Chronic prostatitis (bacteria) is characterized by persistent or recurrent symptoms with bacterial infections certified in the prostate gland.
Prostatitis This category is rare, about 10% of cases of all cases of prostatitis.The question - whether atypical pathogens can, such as ureaplasma urealiticum), causes prostate inflammation - discussed.They may be present in a man's body and without any signs of inflammation and complaints.
The cause of chronic prostatitis
The cause of chronic prostatitis is the same as the cause of the development of acute bacterial prostatitis.In most cases, the inclusion of microorganisms into the prostate occurs through the urethra - as a result of urine casting into the prostate gland.
Chronic bacterial prostatitis develops due to inadequate treatment or short course of acute bacterial prostatitis.
Symptom
- Discomfort or pain - in the crotch, lower abdomen, in the thighs, scrotum, penis, during ejaculation
- Changes in urination - urinary tract, rapid urination in small parts, incomplete emptying of bladder.
Patients can complain about some symptoms and any symptoms separately.Increased body temperature is unclear (or small).
Important:
Many men associate erectile dysfunction with prostatitis.This is often facilitated by unprofessional publications in media and dubious drug advertising.The fact that erection can remain even with the complete removal of the prostate (due to the presence of malignant organ tumors), indicating that it itself does not play a role in maintaining erection.
According to many credible urologists, erectile dysfunction in patients with chronic prostatitis is due to psychogenic and neurotic problems.
Diagnostics
For the main evaluation, the questionnaire was used - a chronic prostatitis symptom index.On it, you can object to the patient's complaint.
The standard method for diagnosing prostatitis is sample performance.This is a microscopic study and bacteriology of urine samples obtained from different sections of the genitourinary tract and the secretion of the prostate gland.However, the test method is a bit difficult, and at present, samples are more commonly used.The possible alternative is the delivery of ejaculation (sperm) for microscopic and bacterial examination, as partially ejaculation (at least 1/3) consists of the secretion of the prostate gland.This method is more comfortable for patients, especially if they absolutely reject the rectal examination or perform a diagnostic prostate sequence to obtain prostate secrets.However, the submission of ejaculation has lower information and reliability than damage.
The delivery of ejaculation for bacteriological examination is included in the diagnostic algorithm for the male genital organs and when examining a man about infertility.
Laboratory test results (general urine analysis, general blood tests, biochemical blood tests, spermograms and other general clinical trials) in chronic prostatitis are not information.Most likely, this test will show "norm".
During rectal examination changes that indicate inflammation in the prostate, in chronic prostatitis patients, are far from being observed.That is, it is impossible to rely on the results of the rectal study for the diagnosis of chronic prostatitis.
Similarly, uz-diagnostics: to make a diagnosis of chronic prostatitis, focusing only on ultrasound data, incorrect.The European and American Urology Association is not recommended for ultrasound for the diagnosis of prostatitis.The type of implementation in this case is not important through the anterior abdominal wall - the lower abdomen or belief - through the rectum.To write in the conclusion of the "chronic prostatitis" ultrasound study, "a sign of ultrasonic prostatitis", "signs of prostatitis" is wrong.The prerogative of this diagnosis has only a urologist who determines it based on complaints, anamnesis, laboratory tests and - only after - ultrasound.
The most common ultrasonic signs, according to the diagnosis of chronic prostatitis are established - changes spread to the prostate gland associated with the transferred inflammatory process or other changes in the prostate parenchyma.This is a type of fibrous process, replacing the normal prostate parenchyma with a scar.However, there is no correlation of the number of fibrous changes in the prostate with the presence of complaints.With age, the possibility of such a "scars" appearance in the organs is increasing, but a man can live his life, without feeling uncomfortable in the joint or genital area.However, once this change is present in the ultrasound, some "experts" will diagnose prostatitis.And some men will have a feeling that they are really bad, start listening to themselves, feeling all the symptoms described on the internet.
For most men over the age of 30, ultrasound can show a seizure change in the prostate gland.However, the fibrous process does not indicate the presence of prostatitis.
Chronic prostatitis diagnosis is established based on the exception of other diseases of the genitourinary system - especially urethritis, prostate hyperplasia, urethra tension, neurogenic disorders, prostate cancer, and bladder cancer.
There is no specific picture for chronic prostatitis based on routine examination results.
Treatment of chronic prostatitis
Phthikinolone group antibiotics are optimal antimicrobial drugs for the treatment of chronic bacterial prostatitis.The recommended antibacterial therapy course is from 4 to 6 weeks.Such long courses are allowed by scientific data that indicate a decrease in the probability of relapse of the disease.
If sexual infection (STI), such as chlamydia, is a group of antibiotic groups of macrolides.
There is data on decreases in the relaxation of the bladder neck in patients with chronic prostatitis, which leads to urine reflux into the urethra and causes inflammation of the prostate tissue and pain.Such patients are recommended by the appointment of alpha-blockers.
In the treatment of chronic prostatitis, it is advisable for patients to refrain from seducing the verses for the use of herbal medicine.The characteristic feature of plant supplements and additives is that the instability of plant components in some of the ingredients, they may be different even in the same manufacturers.In addition, from the point of view of evidence -based drugs, the benefits of herbal medicine do not withstand criticism.
Prostate massage, which in the mid -20th century used as a basis of therapy, today, thanks to new scientific approaches and classifications, remains an important tool for diagnosing prostatitis, but not its treatment.You do not need to use the prostate sequence as a therapeutic procedure (the effect is not proven).There is an assumption that frequent ejaculation in its nature is similar to a prostate therapeutic massage session.
To another method whose effectiveness has been proven as a result of only one or more studies or is still being studied: related:
- Undertaking muscle training - some data shows the effectiveness of special exercises to reduce the symptoms of chronic prostatitis and chronic pelvic pain syndrome;
- Acupuncture - a small number of studies show the advantages of acupuncture compared to the placebo in patients with chronic prostatitis;
- Extracorporeal shock wave therapy based on the effects of significant acoustic impulses of amplitude on connective tissue and bone, widely used in the treatment of musculoskeletal system diseases, which are recently used in urology, its effectiveness is being studied;
- Behavioral therapy and psychological support - since chronic prostatitis is associated with low quality of life and depression development, this method can improve the patient's psychological condition and help reduce some of the symptoms of the disease.
Separately, it should be mentionedAsymptomatic chronic prostatitis (asymptomatic).This diagnosis is most commonly established in accordance with histological conclusions - after the biopsy of the prostate gland or after the treatment of prostate surgery.The frequency of inflammation in the prostate tissue varies from 44% (with prostate biopsy) to 98-100% (after prostate surgery treatment).Scientists have suggested that the changes in inflammation revealed in this way are no more than age -related physiological features.No one is involved in the specific diagnostics of this category of prostatitis, this is a kind of random search.It does not require treatment, it does not require further action by the doctor and the patient.