Chronic prostatitis is a long-term inflammation of the prostate gland, often there are no symptoms, so the majority of the male population is unaware of this disease.
The development of a chronic form of prostatitis is the result of an acute process, although in practice this is extremely rare.As a rule, inflammatory chronic prostatitis begins gradually without any unpleasant symptoms and sensations;The course of the disease is often discovered accidentally in a patient during an ultrasound examination.
Both young and middle-aged and elderly people are susceptible to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead an inactive lifestyle, feel excessive physical strain on the perineum, and refuse sexual intercourse.
Classification
According to the modern classification of prostatitis developed in 1995, there are several categories of the disease:
- Acute bacterial prostatitis (ABP) is the most common type of prostatitis.It is usually caused by a bacterial infection and is easily diagnosed by its typical symptoms.Acute bacterial prostatitis can occur at any age.Symptoms include painful urination, inability to empty the bladder completely, and pain in the lower abdomen, back, or pelvis.There may be fever with chills.
- Chronic bacterial prostatitis is a disease characterized by typical symptoms of chronic inflammation and an increase in the number of bacteria and leukocytes in urine and prostate secretions after massage.
- Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, this is the result of acute bacterial prostatitis (untreated or poorly treated).If symptoms do occur, they may include genital or pelvic pain, difficulty urinating, or painful urination and ejaculation.
- Asymptomatic inflammatory prostatitis - this form of the disease does not have the classic symptoms of prostatitis, and the disease itself is discovered accidentally when visiting the clinic for another reason.
In the presence of an infectious component, they speak of bacterial (infectious) chronic prostatitis;in the absence of microbial pathogens - about non-bacterial (non-infectious) prostatitis.It is believed that 90-95% of all cases of chronic prostatitis are non-bacterial and only 10-5% are bacterial.
Reasons
A number of factors can contribute to chronic prostatitis.First of all, this:
- STI: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungus, Escherichia coli can infect the urethra and can be detected in prostate tissue;
- Poor circulation in the pelvic organs (blockage in the prostate causes its inflammation);
- Sedentary lifestyle (drivers, office workers, officials);
- Rejection of sexual intercourse for a long time, interruption of sexual intercourse or artificial prolongation of sexual intercourse;
- Constant hypothermia (fans of extreme recreation: diving, surfing and skiing);
- Stress: mental and physical strain.
For the development of chronic prostatitis, it is not the presence and activity of pathogenic microorganisms, but the condition of the pelvic organs and blood circulation in them, the presence of accompanying diseases and the level of protective mechanisms that are important.
Symptoms of chronic prostatitis
Often, with the development of a chronic form of prostatitis, the symptoms practically do not bother a man.In this case, all the symptoms of acute prostatitis will not manifest themselves at all or will manifest themselves to a very small extent.
The most common symptoms of chronic prostatitis in men are:
- periodic pain and discomfort in the perineum;
- discomfort during bowel movements and urination;
- radiation to the anus, thighs, testicles;
- discharge from the urethra.
Changes in the course of the disease, which are already not very bright, can be so insignificant that patients with chronic prostatitis do not pay special attention to them.
Exacerbation of chronic prostatitis
An exacerbation of the disease is usually accompanied by the following symptoms:
- pain and burning in the urethra;
- increased urination;
- pain in the lower abdomen, perineum and rectum;
- signs of decreased sexual activity in men;
- pain during defecation.
According to some doctors, psychological symptoms of chronic prostatitis can also be identified, which include increased irritability, anxiety, fatigue, irritability, sleep disturbances, obsessions and depression.
It is almost impossible to determine all the symptoms in a patient at once, because a man usually shows only 2-3 signs of the disease.For example, the most common are erectile dysfunction and lower abdominal pain.
Why can prostatitis cause infertility?
The fact is that the prostate gland produces a special secretion that ensures the viability of sperm.With inflammation, the secretory function of the prostate gland deteriorates, which inevitably affects the quality of sperm.
In addition, the prostate gland is actively involved in the regulation of testosterone production and the erection process.For this reason, chronic prostatitis causes a decrease in erectile function and even impotence.However, if timely and competent treatment is carried out, these scenarios for the development of the disease can be avoided.
Diagnostics
The following procedures are necessary to confirm/disprove the diagnosis:
- rectal examination;
- microscopy of prostate secretion;
- culture of prostate secretion for sensitivity to antibiotics;
- tests for sexually transmitted diseases;
- transrectal ultrasound.
Sometimes additional endoscopic and urodynamic studies are performed.
How to treat chronic prostatitis
If a man is diagnosed with chronic prostatitis, the treatment is always long and difficult.Its duration directly depends on the stage of the disease for which the patient turns to a specialist.Therapy includes an integrated approach, that is, a combination of several methods at the same time:
- antibacterial therapy;
- prostate massage;
- physiotherapeutic procedures;
- modification of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
In addition, anti-inflammatory and antispasmodics are used in the treatment of chronic forms of the disease.
Drug treatment
The choice of drugs depends on the cause and symptoms of the disease.Antibacterial drugs are used to treat chronic prostatitis of infectious etiology:
- fluoroquinolones;
- macrolides;
- tetracyclines.
Analgesics and non-hormonal anti-inflammatory drugs are used to relieve inflammation and pain.
Also, in recent years, the treatment of chronic prostatitis is carried out using drugs that were not used for this purpose before: alpha1-blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect the metabolism of urates and citrates.
Physiotherapy
Some physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis and others, also help to improve prostate tissue trophism and speed up the healing process.
Also, therapeutic hot baths, mud treatments and special enemas can be prescribed for chronic prostatitis.
Prostate massage
It improves the drainage of prostate secretion and microcirculation at the level of this organ, which in turn helps the patient to recover quickly.
Prostate massage cannot be done during acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is usually combined with antibiotic therapy.Numerous clinical studies have shown the high effectiveness of this treatment.
Operation
It is possible to surgically remove areas of the prostate gland affected by bacteria.Transurethral resection is an operation performed under epidural or intravenous barbiturate anesthesia.Post-operative recovery time is no more than a week.
The methods required for the treatment of chronic prostatitis are determined by the urologist based on diagnostic data and his practical experience.According to reviews on the Internet, self-treatment at home is full of results.