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 is made up of glandular and connective tissue. Its function is to produce fluid, consisting partly of ejaculate. This fluid carries 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 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 nonbacterial prostatitis is the most common. And he's the worst to deal with.
A disease is considered chronic if the symptoms do not disappear for more than 3 months. However, they develop slowly and are less pronounced than the acute form.
Another feature of chronic inflammation of the prostate is its recurrent course. This means that symptoms may disappear for a while and then reappear. Without treatment, this condition can disturb the patient for a very long time.
Bacterial and non-bacterial forms have 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. Furthermore, the chronic form is much more common than the acute one. The reason for approximately 25% of visits to the urologist is related to chronic prostatitis.
The pathology can occur 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
When in the prostate secretion during the analysisdiscoveryleukocytes and pathogens
The inflammatory process causes a bacterial infection to enter the prostate from the urinary tract. 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 the prostate secretion during the analysisnot detectedleukocytes and pathogens
Researchers have not established the causes of chronic pelvic pain syndrome. With this form there is no infection in the prostate gland. What causes the disturbances in this case is not known exactly. It is assumed 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 entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- fatigue
Symptoms of chronic prostatitis
With chronic prostatitis, the 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 sexual intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- nausea
The disease also affects the general condition of the patient. 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 diseases that require urgent medical attention. If treatment is delayed, there is a risk of developing life-threatening 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 the diagnosis and treatment of the male reproductive system and urinary system in both men and women.
The initial consultation involves several phases:
- Taking the story.
The urologist will ask you about the reason for your visit, any previous illnesses and medications you have taken now and in the past. - Examination of the genital organs
- Digital rectal exam.
During the procedure, the urologist inserts a finger into the patient's anus to palpate the surface of the prostate gland. The test helps determine the size of the prostate and check for swelling and tenderness. - Other studies.
The doctor can prescribe one or more diagnostic tests, some of which can be performed immediately at the visit, others later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urinalysis
It allows you to see signs of infection. This can be indicated by pathogenic bacteria in the overall analysis. - Blood test for PSA (prostate specific antigen)
Helps evaluate the condition of the prostate gland. An elevated PSA level indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostatic 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 will 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 using prostate massage. Massage can be combined with a digital rectal exam.
Instrumental research methods
- Cystoscopy. Examination of the internal 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 urinary tract problems.
- 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 evaluate the condition of the prostate tissue. You may need to see foci of inflammation in the prostate 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 tips:
- For intimate hygiene, do not use special products before use, only warm water is sufficient.
- Do not go to the bathroom 2 hours before your visit to the clinic. Then, at the appointment, if necessary, you can immediately do some tests or undergo an ultrasound.
- If you take medications regularly, write their names in your diary or in the notes on your phone.
- Bring 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 the time of your appointment.
Treatment of chronic prostatitis
There is no universal method of getting rid of prostatitis. Different treatments are indicated for the different forms and manifestations of the disease.
To determine the type of chronic prostatitis, it is necessary to undergo diagnostics. Based on the results, your doctor will prescribe a therapy that will give specific results 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 is aimed at combating 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 sitz baths, hot showers
Water procedures will help reduce the manifestations of the disease. - More water
Drink enough fluids. Going to the bathroom more frequently will help eliminate pathogenic bacteria from the bladder. - Chair cushions
When sitting, place a soft pillow under you. - Physical activity
Regular walking and exercise will help reduce pain and clear congestion. - Regular sex life
Sexual activity is helpful in preventing congestion.
The listed methods will complement the prescribed therapy, but will not replace it.
Pharmacological treatment
- Antibiotics. For the infectious form, antibacterial therapy is indicated. The drugs destroy the bacteria that cause inflammation of the prostate. Different types of pathogenic microorganisms require different antibiotics, so before prescribing it is necessary to undergo 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 drugs relax the organs of the urinary system and this relieves the 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 (non-steroidal anti-inflammatory drugs). Prescribed to relieve pain and reduce swelling of the prostate gland.
- Muscle relaxants. Used when it is necessary to relieve spasm of the pelvic muscles.
- Antidepressants. Indicated for depression, which can develop due to stress and prolonged pain.
- Drugs for the treatment of erectile dysfunction. Used if prostatitis causes problems in sexual 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 treatment method. They can be used as a supplement to reduce inflammation of the prostate. For this purpose, drugs based on quercetin, a substance present in vegetables, fruits and berries, are prescribed.
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 course of several sessions. Massage is contraindicated in the development of pathological complications: abscesses, stones in the tissues of the prostate gland.
- Bladder catheterization. This 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, it will be useful to consult a psychotherapist.
- Biofeedback programs. It can help reduce tension in the pelvic muscles.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be needed if complications develop.
Types of operations:
- TUR (transurethral resection) of the prostate.Indicated for the appearance of stones in the prostate tissues
- Prostatectomy. Removal of the prostate gland 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 relieve symptoms associated with urinary disorders. How to perform the exercises:
- Sit comfortably.
- Contract your pelvic muscles for 5 seconds. To do this, imagine you are trying to stop urinating.
- Relax your muscles.
- Repeat the operation 10-15 times.
- Gradually you can increase the number of repetitions and strain the muscles for a longer time.
- 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 the possibility of achieving 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 chronic non-infectious prostatitis: well-chosen symptomatic therapy.
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 (buildup of pus in the tissues). In case of an abscess, surgery is performed to clean and drain the purulent focus; in rare cases, the prostate may be removed.
- Infertility. Conception problems 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
- Depressive disorder. Chronic conditions increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and his emotional state.
To prevent prostatitis it is important:
- Use barrier contraceptives (condoms): sexually transmitted diseases are a factor that increases the risk of developing prostatitis
- Visit a urologist annually if you are over 40
- If you experience symptoms of a urinary tract infection, contact your doctor immediately