Many men suffer from chronic prostatitis but they attribute the 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 diagnostic methods, various treatment methods.
Despite all the successes of modern medicine, diagnosing a disease such as chronic prostatitis still causes certain difficulties.This also negatively affected the effectiveness of his treatment.
What is chronic prostatitis?
In ICD-10 (International Classification of Diseases, 10th Revision) there is no such thing as “chronic prostatitis”.There are also no generally accepted characteristics of this condition.In urological practice, people often use the classification developed by AHI (American Institute of Health).It identifies the types of prostate disease.Diseases 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 perineal area.So, chronic prostatitis can be called a long-term inflammatory process, the consequences of which are changes in the structure of the prostate gland and its dysfunction.But other prostate diseases 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.Patients' quality of life declines to the same level as that experienced by people who have had a heart attack or angina.
According to data from various sources, every 3rd or 4th man is diagnosed with prostatitis.And usually this is not the initial or acute stage of the disease, but an established and long-term process - chronic.
Not so long ago, it was generally accepted that this pathology is mainly characteristic of older men.But statistical data refute this idea.Today it is known that chronic prostatitis is a disease of sexually active men of reproductive age.
More than 30% of patients consult a specialist for complaints characteristic of chronic prostatitis.Usually, when you see a doctor, the disease will be complicated by accompanying diseases: erectile dysfunction, cystitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis vary widely.Among the many negative factors that affect men's health, it is difficult to single out exactly those that provoke the development of the disease.Often this is the complexity of situations and circumstances that accompany a man's life.
The main causes of chronic bacterial prostatitis are as follows:
- arrhythmia (irregular) heartbeat during sex;
- physical inactivity, characteristic of overweight people;
- prolonged stress;
- the predominance of fatty foods in the diet;
- negative impact on the body in dangerous industries.
Chronic bacterial prostatitis is the result of bacterial prostatitis that is not completely cured.Or the man ignores the illness and does not seek help from a urologist.Therefore, no treatment was performed.
Chronic bacterial prostatitis develops as a result of exposure to infectious agents in the context of reduced immunity.As a rule, such patients are diagnosed with diseases of the endocrine system.
Factors that stimulate the development of chronic bacterial prostatitis are:
- prostate surgery (if antibacterial treatment is not performed before surgery);
- refusal to use contraception;
- lack of habit of keeping the body clean.
Symptoms of chronic prostatitis
Today there are many myths associated with chronic prostatitis.For this reason, any temporary disturbance in sexual function is believed to be caused by this disease.You can often hear the opinion that decreased sexual desire and erectile dysfunction are due to prostatitis, and if you are an older man, it is due to chronic prostatitis.
This is not true because sexual dysfunction has many other causes and the main symptom of chronic prostatitis is pain.All other signs can be considered simultaneous and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome because the symptoms of these diseases are largely similar.This is due to the formation of facial muscle areas near the prostate, which appear as a result of trauma and surgical intervention.Pain in these areas can be confused with symptoms of prostatitis.
When diagnosing the disease, complaints of pain and discomfort in the perineum and pelvis, lasting at least 3 months, appear.The pain is localized near the prostate, spreading to the sacrum, rectum and scrotum.With prolonged exposure to negative factors (carrying heavy objects, excessive physical activity, standing for a long time), pain increases.
The typical sign of the disease is premature ejaculation.Patients suffer from decreased sexual desire and erectile dysfunction.These symptoms are also characteristic of other genital tract diseases.Therefore, it cannot be said that they are a characteristic sign of chronic prostate disease.
An important symptom is the gradual loss of orgasm.If the patient begins to notice that the severity of the sensation during ejaculation has disappeared, this is a reason to take a more attentive attitude to his health and a signal about the need to visit a urologist.
The structure of the inflamed prostate becomes more dense, pressure on the urinary tract increases, and the quality of urination decreases.Patients with chronic prostatitis frequently urinate at night.The process of urine excretion is accompanied by a burning sensation, stinging and pain.Urinary incontinence often occurs.
Signs of chronic prostatitis can be fully or partially manifested.Much depends on the patient's health condition and the presence or absence of other diseases.Chronic prostatitis is characterized by a wave-like course, with symptoms increasing and decreasing.With this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
When there are obvious symptoms, diagnosing chronic prostatitis is not difficult.But this disease often has no symptoms, so detecting it is very complicated.For diagnostic purposes, a series of studies are performed.
The Association of Urologists has developed questionnaires that may help identify asymptomatic chronic prostatitis.The questions are formulated in such a way as to clarify the patient's subjective feelings.Not every man can give an accurate assessment of erectile function, orgasm quality and other details of sex life.Questionnaires filled out by the patient provide the specialist with the information needed to make a diagnosis.In urological practice, the NIH-CPS scale is most often used.
To distinguish chronic prostatitis from other diseases, a neurological examination is performed.The list of diagnostic methods used includes clarifying the patient's immune status.
Research methods in the laboratory
If chronic prostatitis is suspected, they first find out what its nature is: bacterial or bacterial.In the first case, it is necessary to identify the pathogen or pathogens and find out to which drugs they are sensitive.To do this, laboratory tests of urine and prostatic secretions are performed.
If, after a period of 10 days after DRE, the PSA test shows a prostate-specific antigen level exceeding 4.0 ng/ml, this is a reason to refer the patient for a biopsy to rule out a cancerous process.
The following research methods are recommended:
- scraping from the urethra;
- General and biochemical urinalysis;
- LHC culture of prostate secretion.
Instrumental research methods
TRUS (transrectal ultrasound) is performed using a device equipped with instruments that are inserted into the patient's rectum.If an irregularly shaped hypoechoic area is detected, there is every reason to suspect a malignant tumor.With chronic prostatitis, scarring, structural compaction of the glandular tissue and changes in the seminal vesicles can be observed.
UDI is the primary functional diagnostic method.It allows you to learn the nature of urination, signs of urine stagnation and its composition.The study includes several tests: urine flow measurement, cystometry, residual urine measurement, assessment of pressure inside the bladder and urine flow rate.
Tomography (magnetic or computed resonance imaging) is needed to rule out benign and malignant tumors.These research methods are highly informative and help evaluate the condition of prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires an integrated approach.Medication alone is not enough.Physical therapy procedures and therapeutic exercises are necessary.In general, chronic prostatitis is difficult to treat and requires radical lifestyle changes, changes in habits, and in some cases, job changes.Urologists emphasize that there are only a few measures that will help completely eliminate the disease or ensure long-term remission.
Regardless of whether the disease is viral or bacterial in nature, blockages in the prostate play an important role in its formation.The mucus deposited in the ducts of the gland is a favorable environment for the growth of pathogenic and opportunistic microorganisms.Therefore, the main attention should be directed to eliminating stagnation.
The problem can be solved by making lifestyle changes and incorporating physical therapy classes into the daily schedule.
Complex exercises have been developed suitable for different life situations:
- for men forced to sit most of the time (drivers, office workers, managers);
- for people with excess body weight;
- for people who don't have time to exercise.
After thinking about how to treat chronic prostatitis, you need to decide to seriously reconsider your attitude towards your health.
Treatment of acute prostatitis
Acute prostatitis requires bed rest, a special, salt-free diet, and sexual rest.
Course treatments:
- The most effective treatment for prostatitis is etiotropic therapy.If the cause of prostatitis is infection, then the use of antibacterial drugs is the top priority, which helps reduce inflammatory manifestations.
- Pain syndrome is alleviated by analgesics, antispasmodics, rectal suppositories, microenemas with warm analgesic solutions.NSAIDs may be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and combinations of trace elements have proven their effectiveness.
- Physiotherapy can only be performed in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
- Massage is another effective method of affecting the prostate.It opens the ducts, normalizing blood circulation in the scrotum and pelvis.
- Acute hydronephrosis can be corrected with urinary catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Consulting by a psychologist.
Treatment of chronic prostatitis
With long-term effects (at least a month) on the prostate, there is no guarantee of 100% cure.Prioritize herbal medicines, regulate immunity, and change family habits:
- Herbal 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.
- Antibacterial therapy is selected individually, based on the sensitivity of bacteria to the drug.
- Immunity enhancing drugs not only help to cope with prostatitis, but also correct the negative effects of antibiotics that disrupt the function of the immune system.
- Pain syndrome is alleviated using alpha blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove “excess” secretions of the gland through the urethra, improving blood circulation and minimizing blockages.
- Physical therapy: laser, magnet, ultrasound, iontophoresis, warm water bath or microbiological machine with herbs.
- In severe cases, intravenous fluids with diuretics are indicated.This stimulates abundant urine production, prevents symptoms of intoxication, the development of ascending cystitis and pyelonephritis.
- For constipation, herbal laxatives are used.
- The urologist and psychologist, together with the patient, develop a long-term program for each individual regarding daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- If the chronic process cannot be treated and the urine flow is blocked, surgical intervention is indicated: removal of all affected tissue (transurethral prostatectomy) or complete removal of the gland with surrounding tissues (prostatectomy).Practiced in special cases, it causes impotence and urinary incontinence.Young people do not have surgery because it can cause infertility.
Outpatient treatment is recommended
Patients must avoid situations that may damage the pelvic organs.
It is necessary to avoid any stress on the prostate: do not ride a bicycle, do not do strength exercises, do not carry weights.
If your job is sedentary, every 2-3 hours you need to warm up by squatting, swinging your legs and running on the spot.
You need to try to normalize your sexual life, this is extremely important to eliminate stagnation of secretions in the prostate.
Alcohol consumption should be limited to minimum doses or completely eliminate alcohol consumption.
Drug treatment
For chronic prostatitis, outpatient treatment is mainly performed.If the pathological process continues and cannot be relieved by this method, hospitalization is recommended.In the hospital, under the supervision of medical staff, there are 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, it is recommended to take 5-alpha reductase inhibitors and alpha 1 blockers. They help normalize hormone levels and eliminate pathological symptoms.For these purposes, drugs such as Finasteride and Terazosin are prescribed.
An integrated approach includes taking medications such as:
Treatment methods for chronic bacterial prostatitis
Chronic bacterial prostatitis is treated with antibiotics.The most effective drug for a particular patient is determined using preliminary laboratory research on prostatic secretions.
There is no universal drug that can suppress and destroy pathogenic microflora.What helps one patient may not help another.For this reason, there are many negative reviews about drugs advertised for the treatment of chronic prostatitis.
The drugs recommended for antibacterial treatment are fluoroquinolones.Most bacteria are sensitive to them.
Antibiotics may also be included in the treatment plan for patients with bacterial prostatitis.This therapy is carried out for preventive purposes.According to indications, treatment with penicillin drugs is included.
After completing antibacterial therapy, treatment with hormonal drugs begins.
For intraprostatic reflux, α-blockers are needed.
For pain, pain relievers are effective.
Herbal treatment
Many people doubt whether chronic prostatitis can be cured with herbal remedies.The answer to this question was obtained after many years of using these medicinal substances in urological practice.
Today, the following treatment complexes are recommended:
All of these drugs have a beneficial effect on the functioning of the male reproductive system.Chronic prostatitis can be effectively treated provided that urinary function is normalized.The ingredients in herbal medicine all perform this task.They help reduce the frequency of urges and eliminate sluggish flow syndrome.
For patients with chronic prostatitis, herbal mixtures containing pumpkin extract or pumpkin seeds are recommended.The latter has a unique chemical composition and acts in three directions at once:
- normalizes metabolism;
- strengthens the walls of blood vessels;
- Activates blood circulation in the pelvic organs.
Taking herbal medicine cannot be considered the main treatment method.These health-promoting agents are considered to be used concurrently with drug therapy.
Non-drug treatment
Non-drug treatments allow you to act directly on the prostate, increasing the concentration of drugs in its tissues and helping to eliminate blockages.
For this purpose, the following techniques are used: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe inserted into the patient's anus.The device can be used to set the temperature required for a particular type of exposure.To increase the drug concentration in the prostate, heating at a temperature of 38-40°C is required.To obtain antibacterial effect – 40-45°C.
Today, non-pharmacological treatment focuses on laser therapy.The possibilities of this technique are very wide.Under the influence of laser rays, the following processes occur in the prostate:
- activates redox reactions;
- Blood microcirculation is improved;
- New capillaries are formed;
- Pathogenic microflora is inhibited;
- Cell division is activated, promoting tissue regeneration.
During research on the effects of laser therapy on prostatitis patients, a side but positive effect was observed for therapeutic purposes.Those who completed the course increased potency, eliminated erectile dysfunction and restored vitality.To achieve this result, it is necessary to use a beam of a specific wavelength.In general, low-intensity laser radiation is used to treat chronic prostatitis.
Patients can perform a laser treatment session on their own if the treating physician does not prescribe it.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not threaten 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.To free it from prostate stones, transurethral resection is used.
Surgical intervention is performed under TRUS control.
If complications such as prostatic sclerosis occur, transurethral electrosurgery will be performed.If bladder neck sclerosis is observed in association with this pathology, partial prostatectomy is performed.
When the vas deferens and excretory ducts are obstructed, laparoscopic operations are indicated to eliminate the obstruction of the excretion.For this purpose, an incision is made into the seminal vesicles and excretory ducts.In the case of an abscess, the gland can be completely removed.
Exercises to treat chronic prostatitis
There are a number of exercises that are effective in stimulating the prostate, helping to relieve congestion.This complex was developed for patients with problems with the hip joint.Practice has shown that these exercises are also useful for people diagnosed with prostatitis.Classes can be conducted at convenient times;The complex will take no more than 15 minutes to complete.
Exercise number 1
- Lie on the exercise mat, stretch your arms straight up.
- Bend your knees and pull them towards you, while spreading them in different directions.
- Raise your pelvis as high as possible.
- Repeat 10-12 times.
Exercise number 2
- Standing on the mat, perform a deep squat.
- Repeat 10-12 times.
Exercise number 3
- Lie on your stomach.
- Lift one leg, then the other.
- Repeat 10-12 times.
When performing this set of exercises, all movements must be rhythmic.This is the main condition to achieve high treatment effectiveness.
Prognosis of treatment
Very few men can completely cure chronic prostatitis.Prostatitis often goes into a long-term remission period.But when conditions trigger the pathology, the disease will relapse.The exacerbation begins with the appearance of pain in the prostate.Often they are accompanied by urinary disorders.At the first symptoms of a relapse, you should seek help from a specialist.
Patients should see a urologist regularly, at least every six months.With the same frequency, they conduct an examination of the state of the prostate and do a PSA test.By systematically monitoring the condition of the gland, the processes that cause disease recurrence can be identified in time.But even with long-term remission there is no guarantee that it will not be interrupted.
Patients must follow recommendations to prevent exacerbation of the disease.It is recommended to balance your diet by excluding fatty and spicy foods.The use of herbal remedies and traditional medicine must be approved by the treating physician.With this method, the risk of exacerbation of chronic prostatitis can be minimized.
prevent
To prevent the appearance of a disease that causes discomfort in men, you need to eliminate provoking factors and follow simple rules:
- Have a healthy lifestyle, give up bad habits.
- Don't be too cold.
- Drink at least 1.5-2 liters of water every day.
- Strengthen your immune system, walk a lot, stay flexible.
- Participate in sports, visit fitness clubs.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.