Many men suffer from chronic prostatitis, but attribute the symptoms to other diseases or waste time with ineffective treatments.In our article you will get complete information about this male problem: causes, exact symptoms and diagnostic methods, various treatment methods.
Despite all the successes of modern medicine, the diagnosis of a disease such as chronic prostatitis poses certain difficulties.This also negatively affects the effectiveness of your treatment.
What is chronic prostatitis?
In the ICD-10 (International Classification of Diseases, tenth revision) there is no disease called "chronic prostatitis."There is also no single and generally accepted characteristic of this pathology.In urological practice, it is customary to use the classification developed by the AHI (American Health Institute).Defines categories of prostate diseases.Those that can be described as “chronic” include:
- chronic bacterial prostatitis;
- Chronic abacterial prostatitis.
To make these diagnoses, the following symptoms are required: prolonged pain (at least 3 months) in the perineal area.Therefore, chronic prostatitis can be called a long-term inflammatory process, the consequence of which is 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 family performance and relationships.The quality of life of patients decreases to the same extent as that of people who have suffered a heart attack or suffer from angina.
According to data from various sources, one in three or four men is diagnosed with prostatitis.And most often this is not the initial or acute stage of the disease, but an already formed and long-term process - chronic.
Not so long ago, it was generally accepted that this pathology is characteristic mainly of older men.But statistical data refute this opinion.Today it is known that chronic prostatitis is a disease of men of childbearing age who are sexually active.
More than 30% of patients consult a specialist with complaints characteristic of chronic prostatitis.Often, at the time of a visit to the doctor, the disease is complicated by concomitant pathologies: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis.
The causes of chronic prostatitis are very different.Of the variety of negative factors affecting a man's health, it is difficult to distinguish exactly those that provoked the development of the disease.Often this is a complex of situations and circumstances that accompany a man's life.
The main causes of chronic abacterial prostatitis are the following:
- dysrhythmia (irregularity) of sexual relations;
- physical inactivity, typical of overweight people;
- long-term stressful conditions;
- the predominance of high-fat 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 ignored his ailments and did not seek help from a urologist.Therefore, no treatment was performed.
Chronic prostatitis of abacterial type develops due to exposure to infectious agents against a background of decreased immunity.As a rule, such patients are diagnosed with diseases of the endocrine system.
The factors that provoke the development of chronic bacterial prostatitis are:
- surgical operations on the prostate (if antibacterial therapy was not performed before the operation);
- refusal to use contraceptives;
- lack of habit of keeping the body clean.
Symptoms of chronic prostatitis.
Today there are many myths about chronic prostatitis.For this reason, any temporary alteration in sexual function is attributed to this disease.You can often hear the opinion that decreased libido and erectile dysfunction are due to prostatitis and, if you are an older man, chronic prostatitis.
This is not true, since sexual dysfunction has many other causes and the main symptom of chronic prostatitis is pain.All other signs can be considered concomitant and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome, since the symptoms of these diseases are very similar.This is due to the formation of myosfacial trigger zones near the prostate, which appear as a result of injuries and surgical interventions.Pain in these areas can be confused with a symptom of prostate inflammation.
When diagnosing the disease, complaints of pain and discomfort in the perineum and pelvis come to the fore, lasting at least 3 months.The pain is located near the prostate and radiates to the sacrum, rectum and scrotum.With prolonged exposure to negative factors (carrying heavy objects, excessive physical activity, standing for a long time), the pain intensifies.
A characteristic sign of the disease is premature ejaculation.Patients experience decreased sexual desire and erectile dysfunction.These symptoms are also characteristic of other genitourinary diseases.Therefore, it cannot be said that they are characteristics of chronic prostate disease.
An important symptom is the disappearance of orgasm.If the patient begins to notice that the severity of sensations during ejaculation has disappeared, this is a reason for a more attentive attitude to his health and a signal about the need to visit a urologist.
The structure of the inflamed prostate becomes denser, the pressure on the urinary tube increases, and the quality of urination deteriorates.Patients with chronic prostatitis notice a frequent need to urinate at night.The process of excretion of urine is accompanied by a sensation of burning, stinging and pain.Urinary incontinence often occurs.
Signs of chronic prostatitis can be expressed in whole or in part.Much depends on the patient's health and the presence or absence of other diseases.Chronic prostatitis is characterized by an undulating course, with waxing and waning symptoms.With this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis.
In the presence of pronounced symptoms, it is not difficult to diagnose chronic prostatitis.But this disease is usually asymptomatic, which complicates its detection.For diagnostic purposes, a wide range of studies is carried out.
The Association of Urologists has developed questionnaires that can help identify asymptomatic chronic prostatitis.The questions are formulated in such a way that the patient's subjective feelings can be clarified.Not all men can correctly evaluate their erectile function, the quality of orgasm and other details of sexual life.The questionnaires completed by the patient provide the specialist with the information necessary to make a diagnosis.In urological practice, the NIH-CPS scale is most often used.
To differentiate chronic prostatitis from other diseases, a neurological examination is performed.The list of diagnostic methods used includes clarification of the patient's immunity status.
Laboratory research methods.
If chronic prostatitis is suspected, first of all its nature is discovered: bacterial or non-bacterial.In the first case, it is necessary to identify the pathogen or pathogens and find out which drugs they are sensitive to.For this, laboratory tests of urine and prostate secretions are performed.
If, after a period of 10 days after DRE, the PSA test shows that the level of prostate-specific antigen exceeds 4.0 ng/ml, this is a reason to refer the patient for a biopsy to exclude an oncological process.
The following research methods are recommended:
- scraping of the urethra;
- general and biochemical urinalysis;
- LHC culture of prostate secretion.
Instrumental research methods.
TRUS (transrectal ultrasound) is performed using equipment equipped with an instrument that is inserted into the patient's rectum.If an irregularly shaped hypoechoic area is detected, there are many reasons to suspect malignancy.With chronic prostatitis, scars, compaction of the glandular tissue structure and changes in the seminal vesicles can be observed.
UDI is the main method of functional diagnosis.It allows you to find out the nature of urination, signs of urine stagnation and its composition.The study includes several tests: uroflowmetry, cystometry, measurement of residual urine volume, evaluation of pressure inside the bladder and urine output rate.
Tomography (computed or magnetic resonance imaging) is necessary to exclude benign and malignant neoplasms.These research methods are very informative and help to assess the state of the prostate tissue.
Treatment of chronic prostatitis.
Treatment of chronic prostatitis requires an integrated approach.Medication alone is not enough.Physiotherapeutic procedures and therapeutic exercises are necessary.In general, chronic prostatitis is difficult to treat and requires a radical revision of lifestyle, changes in habits and, in some cases, a change of job.Urologists insist that only a set of measures will help to completely eliminate this disease or ensure long-term remission.
Regardless of whether the disease is bacterial or abacterial in nature, prostate congestion played an important role in its formation.The viscous secretion deposited in the ducts of the gland is a favorable environment for the development of pathogenic and opportunistic microorganisms.Therefore, the main attention should be directed to eliminating stagnation.
The problem can be solved by changing lifestyle and including physiotherapy classes in the daily schedule.
Complexes of exercises suitable for different life situations have been developed:
- for those men who are forced to sit most of the time (drivers, office workers, managers);
- for people with excess body weight;
- For those who don't have time to exercise.
After thinking about how to treat chronic prostatitis, you should 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 treatment methods:
- The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, the priority is treatment with antimicrobial agents, which relieve the manifestations of inflammation.
- Pain syndrome is relieved by analgesics, antispasmodics, rectal suppositories and microenemas with warm solutions of analgesics.NSAIDs can be used.
- Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven effective.
- Physiotherapeutic methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwaves, electrophoresis, laser, magnetotherapy.
- Massage is another effective method of influencing the prostate.Opens the ducts, normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Psychologist consultations.
Treatment of chronic prostatitis.
With a long-term effect (at least one month) on the prostate, there is no 100% guarantee of cure.Priority is given to herbal medicines, immunocorrection and changing household 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, eliminate free radicals and prevent the proliferation of glandular tissue.
- Antibiotic therapy is selected individually, depending on the sensitivity of microbes to drugs.
- Immunity-enhancing drugs not only help fight prostatitis, but also correct the negative effects of antibiotics that disrupt the functioning of the immune system.
- The pain syndrome is relieved by the administration of alpha-blockers and muscle relaxants.
- Prostate massage allows you to mechanically remove "extra" secretion from the gland through the urethra, improve blood circulation and minimize congestion.
- Physiotherapy: laser, magnet, ultrasound, iontophoresis, warm sitz baths or microenemas 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 an individual long-term program of daily routine, necessary rest, diet, dosed physical activity and sexual activity.
- If the chronic process is resistant to therapy and the outflow of urine is blocked, surgical intervention is prescribed: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy).Practiced in exceptional cases, it is plagued by impotence and urinary incontinence.Young people do not undergo surgery because it can cause infertility.
Recommendations for outpatient treatment.
The patient should avoid situations in which he may suffer injuries to 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 lift weights.
If the work is sedentary, every 2-3 hours it is necessary to warm up by doing squats, leg swings and running in place.
You should try to normalize your sex life, which is extremely important to eliminate stagnation of secretions in the prostate.
It is recommended to limit alcohol consumption to minimal doses or eliminate alcohol consumption completely.
Drug treatment
For chronic prostatitis, treatment is mainly carried out on an outpatient basis.If the pathological process persists and remission cannot be achieved with this method, hospitalization is recommended.In a hospital, under the supervision of medical staff, there are many 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 sense, 5-alpha reductase inhibitor drugs and alpha 1 blockers are recommended. They help to normalize hormonal levels and eliminate the symptoms of the pathology.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 by a preliminary laboratory study of prostate secretions.
There is no universal medicine to 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 recommended medications for antibacterial therapy are fluoroquinolones.Most bacteria are sensitive to them.
Antibiotics may also be included in the treatment plan for patients with abacterial prostatitis.This therapy is carried out for preventive purposes.According to indications, treatment with penicillins is included.
After the end of antibiotic therapy, treatment with hormonal drugs begins.
For intraprostatic reflux, it is necessary to take alpha blockers.
For pain, pain relievers are effective.
Treatment with herbal remedies.
Many people doubt that chronic prostatitis can be cured with the help of herbal remedies.The answer to this question was obtained after many years of use of these healing agents in urological practice.
Today the following treatment complexes are recommended:
All these drugs have a beneficial effect on the functioning of the male genitourinary system.Effective treatment of chronic prostatitis is possible as long as urinary function is normalized.The components included in herbal medicines perform this task.They help reduce the frequency of impulses and eliminate slow flow syndrome.
For patients with chronic prostatitis, herbal mixtures containing pumpkin extract or pumpkin seeds are recommended.The latter have a unique chemical composition and act in three directions at once:
- normalize metabolism;
- strengthen the walls of blood vessels;
- Activate blood circulation in the pelvic organs.
Taking herbal medicines cannot be considered the main method of treatment.These health-enhancing agents are considered to be concomitant with drug therapy.
Non-pharmacological treatment
Non-drug therapy methods allow you to act directly on the prostate, increase the concentration of drugs in its tissues and help eliminate congestion.
For these purposes, the following techniques are used: rectal ultrasound;
Microwave hyperthermia is performed using a rectal probe that is inserted into the patient's anus.The device can be used to set the temperature required for a specific type of exposure.To increase the concentration of the drug in the prostate, it is necessary to warm it to 38-40°C.To obtain an antibacterial effect – 40-45°C.
Today, non-drug treatment focuses on laser therapy.The possibilities of this technique are wide.Under the influence 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 suppressed;
- The cell division process is activated, which promotes tissue regeneration.
During the research period on the effects of laser therapy in patients with prostatitis, a side effect was observed, but positive for the treatment.Those who completed the course increased potency, eliminated erectile dysfunction and regained vitality.To achieve this result, it is necessary to use a beam with a specific wavelength.In general, low-level laser radiation is used to treat chronic prostatitis.
Patients can, on their own initiative, undergo laser treatment, if not prescribed by the treating doctor.
Surgical treatment of chronic prostatitis.
Chronic prostatitis does not pose a threat to the patient's life, but can significantly reduce its quality.The most serious complication of this disease is the formation of stones in the gland tissues.To free it from prostatoliths, transurethral resection is used.
The surgical intervention is performed under TRUS control.
If complications such as prostate sclerosis occur, transuretal electrosurgery is performed.If sclerosis of the bladder neck is observed in combination with this pathology, a partial resection of the prostate is performed.
When the seminal and excretory ducts are blocked, endoscopic operations are indicated to eliminate the obstruction of the patency of secretions.To do this, an incision is made in the seminal vesicles and excretory ducts.In case of abscess, complete removal of the gland is possible.
Exercises for the treatment of chronic prostatitis.
There are a number of exercises that are effective in stimulating the prostate, which helps relieve congestion.This complex was developed for patients with hip joint problems.Practice has shown that these exercises are also useful for people diagnosed with prostatitis.Classes can be held at a convenient time;The complex will take no more than 15 minutes to complete.
Exercise #1
- Lying on a gymnastics mat, stretch both arms up.
- Bend your knees and pull them towards you, simultaneously extending them in different directions.
- Raise your pelvis as much as you can.
- Repeat 10 to 12 times.
Exercise #2
- Standing on the mat, do deep squats.
- Repeat 10 to 12 times.
Exercise No. 3
- Lie face down.
- Raise one leg and then the other.
- Repeat 10 to 12 times.
When performing this set of exercises, all movements should be smooth.This is the main condition for obtaining a high therapeutic effect.
Treatment prognosis
Few men can completely cure chronic prostatitis.Prostate inflammation often enters a long-term remission stage.But when the conditions arise for the activation of the pathology, a relapse occurs.An exacerbation begins with the appearance of pain in the prostate.They are often accompanied by urinary disorders.At the first symptoms of a relapse, you should seek help from a specialist.
Patients are recommended to regularly visit a urologist, at least once every six months.With the same frequency, they conduct examinations of the state of the prostate and conduct a PSA test.By systematically monitoring the condition of the gland, processes that provoke a relapse of the disease can be identified in a timely manner.But even with long-term remission there is no guarantee that it will not be altered.
The patient must follow the recommendations to prevent exacerbations of the disease.It is recommended to balance the diet by excluding fatty and spicy foods.The use of herbal remedies and traditional medicine should be coordinated with the treating physician.With this approach, the risk of exacerbation of chronic prostatitis can be minimized.
Prevention
To prevent the appearance of an unpleasant disease for men, it is necessary to eliminate provoking factors and follow simple rules:
- Lead a healthy lifestyle, give up bad habits.
- Don't be too cold.
- Drink at least 1.5-2 liters of water daily.
- Strengthen your immune system, walk a lot, toughen up.
- Participate in physical education and sports, visit gyms.
- Avoid stressful situations.
- Practice a regular sex life with a regular partner.