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 below a man's 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 ejaculation. This fluid transports the sperm during ejaculation (ejaculation) and protects the sperm as it travels to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may 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 appropriate treatment, there is every chance of achieving long-term remission and significantly improving the patient's quality of life. We figured out how to tell if 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, non-bacterial chronic prostatitis is the most common. And it is the worst to heal.
A disease is considered chronic if the symptoms do not subside for more than 3 months. However, they develop slowly and are less intense than the acute form.
Another characteristic feature of chronic prostate inflammation is its recurrent course. This means that symptoms may go away for a while and then come back. Without treatment, this condition can bother the patient for a very long time.
Bacterial and non-bacterial forms share common symptoms. They usually include problems with urination, 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. The reason for about 25% of visits to a urologist is related to chronic prostatitis.
The pathology can appear at any age, but the chronic form develops more often in men after the age of 50.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of diseases have common symptoms but different causes.
Chronic bacterial prostatitis
The inflammatory process causes a bacterial infection from the urinary tract to enter the prostate. The causative factor can be: acute form of prostatitis, urinary tract infection (UTI), STD. The causative agents of the inflammatory process in the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic non-bacterial prostatitis (chronic pelvic pain syndrome)
Researchers have not determined the causes of chronic pelvic pain syndrome. In this form, there is no infection in the prostate gland. What causes disturbances in this case is not exactly known. It is hypothesized 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 persisted despite treatment.
- urine enters the prostate due to bladder problems.
- nerve damage?
- damage to the urinary system due to injury or surgery;
- stress
Symptoms of chronic prostatitis
With chronic prostatitis, symptoms bother the patient for a long time - for 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:
- urination 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 general condition of the patient. Some people experience irritability, increased fatigue, lethargy and anxiety.
If you have these signs, consult 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 life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you need to make an appointment with 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 includes several stages:
- Download History.
The urologist will ask you about the reason for your visit, about previous illnesses and about medications you have taken now and in the past. - 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 gland. The exam 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, some later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urinalysis
Allows you to see 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 gland. An elevated PSA level indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostate secretion
Prostatic 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 will increase, and a high level of pathogenic bacteria may indicate a bacterial infection in the prostate. Microscopic examination of the fluid will help you see these changes. - Prostate secretions are collected by prostate massage. The massage can be combined with a digital rectal examination.
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 with the urinary system.
- TRUS (transrectal ultrasound examination of the prostate). For the examination, 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. It helps to assess the condition of the prostate tissue. It may be necessary to look for foci of prostate inflammation and rule out prostate cancer.
There is no special preparation for an appointment with a urologist. But to make the consultation as effective as possible, follow some simple recommendations:
- For personal hygiene, you should not use special products before use, only warm water is sufficient.
- Do not go to the toilet 2 hours before your visit to the clinic. Then, at your appointment, if necessary, you can immediately do tests or undergo an ultrasound.
- If you take regular medications, write down their names in your diary or notes on your phone.
- Take the results of previous studies with you so that the specialist can see the full 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 to get rid of prostatitis. For different forms and manifestations of the disease, different treatments are indicated.
To determine the type of chronic prostatitis, you need to undergo diagnostics. Based on its results, the doctor will prescribe a treatment that will give results specifically in your case.
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 will include antibiotic therapy and other methods to relieve symptoms.
Non-bacterial form: Treatment is symptomatic. That is, 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 acidic foods. These products irritate the bladder and worsen the patient's condition. - Hot 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 will help flush pathogenic bacteria from the bladder. - Cushions for chairs
When sitting, place a soft pillow under you. - Physical activity
Regular walks and exercise will help reduce pain and relieve congestion. - Regular sex life
Sexual activity is helpful in preventing congestion.
The methods listed will supplement your prescribed treatment, but not replace it.
Pharmaceutical treatment
- Antibiotics. Antibacterial treatment is indicated for the infectious form. The drugs destroy the bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, you need to undergo a study of prostate secretions and determine their type. In the treatment of the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary disorders. Medicines relax the organs of the urinary system and this relieves the symptoms. Most often, alpha blockers are used for non-infectious chronic prostatitis, but to improve the patient's well-being they can also be prescribed for an infectious form of the inflammatory process.
- NSAIDs (non-steroidal anti-inflammatory drugs). It is prescribed to relieve pain and reduce swelling of the prostate gland.
- Muscle relaxants. It is used when you need to relieve pelvic muscle spasm.
- Antidepressants. It is indicated for depression, which can develop due to stress and prolonged pain.
- Medicines to treat erectile dysfunction. It is used if prostatitis is causing problems in your sex life.
- Obediently. They may prescribe it if symptoms include pain during bowel movements.
Herbal treatment
Herbal medicines.Herbal medicines do not work as a main method of treatment. They can be used as a supplement to reduce prostate inflammation. For this purpose, drugs are prescribed with quercetin, a substance found in vegetables, fruits and berries.
Non-pharmacological 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 cycle of several sessions. Massage is contraindicated in the development of complications of the pathology: abscess, stones in the tissues of the prostate.
- Bladder catheterization. It may be needed if you have problems with your bladder.
- Psychotherapy. Because of the chronic pain, patients with prostatitis may develop depression and anxiety disorders. Psychological problems have a negative impact on the patient's well-being and worsen the pain syndrome. In such cases, consultation with a psychotherapist will 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 develop.
Types of functions:
- TUR (transurethral resection) of the prostate. It is indicated for the appearance of stones in the tissues of the prostate
- Prostatectomy. The removal of the prostate in some cases is carried out in case of an 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 muscles of the pelvic floor and relieve symptoms related to urinary system disorders. How to do the exercises:
- Sit back.
- 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 strain the muscles for a longer period of time.
- You should do 2-3 approaches per day.
Changes can be seen only 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 the possibility of achieving a long-term remission and returning the patient to the previous quality of life. To do this, it is important to undergo a thorough diagnosis to determine the form of the disease. If the cause of the inflammatory process is an infection, antibacterial therapy will help. And for non-infectious chronic prostatitis - well-chosen symptomatic treatment.
Complications of chronic prostatitis can include:
- Bacteremia (bacterial blood poisoning). Bacteria entering the bloodstream. It can be a consequence of bacterial forms of 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 tissue). In the event of an abscess, surgery is performed to clean and drain the purulent focus, in rare cases the prostate can be removed.
- Infertility. Problems with conception can 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
- Depression. Chronic pathologies increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a reduction in the man's quality of life and his emotional state.
To prevent prostatitis it is important to:
- Use barrier contraception (condoms): STDs are a factor that increases the risk of developing prostatitis
- See a urologist annually if you are over 40
- If you have symptoms of a UTI, contact your doctor immediately