Many men suffer from chronic prostatitis, but attribute the symptoms to other diseases or waste time on ineffective treatment.From 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, the diagnosis of a disease such as chronic prostatitis causes certain difficulties.This also negatively affects the effectiveness of his 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 feature of this pathology.In urological practice, it is customary to use the classification developed by AHI (American Institute of Health).Defines categories of prostate diseases.What can be described as "years" include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses, the following symptoms are required: long-term (at least 3 months) pain in the perineal area.Thus, chronic prostatitis can be called a long-term inflammatory process, the consequence of which are changes in the structure of the prostate gland 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.Patients' quality of life is reduced to the same extent as for people who have had a heart attack or suffer from 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 formed and long-term process - years.
Not so long ago, it was generally accepted that this pathology is characteristic mainly of elderly men.But the statistics belied this view.Today it is known that chronic prostatitis is a disease of men of reproductive age who are sexually active.
More than 30% of patients consult a specialist with complaints characteristic of chronic prostatitis.Often, at the time of the visit to the doctor, the disease is complicated by accompanying pathologies: erectile dysfunction, cystitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very different.From the variety of negative factors that affect a man's health, it is difficult to single out exactly those that caused 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, which is characteristic of overweight people.
- long-term stressful conditions;
- the prevalence of high-fat foods in the diet;
- negative effects on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely treated bacterial prostatitis.Or the man ignored the ailments and did not seek help from a urologist.Therefore, no treatment was performed.
Chronic bacterial prostatitis develops due to exposure to infectious agents against a background of reduced immunity.As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors that cause the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibacterial treatment was not carried out before the operation);
- refusal to use contraception.
- lack of habit of keeping your body clean.
Symptoms of chronic prostatitis
Today there are many myths about chronic prostatitis.For this reason, any temporary disturbances in sexual function are attributed to this disease.Often you can hear the opinion that reduced libido and erectile dysfunction are due to prostatitis, and if it is an old man, then to 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 accompanying 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 activation zones near the prostate, which appear as a result of injuries and surgeries.Pain in these areas can be mistaken for a symptom of prostate inflammation.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and pelvis, lasting at least 3 months, come to the fore.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, prolonged stay on your feet), the pain intensifies.
A characteristic sign of the disease is premature ejaculation.Patients experience reduced sexual desire and erectile dysfunction.These symptoms are also characteristic of other diseases of the genitourinary system.Therefore, they cannot be said to be characteristic features of chronic prostate disease.
An important symptom is the fading of orgasm.If the patient begins to notice that the severity of sensations during ejaculation has disappeared, this is a reason for a more careful attitude to his health and a signal for the need to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure in the urinary tract increases and the quality of urination worsens.Patients with chronic prostatitis note a frequent urge to urinate at night.The process of urine excretion is accompanied by a burning sensation, stinging and pain.Urinary incontinence often occurs.
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 an undulating course, with waxing and waning symptoms.With this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of severe symptoms, it is not difficult to diagnose chronic prostatitis.But this disease is often asymptomatic, which complicates its detection.For diagnostic purposes, a whole series of studies is carried out.
The Urological Association has developed questionnaires that can help identify asymptomatic chronic prostatitis.The questions are phrased in such a way that the patient's subjective feelings can be clarified.Not everyone is able to correctly assess his erectile function, orgasm quality and other details of sex life.The questionnaires filled out by the patient provide the specialist with the necessary information for the diagnosis.In urological practice, the NIH-CPS scale is most often used.
To differentiate chronic prostatitis from other diseases, a neurological examination is performed.The list of diagnostic methods used includes clarification of the patient's immune status.
Laboratory research methods
If chronic prostatitis is suspected, first of all they find out what its nature is: bacterial or bacterial.In the first case, it is necessary to identify the pathogen or pathogens and find out which drugs they are sensitive to.To do this, laboratory tests of urine and prostate secretions are performed.
If, after a period of 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 in order to rule out an oncological process.
The following research methods are recommended:
- scraping from the urethra;
- general and biochemical analysis of urine.
- Prostate secretion LHC culture.
Instrumental research methods
TRUS (rectal ultrasound) is performed using equipment equipped with an instrument that is inserted into the patient's rectum.If a hypoechoic area of irregular shape is detected, there is every reason to suspect a malignant neoplasm.With chronic prostatitis, scarring, compression of the glandular tissue structure, and changes in the seminal vesicles may be seen.
UDI is the primary method of functional diagnosis.It allows you to learn the nature of urination, signs of urine stagnation and its composition.The study includes various tests: urometry, cystometry, measurement of the residual volume of urine, assessment of the pressure inside the bladder and the rate of urine outflow.
Tomography (computed tomography or magnetic resonance imaging) is necessary to exclude benign and malignant neoplasms.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 a comprehensive approach.Taking medication alone is not enough.Physiotherapy procedures and therapeutic exercises are necessary.In general, chronic prostatitis is difficult to treat and requires a radical revision of lifestyle, changes in habits and in some cases, a change of job.Urologists insist that only a set of measures will help to get rid of this disease completely or ensure long-term remission.
Regardless of whether the disease is bacterial or bacterial in nature, congestion in the prostate gland played an important role in its formation.The thick secretion deposited in the ducts of the gland is a favorable environment for the growth of pathogenic and opportunistic microorganisms.Therefore, the main attention should be given to eliminating stagnation.
The problem can be solved by changing the lifestyle and incorporating physical therapy classes into the daily schedule.
Complexes of exercises have been developed that are suitable for different life situations:
- 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 do exercises.
Having thought about how to deal with chronic prostatitis, you should decide to seriously revise your attitude towards your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.
Course Therapy Methods:
- The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, a series of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
- The pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers.NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their 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 method of influencing the prostate.It opens the pores, normalizes blood circulation in the scrotum and pelvis.
- Acute renal retention of infiltrate can be corrected by catheterization and trocar cystostomy.
- The purulent process involves surgery.
- Psychologist consultations.
Treatment of chronic prostatitis
With a long-term, course (at least one month) effect on the prostate, there is no 100% guarantee of cure.Priority is given to herbal medicines, immunocorrection, 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.
- Immune-boosting drugs not only help treat prostatitis, but also correct the negative effects of antibiotics that disrupt immune system function.
- The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secretion of the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or micro enemas with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.This stimulates the abundant production of urine, prevents the symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- Herbal laxatives are used for constipation.
- The urologist and the 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 treatment and the outflow of urine is blocked, surgery is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy).Applied 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 must avoid situations in which he may suffer injuries to the pelvic organs.
It is necessary to avoid any pressure 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 need to warm up by doing squats, leg swings and running in place.
You must try to normalize your sex life, which is extremely important to eliminate stagnation of secretions in the prostate.
It is recommended to limit alcohol consumption to minimal doses or completely eliminate alcohol consumption.
Drug treatment
Chronic prostatitis is mainly treated externally.If the pathological process persists and it is not possible to achieve remission with this method, hospitalization is recommended.In a hospital, under the supervision of medical staff, there are much more opportunities to comply with the regime and monitor changes in the patient's condition.
Chronic prostatitis in men develops in the context of endocrine disorders.In this regard, drugs 5-alpha reductase inhibitors and alpha 1-inhibitors are recommended.They help normalize hormonal levels and eliminate the symptoms of pathology.For these purposes, drugs such as Finasteride and Terazosin are prescribed.
A comprehensive approach includes taking medications such as:
Treatment methods for bacterial chronic prostatitis
Chronic bacterial prostatitis is treated with antibiotics.The most effective drug for a particular patient is determined using a preliminary laboratory study of prostate secretions.
There is no universal medicine for the suppression and destruction of pathogenic microflora.What helps one patient may not help another.For this reason, there are many negative reviews about advertised drugs 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 bacterial prostatitis.This treatment is carried out for preventive purposes.According to indications, treatment with penicillin drugs is included.
After completion of antibacterial therapy, treatment with hormonal drugs begins.
For endoprostatic reflux it is necessary to take α-blockers.
For pain, painkillers are effective.
Herbal treatment
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 therapeutic agents in urological practice.
Today, the following therapeutic complexes are recommended:
All these drugs have a beneficial effect on the functioning of the male urogenital system.Effective treatment of chronic prostatitis is possible provided that the urinary function has been normalized.The ingredients included in herbal medicines perform this task.They help reduce the frequency of impulses and eliminate sluggish 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 simultaneously:
- normalization of metabolism;
- strengthening the walls of blood vessels.
- activates blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment.These health-enhancing factors are considered to be combined with drug therapy.
Non-pharmacological treatment
Drug-free treatment methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues and help eliminate congestion.
For these purposes, the following techniques are used: rectal ultrasound.
Microwave hyperthermia is performed using a rectal catheter 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 requires heating to 38-40°C.To obtain an antibacterial effect – 40-45°C.
Today, non-drug treatment focuses on laser therapy.The possibilities of this technique are great.Under the influence of a laser, the following processes occur in the prostate gland:
- activation of redox reactions.
- blood microcirculation improves.
- new capillaries are formed.
- the pathogenic microflora is suppressed.
- The process of cell division is activated, which promotes tissue regeneration.
During the period of research on the effects of laser therapy on patients with prostatitis, a side effect was observed, but positive for therapeutic purposes.Those who completed the course increased potency, eliminated erectile dysfunction and restored vitality.To achieve this effect, 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, undergo a course of laser treatment if not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis is not 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 free it from prostate stones, transurethral resection is used.
The surgery is performed under TRUS control.
If complications such as prostate induration occur, transurethral electrosurgery is performed.If induration of the bladder neck is observed in combination with this pathology, a partial resection of the prostate is performed.
When the spermatic and excretory ducts are blocked, endoscopic procedures are indicated to eliminate the obstruction of the patency of the secretion.For this purpose, an incision is 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 a number of 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 those diagnosed with prostatitis.Classes can be held at a convenient time.the assembly will take no more than 15 minutes to complete.
Exercise No. 1
- Lie on an exercise mat, stretch both arms up.
- Bend your knees and pull them towards you, simultaneously spreading them in different directions.
- Raise the pelvis as high as they can.
- Repeat 10-12 times.
Exercise No. 2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise No. 3
- Lie on your stomach.
- Lift one leg, 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 can 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 appearance 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.
Patients are advised to visit a urologist regularly, at least once every six months.With the same frequency, they do prostate health tests and PSA tests.By systematically monitoring the state of the gland, processes that cause a relapse of the disease can be identified in time.But even with a long recession there is no guarantee that it will not be disrupted.
The patient must follow the recommendations to prevent exacerbations of the disease.It is recommended to balance your diet by excluding fatty and spicy foods.The use of herbal medicines 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 appearance of a disease that is unpleasant for men, you need to eliminate the causative factors and follow simple rules:
- Follow a healthy lifestyle, give up bad habits.
- Don't get too cold.
- Drink at least 1.5-2 liters of water a day.
- Boost your immune system, walk a lot, toughen up.
- Engage in physical education and sports, visit gyms.
- Avoid stressful situations.
- Have a regular sex life with a regular partner.