Symptoms, diagnosis and treatment of chronic prostatitis

If you do not want to prevent chronic prostatitis, carefully study the causes of the development of this disease, pay attention to the signs of the chronic course and be sure to read the rules of diagnosis and treatment.Read about all this in our article.

Chronic prostatitis is characterized by a long-term inflammatory process in the prostate gland, which leads to morphological and functional disorders of the prostate.It is difficult to get rid of pathology, severe complications, so it is easier to prevent this disease if you know about the causes of its development.

Cause

The main reason for the chronic course is untreated prostatitis, which enters the next phase.The following reasons and factors can contribute to this:

1. Genitourinary tract infections with mycoplasmas, chlamydia, herpes, ureaplasmas, candida, E. coli, cytomegalovirus or trichomonas.
2. Congestion in the pelvic organs, which occurs against the background of an inactive lifestyle, impaired blood supply, poor nutrition, and bad habits.
3. Frequent hypothermia (the risk group includes people involved in surfing, diving, skiing, etc.).
4. Prolonged abstinence from sexual intercourse, disturbed action.
5. Obesity due to rich fatty foods.
6. Disorders in the endocrine system.
7. Inflammatory processes throughout the body, especially chronic ones.
8. Weak immune system.
9. Injury to the genital organs.
10. Persistent constipation.
11. Depression, stress, hard work.

Special attention should be paid to bad habits - drinking alcohol, drugs, smoking.Harmful substances released by the product lead to vasospasm, reducing the level of blood circulation.As a result, the nutrition of all organs deteriorates.

Symptoms

With chronic prostatitis, the prostate gland enlarges, which compresses the elements of the genitourinary system and narrows the urethra.As the disease progresses, the gland completely encloses the urethra, compressing the canal.This is why problems with urine output arise.

How to recognize chronic prostatitis:

• Pain periodically occurs in the pelvis and perineum;
• discomfort during urination and bowel movements;
• Discharge from the urethra is observed;
• Pain spreads to thighs, testicles, anus;
• Problems with urination occur;
• severe burning and itching in the urethra;
• Frequent urges;
• decreased libido and erection;
• rapid ejaculation with the presence of pain;
• If an infection occurs, the body temperature rises and the condition worsens;
• After a year, infertility appears;
• the occurrence of pain after normal physical activity;
• acute urinary retention and false urge;
• slow flow of urine.

In the early stages, symptoms seem slow, but as they progress, they intensify.The pain syndrome becomes very strong, radiating to nearby organs and areas.Particular attention should be paid to the process and frequency of urination.Against the background of such changes, a man experiences psycho-emotional problems, which manifest themselves in the following:

• severe anxiety;
• depression or, on the contrary, aggressiveness;
• insomnia at night;
• obsession;
• fear of sexual intercourse and urination;
• Hot and furious.

Classification

The current requirements for the classification of chronic prostatitis were developed in the 95th year of the last century.Based on this, the disease is divided into:

1. Chronic bacterial prostatitis.Occurs against the background of untreated acute bacterial disease.It presents itself with the usual symptoms, but with increased body temperature, chills, and fever.When examined, an increased number of leukocytes and pathogenic microorganisms are detected in secretions and urine.
2. Chronic prostatitis is the most common.
3. Asymptomatic inflammatory prostatitis is characterized by the absence of specific symptoms.Often found by chance.

Based on statistics, the most common form is non-bacterial prostatitis.Much less common (in a maximum of 10 cases out of 100) is the bacterial form.This is due to the fact that when infected, the symptoms are always pronounced, so the patient, as a rule, undergoes timely examination and treatment.

Possible complications and consequences

With chronic prostatitis, exacerbation and remission alternate, and the inflammatory process quickly destroys the prostate gland, so the following complications arise, which are considered the most dangerous to human life:

1. Adenoma.It is formed in the prostate gland.The inflammatory process that occurs over a long period of time leads to intense cell division.At the same time, the epithelium of the gland in the duct hyperplasias, increasing the organ in size.Against this background, benign hyperplasia develops.
2. Cancerous growth in the prostate.More common after prostate adenoma.In the early stages of the onset of oncological tumors, recognizing cancer is problematic.This is due to the fact that men with chronic prostatitis experience similar symptoms.For this reason, patients must undergo appropriate urological tests to detect prostate-specific antigens in the blood.
3. Significant decrease in erection and further impotence.This is the most unpleasant consequence.The disease develops in a certain sequence.At first, the erection becomes a little weak, after that it does not appear regularly and ejaculation occurs quickly.Further, sexual desire decreases and the patient experiences pain during ejaculation.Then comes impotence.
4. Infertility.It occurs within a year after the course of chronic prostatitis.The fact is that the chronic inflammatory process leads to a decrease in the number of sperm, slower sperm motility, and the destruction of their tails and heads.Infertility can be determined using a spermogram.
5. Vesiculitis.Inflammation occurs in the seminal vesicles, which contain sperm.
6. Swelling of the sphincter in the bladder, against the background of acute urinary retention occurs, causing death.
7. Prostatic sclerosis.This disease is characterized by the replacement of the prostate gland with connective tissue.That is, a cord of connective tissue is formed, which involves sexual dysfunction.

Other consequences:

• cyst formation;
• Stones in the prostate;
• hemorrhoids;
• Cystitis;
• psychological instability that needs to be treated.

If a man is diagnosed with chronic bacterial prostatitis, he should have sexual intercourse only with a condom, because the disease leads to infection of his partner.Bacteria penetrate the fallopian tubes, genital tract and organs, leading to disease and female infertility.

Which doctor treated you?

A urologist treats the male genitourinary system.But if you visit the clinic for the first time with the same problem, then you need to visit a therapist.

As diagnostic measures are carried out, consultation with other highly specialized doctors is also required - infectious disease specialists, psychologists, depending on the cause of the disease.

Diagnostics

At the initial visit to the Andrologist, the doctor initially collects an anamnesis, which includes the following:

• study the history of urological, infectious, chronic and other diseases;
• interviewing patients about lifestyle and bad habits;
• identification of factors contributing to pathology;
• question the patient about the nature, type and duration of symptoms.

After this, the doctor visually and easily examines the man and refers him for further examination.

Laboratory methods

What is being done:

1. Collection of fluid secreted from the urethral canal.Pathogenic microflora, mucus, and leukocytes are determined.
2. PCR - scraping from the urethra.Pathological agents are identified.
3. Microscopic examination of prostate secretions.Macrophages, amyloid bodies and trousseau-lallement, and leukocytes were counted.
4. Immunological examination to assess the level of non-specific antibodies.
5. Take a blood sample to determine the PSA level.If a high level is detected, then a prostate biopsy is also prescribed, which will rule out or confirm a cancerous tumor.

Instrumental method

Instrumental diagnostics are as follows:

1. Ultrasound examination of the prostate gland.Usually the transrectal method is performed (the sensor is inserted into the rectum).The extent of the disease and its form are explained by studying the size and echostructure of the prostate, the density and uniformity of the seminal vesicles.
2. Pelvic floor muscle myography and urodynamic studies.Neurogenic disorders and bladder outlet obstruction are determined.
3. Magnetic resonance and computed tomography.Pathological disorders in the pelvic organs, as well as cancerous tumors, are detected.After this, the differential diagnosis is established.

Differential diagnosis

Establishing a differential diagnosis is necessary, as it allows timely identification of diseases such as:

• prostate cancer;
• dysfunction in the bladder of neurogenic etiology;
• disorders of the detrusor-sphincter system;
• Pseudodyssynegria;
• tightness in the bladder;
• bladder neck hypertrophy;
• Cystitis;
• adenomas;
• prostate sclerosis and so on.

Treatment of chronic prostatitis

Therapy for chronic prostatitis is carried out comprehensively - drugs are used, massage, physiotherapy procedures, and exercises are performed.In particular is the correction of the patient's own life - complete abandonment of bad habits, proper nutrition, normalization of sexual relations.In some cases, the help of a psychotherapist and psychologist is required.One treatment method cannot be used without the other, as each method complements the other.

Indications for hospitalization

Treatment of chronic prostatitis is carried out on an outpatient basis, but some patients are subject to hospitalization - when serious complications are detected, advanced forms of the disease and the absence of positive results during therapy.

Antibiotics

Antibacterial drugs are used for chronic bacterial prostatitis.The choice of drug depends on the type of pathogen.The duration of therapy is from 2 to 8 weeks.Antibiotics aim to destroy pathogenic microorganisms and reduce the inflammatory process.

Different groups are used:

1. Aminopenicillin group.
2. Cephalosporin drugs.
3. Macrolides.
4. Fluoroquinolone group.

Alpha Blocker

This is a group that inhibits adrenergic receptors in the tissues of the pelvic organs, thereby stopping spasms in the bladder, increasing the flow of urine, and facilitating the urination process.In addition, the function of the muscle system and sphincter is normalized.

Nonsteroidal anti-inflammatory drugs

Chronic prostatitis is characterized by an inflammatory process in the prostate gland, so non-steroidal anti-inflammatory drugs are necessarily prescribed.They aim to relieve pain and eliminate inflammation.In addition, non-steroids normalize the permeability of the walls of the circulatory system, restoring blood circulation, against the background of which existing inflammatory mediators are not absorbed.

This product is used in the form of gel, tablet, injection.

Hormone therapy

If non-steroidal (non-hormonal) drugs do not have a positive effect, or the patient has a hormonal imbalance, then hormonal drugs are prescribed.They eliminate inflammation, help stimulate erectile function and tissue regeneration.

Restoration of blood circulation

Since prostatitis worsens the process of microcirculation in the genitourinary system, the doctor prescribes appropriate drugs.When blood circulation returns to normal, the regeneration process is launched and local metabolism accelerates.Therefore, patients quickly get rid of unpleasant symptoms.In addition, many products strengthen the walls of blood vessels and reduce blood viscosity.

Other medicines

Also, for chronic prostatitis, other drug groups are used:

1. Muscle relaxants are intended to relax muscles, relieve pain, accelerate blood circulation and reduce tone in the smooth muscles of the genital organs.
2. Immunomodulators are the correct immune changes, but are prescribed mainly when the patient has immunodeficiency.
3. If stones are found in the prostate, the patient needs to take drugs that control uric acid.
4. To destroy the adhesions formed and accelerate the process of action of anti-inflammatory drugs and non-steroidal antibiotics, enzyme drugs are prescribed.
5. Vitamin and mineral therapy is shown to strengthen the immune system.This medicine is selected based on the deficiency of certain vitamins or minerals.
6. To restore the metabolism in the prostate tissue and regenerate it, bioregulatory peptides are used, which are made from the prostate gland removed from cows.
7. If the disease is accompanied by anxiety, depression, aggression and other mental disorders, sedative drugs or selective antidepressants are prescribed: Tincture of Valerian, Motherwort.

Surgery

Surgical intervention for chronic prostatitis is rarely used, only in cases where the operation is justified and does not carry the risk of complications.In addition, after surgery there is a relatively long recovery period.

In what cases is surgery prescribed:

• if there is no positive result after complex conservative treatment;
• prostate abscess;
• tissue suppuration;
• Inability to urinate:
• benign prostatic hyperplasia;
• cancerous tumors;
• other complications.

Prostatectomy

This operation involves removing the prostate gland and, in some cases, lymph nodes.Radical prostatectomy according to the surgical method can be of the following types:

• Robot Type - Several small incisions are made in the lower part of the abdomen, after which the prostate is removed (the action is controlled by a special robotic device);
• Open Type - An incision is made in the lower abdomen;
• Laparoscopic - A small incision is made into which a microscopic camera and instruments are inserted.

Peculiarities:

1. Any type of operation is performed under general or local anesthesia (spinal anesthesia).
2. The duration of the procedure is from 2 to 3 hours.
3. The recovery period is a month and a half.
4. The patient's stay in the hospital is a maximum of three days.
5. The beginning of sexual life in one and a half to two months.
6. In many cases, a urinary catheter is placed for a week.
7. Complications are rare, but they can be treated.

Transurethral resection of the prostate

Surgery involves cutting the tissue that surrounds the prostate, making it easier to urinate.To do this, a resectoscope is used, which is inserted into the urethra.This operation is indicated in the absence of urination, and also for the prevention of such complications - hematuria, inflammatory processes in the kidneys and bladder, stones, urinary incontinence.

Peculiarities:

• Duration of intervention - from one hour to one and a half hours;
• stay in the clinic - 2 days;
• wearing a catheter-5-7 days;
• recovery period - a month and a half;
• The start of sexual activity is after 6 weeks.

Abscess drainage

This operation is used for prostate abscess, which occurs as a complication.With this disease, a large amount of purulent exudate accumulates in the prostate gland, which must be removed from the body.During the operation, a puncture needle is inserted into the gland under the control of ultrasound equipment.This method resembles a puncture.

Before the injection procedure, the urological surgeon feels the prostate with his index finger by inserting it into the rectal opening.After suctioning the pus, antiseptic treatment and drainage with a rubber tube are performed.If the patient has an extensive abscess, then pumping purulent fluid is done through the perineal approach, that is, through the rectum.

Peculiarities:

• The duration of the procedure is one and a half hours;
• The maximum time spent in the drainage cavity is 72 hours;
• Recovery period - one month.

Laser surgery

Laser treatment is an innovative and most common technique, because the operation is considered low trauma, safe and with minimal recovery time.During the operation, a laser instrument is installed in the urethral canal, the beam of which removes excess tissue.In this case, no incision is made.

Removal is done in 2 ways - ablative (excess tissue is burned) and enucleation (tissue is cut).Based on the type of removal, laser surgery is divided into the following types:

1. Photoselective Vaporization - Laser vaporizes tissue.
2. Holmium Laser Ablation - This procedure is similar to the previous one, but a holmium laser is used.
3. Holmium Laser Enucleation - Prostate tissue is crushed with a morcellator and then removed.

Peculiarities:

• minimal number of contraindications;
• absence of adverse reactions (bleeding, etc.);
• You can go home immediately after the operation;
• The duration of wearing a urinary catheter is 24 hours;
• Recovery period - maximum 7 days;
• The only negative is that it cannot be used for cancer.

What are the possible consequences after surgery of any kind:

• bleeding;
• temporary problems with urination;
• infection;
• urinary incontinence;
• reverse ejaculation (when sperm enters the bladder);
• tissue swelling;
• erectile dysfunction;
• inguinal hernia;
• Reduction in the length of the penis (only when part of the urethral canal is removed).

To avoid complications, you must follow all the recommendations of the surgeon during the recovery period.You can't bury yourself.

Physiotherapy

Thanks to physiotherapy procedures, the level of inflammation is reduced, pain is relieved, tissue swelling is eliminated, and the effectiveness of drugs is increased.What is used:

• Phonophoresis;
• electrophoresis;
• laser therapy;
• Transrectal microwave hyperthermia.

Massage

Massage is one of the mandatory procedures in the treatment of chronic prostatitis.It is advisable to perform it from a specialist, but if this is not possible, then it can be done at home (but someone else should do the massage movements, because the patient is in a relaxed state).

Contraindications for massage:

• hyperplastic changes in the prostate;
• the presence of stones in the organs;
• venous stagnation;
• Formation of cysts and other tumors.

Procedure progress:

1. The man should expose his lower body and take a lying position - on his side, with his knees pulled to the stomach area.
2. There is another kneeling pose.
3. The person performing the massage must wash their hands thoroughly, wear medical gloves and lubricate the index finger with vaseline or other emollient.
4. The masseur inserts a finger into the anus (the man is relaxed).
5. Massage the prostate gland by stroking gently.
6. The duration of the procedure is 2-5 minutes.

If a man lives alone and cannot visit a massage therapist, special urological shrimp can be used.The treating urologist will help you choose the optimal model for you.

Diet therapy

Patients with prostatitis must adhere to a special diet to prevent the formation of cholesterol plaques, constipation and increased gas formation.Dishes must be steamed or boiled.It is allowed to burn, but without using oil.

Allowed Products:

• seafood;
• pumpkin seeds;
• fruits and vegetables that do not cause gas;
• porridge;
• fermented milk products;
• dried fruits;
• Lean Meat and Fish.

Prohibited products:

• Any nut;
• cabbage;
• carbonated drinks;
• alcohol;
• spicy and salty dishes;
• strong tea and coffee;
• Yeast baked goods.

People's recovery

Traditional medicinal recipes are used exclusively in agreement with the Andrologist, as many of them may have contraindications.

Recipe:

1. Eat about 30-40 pumpkin seeds per day, preferably on an empty stomach.
2. You can drink pear compote, but only without adding sugar.
3. Take a medicated bath three times a week.To do this, make a decoction of herbs in equal proportions: chamomile, sage, pine needles, calendula.Brew according to the standard scheme (for a glass of water - 2 tablespoons of the mixture).Pour into the bath, add sea salt in the free portion and sitz bath for 15 minutes.The water temperature is not higher than 40 degrees.
4. Use parsley - add to salads, juice and drinks.The seed parts can also be used.
5. Make your own rectal suppositories.To do this, combine propolis in equal proportions with butter and cocoa powder.Use your hands to form a candle shape, wrap each suppository in cling film and place in the refrigerator.Every evening before going to bed, administer 1 suppository for 30 days.

Forecast

If we talk about the prognosis, it directly depends on many conditions - the degree of neglect, the form of the disease, the adequacy of therapy, the patient's own behavior.If you see the development of the chronic form and carry out timely and correct treatment, then the prognosis is quite good.

However, you need to know that a complete cure for this disease occurs in very rare cases, but it is possible to achieve a stable remission, where symptoms do not appear.

Throughout his life, the patient needs to comply with preventive measures, periodically undergo examinations and take medicines.

Preventive measures

To prevent the development of chronic prostatitis and its severity during remission, follow simple rules:

• Contact a urologist on time;
• lead a healthy and active lifestyle (get rid of bad habits, engage in moderate sports);
• eat right;
• Having sex should be regular - at least 3 times a week;
• monitor the state of the immune system;
• Do not overcool;
• does not include casual sex;
• Train the muscles of the genitourinary system - do special exercises.

If you have chronic prostatitis, do not worry, because this is not a death sentence.With the right therapeutic approach and regular visits to the Andrologist, you can lead an active sex life without experiencing unpleasant symptoms.