Many men suffer from chronic prostatitis, but they associate the symptoms with other diseases or waste time on ineffective treatment. From our article, you will get comprehensive information about this men's problem: causes, exact symptoms and methods of diagnosis, various treatment methods.
Despite all the successes of modern medicine, the diagnosis of a disease such as chronic prostatitis causes certain difficulties. This has a negative effect on the effectiveness of its treatment.
What is chronic prostatitis?
In ICD-10 (International Classification of Diseases, version 10) there is no such disease as "chronic prostatitis". There is no single, generally accepted characteristic of this pathology. In urological practice, it is customary to use the classification developed by AHI (American Institute of Health). Defines the categories of diseases of the prostate gland. Those that may be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses, the following symptoms are required: pain in the perineum for a long time (at least 3 months). Thus, chronic prostatitis can be called a long-term inflammatory process, which results in changes in the structure of the prostate gland and disruption of its function. But other diseases of the prostate also lead to such sad consequences. Therefore, the diagnosis of chronic prostatitis is difficult.
Epidemiology
Prostatitis is one of the most common diseases in men. It significantly affects performance and relationships in the family. The quality of life of patients decreases to the same extent as people who have had a heart attack or suffer from angina pectoris.
According to various sources, every 3rd or 4th man is diagnosed with prostatitis. And often this is not the initial or acute stage of the disease, but an already formed and long-lasting process - chronic.
Some time ago, it was thought that this pathology was mainly characteristic of elderly men. But statistics refuted this idea. Today it is known that chronic prostatitis is a disease of men of reproductive age who have sex.
More than 30% of patients turn to a specialist with complaints typical of the chronic form of prostatitis. Often, during the visit to the doctor, the disease is complicated by accompanying pathologies: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very diverse. It is difficult to isolate those that lead to the development of the disease from all the negative factors that affect a person's health. Often it is a complex of situations and circumstances that accompany a person's life.
The main causes of chronic abacterial prostatitis are as follows:
- dysrhythmia (irregularity) of sexual intercourse;
- hypodynamia characteristic of overweight people;
- prolonged stressful situations;
- predominance of fat-rich foods in the diet;
- adverse effect on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely healed bacterial prostatitis. Or the man ignored the diseases and did not seek help from a urologist. Therefore, no treatment was performed.
Abacterial chronic prostatitis develops due to exposure to infectious agents against the background of reduced immunity. As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors leading to the development of chronic bacterial prostatitis:
- surgical operations on the prostate (if antibiotic therapy is not carried out before the operation);
- refusal to use contraceptives;
- not having the habit of keeping his body clean.
Symptoms of chronic prostatitis
Today there are many myths about chronic prostatitis. For this reason, any temporary violation of sexual function is attributed to this disease. One can often hear such an opinion that the decrease in sexual desire and erectile dysfunction is a merit of prostatitis, and if a man is old, it is chronic prostatitis.
This is not true, because sexual dysfunction has many other causes, and the main symptom of chronic prostatitis is pain. All other signs can be considered accompanying and indirect.
Often, chronic prostatitis is confused with pelvic pain syndrome, because the symptoms of these diseases are basically similar. This is due to the formation of myofascial trigger zones near the prostate, which appear as a result of injuries and surgical interventions. Pain in these areas can be considered as a sign of inflammation of the prostate gland.
In the diagnosis of the disease, complaints of pain and discomfort in the perineum and small pelvis, lasting at least 3 months, come to the fore. The pain is localized near the prostate, spreads to the sacrum, rectum, and scrotum. When exposed to negative factors for a long time (carrying heavy loads, excessive physical activity, being "on your feet" for a long time), the pain intensifies.
A characteristic symptom of the disease is premature ejaculation. Patients have a decrease in sexual desire, erectile dysfunction. These symptoms are also characteristic of other diseases of the genitourinary field. Therefore, it cannot be said that they are a symptom of chronic prostate disease.
An important symptom is the fading of orgasm. If the patient began to notice that the sharpness of sensations during ejaculation is lost, this is a signal to pay more attention to his health and visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urethra increases, and the quality of urine output deteriorates. Patients with chronic prostatitis report a frequent urge to urinate at night. The process of urination is accompanied by a burning sensation, pain, pain. There is frequent urinary incontinence.
Symptoms of chronic prostatitis can be fully or partially expressed. Much depends on the patient's state of health, the presence or absence of other diseases. Chronic prostatitis is characterized by an undulating course with increasing and decreasing symptoms. In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
Chronic prostatitis is easy to diagnose when symptoms are severe. However, this disease is often asymptomatic, which makes it difficult to detect. A number of studies are conducted for diagnostic purposes.
The Association of Urologists has developed questionnaires, thanks to which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated to determine the patient's subjective feelings. Not every man can properly assess his erectile function, orgasm quality and other details of sex life. Questionnaires filled out by patients provide the specialist with the information needed to make a diagnosis. NIH-CPS scale is most commonly used in urological practice.
A neurological examination is performed to distinguish chronic prostatitis from other diseases. Determining the patient's immunity status in the list of diagnostic methods used.
Laboratory research methods
If you suspect chronic prostatitis, first of all find out what its nature is: bacterial or bacterial. In the first case, it is required to identify the pathogen or pathogens, to find out which drugs they are sensitive to. For this, laboratory examinations of urine and prostate secretion are performed.
If the PSA test after 10 days after DRE showed a level of prostate-specific antigen greater than 4. 0 ng / ml, this is a reason to send the patient to a biopsy to rule out an oncological process.
The following research methods are recommended:
- scraping from the urethra;
- 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 that is 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, thickening of the structure of the glandular tissue, and changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnostics. This allows you to study the nature of urine, signs of urine stagnation, and its composition. The study includes several tests: uroflowmetry, cystometry, measurement of the residual volume of urine, evaluation of the pressure in the bladder and the rate of urine flow.
To exclude benign and malignant neoplasms, tomography (computerized or magnetic resonance) is necessary. These research methods are highly informative and help to assess the condition of prostate tissues.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires a complex approach. One dose of the drug is not enough. Physiotherapy procedures, therapeutic exercises are necessary. In general, the treatment of chronic prostatitis is difficult, requires a radical review of lifestyle, change of habits, and in some cases, change of workplace. Urologists insist that only a complex of measures will help to completely get rid of this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or non-bacterial in nature, blockage in the prostate has played a major role in its development. A viscous secret deposited in the ducts of the gland is a favorable environment for the development of pathogenic and opportunistic microorganisms. Therefore, the main focus should be on eliminating stagnation.
The problem is solved by changing the lifestyle and including physical therapy exercises in the daily schedule.
Exercise complexes suitable for various life situations have been developed:
- for men who have to sit often (drivers, office workers, managers);
- for overweight people;
- for those who don't have time to exercise.
Thinking about how to treat chronic prostatitis, you should decide to seriously consider your attitude to health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet and sexual abstinence.
Course treatment methods:
- The most effective in the treatment of prostatitis is etiotropic therapy. If the basis of prostatitis is an infection, a course of antimicrobial agents that eliminate the manifestations of inflammation is a priority.
- Pain syndrome is eliminated with analgesics, antispasmodics, rectal suppositories, microclysts with warm solutions of painkillers. NSAIDs can be used.
- The combination of immunostimulants, immunomodulators, enzymes, vitamin complexes, trace elements has proven its effectiveness.
- Physiotherapy methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave oven, electrophoresis, laser, magnetotherapy.
- Massage is another effective way to affect the prostate. It opens the channels, normalizes the blood circulation of the scrotum, small pelvis.
- Acute retention of renal filtrate can be corrected by catheterization, trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist advice.
Treatment of chronic prostatitis
If the prostate is exposed to a long-term course (at least one month), there is no 100% guarantee of treatment. Priority for herbal preparations, immunocorrection, change of household habits:
- Phytopreparations 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 growth of glandular tissue.
- Antibacterial therapy is selected individually based on the sensitivity of microbes to drugs.
- Medicines that strengthen immunity not only help to cope with prostatitis, but also correct the negative effect of antibiotics that disrupt the function of the immune system.
- The pain syndrome is stopped by prescribing alpha-blockers, muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secret of the gland through the urethra, improve blood circulation and minimize blockage.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, sitz hot baths or herbal microclysters.
- In severe cases, intravenous fluids with diuretics are indicated. It stimulates abundant urination, prevents the symptoms of intoxication, prevents the development of ascending cystitis, pyelonephritis.
- Herbal laxatives are used for constipation.
- Together with the patient, the urologist and psychologist develop an individual long-term program of daily routine, proper rest, diet, dosed physical activity and sexual activity.
- If the chronic process is resistant to ongoing therapy, preventing the flow of urine, surgical intervention is prescribed: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). It is applied in exceptional cases, it is full of impotence, urinary incontinence. Young people are not operated because it can cause infertility.
Recommendations for outpatient treatment
The patient should avoid situations that could injure the pelvic organs.
It is necessary to exclude any load on the prostate: do not ride a bicycle, do strength training, do not carry heavy loads.
If the work is sedentary, every 2-3 hours you need to do warm-up exercises, squat, swing your legs, run in place.
It is necessary to try to normalize sex life, which is extremely important to eliminate the stagnation of secretion in the prostate.
It is recommended to limit to minimum doses or completely eliminate the use of alcohol.
Treatment with drugs
Chronic prostatitis is mainly treated on an outpatient basis. If the pathological process continues and remission cannot be achieved by this method, hospitalization is recommended. In a hospital, under the supervision of medical staff, there are more opportunities to follow the regimen 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 inhibitors and alpha 1-blockers are recommended. They help normalize hormonal levels and eliminate the symptoms of pathology. For these purposes, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach includes taking medications such as:
Methods of treatment of bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics. The most effective drug for a particular patient is determined using a preliminary laboratory study of prostate secretion.
There is no universal medicine for suppression and destruction of pathogenic microflora. What works for one patient may not work for 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 can be included in the treatment plan of patients with abacterial form of prostatitis. Such therapy is carried out for preventive purposes. According to indications, treatment with penicillin preparations is related.
After antibiotic therapy is completed, treatment with hormonal drugs begins.
With intraprostatic reflux, it is necessary to take α-blockers.
Pain relievers are effective in relieving pain.
Treatment with herbal remedies
Many people doubt that chronic prostatitis can be treated with herbal remedies. The answer to this question has come from years of use of these health-improving agents in urological practice.
Today, the following medical complexes are recommended:
All these drugs have a beneficial effect on the work of the male genitourinary system. Effective treatment of chronic prostatitis is possible if the urinary function is normalized. The components included in herbal remedies perform this task. They help reduce the frequency of urges, eliminate a sluggish jet syndrome.
For patients with chronic prostatitis, phytocalciums containing pumpkin extract or pumpkin seeds are recommended. The latter has a unique chemical composition and acts in three directions at once:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered as the main method of treatment. These healing agents are considered adjunctive drug therapy.
Non-drug treatment
Non-drug methods of therapy allow to act directly on the prostate, increase the drug concentration in its tissues, and help to eliminate obstruction.
The following methods are used for these purposes: rectal ultrasound exposure;
Microwave hyperthermia is performed using a rectal probe inserted into the patient's anus. You can set the required temperature for a certain type of exposure on the device. To increase the concentration of the drug in the prostate, it is necessary to warm it to 38-40 ° C. To achieve 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 the laser, the following processes occur in the prostate gland:
- activation of redox reactions;
- improves blood microcirculation;
- new capillaries are formed;
- pathogenic microflora is suppressed;
- the process of cell division is activated, which helps tissue regeneration.
During studies on the effect of laser therapy on patients with prostatitis, side effects, but positive for therapeutic purposes, were noted. In those who finished the course, potency increased, erectile dysfunction was eliminated, vitality was restored. To achieve this result, it is necessary to use a beam with a certain wavelength. In general, low-intensity laser radiation is used in the treatment of chronic prostatitis.
Patients can undergo a course of laser therapy on their own initiative, if not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not threaten 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. Transurethral resection is used to free it from prostatitis.
The operation is carried out under the supervision of TRUS.
If complications such as sclerosis of the prostate gland occur, transurethral electrosurgery is performed. If sclerosis of the bladder neck is observed along with this pathology, a partial resection of the prostate is performed.
Endoscopic operations are indicated to eliminate the violation of the openness of the secret due to the blockage of the seminal and excretory ducts. For this purpose, an incision is made in the seminal vesicles and excretory ducts. With 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 for stimulating the prostate, which helps to clear the blockage. This complex is designed for patients with hip joint problems. Experience has shown that these exercises are 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 the gym mat, raise both arms up.
- They bend their knees and pull them towards themselves, and at the same time spread them in different directions.
- Raise the bowl as high as they can.
- Repeat 10-12 times.
Exercise #2
- While standing on the floor, do deep squats.
- Repeat 10-12 times.
Exercise # 3
- Lie on your stomach.
- Lift one leg up, 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
Very few men can completely cure chronic prostatitis. Inflammation of the prostate often goes into a long-term remission phase. However, when the conditions for the activation of the pathology are created, relapse occurs. Exacerbation begins with the onset of pain in the prostate. Often they are accompanied by urinary tract disorders. At the first signs of relapse, you should seek help from a specialist.
Patients are advised to visit a urologist regularly, at least once every six months. At the same frequency, they conduct research on the condition of the prostate gland and conduct an analysis for PSA. With the systematic monitoring of the condition of the gland, it is possible to determine the processes that lead to the relapse of the disease in time. But even with a long remission, there is no guarantee that it will not break.
The patient should follow the recommendations to prevent exacerbation of the disease. It is recommended to balance the diet, excluding fatty and spicy foods. Taking phytopreparations and traditional medicine should 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 an unpleasant disease for men, it is necessary to eliminate provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't get cold.
- Drink at least 1. 5-2 liters of water per day.
- Strengthen immunity, walk a lot, get tough.
- Do physical education and sports, participate in fitness clubs.
- Avoid stressful situations.
- Have regular sex with a regular partner.