Prostatitis is a disease that causes problems urinating, sexual dysfunction, pain in the perineum and lower abdomen. The cause of these symptoms is inflammation of the prostate.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located below the man's bladder and in front of the rectum. The prostate is made up of glandular and connective tissue. Its function is to produce fluid, which partly consists of ejaculate. This fluid carries the 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 at most several weeks. It is usually easy to treat, but sometimes it becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure forever. But with proper treatment, there is a good chance of achieving long-term remission and significantly improving the patient's quality of life. We found out how to understand that you have chronic prostatitis and what to do next.
What is chronic prostatitis?
In total, four types of prostatitis are distinguished: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome) and asymptomatic. Of these, chronic nonbacterial prostatitis is the most common. And he's the worst to deal with.
A disease is considered chronic if the symptoms do not disappear for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its recurrent course. This means that symptoms may go away for a while and then come back. Without treatment, this condition can bother the patient for a long time.
The bacterial and nonbacterial forms have common symptoms. They usually include problems with urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. In addition, the chronic form is much more common than the acute one. The reason for around 25% of visits to the urologist is related to chronic prostatitis.
Pathology can appear at any age, but the chronic form develops more often in men after 50 years of age.
Causes of chronic prostatitis.
Chronic prostatitis can be bacterial (infectious) or nonbacterial. These types of diseases have common symptoms but different causes.
Chronic bacterial prostatitis
When in prostate secretion during analysis.discoveredleukocytes and pathogens
The inflammatory process causes a bacterial urinary tract infection to reach the prostate. The provoking factor may be: acute form of prostatitis, UTI (urinary tract infection), STI. The causative agents of the inflammatory process in the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic nonbacterial prostatitis (chronic pelvic pain syndrome)
When in prostate secretion during analysis.not detectedleukocytes and pathogens
Researchers have not established the causes of chronic pelvic pain syndrome. With this form, there is no infection in the prostate. It is not known exactly what causes the disturbances in this case. It is assumed that this may be due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sexual life;
- The patient already had prostatitis and chronic pain persisted despite treatment;
- urine entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- stress
Symptoms of chronic prostatitis.
In chronic prostatitis, the symptoms bother the patient for a long time, for several months or even years. The disease is characterized by a recurring course, that is, problems appear and disappear.
Infectious and non-infectious prostatitis have common symptoms and include:
- urination disorders: frequent and sudden urges, difficulty urinating, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during sexual intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- nausea vomiting
The disease also affects the general condition of the patient. Some people experience irritability, increased fatigue, lethargy, and anxiety.
If you have these signs, consult a urologist. Some of them may indicate other, more serious illnesses that require urgent medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis.
At the first signs of the disease, it is necessary to make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and the urinary system in both men and women.
The initial consultation includes several stages:
- story take.
The urologist will ask him about the reason for his visit, previous illnesses and medications he has taken now and in the past. - Examination of the genital organs.
- digital rectal exam.
During the procedure, the urologist inserts a finger into the patient's anus to palpate the surface of the prostate. The test allows you to determine the size of the prostate and detect swelling and tenderness. - Other studies.
The doctor may prescribe one or more diagnostic procedures, some of which can be performed immediately at the appointment and others later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods.
- General urine analysis.
Allows you to see signs of infection. This may be indicated by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate-specific antigen)
Helps evaluate the condition of the prostate gland. An elevated PSA level indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostate secretion.
Prostate secretion is a fluid produced by the prostate gland. With changes in the organ, the composition of the secretion also changes. For example, during an inflammatory process, white blood cells will increase and a high level of pathogenic bacteria may indicate a bacterial infection in the prostate. Microscopic examination of the fluid will help see these changes. - Prostatic secretions are collected through prostate massage. The massage can be combined with a rectal examination.
Instrumental research methods.
- Cystoscopy. Examination of the inner surface of the bladder using an endoscope, a thin, flexible tube with a camera. The device is inserted into the bladder through the urethra. The study allows you to see problems with the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). For the examination, 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 state of prostate tissue. It may be necessary to visualize foci of prostate inflammation 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:
- For intimate hygiene, it is not advisable to use special products before use, warm water is enough.
- Do not go to the bathroom 2 hours before your clinic visit. Then at your appointment, if necessary, you will be able to immediately take tests or have an ultrasound.
- If you take any medications regularly, write their names in your journal or in notes 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 treatments are indicated.
To determine the type of chronic prostatitis, it is necessary to undergo a diagnosis. Based on your results, your doctor will prescribe a therapy that will work specifically for you.
Unlike the acute form, chronic inflammation of the prostate cannot be cured forever. The 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.
nonbacterial form: Treatment is symptomatic. That is, each method aims to combat a specific symptom.
Recommendations for outpatient treatment.
Changes in lifestyle:
- Dietary restrictions
It is worth giving up alcohol, coffee and spicy and sour foods. These products irritate the bladder and worsen the patient's condition. - Warm sitz baths, warm showers.
Water procedures will help reduce the manifestations of the disease. - More water
Drink enough fluids. Going to the bathroom more frequently will help eliminate pathogenic bacteria from the bladder. - Chair cushions
When you are sitting, place a soft pillow under you. - Physical activity
Regular walks and exercise will help reduce pain and clear congestion. - regular sex life
Sexual activity is helpful in preventing congestion.
The methods listed will complement the therapy you have been prescribed, but will not replace it.
Pharmacotherapy
- antibiotics. Antibacterial therapy is indicated for the infectious form. The medications destroy bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, therefore, before prescribing them, it is necessary to undergo a study of prostate secretions and determine their type. In the treatment of the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary disorders. The medications relax the organs of the urinary system and this relieves the symptoms. Most often, alpha-blockers are used for chronic non-infectious prostatitis, but to improve the patient's well-being, 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 swelling of the prostate.
- Muscle relaxants. It is used when it is necessary to relieve spasm of the pelvic muscles.
- Antidepressants. Indicated for depression, which can develop due to stress and prolonged pain.
- Medications for the treatment of erectile dysfunction.. It is used if prostatitis causes problems in your sex life.
- Laxatives. They may prescribe it if symptoms include pain when defecating.
Treatment with herbal remedies.
Herbal remedies.Herbal medicines do not work as the main method of treatment. They can be used as a supplement to reduce inflammation of the prostate. To do this, medications with quercetin are prescribed, a substance found in vegetables, fruits and berries.
Non-pharmacological treatment
- Physiotherapy and prostate massage.. The methods are used to relax the pelvic floor muscles, relieve pain and prevent congestion. To obtain a therapeutic effect, the patient undergoes a multi-session massage course. Massage is contraindicated in the development of complications of pathology: abscesses, stones in the prostate tissues.
- Bladder catheterization. It may be needed if you have problems with your bladder.
- Psychotherapy. Due to chronic pain, patients with prostatitis may develop depression and anxiety disorders. Psychological problems have a negative impact on the patient's well-being and worsen the pain syndrome. In such cases, it will be useful to consult a psychotherapist.
- Biofeedback programs. It can help reduce tension in the pelvic muscles.
Surgical treatment of chronic prostatitis.
Surgical methods are rarely used. They may be needed if complications develop.
Types of operations:
- TUR (transurethral resection) of the prostate.Indicated for the appearance of stones in the tissues of the prostate gland.
- Prostatectomy. Removal of the prostate in some cases is carried out in case of abscess (accumulation of pus) or serious disturbances in the functioning of the bladder.
Exercises for the treatment of chronic prostatitis.
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and relieve the symptoms associated with urinary disorders. How to do the exercises:
- Sit comfortably.
- Squeeze your pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
- Relax your muscles.
- Repeat this 10 to 15 times.
- Little by little you will be able to increase the number of repetitions and tense your muscles for longer.
- You should make 2-3 approaches a day.
Changes can only be noticed with regular exercise.
Treatment prognosis
It is very difficult to cure chronic prostatitis forever. In some cases, the disease is incurable, but there is always the possibility of achieving long-term remission and returning the patient to his 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 an infection, antibiotic therapy will help. And for chronic non-infectious prostatitis - a well-chosen symptomatic therapy.
Complications of chronic prostatitis may include:
- Bacteremia (bacterial blood poisoning). Bacteria entering the bloodstream. It may be a consequence of bacterial forms of pathology. Bacteremia 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 the tissue). In case of abscess, surgery is performed to clean and drain the purulent focus; In rare cases, the prostate may be removed.
- Sterility. Problems with conception can occur when there is a lack of sperm due to an inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bone.
- depressive disorder. Chronic pathologies increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and his emotional state.
To prevent prostatitis it is important:
- Use barrier contraceptives (condoms): STIs are a factor that increases the risk of developing prostatitis
- Visit a urologist annually if you are over 40 years old
- If you have symptoms of a UTI, contact your doctor right away.