Chronic prostatitis - symptoms and treatment

Chronic prostatitis is a long-term inflammation of the prostate gland, often without symptoms, so most men are not aware of this disease.

The development of a chronic form of prostatitis is a consequence of an acute process, although in fact this is quite rare.As a rule, chronic prostatitis begins gradually, without any symptoms or unpleasant sensations;The progression of the disease is often discovered by patients accidentally during ultrasound.

Both young men, middle-aged people, and the elderly are susceptible to chronic diseases.Prostatitis also threatens those who, due to the nature of their work, lead a sedentary lifestyle, feel excessive physical tension in the perineal area and abstain from sexual intercourse.

Classify

According to the modern classification of prostatitis, developed in 1995, there are several types of the disease:

1. Acute bacterial prostatitis (ABP) is the most common type of prostatitis.It is usually caused by a bacterial infection and is easily diagnosed thanks to typical symptoms.Acute bacterial prostatitis can occur at any age.Symptoms include painful urination, inability to completely empty the bladder, and pain in the lower abdomen, back, or pelvic area.Fever may be accompanied by chills.
2. Chronic bacterial prostatitis is a disease with typical symptoms of chronic inflammation and the number of bacteria and white blood cells in urine and prostate secretions increases after massage.
3. Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, it is a consequence of acute bacterial prostatitis (untreated or poorly treated).If there are symptoms, they occur in the form of pain in the genitals or pelvic area, difficulty urinating, or pain during urination and ejaculation.

4. Asymptomatic inflammatory prostatitis - in this form of the disease, typical symptoms of prostatitis are absent, and the disease itself is discovered by chance when visiting the clinic for another reason.

In the presence of an infectious component, they talk about chronic bacterial prostatitis (infection);in the absence of bacterial pathogens - about non-bacterial (non-infectious) prostatitis.It is believed that in 90-95% of all cases, chronic non-bacterial prostatitis occurs, and only in 10-5% - bacterial.

Reason

Several factors may contribute to the occurrence of chronic prostatitis.First of all, this:

1. STIs: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida, Escherichia coli can infect the urethra and are detected in prostate tissue;
2. Poor circulation in the pelvic organs (blockage in the prostate leads to inflammation);
3. Sedentary lifestyle (drivers, office workers, officials);
4. Abstain from prolonged sexual intercourse, interrupted sexual intercourse or artificially prolonged sexual intercourse;
5. frequent hypothermia (lovers of extreme recreational activities: diving, surfing and skiing);
6. Stress: mental and physical overload.

For the development of chronic prostatitis, what is important is not the presence and activity of pathogenic microorganisms, but the state of the pelvic organs and blood circulation in them, the presence of concomitant diseases and the level of protective mechanisms.

Symptoms of chronic prostatitis

Usually, with the development of a chronic form of prostatitis, symptoms practically do not bother the man.In this case, all signs of acute prostatitis will not manifest at all or will manifest themselves to a much lower degree.

The most common symptoms of chronic prostatitis in men are:

• periodic pain and discomfort in the perineum;
• discomfort during bowel movements and urination;
• Irradiation to the anus, thighs, testicles;
• discharge from the urethra.

Changes in the course of the disease, which are inherently insignificant, may be so insignificant that patients with chronic prostatitis do not pay special attention to them.

Exacerbation of chronic prostatitis

Exacerbation of the disease is often accompanied by the following symptoms:

• pain and burning in the urethra;
• increased urge to urinate;
• pain in the lower abdomen, perineum and rectum;
• signs of decreased sexual activity in men;
• pain when defecating.

According to some doctors, psychological symptoms of chronic prostatitis can also be identified, including increased irritability, anxiety, fatigue, short temper, sleep disorders, phobias and depression.

It is almost impossible to identify all the symptoms in the patient at once, since a man usually exhibits only 2-3 signs of the disease.For example, the most common are erectile dysfunction and lower abdominal pain.

Why can prostatitis cause infertility?

The fact is that the prostate gland secretes a special secretion that ensures the viability of sperm.When inflamed, the prostate's secretory function declines, which certainly affects sperm quality.

In addition, the prostate also actively participates in regulating testosterone production and the erection process.This is the reason why chronic prostatitis causes impaired erectile function, even impotence.However, these scenarios of development of the disease can be avoided if timely and effective treatment is carried out.

Diagnose

The following procedures are necessary to help establish/refute the diagnosis:

• rectal examination;
• Prostate secretion microscopy;
• culture of prostatic secretions to determine antibiotic sensitivity;
• testing for sexually transmitted diseases;
• Cross-sectional ultrasound.

Sometimes additional endoscopic and urological studies are performed.

How to treat chronic prostatitis

If a man is diagnosed with chronic prostatitis, treatment is always long and difficult.Its duration directly depends on the stage of the disease at which the patient consulted a specialist.Therapy includes an integrated approach, that is, combining several methods simultaneously:

• antibacterial therapy;
• prostate massage;
• physiotherapy procedures;
• Adjust your diet and lifestyle;
• use folk remedies;
• surgical treatment.

In addition, anti-inflammatory and antispasmodic agents are used in the treatment of chronic forms of the disease.

Treatment with medication

The choice of medication depends on the cause and symptoms of the disease.To treat chronic prostatitis of infectious causes, antibacterial drugs are used:

• fluoroquinolone;

• macrolides;
• tetracycline.

To eliminate inflammation and pain, pain relievers and non-hormonal anti-inflammatory drugs are used.

In addition, in recent years, the treatment of chronic prostatitis has been carried out using drugs that were not previously used for this purpose: alpha1 blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect urate and citrate metabolism.

Physical therapy

Some physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, vaginal ultrasound and others, also help improve the nutrition of prostate tissue and accelerate the healing process.

In addition, for chronic prostatitis, warm therapeutic baths, mud therapy and special douching methods may be prescribed.

Prostate massage

Improves drainage of prostatic secretions and microcirculation at the level of this organ, thereby contributing to the patient's rapid recovery.

It is impossible to massage the prostate in case of acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is often combined with antibiotic therapy.Many clinical studies have shown the high effectiveness of this treatment method.

work

Surgery can remove areas of the prostate affected by bacteria.Transurethral resection is a surgery performed under epidural anesthesia or intravenous barbiturates.The recovery period after surgery lasts no more than a week.

The necessary methods for treating chronic prostatitis are determined by the urologist based on his diagnostic information and practical experience.Self-treatment at home based on Internet reviews will have many consequences.