Many men suffer from chronic prostatitis, but they attribute symptoms to other diseases or waste time on ineffective treatments. From our article, you will learn comprehensive information about this male problem: causes, exact symptoms and diagnosis, various treatments.
Despite all the successes of modern medicine, there are still certain difficulties in the diagnosis of diseases such as chronic prostatitis. This negatively affects his healing.
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 classification developed by the AHI (American Institutes of Health). It defines the categories of prostate diseases. Those that can be described as "chronic" include:
- chronic bacterial prostatitis;
- Chronic nonbacterial prostatitis.
To make these diagnoses, the following symptoms are needed: Prolonged (at least 3 months) pain in the perineum. Therefore, chronic prostatitis can be referred to as a long-term inflammatory process, leading to changes in the structure of the prostate and its dysfunction. But other diseases of the prostate also contribute to this tragic outcome. Therefore, the diagnosis of chronic prostatitis is difficult.
Epidemiology
Prostatitis is one of the most common diseases in men. It has a major impact on family performance and relationships. The patient's quality of life declines to the same extent as a patient with a heart attack or angina.
According to various sources, every 3 or 4 men are diagnosed with prostatitis. In most cases, this is not the initial or acute phase of the disease, but an established and long-lasting process—chronic.
Not so long ago, it was thought that the condition was predominantly found in older men. But statistics refute this view. Today, it is well known that chronic prostatitis is a disease of sexually active men of reproductive age.
More than 30% of patients turn to specialists with features of chronic prostatitis. Often, when visiting a doctor, the disease is complicated by accompanying pathologies: erectile dysfunction, seminal vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The etiology of chronic prostatitis is very different. Among the various negative factors affecting men's health, it is difficult to isolate exactly those factors that trigger the development of the disease. This is often the complex situations and circumstances that accompany a person's life.
The main causes of chronic nonbacterial prostatitis are as follows:
- Arrhythmia (irregularity) of sexual intercourse;
- lack of motivation, which is typical for overweight people;
- prolonged stress conditions;
- Predominance of fat-rich foods in the diet;
- Negative effects of hazardous industries on the body.
Chronic bacterial prostatitis is the result of incomplete cure of bacterial prostatitis. Or the man ignored the ailments and didn't seek help from a urologist. Therefore, no treatment was given.
Chronic prostatitis of the non-bacterial type develops as a result of exposure to infectious agents against the background of weakened immunity. Often, these patients are diagnosed with endocrine disorders.
Factors that contribute to the development of chronic bacterial prostatitis are:
- Prostate surgery (if antibiotics were not given before surgery);
- refuse to use contraceptives;
- Lack of the habit of keeping the body clean.
Symptoms of chronic prostatitis
There are many novels about chronic prostatitis today. For this reason, any temporary functional impairment is attributed to this disease. You often hear the idea that decreased libido and erectile dysfunction are the pluses of prostatitis, and if the man is older, it's chronic prostatitis.
This is not true because there are many other causes of sexual dysfunction 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 because the symptoms of these conditions are broadly similar. This is due to the formation of a myofacial trigger zone near the prostate, which arises as a result of injury and surgical intervention. Pain in these areas can be seen as a symptom of prostate inflammation.
At the diagnosis of the disease, complaints of pain and discomfort in the perineum and small pelvis, lasting at least 3 months, stand out. The pain is localized near the prostate and radiates to the sacrum, rectum, and scrotum. Pain increases with prolonged exposure to negative factors (weight bearing, excessive physical activity, prolonged "standing").
A characteristic symptom of this disorder is premature ejaculation. The patient had decreased libido and erectile dysfunction. These symptoms are also characteristic of other diseases of the urogenital region. Therefore, they cannot be said to be markers of chronic prostate disease.
An important symptom is the resolution of orgasm. If the patient begins to notice a loss of sensory acuity during ejaculation, this is an opportunity to take a more focused approach to his health and a signal to see a urologist.
The inflamed prostate structures become denser, the pressure on the urinary catheter increases, and the quality of urination decreases. Patients with chronic prostatitis often 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 manifest in whole or in part. Much depends on the patient's health, whether other medical conditions are present. Chronic prostatitis is characterized by an ups and downs in the course of the disease, with symptoms increasing and decreasing. In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
In the presence of severe symptoms, the diagnosis of chronic prostatitis is easy. But the disease is often asymptomatic, complicating detection. For diagnostic purposes, a series of studies are performed.
The Association of Urologists has developed a questionnaire so that asymptomatic chronic prostatitis can be identified. These questions are formulated in a way that determines the patient's subjective feelings. Not every man can make a proper assessment of his erectile function, the quality of his orgasm, and other details of his sex life. Questionnaires filled out by patients provide specialists with the information needed for a diagnosis. In urological practice, the NIH-CPS scale is most commonly used.
To differentiate chronic prostatitis from other diseases, a neurological examination is performed. From the list of diagnostic methods used, determine the immune status of the patient.
laboratory research methods
If you suspect chronic prostatitis, you must first find out what its nature is: bacterial or non-bacterial. In the first case, pathogens or pathogens need to be identified and to which drugs they are susceptible. For this, laboratory tests of urine and prostate secretions are performed.
If after 10 days after DRE, PSA testing shows prostate-specific antigen levels above 4. 0 ng/ml, this is a reason to refer the patient for biopsy to rule out a neoplastic process.
The following research methods are recommended:
- scraping from the urethra;
- General and biochemical analysis of urine;
- LHC culture of prostatic secretions.
Instrumental Research Methods
TRUS (diagnostic transrectal ultrasonography) is performed using a device 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 malignancy. In chronic prostatitis, scarring, compaction, changes in the seminal vesicles of the glandular tissue structure can be observed.
UDI is the main method of functional diagnosis. It can give you an idea of the nature of urination, the signs of stagnant urine, its composition. The study included several tests: uroflowmetry, cystometry, measurement of urine residual volume, assessment of intravesical pressure, and urine flow rate.
Tomography (computed or MRI) is necessary to rule out benign and malignant tumors. These research methods are informative and helpful in assessing the condition of prostate tissue.
Treat chronic prostatitis
Treatment of chronic prostatitis requires a comprehensive approach. One dose of medicine is not enough. For physical therapy procedures, therapeutic exercises are necessary. In general, chronic prostatitis is difficult to treat and requires a thorough lifestyle review, habit changes and, in some cases, a job change. Urologists insist that only one set of measures can help get rid of the disease completely or ensure long-term remission.
Whether the disease is bacterial or non-bacterial in nature, prostate congestion plays a major role in its development. The viscous secrets deposited in glandular ducts are a favorable environment for the development of pathogenic and opportunistic microorganisms. Therefore, the main focus should be on eliminating stagnation.
This problem can be addressed by making lifestyle changes and including physical therapy exercises in your daily routine.
Exercise complexes have been developed to suit different life situations:
- For those 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.
Considering how to treat chronic prostatitis, you need to decide to seriously modify your attitude towards health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special salt-free diet, and sexual rest.
Treatment method:
- The most effective treatment for prostatitis is symptomatic treatment. If the basis of prostatitis is infection, antibiotics are preferentially used, which can relieve the manifestations of inflammation.
- Pain relievers, antispasmodics, rectal suppositories, microenemas, and warm solutions of pain relievers can relieve pain syndromes. Non-steroidal anti-inflammatory drugs can be used.
- Combinations of immunostimulants, immunomodulators, enzymes, vitamin complexes, trace elements have demonstrated their effectiveness.
- Physical therapy methods are only possible in the subacute phase of the disease. They improve microcirculation and improve immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
- Massage is another effective way to affect the prostate. It opens the ducts and normalizes blood circulation in the scrotum, small pelvis.
- Acute retention of renal filtrate can be corrected by catheterization, trocar cystostomy.
- The purulent process involves surgical intervention.
- psychological counseling.
Treat chronic prostatitis
Long-term (at least one month) exposure to the prostate does not guarantee a 100% cure. Prioritize herbal preparations, immunomodification, changing household habits:
- Botanicals are widely used in urological practice. They are able to accumulate at the sites of the most active pathological processes, protect cells from oxidation, scavenge free radicals, and prevent the growth of glandular tissue.
- Antibacterial therapy is selected individually based on the susceptibility of the microorganism to the drug.
- Immunity-boosting drugs not only help with prostatitis, but also correct the negative effects of antibiotics that disrupt immune system function.
- Pain syndrome can be stopped by the use of alpha-blockers, muscle relaxants.
- Prostate massage allows you to mechanically remove the gland's "extra" secret through the urethra, improving circulation and reducing congestion.
- Physiotherapy: Laser, magnet, ultrasound, iontophoresis, sitting in warm water bath or herbal micro-irrigation.
- In severe cases, intravenous fluids and diuretics are required. This stimulates a large amount of urine and prevents the development of toxic symptoms, ascending cystitis, pyelonephritis.
- For constipation, use plant-derived laxatives.
- Urologists and psychologists work with patients to develop an individual long-term plan, including routine, necessary rest, diet, and dosed physical and sexual activity.
- If the chronic process is resistant to ongoing treatment, preventing the flow of urine, surgical intervention is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland and surrounding tissue (prostatectomy). Practice in special cases, full of impotence, urinary incontinence. Young people do not undergo surgery because it can lead to infertility.
Outpatient Treatment Recommendations
The patient must avoid situations that could lead to injury to the pelvic organs.
It is necessary to remove any load on the prostate: do not ride a bicycle, do not do strength exercises, do not carry heavy objects.
If the job is sedentary, warm up every 2-3 hours by doing squats, swinging legs, and running in place.
It is necessary to try to normalize the sex life, which is extremely important to eliminate the secret stagnation in the prostate.
It is recommended to limit the use of alcohol to the lowest dose or to eliminate it completely.
medical treatement
In chronic prostatitis, outpatient treatment is mainly performed. If the pathological process persists and remission cannot be achieved by this method, hospitalization is recommended. In a hospital, there are more opportunities to comply with treatment protocols and monitor changes in a patient's condition under the supervision of medical staff.
Chronic prostatitis in men develops against the background of endocrine disorders. In this regard, 5-alpha reductase inhibitors and alpha1-blockers are recommended. They help to normalize hormonal levels and eliminate pathological symptoms. For this purpose, drugs such as finasteride and terazosin are prescribed.
An integrated approach involves taking medications such as:
Treatment of bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics. The most effective drug for a particular patient is determined using preliminary laboratory studies of prostate secretion.
There is no universal drug for inhibiting and destroying pathogenic microbial communities. What works for one patient may not work for another. For this reason, there are many negative reviews of advertised drugs for chronic prostatitis.
The drugs recommended for antimicrobial therapy are fluoroquinolones. Most bacteria are sensitive to them.
Antibiotics can also be included in the treatment plan for people with nonbacterial prostatitis. This treatment is given for prophylactic purposes. Depending on the indication, it is associated with treatment with penicillin preparations.
After finishing antibiotic treatment, start hormonal medication.
For intraprostatic reflux, it is necessary to take alpha-blockers.
Painkillers are great for relieving pain.
Healing with herbs
Many people wonder if chronic prostatitis can be cured with herbal medicine. The answer to this question has been obtained through years of use of these health-improving drugs in urology practice.
The following medical complexes are recommended today:
All these drugs are beneficial for the work of the male genitourinary system. Effective treatment of chronic prostatitis is possible if urination is normal. The ingredients that make up the herb perform this task. They help reduce the frequency of urges and eliminate the jet-slow syndrome.
Plant extracts, including pumpkin extract or pumpkin seeds, are recommended for patients with chronic prostatitis. The latter has a unique chemical composition that acts in three directions simultaneously:
- normalizes metabolism;
- strengthen the walls of blood vessels;
- Activates blood circulation to the pelvic organs.
Taking herbal medicines cannot be considered as a primary treatment. These healing agents are considered concomitant medication.
non-drug treatment
Non-drug treatments allow you to act directly on the prostate to increase the concentration of drugs in its tissues and help clear up congestion.
For this, the following methods were 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 desired temperature for a specific type of exposure. To increase the concentration of the drug in the prostate, heating is required at 38-40°C. For antibacterial effect - 40-45°C.
Today, the focus of non-drug treatments is laser therapy. The possibilities of this technique are wide-ranging. Under the influence of the laser, the following processes take place in the prostate:
- activate redox reactions;
- Improve blood microcirculation;
- formation of new capillaries;
- Pathogenic microbial communities are suppressed;
- The process of cell division is activated, which aids in tissue regeneration.
During the study of the effects of laser therapy on patients with prostatitis, side effects were noted, but were positive for the purpose of treatment. In those who complete the course, potency is increased, erectile dysfunction is eliminated, and vitality is restored. To achieve this effect, a beam of a certain wavelength needs to be used. Typically, low-level laser radiation is used to treat chronic prostatitis.
If the attending physician does not prescribe it, the patient can voluntarily receive laser treatment.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not pose a threat to the patient's life, but significantly reduces its quality. The most serious complication of this disease is the formation of stones in glandular tissue. To release it from the prosthesis, a transurethral resection was used.
Surgery was performed under the control of TRUS.
If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If, in combination with this pathology, bladder neck sclerosis is observed, partial prostatectomy is performed.
With the blockage of the seminiferous and excretory ducts, endoscopic surgery is required to remove the violation of the secret opening. To do this, an incision is made in the seminal vesicle and excretory duct. For an abscess, the gland can be removed completely.
Exercise for the treatment of chronic prostatitis
There are many exercises that can effectively stimulate the prostate, which can help clear up congestion. This complex was developed for patients with hip problems. Practice has shown that these exercises are useful for people diagnosed with prostatitis. Classes can be taken at a convenient time and the time to complete the complex does not exceed 15 minutes.
Exercise #1
- Lie on the gymnastics rug with your arms extended upwards.
- They bend their knees and pull them towards themselves while spreading them out in different directions.
- Elevate the pelvis as high as possible.
- Repeat 10-12 times.
Exercise #2
- Stand on the mat and do squats.
- Repeat 10-12 times.
Exercise #3
- Lie on your stomach.
- Lift one leg, then lift the other.
- Repeat 10-12 times.
All movements should be fluid while doing this set of exercises. This is the main condition for obtaining a high therapeutic effect.
Treatment prognosis
Few men have a complete cure for chronic prostatitis. Prostate inflammation usually goes into long-term remission. However, when conditions that activate the pathology arise, relapse occurs. The worsening begins with the onset of prostate pain. They are often accompanied by disorders of the urinary system. At the first symptoms of a recurrence, you should seek professional help.
Patients are advised to see their urologist regularly, at least every six months. They study the state of the prostate with the same frequency and analyze the PSA. Through systematic monitoring of glandular status, the processes causing disease recurrence can be identified in time. But even with long-term mitigation, there's no guarantee that it won't be violated.
Patients must follow recommendations to prevent disease progression. A balanced diet is recommended, excluding fatty and spicy foods. Acceptance of botanicals and traditional medicines should be agreed with the attending physician. In this way, you can minimize the risk of chronic prostatitis getting worse.
prevention
To prevent unpleasant diseases in men, it is necessary to eliminate the irritants and follow simple rules:
- Develop a healthy lifestyle and break bad habits.
- do not catch a cold.
- Drink at least 1. 5-2 liters of water per day.
- Boost your immunity, walk more, get hard.
- Engage in physical education and exercise, and join a health club.
- Avoid stressful situations.
- Have regular sex with a regular partner.