Prostatitis is a disease that causes problems with urination, sexual dysfunction, and pain in the perineum and lower abdomen. The cause of these symptoms is prostatitis.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located below the male bladder and in front of the rectum. The prostate consists of glandular tissue and connective tissue. Its function is to produce fluid, which partly includes ejaculation. This fluid carries sperm during ejaculation (ejaculation) and protects the sperm as they travel to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not go away for months or even years. The acute form of the disease appears suddenly and lasts up to several weeks. The disease is usually easy to treat but sometimes becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure completely. But with appropriate treatment, the patient has every chance of lasting remission and significantly improving the patient's quality of life. We figured out how to understand that you have chronic prostatitis and what to do next.
What is chronic prostatitis?
In total, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Of these, chronic nonbacterial prostatitis is the most common. And he is the worst person to treat.
A disease is considered chronic if symptoms do not go away for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic prostatitis is its recurrent course. This means symptoms may go away for a while and then reappear. If left untreated, this condition can cause discomfort for a very long time.
Bacterial and non-bacterial forms have common symptoms. These often include problems with urination, sexual function, and perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. Furthermore, the chronic form is much more common than the acute form. The reason for about 25% of visits to a urologist is related to chronic prostatitis.
The pathology can appear at any age, but the chronic form often develops in men after 50 years of age.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These diseases have common symptoms but different causes.
Chronic bacterial prostatitis
When the prostate secretes during analysisdiscoveredleukocytes and pathogens
The inflammatory process causes infection as bacteria from the urinary tract enter the prostate. Triggers can be: acute forms of prostatitis, UTI (urinary tract infection), STI. The agents that cause the inflammatory process in the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic nonbacterial prostatitis (chronic pelvic pain syndrome)
When the prostate secretes during analysisnot detectedleukocytes and pathogens
Researchers have not determined the cause of chronic pelvic pain syndrome. With this form, there is no infection in the prostate. What caused the disturbance in this case is not exactly known. There is an assumption that this could be due to several factors:
- stagnation due to sedentary work, lack of exercise, irregular sex life;
- The patient had prostatitis and continued to have chronic pain despite treatment;
- urine entering the prostate due to bladder problems;
- nerve damage;
- urinary tract damage due to trauma or surgery;
- emphasize
Symptoms of chronic prostatitis
With chronic prostatitis, symptoms bother the patient for a long time - for several months or even years. The disease is characterized by a relapsing course, meaning problems come and go.
Infectious and non-infectious prostatitis have common symptoms and include:
- urinary disorders: frequent and sudden urge to urinate, difficulty urinating, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during sex;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- nausea and vomiting
The disease also affects the patient's general condition. Some people feel irritable, tired, lethargic and anxious.
If you have these signs, consult a urologist. Some of them may indicate other serious illnesses that require urgent medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial septicemia, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you need to make an appointment with a urologist. This doctor specializes in diagnosing and treating the male reproductive system and urinary system in both men and women.
The initial consultation process includes several stages:
- Get history.
The urologist will ask you about the reason for your visit, your past medical conditions, and the medications you have taken now and in the past. - Examination of genital organs
- Digital rectal exam.
During the procedure, the urologist will insert a finger into the patient's anus to feel the surface of the prostate. This test allows you to determine the size of your prostate and check for swelling and pain. - Another subjects.
Your doctor may prescribe one or more diagnostic procedures, some may be performed at the appointment, some may be performed later.
Diagnosis usually includes laboratory and instrumental studies.
Research methods in the laboratory
- General urine analysis
Allows you to see signs of infection. This can be indicated by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate specific antigen)
Helps evaluate the condition of the prostate. Elevated PSA levels indicate inflammation in the prostate or tumors. - Examination of prostatic secretions
Prostatic secretions are fluid produced by the prostate gland. With changes in the organ, the composition of the secretions also changes. For example, during inflammation, white blood cells will increase and high levels of pathogenic bacteria may indicate a bacterial infection in the prostate. Fluid microscopic examination will help to see these changes. - Prostatic secretions are collected by prostate massage. Massage can be combined with a digital rectal exam.
Instrumental research methods
- Cystoscopy. Check the internal surface of the bladder with an endoscope - a thin flexible tube with a camera. The device is inserted into the bladder through the urethra. Research allows you to see problems with the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). To examine, the specialist will carefully insert an ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
- MRI (magnetic resonance imaging) of the pelvis. Helps evaluate the condition of prostate tissue. It may be necessary to look for foci of prostatitis and rule out prostate cancer.
There is no special preparation for an appointment with a urologist. But to make the consultation as effective as possible, follow some simple recommendations:
- To clean private areas, you should not use special products before use, just warm water is enough.
- Do not go to the bathroom 2 hours before coming to the clinic. Then, at the appointment, if needed, you can have tests or an ultrasound done right away.
- If you regularly take any medications, write them down in a diary or note them on your phone.
- Bring the results of previous studies with you so that the specialist can see the full picture of the disease.
- Make a list of questions you want to ask your doctor at your appointment.
Treatment of chronic prostatitis
There is no universal method to get rid of prostatitis. For different forms of the disease and manifestations, different treatment methods are indicated.
To determine the type of chronic prostatitis, you need to conduct a diagnosis. Based on its results, your doctor will prescribe a treatment that will bring specific results to your case.
Unlike the acute form, chronic prostatitis cannot be cured permanently. Your doctor's goal is to achieve long-term remission and reduce symptoms.
Bacterial form: Treatment will include antibiotic therapy and other methods to relieve symptoms.
Non-bacterial form: Symptomatic treatment. That is, each method is aimed at combating a specific symptom.
Outpatient treatment is recommended
Lifestyle changes:
- Diet restrictions
You should give up alcohol, coffee, spicy and sour foods. These products irritate the bladder and worsen the patient's condition. - Take a warm sitz bath, take a warm bath
Water procedures will help reduce the manifestations of the disease. - More water
Drink enough fluids. Going to the toilet more often will help remove disease-causing bacteria from the bladder. - Pillows for chairs
When sitting, put a soft pillow underneath. - Physical activity
Walking and exercising regularly will help relieve pain and get rid of congestion. - Regular sex life
Sexual activity is helpful to prevent blockages.
The methods listed will complement the therapy prescribed for you but do not replace it.
Treatment medicine
- Antibiotics. Antibacterial therapy is indicated for the infectious form. The drug kills bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, you need to conduct research on prostatic secretions and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Supports the treatment of urinary disorders. The medicine relaxes the organs of the urinary system and this reduces symptoms. Most often, alpha-blockers are used for chronic non-infectious prostatitis, but to improve the patient's health, they can also be prescribed for an infectious form of the inflammatory process.
- NSAIDs (non-steroidal anti-inflammatory drugs). Prescribed to relieve pain and reduce prostate swelling.
- Muscle relaxants. Used when you need to relieve pelvic muscle spasms.
- Antidepressants. Indicated for depression, which can develop due to prolonged stress and pain.
- Medicines to treat erectile dysfunction. Used if prostatitis is causing problems in your sex life.
- Laxative. They may prescribe it if symptoms include pain during bowel movements.
Herbal treatment
Herbal medicine.Herbal medicine is not effective as a primary treatment method. They can be used as a supplement to reduce prostatitis. For this purpose, drugs are prescribed containing quercetin, a substance found in vegetables, fruits and berries.
Non-drug treatment
- Physical therapy and prostate massage. Methods are used to relax the pelvic floor muscles, relieve pain, and prevent blockages. For effective treatment, the patient must undergo a massage treatment consisting of many sessions. Massage is contraindicated when pathological complications develop: abscesses, stones in the tissues of the prostate.
- Bladder catheterization. May be necessary if you have problems with your bladder.
- Psychotherapy. Due to chronic pain, patients with prostatitis may suffer from depression and anxiety disorders. Psychological problems have a negative impact on the patient's health and aggravate the pain syndrome. In such cases, consulting a psychotherapist will help.
- Biofeedback program. May help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be necessary if complications develop.
Types of activities:
- TUR (transurethral resection) of the prostate.Indicated for the appearance of stones in the tissues of the prostate
- Removal of the prostate. Prostatectomy in some cases is performed in case of an abscess (accumulation of pus) or severe disorders in the functioning of the bladder.
Exercises to treat chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and relieve symptoms related to urinary disorders. How to do the exercises:
- Sit comfortably.
- Tighten your pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
- Relax your muscles.
- Repeat this 10-15 times.
- Gradually you can increase the number of repetitions and stretch for longer periods of time.
- You should do 2-3 approaches per day.
Changes can only be noticed with regular exercise.
Prognosis of treatment
It is very difficult to cure chronic prostatitis permanently. In some cases, the disease cannot be cured, but there is always a chance of lasting remission and returning the patient to their previous quality of life. To do this, it is important to undergo a thorough diagnosis to determine the form of the disease. If the cause of the inflammatory process is infection, antibacterial therapy will help. And for chronic non-infectious prostatitis - symptomatic therapy is a good choice.
Complications of chronic prostatitis may include:
- Sepsis (blood poisoning caused by bacteria). Bacteria enter the blood. May be the result of various forms of bacterial pathology. Sepsis develops suddenly and can lead to sepsis. This condition is life-threatening.
- Epididymitis (inflammation of the epididymis). The disease can cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in tissue). In the case of an abscess, surgery is performed to clean and drain the pus; In rare cases, the prostate may be removed.
- Dry. Problems with conception can occur when there is a lack of sperm due to inflammation in the prostate.
- The infection spreads to the spine and pelvis
- Depressive disorder. Chronic illness increases the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a reduction in a man's quality of life and emotional state.
To prevent prostatitis, it is important to:
- Using barrier contraception (condoms): STIs are factors that increase the risk of developing prostatitis
- See a urologist annually if you are over 40 years old
- If you have symptoms of a UTI, contact your doctor immediately