Many men suffer from chronic prostatitis, but they attribute their symptoms to other illnesses or waste time on ineffective treatments.From our article you will get comprehensive information about this male problem: causes, exact symptoms and diagnosis, various treatments.
Despite the great success of modern medicine, there are still certain difficulties in diagnosing diseases such as chronic prostatitis.This also had a negative impact on the effectiveness of his treatment.
What is chronic prostatitis
There is no such disease as “chronic prostatitis” in ICD-10 (International Classification of Diseases, Tenth Revision).There is also no single, universally accepted characteristic of this pathology.In urological practice, the classification developed by the AHI (American Institute of Health Research) is commonly used.It defines categories of prostate disease.Those that can be described as "chronic" include:
- Chronic bacterial prostatitis;
- Chronic nonbacterial prostatitis.
To make these diagnoses, the following symptoms are required: Prolonged (at least 3 months) pain in the perineal area.Therefore, chronic prostatitis can be called a long-term inflammatory process, the consequences of which are changes in the structure of the prostate and its dysfunction.But other prostate diseases can lead to such tragic 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.A patient's quality of life is reduced to the same extent as a patient suffering from a heart attack or angina.
According to data from various sources, one in every three to four men is diagnosed with prostatitis.In most cases, this is not an initial or acute stage of the disease, but a long-term process that has developed - chronicity.
Not long ago, it was generally believed that this pathology was primarily a characteristic of older men.But statistics refute this notion.Today, it is well known that chronic prostatitis is a disease of sexually active men of childbearing age.
More than 30% of patients consult a specialist because of symptoms of chronic prostatitis.Often, when visiting a doctor, the disease is complicated by accompanying conditions: erectile dysfunction, seminal vesiculitis, primary or secondary infertility, epididymitis.
Causes of chronic prostatitis
The causes of chronic prostatitis vary widely.Among the various negative factors that affect men's health, it is difficult to pinpoint the factors that trigger the development of the disease.Often, this is a complex set of situations and circumstances that accompanies a person throughout his or her lifetime.
The main causes of chronic non-bacterial prostatitis are as follows:
- Coital rhythm disorder (irregular);
- Lack of physical activity, which is typical of overweight people;
- Being in a state of chronic stress;
- The predominance of fat-rich foods in the diet;
- Hazardous industries have negative effects on the body.
Bacterial chronic prostatitis is the result of incomplete cure of bacterial prostatitis.Or the man ignored the conditions and did not seek help from a urologist.Therefore, no treatment was performed.
Nonbacterial chronic prostatitis occurs due to exposure to infectious agents in the context of compromised immunity.Typically, such patients are diagnosed with disorders of the endocrine system.
Factors causing chronic bacterial prostatitis include:
- Prostate surgery (if antimicrobial treatment was not performed before surgery);
- Refusal to use contraception;
- Lack of habit of keeping the body clean.
Symptoms of chronic prostatitis
Today, there are many misconceptions about chronic prostatitis.Therefore, any temporary sexual dysfunction is attributed to this disorder.You'll often hear the idea that decreased libido and erectile dysfunction are caused by prostatitis, or in the case of older men, chronic prostatitis.
This is incorrect because there are many other causes of sexual dysfunction, and the main symptom of chronic prostatitis is pain.All other signs can be considered incidental and indirect.
Chronic prostatitis is often confused with pelvic pain syndrome because the symptoms of these conditions are often similar.This is due to the formation of myofacial trigger zones near the prostate, which occur as a result of injury and surgical intervention.Pain in these areas may be mistaken for symptoms of prostate inflammation.
Complaints of perineal and pelvic pain and discomfort, lasting at least 3 months, stand out in the diagnosis of the disease.The pain is localized near the prostate and radiates to the sacrum, rectum, and scrotum.Pain can be exacerbated by prolonged exposure to negative factors (lifting heavy objects, excessive physical activity, standing for long periods of time).
A classic symptom of the disease is premature ejaculation.Patients may experience decreased libido and erectile dysfunction.These symptoms are also characteristic of other genitourinary disorders.Therefore, they cannot be said to be signs of chronic prostate disease.
An important symptom is the loss of orgasm.If the patient begins to notice that the severe sensation during ejaculation disappears, this is a reason to take a more cautious approach to his health and is a sign that a visit to a urologist is needed.
Inflamed prostate structures become denser, pressure on the urinary catheter increases, and the quality of urination worsens.Patients with chronic prostatitis often urinate at night.The process of passing urine can be accompanied by burning, stinging, and pain.Urinary incontinence often occurs.
The signs of chronic prostatitis may be manifested in whole or in part.Much depends on the patient's health and the presence of other medical conditions.Chronic prostatitis is characterized by a wave-like course with gradually increasing and decreasing symptoms.In this disease, the inflammatory process is not acute.
Diagnosis of chronic prostatitis
Diagnosing chronic prostatitis is not difficult in the presence of obvious symptoms.But the disease is often asymptomatic, which complicates its detection.For diagnostic purposes, a series of studies were performed.
The Association of Urologists has developed a questionnaire that can help identify asymptomatic chronic prostatitis.Questions are asked in a way that clarifies the patient's subjective feelings.Not every man can correctly assess his erectile function, the quality of his orgasms, and other details of his sex life.Questionnaires filled out by patients provide experts with the information needed for diagnosis.In urological practice, the NIH-CPS scale is most commonly used.
To differentiate chronic prostatitis from other diseases, a neurological examination is required.The list of diagnostic methods used includes clarifying the immune status of the patient.
laboratory research methods
If chronic prostatitis is suspected, the first thing to do is to find out its nature: bacterial or non-bacterial.In the first case, the pathogens need to be identified and find out which drugs they are sensitive to.For this purpose, laboratory tests of urine and prostate secretions are required.
If, 10 days after DRE, the PSA test shows prostate-specific antigen levels above 4.0 ng/ml, the patient needs to be referred for biopsy to rule out a neoplastic process.
The following research methods are recommended:
- scraping from urethra;
- General and biochemical urinalysis;
- LHC cultures of prostate secretions.
Instrumental Research Methods
TRUS (transrectal ultrasound) is performed using a device equipped with an instrument inserted into the patient's rectum.If irregularly shaped hypoechoic areas are detected, there is good reason to suspect malignancy.With chronic prostatitis, scarring, compaction of the glandular tissue structure, and changes in the seminal vesicles can be observed.
UDI is the primary method of functional diagnosis.It allows you to understand the nature of urination, signs of stagnant urine and its composition.The study included several tests: uroflowmetry, cystometry, measurement of residual urine volume, assessment of intravesical pressure, and urine outflow rate.
Tomography (computed or magnetic resonance imaging) is necessary to rule out benign and malignant tumors.These study methods are informative and helpful in assessing the condition of prostate tissue.
Treatment of chronic prostatitis
Treatment of chronic prostatitis requires a comprehensive approach.Simply taking medication is not enough.Physical therapy procedures and therapeutic exercises are necessary.Generally speaking, chronic prostatitis is difficult to treat and requires radical changes in lifestyle, habits, and in some cases, a job change.Urologists insist that only a set of measures can help get rid of the disease for good or ensure long-term remission.
Whether the disease is bacterial or non-bacterial in nature, prostatic congestion plays an important role in its development.The viscous secretions deposited within the glandular ducts provide a favorable environment for the growth of pathogenic and opportunistic microorganisms.Therefore, the main focus should be on eliminating stagnation.
This problem can be solved by making lifestyle changes and incorporating physical therapy sessions into your daily schedule.
Compound exercises have been developed to suit different life situations:
- For men who are forced to sit most of the time (drivers, office workers, managers);
- For people who are overweight;
- For those who don't have time to exercise.
After considering 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.
Treatment method:
- The most effective treatment for prostatitis is allotropic therapy.If the basis of prostatitis is infection, a course of antibacterial drugs is preferred to relieve the manifestations of inflammation.
- Pain syndromes can be relieved with analgesics, antispasmodics, rectal suppositories, microenemas containing warm analgesic solutions.Nonsteroidal anti-inflammatory drugs may be used.
- Combinations of immunostimulants, immunomodulators, enzymes, vitamin complexes and trace elements have proven their effectiveness.
- Physiotherapy methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
- Massage is another effective way to affect the prostate.It opens the ducts and normalizes blood circulation in the scrotum and pelvis.
- Acute renal filtrate retention can be corrected with catheterization and trocar cystostomy.
- The purulent process involves surgical intervention.
- Consultation with a psychologist.
Treatment of chronic prostatitis
Due to long-term, course-of-treatment (at least one month) effects on the prostate, 100% cure is not guaranteed.Prioritize herbal medicine, immune correction, changing family habits:
- Herbal preparations are widely used in urological practice.They are able to accumulate at the sites of the most active pathological processes, protect cells from oxidation, scavenge free radicals and prevent glandular tissue proliferation.
- Antimicrobial treatment is selected individually based on the susceptibility of the microorganism to the drug.
- Immunity-boosting medications not only help deal with prostatitis but can also correct the negative effects of antibiotics that disrupt immune system function.
- Pain syndrome can be relieved by taking alpha-blockers and muscle relaxants.
- Prostate massage can mechanically remove "excess" secretions from the gland through the urethra, improve circulation, and minimize congestion.
- Physical therapy: laser, magnet, ultrasound, iontophoresis, warm sitz bath or herbal micro-enema.
- In severe cases, intravenous fluids containing diuretics may be needed.This stimulates the production of large amounts of urine, preventing the development of symptoms of intoxication, ascending cystitis, and pyelonephritis.
- For constipation, herbal laxatives can be used.
- Urologists and psychologists work with patients to develop a personal long-term plan that includes daily living, necessary rest, diet, moderate physical activity, and sexual activity.
- If the chronic process is resistant to treatment and the outflow of urine is blocked, surgical intervention is required: removal of all affected tissue (transurethral resection of the prostate) or complete removal of the gland and its surrounding tissue (prostatectomy).Practiced under special circumstances, it can lead to impotence and urinary incontinence.Young people do not undergo surgery because it can lead to infertility.
Outpatient treatment recommendations
Patients must avoid situations that may cause injury to the pelvic organs.
It is necessary to avoid any pressure on the prostate: do not ride a bicycle, do not do strength exercises, do not bear weights.
If your job is sedentary, you need to do warm-up activities every 2-3 hours, such as squats, leg swings, running in place, etc.
You need to try to normalize your sexual life, which is extremely important to eliminate stagnation in prostate secretions.
It is recommended to limit alcohol consumption to a minimum or abstain from alcohol altogether.
drug treatment
For chronic prostatitis, treatment is mainly performed on an outpatient basis.If the pathological process persists and relief cannot be achieved with this method, hospitalization is recommended.In a hospital, under the supervision of medical staff, there is greater opportunity to comply with the system and monitor changes in the patient's condition.
Chronic prostatitis in men occurs against the background of endocrine disorders.For this, the drugs 5-alpha reductase inhibitors and alpha1-blockers are recommended.They help normalize hormonal levels and eliminate pathological symptoms.For this purpose, drugs such as finasteride and terazosin are prescribed.
A comprehensive approach includes taking medications such as:
Treatment of bacterial chronic prostatitis
Bacterial chronic prostatitis is treated with antibiotics.The most effective medication for a specific patient is determined through preliminary laboratory studies of prostate secretions.
There is no universal drug that can suppress and eliminate disease-causing microbiota.What helps one patient may not help another.Therefore, there are many negative reviews in advertisements for drugs that treat chronic prostatitis.
The drugs recommended for antimicrobial treatment are fluoroquinolones.Most bacteria are sensitive to it.
Antibiotics may also be included in the treatment plan for patients with nonbacterial prostatitis.This therapy is performed for preventive purposes.Medication including penicillin, as indicated.
After completion of antimicrobial therapy, hormonal drug therapy is initiated.
For intraprostatic reflux, alpha-blockers are required.
For pain, painkillers are effective.
herbal treatment
Many people doubt whether chronic prostatitis can be cured through herbal medicine.The answer to this question was gained through the use of these therapeutic agents in urological practice over many years.
Today we recommend the following comprehensive treatments:
All these drugs have a beneficial effect on the function of the male genitourinary system.As long as urinary function is normalized, chronic prostatitis may be effectively treated.Herbs contain ingredients that perform this task.They help reduce the frequency of urges and eliminate sluggish water syndrome.
For patients with chronic prostatitis, it is recommended to use herbal mixtures containing pumpkin extract or pumpkin seeds.The latter has a unique chemical composition that works in three directions simultaneously:
- normalizes metabolism;
- Strengthen blood vessel walls;
- Activates blood circulation in the pelvic organs.
Taking herbal medicine should not be used as the primary treatment.These health-improving agents are considered to be administered concurrently with medication.
non-pharmacological treatment
Non-drug treatments can work directly on the prostate, increasing drug concentrations in its tissue and helping relieve congestion.
For this purpose, the following techniques are used: rectal ultrasound;
Microwave heat therapy is delivered using a rectal probe inserted into the patient's anus.This 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, heating to 38-40°C is required.For antimicrobial effect – 40-45°C.
Today, non-drug treatments focus on laser therapy.The possibilities of this technology are vast.Under the influence of laser, the following processes occur in the prostate:
- Activation of redox reactions;
- Improvement of blood microcirculation;
- New capillaries form;
- Pathogenic microbiota are suppressed;
- The process of cell division is activated, thereby promoting tissue regeneration.
During a study of the effects of laser therapy in patients with prostatitis, a side effect was noted that was positive for therapeutic purposes.Those who complete the course experience increased potency, elimination of erectile dysfunction and renewed energy.To achieve this result, a beam with a specific wavelength is used.Generally, low-level laser radiation is used to treat chronic prostatitis.
If the attending doctor does not prescribe it, the patient can undergo laser treatment on his own.
Surgical treatment of chronic prostatitis
Chronic prostatitis does not pose a threat to the patient's life, but it will significantly reduce his or her quality of life.The most serious complication of this disease is the formation of stones in the glandular tissue.To remove prostate stones, transurethral resection is performed.
Surgical intervention was performed under TRUS control.
If complications such as prostatic sclerosis occur, transurethral electrosurgery may be necessary.If bladder neck sclerosis is observed in combination with this pathology, partial prostatectomy is performed.
When the seminiferous ducts and excretory ducts are blocked, endoscopic surgery is required to remove obstacles to the smooth flow of secretions.To do this, an incision is made in the seminal vesicles and excretory ducts.If an abscess develops, the gland can be completely removed.
Exercise to treat chronic prostatitis
There are many exercises that can effectively stimulate the prostate and help relieve congestion.This complex was developed for patients suffering from hip joint problems.These exercises have also proven useful for people diagnosed with prostatitis.Classes can be taken at a time that is convenient; the entire complex should take no more than 15 minutes to complete.
Exercise 1
- Lie on a gymnastics mat with your arms extended upward.
- Bend your knees and pull them toward you while spreading them out in different directions.
- Elevate your pelvis as much as possible.
- Repeat 10-12 times.
Exercise 2
- Stand on the mat and do squats.
- Repeat 10-12 times.
Exercise 3
- Lie on your stomach.
- Lift one leg, then the other.
- Repeat 10-12 times.
When performing this set of exercises, all movements should be smooth.This is the main condition for obtaining high therapeutic effect.
Treatment prognosis
Very few men are completely cured of chronic prostatitis.Prostatic inflammation often goes into long-term remission.But when pathologically activating conditions arise, relapse occurs.The worsening started with prostate pain.They are often accompanied by urinary tract disease.When the first symptoms of relapse appear, you should seek expert help.
Patients are advised to see a urologist regularly, at least every six months.They had prostate status checks and PSA tests done with the same frequency.By systematically monitoring the condition of the glands, processes causing disease recurrence can be identified in a timely manner.But even if you get long-term relief, there's no guarantee it won't be disrupted.
Patients must follow the recommendations to prevent the disease from getting worse.It is recommended to balance the diet by eliminating fatty and spicy foods.The use of herbal and traditional medicines must be approved by the attending physician.In this way, the risk of worsening chronic prostatitis can be minimized.
prevention
To prevent the occurrence of unpleasant male diseases, you need to eliminate triggering factors and follow simple rules:
- Maintain a healthy lifestyle and quit bad habits.
- Don't be too cold.
- Drink at least 1.5-2 liters of water every day.
- Strengthen your immune system, walk more, and improve your physical fitness.
- Play sports and visit a health club.
- Avoid stressful situations.
- Maintain a regular sex life with a regular partner.