Chronic prostatitis: symptoms and treatment

Inflammatory processes observed in the prostate tissue for three or more months are called chronic prostatitis.The long course of the disease makes it possible to judge the beginning of the chronic phase.Statistics show that acute and chronic prostatitis often occurs against the background of complicated urethritis.

A distinctive feature of chronic prostatitis is that in 50-70% of cases the disease is not felt by pronounced symptoms.Only in 20% of cases patients describe signs indicating a chronic form of prostatitis.The remaining men's category scores onlyindirect symptoms of the disease, which is not directly related to prostatitis.Both young men and middle-aged and elderly men are not immune from chronic prostatitis.

Those who experience a lack of physical activity, are associated with sedentary work and practice sexual abstinence, are susceptible to prostatitis.Thus, truck drivers, who spend most of their time behind the wheel, experience the effects of negative factors: hypothermia and overload on the pelvic organs.Representatives of contact sports and weightlifters are prone to microtraumas of the prostate tissue.Men who exhibit low sexual activity become hostage to this unpleasant disease due to the stagnation of prostate secretions.They affect the prostate gland, causing acute and chronic prostatitis, various sexually transmitted infections, through blood or lymph fluid.

Types and stages of chronic prostatitis

In urological practice, the following are distinguished:Forms of chronic prostatitis:

• Bacterial.The cause of the disease lies in an infection or pathogenic bacteria that have penetrated the prostate gland.The most common is chronic prostatitis caused by chlamydia.The danger of this form lies in the possible infertility that awaits a man without timely treatment.
• Abacterial.Chronic prostatitis of a non-infectious nature.Diagnosing the exact cause is quite problematic.Typically, such prostatitis develops due to the anatomical features of an individual man's prostate.The wrong structure of the organ creates increased pressure in the urethra, which leads to frequent discharge of urine.Autoimmune diseases can also cause degenerative changes in prostate tissue.
• Stagnant.Chronic congestive prostatitis develops when the prostate does not empty completely and an excess blood mass forms.Stagnation creates an inflammatory response.
• Persistent pelvic pain syndrome.A man complains of constant and unrelenting pain in the perineal area.
• Asymptomatic.Chronic prostatitis appears in a latent form, without causing pain or discomfort, despite the presence of inflammation.

Chronic prostatitis has its own stages of development

• Exudation phase.Rapid ejaculation and sharp pains in the prostate.
• Alternate phase.Painful sensations are replaced by restlessness, reduction in the time of sexual intercourse and frequent urination.
• Diffusion phase.The frequency of the desire to go to the toilet increases, but there are problems with the output of urine.
• Stage of scar changes.Sclerosis of healthy prostate tissue appears.As a result of morphological transformations, heaviness appears in the area of the sacrum and pubis, the flow of urine weakens and the power decreases.Sensations during orgasm are often vague.

Causes

• INFECTION.The source of pathogenic bacteria entering the prostate gland is the blood and lymphatic vessels.Urological diseases and inflammations in the rectum are prerequisites for infection of the prostate tissue.,Methods of infection:
  • Coming down- The infection enters the gland together with the urine, which contains microbes.
  • Growing— The path of germs entering the prostate starts from the external opening of the urethra.
• Reduction of the body's protective functions.One of the main culprits of chronic prostatitis is weakened immunity.This is facilitated by hypothermia, frequent stressful situations, poor nutrition and bad habits.When immunity decreases, the body becomes open to infections that provoke inflammation in the prostate.
• Poor circulation.A sedentary and sedentary lifestyle is closely related to chronic prostatitis.A man's internal organ systems suffer from a lack of physical activity: endocrine, cardiovascular, nervous.Blood microcirculation in the pelvis deteriorates, resulting in prostate cell hypoxia.
• Lack of regular sex life.Rejection of intimate life and excessive sexual activity lead to prostate problems.Many men with a strong sexual structure engage in vigorous sexual activity.From frequent sexual relations, their nervous system gets tired, hormonal disturbances appear and the erection gradually weakens.Incomplete sexual intercourse causes great damage to the health of the prostate.
• Chronic prostate injuries.The soft tissues of the prostate, often subject to injury due to excessive stress, vibrations and vibrations, can become inflamed periodically.
• Transurethral procedureswithout concomitant antibiotic therapy may cause prostate infection.
• Urethral catheter, with which a man is forced to live for some time, also contributes to prostate infection.

Symptoms of chronic prostatitis

Symptoms of chronic prostatitis vary.Some of the first signs of chronic prostatitis that attract attention are pain during urination and impaired sexual function.As a rule, problems in the intimate sphere force a man to seek the help of a doctor.If you have discomfort and pain in the pelvic areadoes not sit for more than three months, then with a high probability we can talk about chronic prostatitis.

Most often, the pain syndrome spreads to the perineal area, however, discomfort can be localized in the pubic and groin area.A man complains of pain in the anus, scrotum and penis.The pain radiates to the lumbosacral region.Attacks of pain can cover the inner thighs.Pain in one of the testicles usually does not indicate prostatitis.Complaints of pain after ejaculation are specific to the chronic course of the disease.

Among the common symptoms of chronic prostatitis are increased sweating, a feeling of coldness and trembling in the perineum.Poor circulation in the pelvis can lead toto changes in skin color.

Chronic inflammatory process in the prostate leads to disruption of its tone.In some cases, prostatorrhea develops.With this pathology, the spontaneous secretion of the gland occurs, which is not related to excitement or ejaculation.

With chronic prostatitis, men can notice, mainly in the morning, small purulent or clear discharge from the penis.Some patients find white flakes or threads in the urine.A sign of advanced calculous prostatitis is the presence of traces of blood in the semen.

The appearance of sexual dysfunction, simultaneously with a decrease in libido and a worsening of spontaneous erection, is observed by many patients.It is worth noting that most patients have impotenceit has no critical connotation.In the early stages of chronic prostatitis, men experience premature ejaculation, which can become difficult over time.Some patients report a decrease in the intensity of sensations during sex.Problems with urination are more often of an irritating nature.

The diagnosis of the biological material of a man with chronic prostatitis reveals a quantitative and qualitative violation of the secretion of the prostate gland.Morphological deviations in ejaculate parameters are rarely associated with male infertility.

During remission, most symptoms disappear and the pain decreases.Many men calm down, attributing the situation to self-healing.But without proper therapy, infectious foci in the prostate continue during the period of deteriorationsymptoms worsen significantly, low-grade fever persists.

Diagnosis of the disease

Diagnosing chronic prostatitis is not difficult for an experienced urologist.The most difficult thing here is most likely to determine the real cause that led to chronic prostatitis.

To confirm the diagnosisperform the following procedures:

• Rectal examination using fingers.A digital exam is performed during a man's initial visit to a urologist.The back of the prostate gland is in contact with the rectum, which makes it possible to assess the state of the prostate when a finger is inserted through the anus.Palpation of the back surface of the gland makes it possible to determine the size and shape, as well as the consistency and pain of the inflamed organ.
• Microscopic examination of prostate secretion.While studying biological material, a laboratory technician may notice an increased number of leukocytes - this signals the spread of pathogenic bacteria.
• Culture of secretory glandson nutrient, bacterial type and antibiotic resistance using RIF and PCR methods.
• Cystoscopy.An endoscopic imaging system device is inserted into the bladder cavity.This diagnostic method of chronic prostatitis allows us to exclude cancer, cystitis and bladder injuries.
• Ultrasound.The doctor can prescribe an ultrasound examination before starting treatment for acute prostatitis, so as not to miss the formation of an abscess of the organ.For men suffering from chronic prostatitis, ultrasound is performed to detect stones and cysts, as well as to assess the level of urethral pressure.Today, transrectal ultrasound is more effective, in which a sensor is inserted into the rectum.
• Uroflowmetric diagnostic method.In this way, the indicators of the urinary process are studied: the duration and speed of urine output.A rate above 10-15 ml/s indicates good urethral patency.Indicators below this norm indicate poor patency of the urinary tract caused by chronic prostatitis.

Chronic prostatitis: treatment

Each clinical case requiresindividual choice of treatment regimen.When choosing a therapeutic model, the causes of the disease, the duration of the course and the presence of aggravating factors are taken into account.

Drug treatment:

• Antibiotics.Antibacterial therapy is indicated only in cases of prostate infection with a bacterial agent that has been identified in prostatic secretions or urine.Antibiotics from the fluoroquinolone group are prescribed.Treatment lasts from two to eight weeks.After an antibacterial course, the full range of symptoms often remains, provided the infectious factor has been eliminated.
• Alpha blockersit is recommended to men to reduce the hypertonicity of the bladder muscles and to stabilize the intraurethral pressure.They are ineffective if the patient has impaired muscle innervation and has muscular dystrophy of the pelvic floor.
• Non-steroidal anti-inflammatory drugs.Help relieve pain syndromes.
• Selective antidepressants.It is recommended to men to improve their emotional background, to relieve anxiety and self-doubt.
• Hormonal drugs.Antiandrogens and androgens are used to regulate hormone levels.
• Immunostimulating drugs.Prescribed for proven immunodeficiency.
• Uric acid level regulators.The appointment is justified if there is sand and stones in the prostate gland.
• Vitamin complexes.

Auxiliary methods for the treatment of chronic prostatitis

Some urologists are of the opinion that physical impact on the prostate significantly alleviates the patient's condition.But most of these therapeutic methods have their contraindications, so theydescribed in certain conditions:

• Prostate massage.Contraindicated in prostatic hyperplasia because it can cause acute urinary retention.In addition, by doing a massage, you can spread the infection throughout the prostate and cause sepsis.Massage should not be done if there are cystic formations in the prostate or venous stagnation.To free the gland from stagnation, natural drainage during ejaculation is considered the best way.
• Bladder gymnastics.The treatment consists of a group of special exercises aimed at improving the tone of the bladder muscles and its ring muscle.
• Instillations.Infusion of medicinal solutions deep into the urethra.The procedure is very painful and often ends with complications.
• Physiotherapy.Treatment of the prostate with transrectal ultrasound, electrical stimulation, magnetotherapy and phonophoresis will be useful for weak pelvic floor muscle tone.Physiotherapy brings only temporary relief to the patient's condition.A lasting effect can be achieved only after eliminating the causes of prostatitis.
• Recipes of traditional medicine.Honey with pumpkin seeds, alcohol solution of horse chestnut and other folk methods are used after consultation with the attending physician.

Surgical treatment of chronic prostatitis

Considering what pathological process provoked prostatitis, they usetransurethral resectionprostate gland.This is a modern method of surgical treatment that replaced open surgery.An endoscope is used for the drainage of the formed prostate cyst, and in case of obstruction of secretions, surgical correction of the seminal vesicles is performed.

Treatment of chronic prostatitis -long process, which requires patience and patience from a man.To prevent the disease from taking you by surprise, you need to monitor your health, strengthen your immune system and treat colds in a timely manner.