Symptoms and treatment of chronic prostatitis

Prostatitis is a condition that causes urinary problems, sexual dysfunction, and 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 male bladder and in front of the rectum. The prostate is composed of glands and connective tissue. Its function is to produce fluid, partly composed of semen. This fluid carries sperm during ejaculation and protects the sperm as it enters 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 for up to several weeks. It's usually easily treated, but sometimes it becomes chronic.Unlike acute prostatitis, chronic prostatitis is difficult to cure permanently. But with appropriate treatment, there is every chance of achieving long-term remission and significantly improving a patient's quality of life. We figured out how to know you have chronic prostatitis and what to do next.

What is chronic prostatitis

There are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), and asymptomatic. Among them, non-bacterial chronic prostatitis is the most common. And he is the most difficult to treat.If symptoms do not go away for more than 3 months, the disease is considered chronic. However, they develop slowly and are less noticeable than the acute form.Another characteristic of chronic inflammation of the prostate is its recurrence. This means symptoms may disappear for a while and then return. If left untreated, this condition can plague patients for a long time.Bacterial and non-bacterial forms share symptoms. They often include problems with urination, sexual function, perineal and pelvic pain.

Epidemiology

Prostatitis is one of the most common diseases in men. Additionally, chronic forms are more common than acute forms. Approximately 25% of visits to a urologist are related to chronic prostatitis.The pathology can appear at any age, but the chronic form is most common in men after the age of 50.

Causes of chronic prostatitis

Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of illnesses share common symptoms but different causes.

chronic bacterial prostatitis

When analyzing prostate secretionsDiscoverWhite blood cells and pathogensThe inflammatory process causes bacterial infection to travel from the urinary tract into the prostate. Predisposing factors may be: acute prostatitis, UTI (urinary tract infection), STI. The causative agents of the inflammatory process of the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella species, Enterococci, Enterobacteriaceae, Proteus, Serenobacterium.

Chronic nonbacterial prostatitis (chronic pelvic pain syndrome)

When analyzing prostate secretionsnot detectedWhite blood cells and pathogensResearchers have not determined the cause of chronic pelvic pain syndrome. In this form, the prostate does not become infected. The exact cause of the interference in this case is unclear. It is speculated that this may be due to the following factors:

• Stagnation caused by sedentary work, lack of exercise, irregular sex life, etc. ;
• The patient already has prostatitis and chronic pain persists despite treatment;
• Urine entering the prostate due to bladder problems;
• nerve damage;
• Urinary tract damage due to injury or surgery;
• pressure

Symptoms of chronic prostatitis

Symptoms of chronic prostatitis can plague patients for a long time—months or even years. The disease is characterized by a relapsing course, in which problems appear and disappear. Infectious and non-infectious prostatitis share common symptoms, including:

• Urinary disorders: frequent and sudden urge to urinate, difficulty urinating, and pain;
• Pain in the penis, testicles, pelvic area, lower back;
• pain during sexual intercourse;
• Pain during ejaculation (ejaculation);
• Decreased sexual desire (libido);
• Fever, chills;
• feel sick and vomit

The disease also affects the patient's general condition. Some people experience irritability, fatigue, drowsiness, and anxiety.If you have these signs, talk to a urologist. Some of these may indicate other, more serious illnesses requiring urgent medical attention. If treatment is delayed, there is a risk of life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.

Diagnosis of chronic prostatitis

When the first signs of the disease appear, you need to make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and the male and female urinary tract.The initial consultation consists of several stages:

1. Medical history collection.
   The urologist will ask you about the reason for your visit, past illnesses, and medications you are taking now and in the past.
2. reproductive organ examination
3. Digital rectal examination.
   During the procedure, the urologist inserts a finger into the patient's anus to feel the surface of the prostate. This test determines the size of the prostate and checks for swelling and tenderness.
4. Other research.
   The doctor may prescribe one or more diagnostic procedures, some of which can be performed immediately at the appointment and some of which can be performed later.

Diagnosis usually involves laboratory and instrumental studies.

laboratory research methods

• General urinalysis
  Allows you to see signs of infection. This can be shown by pathogenic bacteria in general analyses.
• Blood test PSA (prostate specific antigen)
  Helps assess the condition of the prostate. Elevated PSA levels indicate an inflammatory process in the prostate or tumor.
• Microscopic examination of prostate secretions
  Prostatic secretions are fluids produced by the prostate. As the organs change, the composition of the secretions also changes. For example, during inflammation, white blood cells increase, and high levels of pathogenic bacteria may indicate a bacterial infection of the prostate. Microscopic examination of the fluid will help observe these changes.
• Prostatic secretions are collected through prostate massage. Massage can be combined with a digital rectal examination.

Instrumental Research Methods

• Cystoscopy. An endoscope (a thin flexible tube with a camera) is used to examine the inner surface of the bladder. The device is inserted into the bladder through the urethra. This study can allow you to detect urinary tract problems.
• TRUS (Transrectal Ultrasound of the Prostate). During the examination, the specialist will carefully insert the ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
• Pelvic MRI (magnetic resonance imaging). Helps assess the condition of prostate tissue. It may be necessary to look for lesions of prostate inflammation and rule out prostate cancer.

No special preparation is required for an appointment with a urologist. But to make your consultation as effective as possible, follow some simple advice:

1. For private hygiene, it is not advisable to use special products before use, just warm water.
2. Do not use the toilet 2 hours before your appointment. Then, at your appointment, you can have an immediate examination or ultrasound if necessary.
3. If you take any medications regularly, write down the names of them in your journal or in notes on your phone.
4. Keep previous research results with you so experts can gain a complete understanding of the disease.
5. Make a list of questions you want to ask your doctor during your appointment.

Treatment of chronic prostatitis

There is no universal way to get rid of prostatitis. Different forms and manifestations of the disease require different treatments.To determine the type of chronic prostatitis, you need to receive a diagnosis. Based on the results, your doctor will prescribe a treatment plan specific to your situation.Unlike acute inflammation, chronic inflammation of the prostate cannot be permanently cured. Doctors' goal is to achieve long-term relief and reduce symptoms.bacterial morphology: Treatment includes antibiotics and other methods to relieve symptoms.non-bacterial form: Treatment is symptomatic. That is, each method is designed to combat specific symptoms.

Outpatient treatment recommendations

Lifestyle changes:

• dietary restrictions
  It's worth giving up alcohol, coffee, spicy and sour foods. These products can irritate the bladder and worsen a patient's condition.
• Warm sitz bath, warm shower
  Water procedures will help reduce the manifestations of the disease.
• more water
  Drink enough fluids. Going to the bathroom more frequently can help clear your bladder of disease-causing bacteria.
• chair pillow
  When you sit down, place a soft pillow under you.
• physical activities
  Regular walks and exercise will help reduce pain and clear up nasal congestion.
• regular sex life
  Sexual activity can help prevent congestion.

The methods listed will supplement the treatment prescribed for you but do not replace it.

medical treatement

• antibiotic. Antimicrobial treatment is indicated for the infectious form. These drugs destroy the bacteria that cause inflammation of the prostate. Different types of pathogenic microorganisms require different antibiotics, so you need to study the prostate secretion and determine its type before prescribing it. When treating chronic diseases, antibiotics are needed for several months.
• alpha blockers. Helps with urinary system diseases. These medications relax the organs of the urinary system, thereby relieving symptoms. Most commonly, alpha-blockers are used to treat non-infectious chronic prostatitis, but to improve the patient's health, they can also be used to treat infectious inflammatory processes.
• NSAID (non-steroidal anti-inflammatory drug). Prescribed to relieve pain and reduce prostate swelling.
• muscle relaxants. Use when you need relief from pelvic muscle spasms.
• Antidepressants. Indicated for depression caused by stress and chronic pain.
• Drugs to Treat Erectile Dysfunction. Use if prostatitis is causing problems with your sex life.
• laxative. They may prescribe this medicine if symptoms include pain during bowel movements.

herbal treatment

Herbal remedies.Herbal medicine is not the main treatment. They can be used as a supplement to reduce prostate inflammation. For this purpose, doctors prescribe medications containing quercetin, a substance found in vegetables, fruits and berries.

non-pharmacological treatment

• Physical therapy and prostate massage. These techniques are used to relax the pelvic floor muscles, relieve pain, and prevent congestion. To achieve therapeutic effects, patients undergo multiple massage sessions. Massage is contraindicated in the development of pathological complications: abscesses, stones in the prostate tissue.
• bladder catheterization. This may be necessary if you have bladder problems.
• psychotherapy. People with prostatitis may experience depression and anxiety due to chronic pain. Psychological problems can have a negative impact on a patient's health and worsen pain syndromes. In this case, consulting a psychotherapist can be helpful.
• biofeedback program. May help reduce pelvic muscle tension.

Surgical treatment of chronic prostatitis

Surgical methods are rarely used. They may be needed if complications arise.Operation type:

• Prostate TUR (transurethral resection).Indicates the presence of stones in prostate tissue
• prostatectomy. In some cases, the prostate may need to be removed if an abscess (a collection of pus) develops or if there is severe impairment of bladder function.

Exercise to treat chronic prostatitis

Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and reduce symptoms associated with urinary tract disorders. How to perform the exercise:

1. Sit comfortably.
2. Tighten your pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
3. Relax your muscles.
4. Repeat this 10-15 times.
5. Gradually, you can increase the number of repetitions and tense the muscles for longer periods of time.
6. You should approach 2-3 times a day.

Changes can only be noticed if you exercise regularly.

Treatment prognosis

It is very difficult to permanently cure chronic prostatitis. In some cases, the disease is incurable, but there is always a chance of achieving long-term remission and returning the patient to their previous quality of life. For this reason, it is important to perform a thorough diagnosis to determine the form of the disease. If the cause of the inflammatory process is infection, antimicrobial treatment can be helpful. For non-infectious chronic prostatitis - well-selected symptomatic treatment.Complications of chronic prostatitis may include:

• Bacteremia (bacterial blood poisoning). Bacteria enter the bloodstream. May be the result of bacterial pathology. Bacteremia occurs suddenly and may lead to sepsis. This condition is life-threatening.
• Epididymitis (inflammation of the epididymis). This disease may cause severe pain in the scrotum.
• Prostate abscess (accumulation of pus in the tissue). If an abscess develops, surgery will be needed to clean and drain the pus; in rare cases, the prostate may be removed.
• infertility. Conception problems may occur when an inflammatory process in the prostate causes a lack of sperm.
• The infection spreads to the spine and pelvic bones
• depression. Chronic illness increases the risk of depression.
• Erectile dysfunction (impotence). Erectile dysfunction is associated with reduced quality of life and emotional state in men.

To prevent prostatitis, it is important to:

• Use barrier contraception (condoms): Sexually transmitted infections are a factor that increases the risk of prostatitis
• If you are over 40, see a urologist every year
• If you have symptoms of a urinary tract infection, contact your doctor immediately