Chronic prostatitis is a long-term inflammation of the prostate gland, diagnosed only in men and indicates a neglected pathological condition in the reproductive organs. The disease leads to a violation of the morphology and functioning of the prostate, is characterized by pain in the pelvis, genitals with irradiation in the groin, urination disorders, sexual disorders. Long-term treatment consists of stabilization of the general condition, excluding relapses and AUR.
Types of chronic prostatitis
The chronic form of prostatitis can be of different types, it all depends on what is the basis of the onset of the disease. According to the classification, the following types of disease are distinguished:
- Chronic prostatitis of bacterial origin. The cause of the inflammatory process in the gland is the penetration of bacterial microflora along the descending or ascending path (abscesses, through the urethra, caries, etc. ).
- Chronization with inflammatory components of the prostatic secretion. The study reveals an increase in the level of leukocytes and pathogens, infectious agents.
- Chronic bacterial prostatitis. It manifests itself as an inflammatory process with a symptom complex similar to acute inflammation with the participation of pathogenic microflora. But in reality there are no inflammatory components (pathogen + leukocytes).
- Chronic latent prostatitis. The disease has no pronounced signs, does not bring discomfort, almost does not disrupt the functioning of the reproductive organs. But when analyzed in secret, the products of inflammation are found - leukocytes.
Conventionally, STB (pelvic pain syndrome) can be attributed to the chronicity of the process in the prostate. With it, a symptom complex develops, similar to a prolonged course of prostatitis, more than 3 months, with obvious signs of infection.
Causes of chronic prostatitis
According to WHO statistics, only 5-10% of cases of prostate inflammation are bacterial in nature, in the rest a chronic disease is bacterial in nature. This means that most of the problems with the gland in men stem from an unhealthy lifestyle.
Causes of chronic infectious prostatitis:
- Penetration of uropathogenic microflora into the prostate (E. coli, Proteus, Staphylococcus aureus, viral, fungal or parasitic particles).
- Violation of blood circulation in the pelvic organs (physical inactivity, poor condition of blood vessels, blood clots).
- Urological diseases (urethritis, cystitis, pyelonephritis).
- The presence of distant foci of infection in the body (bronchitis, tonsillitis, caries).
- Local hypothermia / systematic overheating of the pelvic region.
- Stress, fatigue, chronic sleep deprivation.
- Poor nutrition, including the predominance of "empty" dishes without sufficient vitamins and minerals.
- Rare urination.
The clinic of bacterial (non-infectious) prostatitis is associated with stagnant processes in the body:
- Violation of drainage in the acini of the prostate.
- Poor venous circulation in the pelvis.
- Overflow of the prostate with blood (swelling, poor secretion).
- Prolonged withdrawal or excessive sexual activity.
- Practice PPA, prolongation of sexual intercourse.
- chronic intoxication.
Symptoms of bacterial inflammation in the prostate almost always appear in men who lead a lazy lifestyle. Physical inactivity, overweight, reluctance to move intensely, laziness, all this affects the work of the prostate, causing congestive phenomena (stagnation).
It is difficult to prevent the development of chronic prostatitis and men employed in the production associated with constant vibrations. Additional etiological factors are pathologies of the pelvic organs, nerves, blood vessels, hemorrhoids, regular constipation, androgen deficiency and BPH.
Chronic Prostatitis Signs and Symptoms
Specific signs of chronic prostatitis are weakly expressed and often outwardly not typical of prostate pathology. The picture changes only during the period of exacerbation, when the general symptoms resemble the course of an acute inflammatory process.
Sensations in a chronic process are a prostatic triad. It is characterized by constant aches, painful in nature and radiating (moving) to the genitals, pubis, scrotum, rectum and sacrum. In fact, a man constantly, during the day, feels discomfort in the pelvic area. The pain doesn't stop, it just changes intensity and direction.
Typical symptoms of chronic inflammation of the prostate:
- Increased pain at the end of urination.
- Irradiation of unpleasant sensations in the head of the penis, scrotum, sacrum.
- Pain during intercourse, especially during ejaculation.
- Painful and frequent urination.
- Burning in the urethra, false solicitation, especially at night.
- Prostatotorrhea (discharge from the urethra, anus during exercise).
- In the groin there are sensations of cold, sweating, burning.
General (visible) disorders associated with chronic prostatitis also include psychological disorders (discomfort prevents a man from working, resting, sleeping and eating normally). Irritability appears, breaks down on close people, subordinates, loses the will to do anything.
In chronic prostatitis, a violation of sexual function is strongly expressed, which does not improve a man's mood. Painful erections, low libido, unfinished sexual intercourse, canceled orgasms, infertility - all these are visual manifestations of chronic prostatitis.
If chronic prostatitis is not treated, the disease will be repeated by continuous relapses of acute prostatitis with a short relaxation period. It can be complicated by blistering, urinary incontinence, stone formation, cysts, sclerosis, and prostate cancer.
Chronic Prostatitis Diagnosis
A complete diagnosis of the state of a man's body is necessary if a pathology of the prostate gland is suspected. A urologist (andrologist) conducts an initial examination, prescribes laboratory and instrumental diagnostics. After making the diagnosis, the specialist prescribes the treatment of chronic prostatitis, which includes the use of drugs, physiotherapy, the use of folk and specific methods to prevent the recurrence of the disease.
Differential diagnosis
It consists in conducting many additional studies to exclude diseases similar in symptoms to chronic prostatitis. Its variety of manifestations makes it difficult to make a true diagnosis, so the doctor methodically excludes similar pathologies one by one.
As a differential diagnosis for chronic prostatitis are:
- Inflammation of the prostate is not in the chronic phase.
- Complex of anogenital symptoms.
- Urogenital vegetative syndrome.
- Adenoma, prostate cancer.
When making a diagnosis, it is not the patient's feelings or complaints that matter, but only the actual data obtained through research.
Laboratory diagnostics
| Name of the laboratory diagnostic method | Characteristic |
|---|---|
| General inspection | They note the appearance of the patient, the condition of the skin, genitals, note the complaints, collect an anamnesis. |
| Identification of infectious agents | The inflammatory process in the prostate can be the result of a distant focus of infection, the bacterial microflora from which it enters the gland through the lymphatic blood. |
| Fence, study of prostatic secretion | Through massage of the prostate gland, they examine it and identify / exclude the presence of leukocytes, bacterial microflora, erythrocyturia. |
| Urinalysis, urethral swab, 3-glass urine sample, RIF, PCR. | They reveal infections of the genital tract (chlamydia, herpes, candidiasis, gonorrhea, etc. ), nonspecific bacterial microflora. |
Instrumental diagnostic methods
The examination is carried out using endoscopic instruments, devices that allow the urologist to "penetrate" closer to the prostate gland and give an accurate assessment of its condition.
| The name of the instrumental diagnostic method | Characteristic |
|---|---|
| Ultrasound (TRUS) of the prostate | Allows you to assess the state of the gland, its volume, tissues, the presence of foci of inflammation, stones, congestion. |
| Urodynamic examination | It is carried out by means of uroflowmetry, profilometry, cystometry, electromyography. With the help of these techniques, stress urinary incontinence, neurogenic bladder, etc. can be ruled out. , similar in symptoms. |
| Biopsy with morphological examination | Necessary for suspected prostate cancer. |
Treatment of chronic prostatitis
The course of treatment for chronic prostatitis must be repeated periodically, it is almost impossible to completely cure the disease. The basic principle of therapy is to avoid relapses and prolong the "quiet" phase of the disease. Mainly eliminate the main causes of chronicity and periods of exacerbation, if they arise from systematic hypothermia, change clothes, try to avoid drafts. Be sure to follow the clinical recommendations of a urologist, exclude food that causes acute inflammation, physical inactivity, excessive exercise, etc.
Medical treatment
For the treatment of chronic prostatitis, complex treatment is used, since it is impossible to cure using only one type of pill. Men are prescribed drugs:
- Antibiotics. They are needed to suppress pathogenic microflora in the gland, eliminate the cause of a bacterial infection and stop inflammation. Among the popular ones, drugs from the group of penicillins, cephalosporins, aminoglycosides, fluoroquinols, macrolides are prescribed.
- NSAIDs (non-steroidal anti-inflammatory drugs). Drugs in this group eliminate severe inflammation and relieve pain.
- Hormones. Assign when other means are helpless or you need to quickly remove an acute relapse. Patients with chronic prostatitis are prescribed drugs in ampoules, tablets.
- Alpha blockers. They are designed to relax smooth muscle, reduce tone, and allow urine to drain completely. Means is prescribed during an exacerbation, the risk of AUR.
- Antispasmodics. Eliminates vasospasm and improves blood flow in the pelvic organs. This reduces the likelihood of stagnation, stone formation, spasm of the prostatic part of the urethra.
Physiotherapy
One of the effective methods of treatment, its essence is to affect the body with electric current, magnetic field, ultrasound and other natural means. Physiotherapy is not contraindicated in 97% of cases of diagnosis of the disease, it does not cause side effects. The following methods are used:
- Electric current (electrophoresis). Electrical stimulation of the prostate with direct or alternating current is useful if the tone of the gland is reduced, there are mild congestions. With combined treatment with medicinal solutions, the effect of the latter will be greater.
- Magnetotherapy. A man's body is affected by a magnetic field of different frequencies. When the process is chronic, vasodilation occurs, blood flow improves and congestion is eliminated, drugs better penetrate the tissues and accumulate.
- Laser therapy. The prostate is affected by a laser beam, while inflammation is suppressed, blood circulation is stimulated and the outflow of prostatic fluid improves.
Chronic prostatitis is treated with ultrasound, the technique consists of exposing the body to high-frequency vibrations. Ultraphonophoresis is a variety - ultrasound is combined with the use of drugs.
Folk remedies
Here, the treatment of prostatitis in the chronic stage is based on the complex use of decoctions, tinctures, baths and other methods, along with traditional drugs for chronic prostatitis. Herbal preparations help the body cope with inflammation and prevent relapses, but they cannot completely replace conservative therapy.
It is forbidden to resort to folk methods in critical conditions. If a man is indicated for an urgent operation and there is a risk of developing AUR, then trying to stop the disease with herbs means starting the pathological condition even more.
What folk methods are used for chronic prostatitis:
- Herbal decoctions. They help cleanse the body of toxins, relieve general inflammation, lower the temperature.
- Douching, enemas. To do this, prepare warm infusions, decoctions of nettle, oak bark, wormwood, calendula. A solution is injected into the pre-purified intestine, this contributes to the rapid relief of inflammation of the prostate.
- Tablets. For their preparation, propolis oil, mustard powder or herbal decoctions are used. The application is only external, made in the evening, so that after them it does not go out and you do not get cold.
- Rectal suppositories. They are made with propolis, beeswax, cocoa butter, pork lard, bee bread and royal jelly. Apply rectally after a cleansing enema, insert suppositories at night or during the day, but it is necessary to lie down for at least 40 minutes.
Exercises
With the help of daily exercises, you can increase the tone of smooth muscles, improve blood circulation in the pelvic organs, remove congestion in the prostate and reduce the effect of hypodynamics if a man's work is sedentary.
For chronic inflammation of the prostate, the following exercises are recommended:
- Gymnastics Kegel. Its essence is to strengthen the muscles of the pelvic floor, the perineum. This is achieved by regular contraction / tension (up to 150 times a day) of the muscles of the anus and between the scrotum and the penis.
- Charge with a tennis ball. It positions itself in the groin area, sits on the floor and sways, moving back and forth while massaging and stretching the desired area.
- Steps on the buttocks. The essence of the exercise is to sit on the buttocks and roll from side to side to move forward (step like a duck). You can't help with your hands, they are pulled out in front of you and try to walk at least 3-5 meters.
- Scissors. The well-known complex is to give a load to the press, pelvic muscles, thighs.
With the exacerbation of chronic prostatitis, any exercise is prohibited. Resume physical education when acute syndrome is relieved.
Surgical intervention
The duration of conservative treatment does not always relieve chronic prostatitis, it regularly reminds itself with relapses. In critical conditions, the andrologist recommends an operation, although he does not exclude relapse if the man does not comply with the disease prevention measures.
List of surgical techniques for the treatment of chronic prostatitis:
- resection of the prostate. With severe inflammation or areas of sclerosis, part of the affected prostate is removed using an endoscope.
- prostatectomy. This is a complete removal of the prostate gland, performed in a critical situation, when inflammation and changes in the gland interfere with normal urination.
- Drainage of a cyst, abscess. If an abscess or cystic formation has formed on the prostate, a puncture is performed using an endoscope, ultrasound, or manipulation through the urethra.
- Urinary neck incision. To deal with sclerosis, obstruction of the bladder, to improve the outflow of urine and ejaculate.
Diet
The main principle of proper nutrition in chronic prostatitis is the exclusion of harmful foods and a change in diet with a predominance of "clean" food. Any semi-finished products, spicy and spicy dishes with artificial preservatives, strong alcohol, tea or coffee are removed from the diet.
The body should receive a sufficient amount of protein in the form of boiled fish, meat, dairy products. Vegetables, fruits and natural juices - instead of fast food, soda. Overcooked dishes are replaced with steam, boiled ones, and those that create increased gas formation in the intestines are also prohibited.
Prevention
Chronic prostatitis is mostly incurable, so the main point of prevention is to prevent the disease from the very beginning. To do this, it is necessary to promptly treat any infectious pathologies, not to get too cold, always remember sexually transmitted diseases and follow the principles of healthy sexual relations.
Physical inactivity is a harbinger of stagnation, so daily exercise and an active lifestyle will help avoid prostatitis. Adhere to a healthy lifestyle, undergo an examination by a urologist once a year, contact a specialist for the slightest problems with the genitourinary system and do not try to be treated on your own. Do not be overweight and do not abuse alcohol, cigarettes.
Consequences and complications
Only a specialist can determine the degree of complications, but as common with chronicity, there are:
- Deficiency of androgens.
- Violation of sexual and reproductive functions.
- Vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis and epididymo-orchitis.
- Psychological issues, psychological problems.
- Prostate necrosis.
Forecast
Prognosis depends on when the patient went to the doctor. In advanced cases and in the presence of age-related factors in 97%, the treatment of chronic prostatitis will require surgery. If conservative treatment is carried out in a timely manner in the chronic stage, and then relapses are regularly prevented, the course of the disease can be improved and the periods of exacerbation can be leveled.