Many men suffer from chronic prostatitis but blame the symptoms on other diseases or waste time on ineffective treatments. In our article you will learn comprehensive information about this problem in men: causes, exact symptoms and methods of diagnosis, various methods of treatment.
Despite all the achievements of modern medicine, diagnosing such a disease as chronic prostatitis creates certain difficulties. This negatively affects the effectiveness of his treatment.
What is chronic prostatitis
In the 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 AHI (American Institute of Health). It defines the categories of diseases of the prostate. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic nonbacterial prostatitis.
To make these diagnoses, the following symptoms are required: Persistent (at least 3 months) pain in the perineum. Therefore, chronic prostatitis can be called a long-term inflammatory process that leads to changes in the structure of the prostate and its dysfunction. But other diseases of the prostate 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. The quality of life of patients is reduced to the same extent as in people who have suffered a heart attack or are suffering from angina pectoris.
According to 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-lasting process - chronic.
Not so long ago it was believed that this pathology is inherent mainly in older men. But the statistics belied that notion. Today it is known that chronic prostatitis is a disease of sexually active men of childbearing age.
More than 30% of patients turn to a specialist with complaints characteristic of the chronic form of prostatitis. Often, at the time of visiting the doctor, the disease is complicated by concomitant diseases: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis are very different. Of all the negative factors affecting a man's health, it is difficult to isolate exactly those that provoked 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 abacterial prostatitis are the following:
- dysrhythmia (irregularity) of sexual intercourse;
- hypodynamia, which is typical for overweight people;
- prolonged stressful conditions;
- the predominance of high-fat foods in the diet;
- negative effects on the body in dangerous industries.
Chronic bacterial prostatitis is the result of incompletely cured 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 a decrease in immunity. As a rule, diseases of the endocrine system are diagnosed in such patients.
Factors provoking the development of chronic bacterial prostatitis are:
- surgical interventions on the prostate (if antibiotic therapy was not carried out before the operation);
- refusal to use contraceptives;
- Lack of habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many fictions about chronic prostatitis. Because of this, all temporary violations of sexual function are attributed to this disease. You can often hear the opinion that a decrease in sexual desire and erectile dysfunction is the merit of prostatitis, and if a man is older, then 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 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 myosfacial trigger zones near the prostate, which occurs as a result of injuries and surgical interventions. Pain in these areas can be interpreted as a symptom of prostate inflammation.
When diagnosing 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 and radiates to the sacrum, rectum, scrotum. With prolonged exposure to negative factors (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 tract. Therefore, they cannot be said to be hallmarks of chronic prostate disease.
An important symptom is the cessation of orgasm. If the patient noticed that the sharpness of sensation during ejaculation disappeared, this is an occasion for a more attentive approach to his health and a signal to visit a urologist.
The structure of the inflamed prostate becomes denser, pressure on the urethra increases, and the quality of urination deteriorates. Patients with chronic prostatitis notice frequent urges to urinate at night. The process of excretion of urine is accompanied by a burning sensation, pain, pain. Urinary incontinence is common.
Signs 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 an increase and decrease in symptoms. In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
When symptoms are severe, diagnosing chronic prostatitis is easy. But this disease is often asymptomatic, which complicates its detection. A number of studies are carried out for diagnostic purposes.
The Association of Urologists has developed questionnaires with which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated in such a way that the patient's subjective feelings can be recorded. Not every man is able to correctly assess his ability to have an erection, the quality of the orgasm and other details of sex life. Questionnaires filled out by the patient provide the specialist with the information needed to make the diagnosis. In urological practice, the NIH CPS scale is most often used.
In order to distinguish chronic prostatitis from other diseases, a neurological examination is carried out. In the list of diagnostic methods used, the state of the patient's immunity is determined.
Methods of laboratory research
If you suspect chronic prostatitis, first find out what its nature is: bacterial or nonbacterial. In the first case, it is necessary to determine the pathogen or pathogens in order to find out what drugs they are sensitive to. For this purpose, laboratory tests of urine and prostate secretion are carried out.
If the PSA test shows an excess of the prostate-specific antigen level from 4. 0 ng/ml after 10 days after DRU, 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 urine analysis;
- LHC culture of prostate secretion.
Instrumental research methods
TRUS (transrectal ultrasound diagnostics) is performed using equipment equipped with an instrument that is inserted into the patient's rectum. If an irregularly shaped hypoechoic area is found, there is every reason to suspect a malignant neoplasm. With chronic prostatitis, scarring, compaction of the structure of the glandular tissue, 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 stagnation of urine and its composition. The study includes several tests: uroflowmetry, cystometry, measuring the residual volume of urine, assessing the pressure in the bladder and the rate of urine outflow.
Tomography (computer or magnetic resonance) is necessary to rule out benign and malignant neoplasms. These research methods are very informative and help to assess the condition of the prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach. One dose of the drug is not enough. Physiotherapeutic procedures, therapeutic exercises are necessary. In general, chronic prostatitis is difficult to treat, requires a radical review of lifestyle, changes in habits and, in some cases, a change of job. Urologists insist that only a set of measures will help to completely get rid of this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or nonbacterial in nature, congestion in the prostate played an important 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 introducing physiotherapy exercises into the daily routine.
Complex exercises have been developed that are suitable for different life situations:
- for men who have to sit most of the time (drivers, office workers, managers);
- for overweight people;
- for those who don't have time to exercise.
Thinking about how to treat chronic prostatitis, you need to decide on a serious overhaul of your attitude towards your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet, and sexual rest.
Methods of course treatment:
- The most effective in the treatment of prostatitis is etiotropic therapy. If the basis of prostatitis is an infection, the priority is treatment with antimicrobial agents, which will reduce the manifestations of inflammation.
- Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microclysters with warm solutions of painkillers. NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes, a combination of microelements have proven their effectiveness.
- Physiotherapeutic methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
- Massage is another effective way to affect the prostate. It opens the channels, normalizes blood circulation in the scrotum and small pelvis.
- Acute retention of renal filtrate can be corrected by catheterization, trocarcystostomy.
- The purulent process involves surgical intervention.
- Psychological consultations.
Treatment of chronic prostatitis
With long-term exposure (at least one month) to the prostate, there is no 100% cure guarantee. Priority for herbal supplements, immune correction, household habit change:
- Phytopreparations are widely used in urological practice. They can 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.
- Immune-boosting drugs not only help to cope with prostatitis, they also correct the negative effect of antibiotics that disrupt the functioning of the immune system.
- The pain syndrome is stopped by the appointment of alpha-blockers, muscle relaxants.
- Prostate massage allows you to mechanically remove the "extra" secret of the gland through the urethra, improving blood circulation and minimizing congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, heated seated baths or herbal microclysters.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates copious excretion of urine, prevents the symptoms of intoxication, the development of ascending cystitis, pyelonephritis.
- With constipation, laxatives of plant origin are used.
- Together with the patient, the urologist, psychologist develops an individual long-term program consisting of daily routine, necessary rest, nutrition, dosed physical activity and sexual activity.
- In case of resistance of the chronic process to the current therapy, blockage of the outflow 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). Practiced in exceptional cases, fraught with impotence, urinary incontinence. Young people do not undergo surgery as it can lead to infertility.
Recommendations for outpatient treatment
The patient must avoid situations in which he can get injuries to the pelvic organs.
It is necessary to exclude any load on the prostate: do not ride a bicycle, do not do strength exercises, do not carry heavy loads.
If the work is seated, warm-ups, squats, leg swings, and running in place must be performed every 2-3 hours.
It is necessary to try to normalize sex life, which is extremely important in order to eliminate the stagnation of the secret in the prostate.
Limiting the use of alcohol to the minimum doses or eliminating it entirely is recommended.
treatment with medication
Chronic prostatitis is mostly treated on an outpatient basis. If the pathological process persists and it is not possible to achieve remission by this method, hospitalization is recommended. In a hospital, under the supervision of medical personnel, there are much more opportunities to follow 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 inhibitors and alpha-1 blockers are recommended. They contribute to the normalization of hormone levels and eliminate the symptoms of pathology. For these purposes, drugs such as finasteride and terazosin are prescribed.
An integrated approach includes taking such drugs as:
Methods of treating 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 drug for the suppression and destruction of pathogenic microflora. What works for one patient may not work for another. Because of this, there are a lot of negative reviews about advertised drugs for the treatment of chronic prostatitis.
The drugs recommended for antibacterial therapy are fluoroquinolones. Most bacteria are sensitive to it.
Antibiotics can also be included in the treatment plan for patients with nonbacterial form of prostatitis. Such therapy is carried out for preventive purposes. Depending on the indication, treatment with penicillin preparations is followed.
After the completion of antibiotic therapy, treatment with hormonal drugs begins.
Intraprostatic reflux requires the use of α-blockers.
Pain relievers are effective for pain relief.
Treatment with herbal remedies
Many doubt that chronic prostatitis can be cured with herbal remedies. The answer to this question was obtained through the long-term use of these health-promoting agents in urological practice.
Today, the following medicinal complexes are recommended:
All these drugs have a positive effect on the work of the male urogenital system. Effective treatment of chronic prostatitis is possible when the function of urination is normalized. The ingredients that make up herbal remedies do this job. They help reduce the frequency of urges and eliminate the syndrome of a sluggish ray.
Patients with chronic prostatitis are recommended phytocollections containing pumpkin extract or pumpkin seeds. The latter have a unique chemical composition and act simultaneously in three directions:
- normalize metabolism;
- strengthen the walls of blood vessels;
- activate blood flow to the pelvic organs.
Taking herbal medicines cannot be considered the main method of treatment. These remedies are considered adjunctive drug therapy.
Non-drug treatment
Non-drug methods of therapy allow you to act directly on the prostate, increasing the concentration of drugs in its tissues and removing congestion.
For these purposes, the following methods are used: rectal ultrasound exposure;
Microwave hyperthermia is performed using a rectal probe inserted into the patient's anus. You can set the temperature required for a specific type of exposure on the device. To increase the concentration of the drug in the prostate, warming to 38-40°C is required. To achieve antibacterial effect - 40-45 ° C.
Today, non-drug treatment focuses on laser therapy. The possibilities of this technology are wide-ranging. Under the influence of a laser, the following processes occur in the prostate:
- activation of redox reactions;
- improves blood microcirculation;
- new capillaries are formed;
- pathogenic microflora is suppressed;
- The process of cell division is activated, which contributes to tissue regeneration.
During the study of the effects of laser therapy on patients with prostatitis, one side effect was noted, but it was positive for the purposes of treatment. In those who completed the course, potency increased, erectile dysfunction was eliminated, and vitality was restored. In order to achieve this result it is necessary to use a beam with a specific wavelength. Generally, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can undergo laser therapy on their own initiative, if not prescribed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not pose a threat to the patient's life, but it can significantly affect its quality. The most serious complication of this disease is the formation of stones in the tissues of the gland. To rid it of prostoliths, transurethral resection is performed.
The operation will be carried out under the control of TRUS.
If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If sclerosis of the neck of the bladder is observed in combination with this pathology, a partial resection of the prostate is performed.
With blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate violations of the patency of the secret. To do this, an incision is made in the seminal vesicles and ducts. If an abscess occurs, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis
There are a number of exercises that are effective in stimulating the prostate, which will help clear a congestion. This complex was developed for patients with problems in the hip joints. Practice has shown that these exercises are useful for those who are diagnosed with prostatitis. Classes can be held at a convenient time, the completion of the complex will take no more than 15 minutes.
Exercise 1
- Lying on a gym blanket stretch both arms upwards.
- They bend their knees and pull them towards them, simultaneously spreading them in different directions.
- Elevate the pelvis as much as possible.
- Repeat 10-12 times.
exercise 2
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
Exercise #3
- Lie on your stomach.
- Lift one leg, then the other.
- Repeat 10-12 times.
When performing these exercises, all movements should be smooth. This is the main condition for achieving a high therapeutic effect.
treatment prognosis
Few men manage to completely cure chronic prostatitis. Inflammation of the prostate often progresses to a stage of long-term remission. But when conditions arise for the activation of the pathology, a relapse occurs. The exacerbation begins with the appearance of pain in the prostate. Often they are accompanied by urinary tract diseases. At the first symptoms of relapse, you should contact a specialist.
Patients are advised to visit a urologist regularly, at least every six months. With the same frequency they conduct studies on the state of the prostate and conduct a PSA analysis. Systematic monitoring of the condition of the gland allows timely detection of the processes that provoke a relapse of the disease. But even with a long remission, there is no guarantee that it will not be violated.
The patient must follow the recommendations to prevent exacerbation of the disease. It is recommended to balance the diet, excluding fatty and spicy foods from it. The reception of phytopreparations and traditional medicine should be agreed with the attending physician. This approach allows you to minimize the risk of exacerbation of chronic prostatitis.
prevention
To prevent the appearance 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 a day.
- Boost immunity, walk a lot, toughen up.
- Engage in sports and sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a steady partner.