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Characteristics of symptoms, diagnosis and treatment of chronic prostatitis

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

Chronic prostatitis is characterized by long-term inflammatory processes in the prostate, which lead to morphological and functional disorders of the prostate.It is difficult to get rid of the pathology, the complications are serious, so it is easier to prevent the disease if you know the causes of its development.

Causes

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

  1. Infection of the genitourinary tract with mycoplasma, chlamydia, herpes, ureaplasmas, candida, E. coli, cytomegalovirus or trichomonas.
  2. Congestion of the pelvic organs, which occurs against the background of a sedentary lifestyle, impaired blood supply, poor diet and bad habits.
  3. Frequent hypothermia (the risk group includes people engaged in surfing, diving, skiing, etc.).
  4. Prolonged abstinence from sexual intercourse, interrupted acts.
  5. Obesity due to high-fat foods.
  6. Disturbances of the endocrine system.
  7. Inflammatory processes throughout the body, especially chronic.
  8. Weak immune system.
  9. Injury to the genital organ.
  10. Constant constipation.
  11. Depression, stress, overwork.

Particular attention should be paid to bad habits - consumption of alcohol, drugs, smoking.Harmful substances released from these products lead to vasospasm, thereby 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, severely compressing the canal.This is why problems with urine production occur.

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;
  • the pain spreads to the thighs, testicles, anus;
  • urination problems occur;
  • severe burning and itching in the urethra;
  • frequent craving;
  • decreased libido and erection;
  • rapid ejaculation with presence of pain;
  • if an infection occurs, the body temperature rises and the condition worsens;
  • after a year, infertility appears;
  • the appearance of pain after normal physical activity;
  • acute urinary retention and false urges;
  • slow stream of urine.

At first, symptoms appear slowly, but as they progress, they intensify.The pain syndrome becomes very powerful and radiates 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 ways:

  • severe anxiety;
  • depression or, conversely, aggression;
  • insomnia at night;
  • obsessions;
  • fear of sexual intercourse and urination;
  • hot temper and irritability.
depressed man with chronic prostatitis

Classification

Current requirements for the classification of chronic prostatitis were developed in the 95th year of the last century.On this basis, the disease is divided into:

  1. Chronic bacterial prostatitis.Occurs against the background of an untreated acute bacterial disease.It manifests itself with typical symptoms, but with an increase in body temperature, chills and fever.During examination, an increased number of leukocytes and pathogenic microorganisms are detected in secretions and urine.
  2. Chronic prostatitis occurs most often.
  3. Asymptomatic inflammatory prostatitis is characterized by the absence of specific signs.Most often discovered by chance.

According to statistics, the most common form is non-bacterial prostatitis.The bacterial form is much less common (in a maximum of 10 cases out of 100).This is due to the fact that in case of infection the symptoms are always pronounced, so the patient is usually examined and treated in a timely manner.

Complications and possible consequences

With chronic prostatitis, an alternation of exacerbation and remission occurs, and inflammatory processes quickly destroy the prostate, so the following complications arise, which are considered the most dangerous for human life:

  1. Adenoma.It forms in the prostate.Inflammatory processes that occur over a long period of time lead to intense cell division.At the same time, the glandular epithelium of the ducts hyperplasia, thereby increasing the size of the organ.Against this background, benign hyperplasia develops.
  2. Prostate cancerous growth.Occurs more often after prostate adenoma.At an early stage of the appearance of an oncological tumor, recognition of cancer is problematic.This is because men with chronic prostatitis experience the same symptoms.For this reason, the patient must undergo appropriate urological tests to detect prostate specific antigen in the blood.
  3. Significant reduction in erection and worsening of impotence.This is the most common unpleasant consequence.The disease develops in a certain order.At first, the erection weakens slightly, after which it no longer appears regularly and ejaculation occurs very quickly.In addition, sexual desire decreases and the patient experiences pain during ejaculation.Then comes helplessness.
  4. Infertility.This occurs within a year following the chronic course of prostatitis.The fact is that chronic inflammatory processes lead to a decrease in the amount of sperm, a slowdown in their motility and the destruction of their tail and head.Infertility can be determined using a spermogram.
  5. Vesiculitis.The inflammation occurs in the seminal vesicles, which contain the sperm.
  6. Swelling of the sphincter in the bladder, against the background of which acute urinary retention occurs, leading to death.
  7. Prostatic sclerosis.The disease manifests itself by the replacement of the prostate by connective tissue.That is, cords of connective tissue form, leading to sexual dysfunction.

Other consequences:

  • cyst formation;
  • stones in the prostate;
  • hemorrhoids;
  • cystitis;
  • psychological instability that needs to be treated.
consultation with a doctor for chronic prostatitis

If a man is diagnosed with chronic bacterial prostatitis, he will have to have sex only with a condom, since the disease leads to infection of his partner.Bacteria enter the fallopian tubes, genital tracts and organs, leading to disease and female infertility.

Which doctor treats you?

A urologist treats a man's genitourinary system.But if you are visiting the clinic for the first time with a similar problem, you should first consult a therapist.

As diagnostic measures are carried out, consultation will also be necessary with other highly specialized doctors - an infectious disease specialist, a psychologist, depending on the cause of the disease.

Diagnosis

During the first visit to the andrologist, the doctor first collects an anamnesis, which includes the following:

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

After that, the doctor examines the man visually and palpably and directs him for further examination.

Laboratory methods

What is done:

  1. Collection of fluids secreted by the urethral canal.Pathogenic microflora, mucus and leukocytes are determined.
  2. PCR – urethral scraping.The pathological agents are identified.
  3. Microscopic examination of prostate secretion.Macrophages, amyloid and Trousseau-Lallement bodies and leukocytes are counted.
  4. Immunological examination to assess the level of non-specific antibodies.
  5. Take blood fluid to determine PSA levels.If high levels are detected, a prostate biopsy is also prescribed, which will rule out or confirm a cancerous tumor.

Instrumental methods

Instrumental diagnostics are as follows:

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

Differential diagnosis

Establishing a differential diagnosis is necessary, as it allows you to identify diseases such as:

  • prostate cancer;
  • bladder dysfunction of neurogenic etiology;
  • disorders of the detrusor-sphincter system;
  • pseudodyssynegria;
  • bladder narrowing;
  • hypertrophy of the bladder neck;
  • cystitis;
  • adenoma;
  • prostate sclerosis, etc.
consultation with a chronic prostatitis specialist

Treatment of chronic prostatitis

Treatment of chronic prostatitis is carried out comprehensively - medications are used, massage, physiotherapeutic procedures and exercises are performed.Correction of the patient's life is especially important - complete abandonment of bad habits, proper nutrition, normalization of sexual intercourse.In some cases, the help of a psychotherapist and psychologist is required.One treatment method cannot be used without the other, because each method complements each 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, an advanced form of the disease and the absence of a positive result during treatment.

Antibiotics

Antibacterial medications are used to treat chronic bacterial prostatitis.The choice of drug depends on the type of pathogen.The duration of treatment is 2 to 8 weeks.Antibiotics are aimed at destroying the pathogenic microorganism and reducing the inflammatory process.

Different groups are used:

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

Alpha blockers

This is a group that blocks adrenergic receptors in the tissues of the pelvic organs, thereby stopping bladder spasms, improving the flow of urine and facilitating the process of urination.In addition, the functioning of the muscular system and sphincter is normalized.

Non-steroidal anti-inflammatories

Chronic prostatitis is characterized by inflammatory processes in the prostate, therefore non-steroidal anti-inflammatory drugs are necessarily prescribed.They are aimed at relieving pain and eliminating inflammation.In addition, non-steroids normalize the permeability of the walls of the circulatory system, restore blood circulation, against the background of which existing inflammatory mediators are not absorbed.

The products are used in the form of gels, tablets, injections.

Hormonal therapy

If non-steroidal (non-hormonal) drugs do not have a positive effect or the patient has a hormonal imbalance, 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 medications.When blood circulation returns to normal, regeneration processes are launched and local metabolism accelerates.As a result, the patient quickly gets rid of unpleasant symptoms.Additionally, many products strengthen blood vessel walls and reduce blood viscosity.

taking medication for chronic prostatitis

Other medications

Additionally, for chronic prostatitis, other groups of drugs are used:

  1. Muscle relaxants are aimed at relaxing muscles, relieving pain, accelerating blood circulation and reducing the tone of smooth muscles of the genital organ.
  2. Immunomodulators correct immune changes, but are prescribed mainly when the patient has an immune deficiency.
  3. If stones are detected in the prostate, the patient should take medications that regulate uric acid.
  4. To destroy the formed adhesions and accelerate the process of action of nonsteroidal anti-inflammatory drugs and antibiotics, enzyme drugs are prescribed.
  5. Vitamin and mineral therapy is indicated to strengthen the immune system.The drug is selected based on the lack of a particular vitamin or mineral.
  6. To restore prostate metabolism and regenerate damaged tissues, bioregulatory peptides made from the prostate taken from cattle are used.
  7. If the disease is accompanied by anxiety, depression, aggression and other mental disorders, sedative drugs or selective antidepressants are prescribed: valerian tincture, 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 surgical interventions, a fairly long rehabilitation period is required.

In what cases is surgery prescribed:

  • in the absence of a 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 and, in some cases, the lymph nodes.Radical prostatectomy according to the surgical method can be of the following types:

  • robotic type - several small incisions are made in the lower abdomen, after which the prostate is removed (actions are 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.

Special features:

  1. Any type of operation is carried out under general or local anesthesia (spinal anesthesia).
  2. The duration of the procedure is 2 to 3 hours.
  3. The rehabilitation period is one and a half months.
  4. The patient's stay in hospital is a maximum of three days.
  5. The start of sexual life is 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

The surgery involves cutting away the tissue surrounding the prostate, making it easier to urinate.To do this, a resectoscope is used, which is inserted into the urethra.The operation is indicated in the absence of urination, as well as for the prevention of such complications - hematuria, inflammatory processes in the kidneys and bladder, stones, urinary incontinence.

Special features:

  • duration of the procedure – from one hour to one and a half hours;
  • stay at the clinic – 2 days;
  • wearing a catheter – 5 to 7 days;
  • recovery period – one and a half months;
  • the start of sexual activity occurs after 6 weeks.

Drainage of abscesses

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

Before the injections, the urological surgeon palpates the prostate with his index finger by inserting it into the rectal opening.After suction of the pus, antiseptic treatment and drainage with rubber tubes are carried out.If the patient has an extensive abscess, pumping of purulent fluid is carried out through the perineal approach, that is, through the rectum.

Special features:

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

Laser surgery

Laser treatment is an innovative and most common technique, as the operation is considered low-traumatic, 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 carried out in 2 ways: ablative (excess tissue is burned) and enucleation (tissue is cut).Depending on the type of ablation, laser surgery is divided into the following types:

  1. Photoselective vaporization – the laser vaporizes the tissue.
  2. Holmium laser ablation – the procedure is the same as the previous one, but a holmium laser is used.
  3. Holmium laser enucleation – prostate tissue is crushed with a morcellator and then removed.

Special features:

  • minimal number of contraindications;
  • absence of adverse effects (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 against cancer.

What consequences can occur after surgical intervention of any type:

  • bleeding;
  • temporary problems urinating;
  • infection;
  • urinary incontinence;
  • reverse ejaculation (when sperm enters the bladder);
  • tissue swelling;
  • weakening of erection;
  • inguinal hernia;
  • reduction in penis length (only when part of the urethral canal is removed).

To avoid complications, you must strictly follow all the surgeon's recommendations during the recovery period.You cannot heal yourself.

a doctor prescribes treatment for chronic prostatitis

Physiotherapy

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

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

Massage

Massage is one of the obligatory procedures in the treatment of chronic prostatitis.It is advisable to carry it out by a specialist, but if this is not possible, it can be done at home (but another person should perform the massage movements, since the patient is in a relaxed state).

Contraindications to massage:

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

Procedure:

  1. The man should expose the lower part of his body and lie down on his side with his knees raised towards the abdominal region.
  2. There is another pose - knee-elbow.
  3. The person performing the massage should wash their hands thoroughly, wear medical gloves and lubricate the index finger with petroleum jelly or other emollient.
  4. The masseur inserts a finger into the anus (the man is relaxed).
  5. Massage the prostate using gentle strokes.
  6. The duration of the procedure is 2 to 5 minutes.

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

Diet therapy

A patient with prostatitis must follow a special diet to avoid the formation of cholesterol plaques, constipation and increased gas formation.Dishes will need to be steamed or boiled.It is allowed to bake in the oven, but without using oil.

Authorized products:

  • seafood;
  • pumpkin seeds;
  • fruits and vegetables that do not cause gas;
  • porridge;
  • fermented milk products;
  • dried fruits;
  • lean meat and fish.

Prohibited products:

  • beans;
  • cabbage;
  • soft drinks;
  • alcohol;
  • spicy and savory dishes;
  • strong tea and coffee;
  • yeast baked goods.
prohibited food for chronic prostatitis

Folk remedies

Traditional medicine recipes are used exclusively in agreement with the andrologist, since many of them may have contraindications.

Recipes :

  1. Eat about 30 to 40 pumpkin seeds per day, preferably on an empty stomach.
  2. You can drink pear compote, but only without adding sugar.
  3. Take a medicinal 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 free proportion and take a sitz bath for 15 minutes.The water temperature does not exceed 40 degrees.
  4. Use parsley - add it to salad, squeeze the juice and drink.The seed part can also be used.
  5. Make your own rectal suppositories.To do this, mix propolis in equal proportions with butter and cocoa powder.Use your hands to form a candle, 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 circumstances - the degree of negligence, the form of the disease, the adequacy of treatment, the behavior of the patient himself.If you notice the development of a chronic form and carry out treatment in a timely and correct manner, then the prognosis is quite favorable.

However, it should be known that complete recovery from the disease occurs in very rare cases, but it is possible to achieve stable remission, during which symptoms do not appear.

Throughout his life, the patient must strictly adhere to preventive measures, periodically undergo examinations and take medications.

Prevention measures

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

  • contact a urologist in a timely manner;
  • lead a healthy and active lifestyle (eliminate bad habits, practice moderate sports);
  • eat well;
  • sex should be regular – at least 3 times a week;
  • monitor the state of the immune system;
  • don't be too cold;
  • exclude casual sex;
  • train the muscles of the genitourinary system - do special exercises.

If you suffer from chronic prostatitis, don't worry, because it 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.