Chronic prostatitis: symptoms and treatment

Inflammatory processes observed in the prostate tissue for three or more months are called chronic prostatitis.The prolonged course of the disease suggests the beginning of the chronic stage.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 with pronounced symptoms.In only 20% of cases, patients describe signs that indicate a chronic form of prostatitis.The rest of the men's category scores onlyindirect symptoms of the disease, which are not directly related to prostatitis.Both young people and men of middle and older age are not immune from chronic prostatitis.

Those who experience a lack of physical activity, are associated with sedentary work and practice sexual abstinence are prone to prostatitis.Thus, truck drivers who spend most of their time behind the wheel experience the impact of negative factors: hypothermia and congestion in the pelvic organs.Representatives of contact sports and weightlifters are prone to microtraumas of the prostate tissue.Men who show low sexual activity become hostages of this unpleasant disease due to stagnation of prostate secretion.They affect the prostate gland, causing acute and chronic prostatitis, various sexually transmitted, blood or lymphatic infections.

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 person without timely treatment.
• Abacterial.Chronic prostatitis of a non-infectious nature.Diagnosing the exact cause is quite problematic.Usually, such prostatitis develops due to the anatomical features of the prostate of an individual man.The incorrect structure of the organ creates increased pressure on the urethra, which leads to frequent leakage of urine.Autoimmune diseases can also cause degenerative changes in prostate tissue.
• At a standstill.Congestive chronic 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 persistent, unrelenting pain in the perineal area.
• Asymptomatic.Chronic prostatitis occurs in a latent form, without causing pain or discomfort, despite the presence of inflammation.

Chronic prostatitis has its own stages of development

• Stage of exudation.Rapid ejaculation and sharp pain in the prostate.
• Alternate scene.Painful sensations are replaced by discomfort, a decrease in the time of intercourse and frequent urination.
• Distribution stage.The frequency of the desire to go to the toilet increases, but problems with the release of urine appear.
• Stage of changes in the scar.Sclerosis of healthy prostate tissue occurs.As a result of morphological transformations, heaviness appears in the area of the sacrum and pubis, the stream of urine weakens and the potency decreases.Sensations during orgasm are often blurred.

reasons

• Infection.The source of penetration of pathogenic bacteria into the prostate gland is the blood and lymphatic vessels.Urological diseases and inflammations in the rectum are a prerequisite for infection of the prostate tissue.Methods of infection:
  • Descent- the infection enters the gland together with the urine, which contains microbes.
  • Rise— The path of microbes entering the prostate starts from the external opening of the urethra.
• Reduced protective functions of the body.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 of the prostate.
• Poor circulation.A sedentary and sedentary lifestyle is closely related to chronic prostatitis.A lack of physical activity affects the internal organs of a person: endocrine, cardiovascular, nervous.Blood microcirculation in the small pelvis deteriorates, which leads to hypoxia of prostate cells.
• Lack of regular sex life.Both the refusal of an intimate life and excessive sexual activity lead to problems with the prostate.Many men with a strong sexual constitution engage in vigorous sexual activity.From frequent sexual contacts, their nervous system is exhausted, hormonal disturbances appear and the erection gradually weakens.Incomplete intercourse causes great harm to the health of the prostate.
• Chronic prostate damage.The soft tissues of the prostate, often subject to injury due to excessive stress, shaking and vibration, can periodically become inflamed.
• Transurethral procedureswithout concomitant antibiotic therapy may cause infection of the prostate.
• Urethral catheter, with which a person is forced to live for some time, also contributes to prostate infection.

Symptoms of chronic prostatitis

The symptoms of chronic prostatitis are different.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 discomfort and pain in the pelvic areado not subside for more than three months, then with high probability we can talk about chronic prostatitis.

Most often, the pain syndrome spreads to the perineal area, but the discomfort can be localized in the pubis and groin area.A man complains of pain in the anus, scrotum and glans 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 frequent 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.

The chronicity of the inflammatory process in the prostate leads to a violation of its tone.In some cases, prostatorrhea develops.In this pathology, there is a spontaneous secretion of the gland, which is not related to arousal or ejaculation.

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

The appearance of sexual dysfunction, simultaneously with a decrease in libido and worsening of spontaneous erections, is noted by many patients.It is worth noting that the majority of patients have impotenceno critical connotation.In the early stages of chronic prostatitis, men experience premature ejaculation, which can become difficult over time.Some patients report a reduction in the intensity of sensations during sex.Problems with urination are most often of an irritative 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-medication.But without appropriate therapy, infectious foci in the prostate continue during the period of exacerbationsymptoms worsen significantly, the subfebrile temperature continues.

Diagnosis of the disease

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

To confirm the diagnosisperform the following procedures:

• Rectal examination with fingers.A digital examination is performed during a man's first 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 the finger is inserted through the anus.Palpation of the back surface of the gland allows to determine the size and shape, as well as the consistency and soreness of the inflamed organ.
• Microscopic examination of prostatic secretion.When examining biological material, the laboratory technician may notice an increased number of leukocytes - this is a signal of the spread of pathogenic bacteria.
• Culture of glandular secretionon the culture medium, bacterial species and antibiotic resistance using the RIF and PCR methods.
• Cystoscopy.An endoscopic imaging device is inserted into the bladder cavity.This diagnostic method of chronic prostatitis allows us to rule out cancer, cystitis and bladder injuries.
• Ultrasound.The doctor can prescribe an ultrasound examination before starting treatment for acute prostatitis, in order not to miss the formation of an abscess on the organ.In men suffering from chronic prostatitis, an ultrasound is done to detect stones and cysts, as well as to assess the level of urethral pressure.Today, transrectal ultrasound, in which the sensor is inserted into the rectum, is more effective.
• Uroflowmetric diagnostic method.In this way, the indicators of the urinary process are studied: the duration and speed of urine flow.A velocity above 10–15 ml/s indicates good urethral patency.Indicators below this norm indicate poor patency of the urinary canal 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.

Treatment with drugs:

• 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 extent of symptoms often remains, provided the infectious factor is eliminated.
• Alpha blockersprescribed to men to reduce hypertonicity of the bladder muscles and stabilize intraurethral pressure.They are ineffective if the patient has impaired muscle innervation and muscular dystrophy of the pelvic floor.
• Nonsteroidal anti-inflammatory drugs.Help relieve pain syndromes.
• Selective antidepressants.It is prescribed to men to improve the emotional background, relieve anxiety and self-doubt.
• Hormonal drugs.Antiandrogens and androgens are used to regulate hormone levels.
• Immunostimulating drugs.Prescribed for proven immune deficiency.
• Uric acid level regulators.The appointment is justified in the presence of 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 theyprescribed under certain conditions:

• Prostate massage.Contraindicated in prostatic hyperplasia, as it may cause acute urinary retention.In addition, by giving a massage, you can spread the infection throughout the prostate and cause sepsis.Massage should not be performed if there are cystic formations in the prostate or venous stasis.To release 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 muscle tone of the bladder and its sphincter.
• Instillations.Infusion of medicinal solutions deep into the urethra.The procedure is very painful and often ends in complications.
• Physiotherapy.Treatment of the prostate with transrectal ultrasound, electrical stimulation, magnetotherapy and phonophoresis will be beneficial for poor pelvic floor muscle tone.Physiotherapy brings only temporary relief to the patient's condition.A lasting effect can be achieved only after removing the causes of prostatitis.
• Recipes from traditional medicine.Honey with pumpkin seeds, alcohol tincture 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 resectionthe prostate gland.It is a modern surgical method of treatment that has replaced open surgery.The formed prostate cyst is drained with an endoscope, and in case of difficulty in draining the secretion, surgical correction of the seminal vesicles is performed.

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