimulates abundant urine production, prevents symptoms of intoxication, development of ascending cystitis and pyelonephritis.
- For constipation, herbal laxatives are used.
- The urologist and psychologist, together with the patient, develop an individual long-term program of daily routine, 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 tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy).Practiced in exceptional cases, it is fraught with impotence and urinary incontinence.Young people do not undergo surgery because it can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations in which they may suffer damage to the pelvic organs.
It is necessary to avoid any stress on the prostate: do not ride a bicycle, do not do strength exercises, do not carry weights.
If the work is sedentary, every 2-3 hours you will need to warm up by doing squats, leg movements 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 gland.
It is recommended to limit alcohol consumption to minimal doses or eliminate alcohol consumption completely.
Drug treatment
In chronic prostatitis, outpatient treatment is mainly carried out.If the pathological process persists and it is not possible to achieve remission using this method, hospitalization is recommended.In a hospital, under the supervision of medical staff, there are many more opportunities to comply with the regimen and monitor changes in the patient's condition.
Chronic prostatitis in men develops against the background of endocrine disorders.In this sense, 5-alpha reductase inhibitors and alpha 1-blockers are recommended.They help to normalize hormonal levels and eliminate symptoms of pathology.For this, medications such as Finasteride and Terazosin are prescribed.
An integrated approach includes taking medications such as:
Treatment methods for chronic bacterial prostatitis
Chronic bacterial prostatitis is treated with antibiotics.The most effective medication for a specific patient is determined through a preliminary laboratory study of prostate secretions.
There is no universal medicine to suppress and destroy pathogenic microflora.What helps one patient may not help another.For this reason, there are many negative reviews about drugs advertised for the treatment of chronic prostatitis.
The recommended drugs 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 indications, treatment with penicillins is included.
After the end of antibiotic therapy, treatment with hormonal medications begins.
For intraprostatic reflux, it is necessary to take α-blockers.
For pain, analgesics are effective.
Treatment with herbal remedies
Many people doubt whether chronic prostatitis can be cured with the help of herbal remedies.The answer to this question was obtained through many years of use of these healing agents in urological practice.
Today the following treatment complexes are recommended:
All these medicines have a beneficial effect on the functioning of the male genitourinary system.Effective treatment of chronic prostatitis is possible as long as urinary function is normalized.The components included in herbal medicines perform this task.They help reduce the frequency of urges and eliminate slow flow 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 once:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood circulation in the pelvic organs.
The use of herbal medicines cannot be considered the main method of treatment.These health-enhancing agents are considered concomitants of drug therapy.
Non-drug treatment
Non-drug therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues and help eliminate congestion.
To this end, the following techniques are used: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe 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, heating to 38-40 ° C is necessary.To obtain an antibacterial effect – 40-45°C.
Today, non-drug treatment focuses on laser therapy.The possibilities of this technique are wide.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 cell division process is activated, which promotes tissue regeneration.
During the period of research into the effects of laser therapy on patients with prostatitis, a side effect was observed, but positive for treatment purposes.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, on their own initiative, undertake a course of laser therapy, if not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not pose a threat to the patient's life, but can significantly reduce its quality.The most serious complication of this disease is the formation of stones in the gland tissues.To free it from the prostatoliths, transurethral resection is used.
Surgical intervention is performed under TRUS control.
If complications such as prostate sclerosis occur, transurethal electrosurgery is performed.If sclerosis of the bladder neck is observed in combination with this pathology, partial resection of the prostate is performed.
When the seminal and excretory ducts are blocked, endoscopic operations are indicated to eliminate the obstruction of secretion patency.To do this, an incision is made in the seminal vesicles and excretory ducts.In case of abscess, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis
There are several exercises that are effective in stimulating the prostate, which helps relieve congestion.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 held at a convenient time;the complex will take no more than 15 minutes to complete.
Exercise #1
- Lying on a gym mat, stretch both arms upwards.
- Bend your knees and pull them towards you, simultaneously spreading them in different directions.
- Raise your pelvis as much as you can.
- Repeat 10-12 times.
Exercise #2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise #3
- Lie face down.
- Raise one leg and then the other.
- Repeat 10-12 times.
When performing this set of exercises, all movements should be smooth.This is the main condition for obtaining a high therapeutic effect.
Treatment prognosis
Few men are able to completely cure chronic prostatitis.Prostate inflammation often goes into a long-term remission stage.But when conditions arise for the activation of the pathology, a relapse occurs.An exacerbation begins with the occurrence of pain in the prostate.They are often accompanied by urinary disorders.At the first symptoms of relapse, you should seek help from a specialist.
It is recommended that patients regularly visit a urologist, at least once every six months.With the same frequency, they perform prostate health checks and take a PSA test.By systematically monitoring the state of the gland, the processes that provoke the relapse of the disease can be identified in a timely manner.But even with long-term remission there is no guarantee that it will not be disturbed.
The patient must follow recommendations to prevent exacerbations of the disease.It is recommended to balance the diet by excluding fatty and spicy foods.The use of herbal medicine and traditional medicine must be agreed with the attending physician.With this approach, the risk of exacerbation of chronic prostatitis can be minimized.
Prevention
To prevent the occurrence of a disease unpleasant for humans, it is necessary 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 physical education and sports, visit fitness centers.
- Avoid stressful situations.
- Have a regular sex life with a regular partner.