Many men suffer from chronic prostatitis, but they attribute their 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, different treatments.
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 the ICD-10 (International Classification of Diseases, 10th Revision), there is no such disease as "chronic prostatitis". Nor is there a single, generally accepted feature of this pathology. In urology practice, it is common to use the classification developed by the AHI (American Institute of Health). It identifies the types of diseases of the prostate gland. Conditions that can be described as "chronic" include:
- chronic bacterial prostatitis;
- chronic bacterial prostatitis.
To make these diagnoses, the following symptoms are required: persistent pain (at least 3 months) in the perineum. Thus, chronic prostatitis can be termed as a protracted inflammatory process, which leads to structural changes 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.
Epidemiology
Prostatitis is one of the most common diseases in men. It significantly affects work efficiency and family relationships. The patient's quality of life is reduced similar to that seen in those who have had a myocardial infarction or angina attacks.
According to various sources, every 3rd or 4th man is diagnosed with prostatitis. And most of the time this is not the initial or acute stage of the disease, but a long-term and ongoing - chronic process.
Not so long ago, it was thought that this pathology was inherent mainly in older men. But the statistics disproved this view. It is now known that chronic prostatitis is a disease of sexually active men of childbearing age.
More than 30% of patients consult a specialist with complaints characteristic of the chronic form of prostatitis. Often, when going to the doctor, the disease has been complicated by accompanying diseases: erectile dysfunction, seminal vesicle inflammation, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis vary widely. Of all the negative factors that affect the health of a man, it is difficult to determine exactly what provokes the development of the disease. Usually this is a complex of situations and circumstances that accompanies a man's life.
The main causes of chronic bacterial prostatitis are the following:
- arrhythmia (abnormal) of sexual intercourse;
- dyskinesia, characteristic of overweight people;
- prolonged stress;
- the predominance of high-fat foods in the diet;
- Negative effects on the body in toxic industries.
Chronic bacterial prostatitis is the result of bacterial prostatitis that is not completely cured. Or the man ignores the disease and does not seek help from a urologist. Therefore, no treatment has been offered.
Chronic bacterial prostatitis develops as a result of exposure to infectious agents against the background of reduced immunity. As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors that provoke the development of chronic bacterial prostatitis are:
- prostate surgery (if antibiotic treatment was not performed before surgery);
- refuse to use contraceptives;
- Lack of good hygiene habits.
Symptoms of Chronic Prostatitis
Today there is a lot of fiction regarding chronic prostatitis. For this reason, any temporary violation of sexual function is attributed to this disease. You may often hear that decreased libido and erectile dysfunction are the causes of prostatitis, and that if a man ages, 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 simultaneous and indirect.
Often, chronic prostatitis is confused with pelvic pain syndrome, as the symptoms of these conditions are largely similar. This is due to the formation of facial muscle activation zones near the prostate gland, which appear as a result of trauma and surgical intervention. Pain in these areas can be considered a symptom of prostatitis.
During diagnosis, pain and discomfort in the perineum and small pelvis, lasting at least 3 months, appeared anteriorly. The pain is localized in the vicinity of the prostate gland, spreading to the sacrum, rectum, scrotum. With long-term exposure to negative factors (carrying heavy loads, excessive physical activity, lying "on the legs" for a long time), the pain increases.
A characteristic symptom of the disease is premature ejaculation. Patients with decreased libido, erectile dysfunction. These symptoms are also characteristic of other diseases of the urogenital region. Therefore, they cannot be said to be telltale signs of chronic prostate disease.
An important symptom is the fading sensation of orgasm. If the patient begins to notice that the sensations of sensitivity during ejaculation have disappeared, this is an occasion for a more concerned attitude about his health and a sign to see a urologist.
The structure of the inflamed prostate gland becomes denser, the pressure on the urinary ducts increases, the quality of urination is impaired. Patients with chronic prostatitis note frequent nighttime urination. The process of urination is accompanied by a feeling of heat, burning, pain. Urinary incontinence is often present.
Signs of chronic prostatitis may be complete or partial. Much depends on the patient's state of health, the presence or absence of other diseases. Chronic prostatitis is characterized by an undulating process, with an increase and decrease in symptoms. In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
When symptoms are severe, the diagnosis of chronic prostatitis is easy. But this disease often has no symptoms, which complicates its detection. For diagnostic purposes, a variety of studies are performed.
The Association of Urologists has developed questionnaires by 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 identified. Not every man can appreciate his erectile function, orgasm quality and other details of his sex life. Questionnaires filled out by the patient provide the specialist with the information needed to make a diagnosis. In urology practice, the NIH-CPS scale is most commonly used.
To distinguish chronic prostatitis from other diseases, a neurological examination is performed. In the list of diagnostic methods used, the determination of the patient's immune status.
Research methods in the laboratory
If you suspect chronic prostatitis, first find out what it is: bacterial or bacterial. In the first case, it is necessary to identify pathogens or pathogens, find out the drugs to which they are sensitive. For this, laboratory tests of urinary excretion and prostate gland are performed.
If, after a 10-day period post-DRE, the PSA test shows an excess of prostate-specific antigen of 4. 0 ng/ml, this is reason to refer the patient for biopsy to rule outcancer process.
The following research methods are recommended:
- scraping from the urethra;
- general and biochemical analysis of urine;
- LHC cultured prostate secretions.
Instrumental research methods
TRUS (diagnostic transrectal ultrasound) is performed using a device equipped with an instrument inserted into the patient's rectum. If an irregularly shaped hypoechoic area is found, there is every reason to suspect a malignancy. In chronic prostatitis, scarring, structural compaction of glandular tissue, changes in the seminal vesicles can be observed.
UDI is the primary functional diagnostic method. It allows you to find out the nature of urination, signs of stagnation of urine, its composition. The study included several tests: flow measurement, tumor measurement, residual urine volume measurement, assessment of the pressure inside the bladder and the rate of urine flow out.
Computed tomography (computer or magnetic resonance) is needed to rule out benign and malignant tumors. 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 is not enough. Physical therapy procedures, therapeutic exercises are necessary. In general, chronic prostatitis is difficult to treat, it is necessary to comprehensively review the lifestyle, change habits, and in some cases have to change jobs. Urologists emphasize that there are only a few measures that can completely eliminate the disease or ensure long-term remission.
Regardless of whether the disease is caused by bacteria or viruses, the blockage in the prostate gland plays an important role in its formation. The viscous secretions deposited in the ducts provide a favorable environment for pathogenic microorganisms and opportunities for growth. Therefore, the main focus is to eliminate stagnation.
The problem is solved by making lifestyle changes and including physical therapy exercises in the daily schedule.
Exercise combinations have been developed to suit different life situations:
- for men who are forced to sit most of the time (drivers, office workers, managers);
- for people who are overweight;
- For those who don't have time to exercise.
Thinking about how to treat chronic prostatitis, you need to decide to seriously rethink your attitude to health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet, and sexual rest.
Treatments of course:
- The most effective in the treatment of prostatitis is etiotropic therapy. If the basis of prostatitis is infection, then preference is given to the use of antibacterial agents to reduce the manifestations of inflammation.
- Pain syndrome is relieved by analgesics, antispasmodics, rectal suppositories, analgesics with warm solutions of analgesics. NSAIDs may be used.
- Immunostimulators, immunomodulators, enzymes, vitamin complexes, combinations of trace elements have proven their effectiveness.
- Physiotherapy methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave, electrophoresis, laser, magnetic field therapy.
- Massage is another effective method of affecting the prostate gland. It opens the ducts, normalizes blood circulation of the scrotum, small pelvis.
- Acute dialysis fluid retention can be corrected by catheterization and trocar cystectomy.
- The purulent process involves surgical intervention.
- Consult a psychologist.
Treatment of chronic prostatitis
With a long course (at least one month) of exposure to the prostate, there is no guarantee of 100% cure. Prioritize herbal preparations, adjust immunity, change living habits:
- Phyto preparations 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.
- Antimicrobial therapy is selected individually, based on the sensitivity of the bacteria to the drug.
- Immune boosters not only help deal with prostatitis, they also overcome the negative effects of antibiotics that disrupt the function of the immune system.
- Pain syndrome is terminated by the appointment of alpha-blockers, muscle relaxants.
- Massaging the prostate allows you to mechanically remove the "excess" secretions of the gland through the urethra, improving blood circulation and minimizing congestion.
- Physiotherapy: laser, electroacupuncture, ultrasound, electrophoresis, local warm bath or herbal microdissolver.
- In severe cases, intravenous fluids with diuretics are indicated. This stimulates an abundance of urine, prevents symptoms of intoxication, the development of cystitis, pyelonephritis.
- For constipation, laxatives of plant origin are used.
- The urologist, psychologist, together with the patient, develops a personalized long-term program of daily routines, needed rest, diet, dosed physical activity and activitysex.
- In the case of a chronic process that resists ongoing therapy, blocking the outflow of urine, surgical intervention is prescribed: removal of all affected tissue (prostatectomy) or excisioncompletely glandular with surrounding tissues (prostatectomy). Practiced in exceptional cases, full of impotence, urinary incontinence. Young people should not have surgery, as this can cause infertility.
Recommend outpatient treatment
The patient must avoid situations where there may be injury to the pelvic organs.
Any load on the prostate should be excluded: no cycling, no strength training, no heavy lifting.
If the job is sedentary, then every 2-3 hours, you have to warm up, squat, rotate your legs, run in place.
It is necessary to try to normalize the sex life, which is extremely important to eliminate stagnation of secretions in the prostate gland.
It is recommended that the use of alcohol should be minimized or completely eliminated.
Drug treatment
In chronic prostatitis, outpatient treatment is predominant. If the pathological process is prolonged and remission cannot be achieved by this method, then hospitalization is recommended. In the hospital, under the supervision of medical staff, there are more opportunities to adhere to 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 the elimination of symptoms of pathology. For these purposes, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach includes taking medications such as:
Treatment of 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 secretion.
There are no universal drugs to prevent and destroy disease-causing microorganisms. What works for one patient may not work for another. For this reason, there are a lot of 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 bacterial prostatitis. Such therapy is carried out with the aim of prevention. As indicated, treatment with penicillin preparations is connected.
After completion of antibiotic therapy, start hormone therapy.
With intravenous reflux, a blocker is required.
Pain relievers relieve pain.
Treatment with herbal remedies
Many people doubt whether chronic prostatitis can be cured with male remedies. The answer to this question has come from many years of using these health-promoting 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. Chronic prostatitis can be effectively treated if urinary function is normalized. The ingredients that make up herbal remedies perform this task. They help reduce the frequency of urges, eliminating sluggish jet syndrome.
Patients with chronic prostatitis are recommended to use phytocollections, which include pumpkin extracts or pumpkin seeds. The latter has a unique chemical composition and works in three directions at once:
- normalize metabolism;
- strengthens the walls of blood vessels;
- activates blood circulation in the pelvic organs.
Taking herbal medicine cannot be considered the main method of treatment. These therapeutic agents are considered concurrent drug therapies.
Non-drug treatment
Non-drug therapy allows you to act directly on the prostate gland, increasing the concentration of the drug in its tissues, which helps to eliminate blockages.
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. 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, it is necessary to heat it to 38-40 ° C. To obtain an antibacterial effect - 40-45 ° C.
Today, non-drug treatments focus on laser therapy. The possibilities of this technique are very wide. Under the action 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 eliminated;
- The process of cell division is activated, which contributes to tissue regeneration.
During research on the effects of laser therapy on patients with prostatitis, a side effect but positive for the purpose of treatment was noticed. In those who complete the course, potency is increased, erectile dysfunction is eliminated and vitality is restored. To achieve this result, it is necessary to use a beam of a certain wavelength. In general, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can undergo a course of laser treatment on their own, unless directed by the attending physician.
Surgical treatment of chronic prostatitis
Chronic prostatitis is not life-threatening but can significantly reduce the quality of the disease. The most serious complication of this disease is the formation of stones in the tissues of the gland. To release it from the prostate gland, transurethral resection is used.
Surgery was performed under the control of TRUS.
If complications such as sclerosis of the prostate do occur, transvaginal electrosurgery will be performed. If, in combination with this pathology, bladder neck sclerosis is observed, a partial prostatectomy is performed.
With obstruction of the vas deferens and excretory ducts, endoscopic operation is indicated to eliminate a violation of the confidentiality of the secret. For this purpose, an incision is made in the seminal vesicles and excretory ducts. With an abscess, complete resection of the gland may be possible.
Exercises to treat chronic prostatitis
There are a number of exercises that work to stimulate the prostate gland, which helps to remove blockages. This complex was developed for patients with hip problems. Practice has shown that these exercises are very helpful for those who have been diagnosed with prostatitis. Classes can be held at a convenient time, the complex will take no more than 15 minutes to complete.
Exercise number 1
- Lie on an exercise mat with both arms straight up.
- They bend their knees and pull them toward themselves, spreading them out in different directions.
- Elevate the pelvis as much as possible.
- Repeat 10-12 times.
Exercise 2
- Standing on the mat, perform a deep squat.
- Repeat 10-12 times.
Exercise number 3
- Lie face down.
- Lift one leg up and then the other.
- Repeat 10-12 times.
When performing this set of exercises, all movements need to be rhythmic. This is the main condition to get a high therapeutic effect.
Treatment prognosis
Very few men can be completely cured of chronic prostatitis. Prostatitis often goes into a long-term stage without remission. But when conditions arise for pathological triggering, a relapse occurs. The exacerbation begins with the onset of pain in the prostate gland. Often they are accompanied by urinary disorders. At the first symptoms of a recurrence of the disease, you should seek the help of a specialist.
Patients should see their urologist regularly, at least every six months. With the same frequency, they conduct studies on the state of the prostate gland, conduct PSA analysis. With systematic monitoring of the condition of the gland, it is possible to timely identify the processes that cause the recurrence of the disease. But even with long-term remission, there is no guarantee that it will not be violated.
Patients must follow recommendations to prevent exacerbations of the disease. The diet should be balanced, excluding fatty and spicy foods. The receipt of plant-based preparations and traditional medicine should be approved by the attending physician. By doing this, you can reduce the risk of exacerbations of chronic prostatitis.
Prevent
To prevent the appearance of an unpleasant disease for men, it is necessary to eliminate the provoking factors and follow simple rules:
- Follow a healthy lifestyle, give up bad habits.
- Don't get cold.
- Drink at least 1. 5-2 liters of water per day.
- Strengthen immunity, move a lot, be strong.
- Participate in fitness activities, sports, join fitness clubs.
- Avoid stressful situations.
- Practice regular sex life with a regular partner.