Many men suffer from chronic prostatitis, but they 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 methods of diagnosis, various methods of treatment.
Despite all the successes of modern medicine, the diagnosis of such a disease as chronic prostatitis causes certain difficulties. This 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 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). It defines the categories of diseases of the prostate. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic abacterial prostatitis.
To make these diagnoses, the following symptoms are required: prolonged (at least 3 months) pain in the perineum. Thus, chronic prostatitis can be called a long-term inflammatory process, which results in changes in the structure of the prostate gland and its dysfunction. But other diseases of the prostate also lead to such sad results. Therefore, the diagnosis of chronic prostatitis is difficult.
Prostatitis is one of the most common diseases in men. It has a significant impact on performance and relationships in the family. The quality of life of patients is reduced to the same extent as in people who have had a heart attack or 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-term ongoing process - chronic.
Not so long ago it was considered that this pathology is inherent mainly in older men. But the statistics disproved this notion. Today it is known that chronic prostatitis is a disease of men of childbearing age who are sexually active.
More than 30% of patients turn to a specialist with complaints characteristic of the chronic form of prostatitis. Often, at the time of the visit to 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. Of all the variety of negative factors affecting the health of a man, 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 the life of a man.
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 food rich in fat in the diet;
- negative impact on the body in hazardous industries.
Chronic bacterial prostatitis is the result of incompletely cured bacterial prostatitis. Or the man ignored the ailments and did not seek help from a urologist. Therefore, no treatment was given.
Chronic prostatitis of the abacterial type develops due to exposure to infectious agents against the background of a decrease in immunity. As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors provoking the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibiotic therapy was not performed before the operation);
- refusal to use contraceptives;
- lack of habit of keeping one's body clean.
Symptoms of chronic prostatitis
Today there are many fictions concerning chronic prostatitis. For this reason, any 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 aged, then 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.
Often, chronic prostatitis is 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 appear as a result of injuries and surgical interventions. Pain in these areas can be taken as a symptom of inflammation of the prostate.
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 in the vicinity of the prostate, radiating 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 urogenital area. Therefore, it cannot be said that they are the hallmarks of chronic prostate disease.
An important symptom is the fading of orgasm. If the patient began to notice that the acuity of sensations during ejaculation had disappeared, this is an occasion for a more attentive attitude to his health and a signal to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urinary tube increases, and there is a deterioration in the quality of urination. Patients with chronic prostatitis note frequent urge to urinate at night. The process of excretion of urine is accompanied by a burning sensation, pain, pain. Often there is urinary incontinence.
Signs of chronic prostatitis can be expressed in full or in part. Much depends on the state of health of the patient, 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
In the presence of severe symptoms, diagnosing chronic prostatitis is easy. But this disease is often asymptomatic, which complicates its detection. For diagnostic purposes, a whole range of studies is carried out.
The Association of Urologists has developed questionnaires, thanks to which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated in such a way that the subjective feelings of the patient can be ascertained. Not every man is able to give a correct assessment of his erectile function, the quality of orgasm and other details of sexual life. Questionnaires filled out by patients provide the specialist with the information necessary for making a diagnosis. In urological practice, the NIH-CPS scale is most often used.
In order to differentiate chronic prostatitis from other diseases, a neurological examination is performed. In the list of diagnostic methods used, the determination of the state of the patient's immunity.
Laboratory research methods
If you suspect chronic prostatitis, first of all find out what its nature is: bacterial or abacterial. In the first case, it is required to determine the pathogen or pathogens, to find out to which drugs they are sensitive. For this, laboratory tests of urine and prostate secretion are carried out.
If, after a 10-day period after DRE, the PSA test showed an excess of the level of prostate-specific antigen from 4. 0 ng / ml, this is a reason to refer the patient for a biopsy in order to exclude 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 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. In 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, its composition. The study includes several tests: uroflowmetry, cystometry, measurement of the residual volume of urine, assessment of the pressure inside the bladder and the speed of urine outflow.
Tomography (computer or magnetic resonance) is necessary to exclude benign and malignant neoplasms. These research methods are highly informative and help to assess the condition of prostate tissues.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach. One dose of medication 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 in job. Urologists insist that only a set of measures will help get rid of this disease completely or ensure a long-term remission.
Regardless of whether the disease is bacterial or abacterial in nature, congestion in the prostate played a major role in its formation. 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 attention should be directed to the elimination of stagnation.
The issue is solved by changing the lifestyle and including physiotherapy exercises in the daily schedule.
We have developed sets of exercises 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 exercise.
Thinking about how to treat chronic prostatitis, you need to decide on a serious revision of your attitude to 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, a course of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
- Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microclysters with warm solutions of painkillers. NSAIDs may 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 method of influencing the prostate. It opens the ducts, normalizes the blood circulation of the scrotum, small pelvis.
- Acute retention of kidney filtrate can be corrected by catheterization, trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist consultations.
Treatment of chronic prostatitis
With a long-term course (at least a month) exposure to the prostate, there is no 100% guarantee of cure. Priority for herbal preparations, immunocorrection, change of household habits:
- Phyto preparations are widely used in urological practice. They are able to accumulate in the place of the most active pathological process, protect cells from oxidation, remove free radicals, and prevent the growth of gland tissue.
- Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
- Immunity-boosting drugs not only help to cope with prostatitis, they also correct the negative effect of antibiotics that disrupt the function 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, improve blood circulation, and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, sitz warm baths or herbal microclysters.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates abundant urine output, prevents the symptoms of intoxication, the development of ascending cystitis, pyelonephritis.
- For constipation, laxatives of plant origin are used.
- The urologist, psychologist, together with the patient, develops an individual long-term program of the daily routine, necessary rest, diet, dosed physical activity, and sexual activity.
- In case of resistance of the chronic process to ongoing therapy, blocking 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 this can cause 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 sedentary, every 2-3 hours it is necessary to do warm-ups, doing squats, leg swings, running in place.
It is necessary to try to normalize sexual life, which is extremely important to eliminate the stagnation of the secret in the prostate.
It is recommended to limit to the minimum doses or completely eliminate the use of alcohol.
Treatment with medications
In chronic prostatitis, outpatient treatment is predominantly performed. 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 staff, there are much more opportunities to comply with 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 contribute to the normalization of 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 drug for the 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 advertised medications for the treatment of chronic prostatitis.
The drugs recommended for antibacterial therapy are fluoroquinolones. Most bacteria are sensitive to them.
Antibiotics can also be included in the treatment plan for patients with abacterial form of prostatitis. Such therapy is carried out for preventive purposes. According to indications, treatment with penicillin preparations is connected.
After completion of antibiotic therapy, treatment with hormonal drugs begins.
With intraprostatic reflux, it is necessary to take a-blockers.
Painkillers are effective for pain relief.
Treatment with herbal remedies
Many doubt whether chronic prostatitis can be cured with herbal remedies. The answer to this question was obtained by many 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 function of urination is normalized. The components that make up herbal remedies perform this task. They help to reduce the frequency of urges, eliminate the syndrome of a sluggish jet.
Patients with chronic prostatitis are recommended phytocollections, which include pumpkin extract or pumpkin seeds. The latter have a unique chemical composition and act 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 regarded as the main method of treatment. These healing agents are considered as concomitant drug therapy.
Non-drug methods of therapy allow you to act directly on the prostate, increase the concentration of drugs in its tissues, help eliminate congestion.
For these purposes, the following methods are used: rectal ultrasonic exposure;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus. On the device, you can set the temperature required for a particular type of exposure. To increase the concentration of the drug in the prostate requires heating 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 wide. Under the influence of a 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 contributes to tissue regeneration.
During the period of research into the effects of laser therapy on patients with prostatitis, a side effect, but positive for the purposes of treatment, was noticed. In those who completed the course, potency increased, erectile dysfunction was eliminated, and 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 to treat chronic prostatitis.
Patients can, on their own initiative, undergo a course of laser therapy, 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 can significantly reduce its quality. The most serious complication of this disease is the formation of stones in the tissues of the gland. In order to free it from prostoliths, transurethral resection is used.
Surgery is carried out under the control of TRUS.
If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If, in combination with this pathology, sclerosis of the bladder neck is observed, 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. For this purpose, an incision is made in the seminal vesicles and excretory ducts. With an abscess, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis
There are a number of exercises that are effective for stimulating the prostate, which helps to eliminate congestion. This complex was developed for patients with problems of the hip joints. Practice has shown that these exercises are useful for those diagnosed with prostatitis. Classes can be held at a convenient time, the complex will take no more than 15 minutes to complete.
- Lying on a gymnastic rug, stretch both arms up.
- They bend their knees and pull them towards themselves, simultaneously spreading them in different directions.
- Raise the pelvis as far as they can.
- Repeat 10-12 times.
- Standing on the mat, do deep squats.
- Repeat 10-12 times.
- Lie down on the stomach.
- Raise 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.
Few men manage to completely cure chronic prostatitis. Inflammation of the prostate often goes into a stage of long-term remission. But when conditions arise for the activation of the pathology, a relapse occurs. The exacerbation begins with the onset of pain in the prostate. Often they are 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 conduct studies of the state of the prostate, take an analysis for PSA. With systematic monitoring of the state of the gland, it is possible to timely identify 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 exacerbations of the disease. It is recommended to balance the diet, excluding fatty and spicy foods from it. Reception of phytopreparations and traditional medicine should be agreed with the attending physician. With this approach, you can minimize the risk of exacerbation of chronic prostatitis.
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, harden.
- Engage in physical education and sports, attend fitness clubs.
- Avoid stressful situations.
- Practice regular sex life with a regular partner.