Many men suffer from chronic prostatitis, but attribute the symptoms to other diseases or waste time with ineffective treatments.From our article you will learn complete information about this male problem: causes, exact symptoms and diagnostic methods, various methods of treatment.
Despite all the successes of modern medicine, the diagnosis of a disease such as chronic prostatitis causes some difficulties.This also negatively affects the effectiveness of your treatment.
What is chronic prostatitis
In the ICD-10 (International Classification of Diseases, 10th revision) there is no such disease as "chronic prostatitis".Furthermore, there is no single, generally accepted characteristic of this pathology.In urological practice it is customary to use the classification developed by the AHI (American Institute of Health).Defines the categories of prostate diseases.Those that can be described as “chronic” include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To make this diagnosis the following symptoms are necessary: chronic pain (at least 3 months) in the perineal area.Therefore, chronic prostatitis can be called a long-term inflammatory process, the consequence of which is 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 family performance and relationships.The quality of life of patients decreases to the same extent as that of people who have had a heart attack or suffer from angina pectoris.
According to data from various sources, 1 in 3 or 4 men 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: chronic.
Not so long ago, it was generally accepted that this pathology is characteristic mainly of older men.But statistical data have disproved this opinion.Today it is known that chronic prostatitis is a disease of men of childbearing age who are sexually active.
More than 30% of patients consult a specialist with disorders characteristic of chronic prostatitis.Often, at the time of visiting the doctor, 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.Among the variety of negative factors affecting a man's health, it is difficult to single out exactly those that provoked the development of the disease.Often it is a complex of situations and circumstances that accompany a man's life.
The main causes of chronic abacterial prostatitis are the following:
- arrhythmia (irregularity) of sexual intercourse;
- physical inactivity, typical of overweight people;
- long-term stressful conditions;
- the predominance of high-fat foods in the diet;
- negative impact on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely healed bacterial prostatitis.Or the man ignored the complaints and did not seek help from a urologist.Therefore no treatment was carried out.
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.
The factors that provoke the development of chronic bacterial prostatitis are:
- prostate surgery (if antibacterial therapy was not performed before surgery);
- refusal to use contraception;
- lack of habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many myths regarding chronic prostatitis.For this reason, any temporary disturbances in sexual function are attributed to this disease.We often hear that decreased libido and erectile dysfunction are due to prostatitis and, if it is an elderly man, to chronic prostatitis.
This is not true, since 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 largely similar.This is due to the formation of myofascial trigger zones near the prostate, which appear following injuries and surgeries.Pain in these areas can be confused with 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 localized 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, they cannot be said to be hallmarks 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 attentive attitude to his health and a signal about the need to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urinary tube increases and the quality of urination worsens.Patients with chronic prostatitis notice a frequent need to urinate at night.The process of excreting urine is accompanied by a sensation of burning, stinging and pain.Urinary incontinence often occurs.
Signs of chronic prostatitis can be expressed completely or partially.Much depends on the patient's state of health and the presence or absence of other pathologies.Chronic prostatitis is characterized by a wave-like course, with waxing and waning symptoms.With 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 complicates its detection.For diagnostic purposes, a whole series of studies is carried out.
The Association of Urologists has developed questionnaires that can help identify asymptomatic chronic prostatitis.The questions are formulated in such a way that they can clarify the patient's subjective feelings.Not all men are able to correctly evaluate their erectile function, the quality of orgasm and other details of sexual life.The questionnaires filled out by the patient provide the specialist with the information necessary to formulate a diagnosis.In urological practice, the NIH-CPS scale is 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 we 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.To do this, laboratory tests are performed on urine and prostate secretions.
If, after a period of 10 days after the DRE, the PSA test shows that the level of prostate specific antigen exceeds 4.0 ng/ml, this is a reason to subject the patient to a biopsy to exclude an oncological process.
The following search methods are recommended:
- scraping from the urethra;
- general and biochemical analyzes of urine;
- LHC culture of prostate secretion.
Instrumental research methods
TRUS (transrectal ultrasound) is performed using equipment 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, compaction of the structure of the glandular tissue and changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnostics.It allows you to find out the nature of urination, signs of urine stagnation and its composition.The study includes various tests: uroflowmetry, cystometry, measurement of the residual volume of urine, evaluation of the pressure inside the bladder and the speed of urine outflow.
Tomography (computed resonance imaging or magnetic resonance imaging) is necessary to exclude benign and malignant tumors.These research methods are highly informative and help evaluate the condition of the prostate tissue.
Treatment of chronic prostatitis
The treatment of chronic prostatitis requires an integrated approach.Taking the drugs alone is not enough.Physiotherapeutic 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 completely eliminate this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or non-bacterial in nature, prostate congestion played an important role in its formation.The viscous secretion deposited in the ducts of the gland constitutes a favorable environment for the development of pathogenic and opportunistic microorganisms.Therefore, the main attention should be paid to 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 men forced to sit most of the time (drivers, office workers, managers);
- for people with excess body weight;
- for those who don't have time to do exercises.
After thinking about how to treat chronic prostatitis, you must 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.
Course treatment methods:
- The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, the priority is a course of antimicrobial agents that relieve the manifestations of inflammation.
- Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers.NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
- Physiotherapeutic methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Massage is another effective method to influence the prostate.Opens the ducts, normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychological consultations.
Treatment of chronic prostatitis
With a long-term effect (at least a month) on the prostate, there is no 100% cure guarantee.The priority goes to phytotherapy, 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.
- Drugs that improve immunity not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the function 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 the “extra” secretion of the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, hot sitz baths or herbal microenemas.
- In more severe cases, intravenous fluids with diuretics are indicated.This stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- For constipation, herbal laxatives are used.
- The urologist and psychologist, together with the patient, develop a long-term individual program including 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 must avoid situations in which he may suffer injury 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 it is necessary to do a warm-up by performing squats, leg swings and running on the spot.
You need to try to normalize your sexual life, which is extremely important to eliminate stagnation of secretions in the prostate.
It is recommended to limit alcohol consumption to minimal doses or eliminate it completely.
Treatment with drugs
For chronic prostatitis, treatment is mainly carried out on an outpatient basis.If the pathological process persists and remission cannot be achieved 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 against the background of endocrine disorders.In this regard, 5-alpha reductase inhibitor drugs and alpha 1-blockers are recommended.They help normalize hormone levels and eliminate the symptoms of the pathology.For these purposes, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach involves taking medications such as:
Treatment methods for chronic bacterial 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 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 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 abacterial prostatitis.This therapy is carried out for preventive purposes.According to indications, treatment with penicillin-based drugs is included.
After completion of antibacterial therapy, treatment with hormonal drugs begins.
For intraprostatic reflux it is necessary to take α-blockers.
For pain, painkillers 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 therapeutic complexes are recommended:
All these drugs have a beneficial effect on the functioning of the male genitourinary system.Effective treatment of chronic prostatitis is possible provided that urinary function is normalized.The components included in herbal medicines perform this task.They help reduce the frequency of impulses 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 simultaneously:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered the main method of treatment.These health-enhancing agents are considered concomitant with drug therapy.
Non-pharmacological 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 gland:
- 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 research period on the effects of laser therapy on patients suffering from prostatitis, a side effect, but positive for the purposes of treatment, was noted.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 certain wavelength.In general, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can, on their own initiative, undergo a course of laser therapy unless prescribed by their doctor.
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 prostatoliths, transurethral resection is used.
The surgery is performed under TRUS control.
If complications such as prostatic sclerosis occur, transuretal electrosurgery is performed.If sclerosis of the neck of the bladder is observed in combination with this pathology, partial resection of the prostate is performed.
When the seminal and excretory ducts are obstructed, endoscopic interventions 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 case of abscess, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis
There are numerous effective exercises to stimulate the prostate, helping to 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.Lessons can be held at a convenient time;completing the complex will take no more than 15 minutes.
Exercise no.1
- Lying on an exercise mat, stretch both arms straight up.
- Bend your knees and pull them towards you, simultaneously spreading them in different directions.
- Raise your pelvis as much as possible.
- Repeat 10-12 times.
Exercise no.2
- Standing on the mat, perform deep squats.
- Repeat 10-12 times.
Exercise n.3
- Lie on your stomach.
- Raise one leg, then the other.
- Repeat 10-12 times.
When performing this series 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 enters a long-term remission phase.But when the 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 recommended to visit a urologist regularly, at least once every six months.With the same frequency they carry out examinations of the condition of the prostate and do the PSA test.By systematically monitoring the condition of the gland, it is possible to timely identify the processes that provoke a relapse of the disease.But even with long-term remission there is no guarantee that it will not be stopped.
The patient must follow the recommendations to prevent exacerbations of the disease.It is advisable to balance your diet by excluding fatty and spicy foods.The use of herbal remedies and traditional medicine must be agreed with the treating doctor.With this approach, the risk of exacerbation of chronic prostatitis can be minimized.
Prevention
To prevent the occurrence of an unpleasant disease for men, it is necessary to eliminate provoking factors and follow simple rules:
- Lead a healthy lifestyle, abandon bad habits.
- Don't get too cold.
- Drink at least 1.5-2 liters of water a day.
- Strengthen your immune system, walk a lot, strengthen yourself.
- Engage in physical education and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.