Chronic prostatitis is a long-term inflammation of the prostate, diagnosed only in men and indicates a neglected pathological condition in Organs reproductive organs. The disease leads to a violation of the morphology and functioning of the prostate, it is characterized by pain in the pelvis, genitals with irradiation to the groin, urination disorders, sexual disorders. Long-term treatment consists of stabilizing the general condition, excluding relapses and AURO.
Types of chronic prostatitis
The chronic form of prostatitis can be of several types, it all depends on what underlies 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 prostate secretion. The study reveals an increased level of leukocytes and pathogens, infectious agents.
- Chronic abacterial prostatitis. It manifests as an inflammatory process with a symptom complex similar to acute inflammation with the participation of pathogenic microflora. But in fact, there are no inflammatory components (pathogen + leukocytes).
- Latent chronic prostatitis. The disease does not show any pronounced signs, does not bring discomfort, almost does not interrupt the functioning of Organs reproductive organs. But when analyzed in secret, products of inflammation - leukocytes are found.
Conventionally, BTS (pelvic pain syndrome) can be attributed to the chronicity of the process in the prostate. With it, a complex of symptoms 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 inflammation of the prostate are bacterial in nature, in the rest - a chronic disease is abacterial in nature. This means that most problems with the gland in men come from an unhealthy lifestyle.
Causes of chronic infectious prostatitis:
- Penetration into the prostate of uropathogenic microflora (E. coli, Proteus, Staphylococcus aureus, viral, fungal or parasitic particles).
- Violation of blood circulation in Organs 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).
- Systematic local hypothermia/overheating of the pelvic region.
- Stress, fatigue, chronic sleep deprivation.
- Poor nutrition, including the predominance of "empty" dishes without enough vitamins and minerals.
- Rare urination.
The clinic of abacterial (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.
- Prostate overflow with blood (swelling, poor secretion).
- Prolonged abstinence or excessive sexual activity.
- PPA practice, prolonging sexual intercourse.
- chronic intoxication.
Symptoms of abacterial inflammation in the prostate almost always appear in men who lead a lazy lifestyle. Physical inactivity, excess weight, unwillingness 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 production associated with constant vibration. Additional etiologic factors are pathologies of Organs pelvic organs, nerves, blood vessels, hemorrhoids, regular constipation, androgen deficiency, and BPH.
Signs and symptoms of chronic prostatitis
Specific signs of chronic prostatitis are poorly expressed and, externally, are often 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.
The sensations in a chronic process are a prostatic triad. It is characterized by constant pain, painful in nature and radiating (transferring) to the genitals, pubis, scrotum, rectum, and sacrum. In fact, a man constantly, during the day, feels discomfort in the pelvic region. The pain doesn't stop, it just changes in intensity and direction.
Typical symptoms of chronic prostate inflammation:
- 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 desire, especially at night.
- Prostatothorrhea (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, he breaks with close people, subordinates, he loses the desire to do anything.
In chronic prostatitis, a violation of sexual function is strongly expressed, which does not improve the man's mood. Painful erections, low libido, unfinished sexual intercourse, fading orgasms, infertility - all these are visual manifestations of chronic prostatitis.
If chronic prostatitis is not treated, the disease will recur by constant relapses of acute prostatitis with a short period of relaxation. It can be complicated by vesiculitis, urinary incontinence, stone formation, cysts, sclerosis and prostate cancer.
Diagnosis of chronic prostatitis
A complete diagnosis of the state of a man's body is necessary if a prostate pathology is suspected. A urologist (andrologist) performs an initial examination, prescribes laboratory and instrumental diagnoses. After diagnosis, the specialist prescribes the treatment of chronic prostatitis, which includes the use of medication, physical therapy, use of folklore and specific methods to prevent the recurrence of the disease.
Differential diagnosis
It consists of carrying out many additional studies to exclude diseases similar in symptoms to chronic prostatitis. Its variety of manifestations makes a true diagnosis difficult, so the doctor methodically excludes similar pathologies one by one.
As a differential diagnosis for chronic prostatitis are:
- Prostate inflammation is not in the chronicity stage.
- Anogenital symptom complex.
- Vegetative urogenital 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 diagnosis
| Name of laboratory diagnostic method | Feature |
|---|---|
| general inspection | They look at the patient's appearance, the condition of the skin, genitals, look at complaints, take 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 prostate secretion | Through prostate massage, they examine it and identify/exclude the presence of leukocytes, bacterial microflora, erythrocyturia. |
| Urinalysis, urethral swab, 3-glass urine sample, RIF, PCR. | Reveal infections of the genital tract (chlamydia, herpes, candidiasis, gonorrhea, etc. ), non-specific bacterial microflora. |
Instrumental diagnostic methods
The exam is done with endoscopic instruments, devices that allow the urologist to "penetrate" closer to the prostate and give an accurate assessment of its condition.
| The name of the instrumental diagnostic method | Feature |
|---|---|
| Ultrasound (TRUS) of the prostate | It allows you to assess the state of the gland, its volume, tissues, presence of foci of inflammation, stones, congestion. |
| urodynamic exam | It is performed using uroflowmetry, profilometry, cystometry, electromyography. With the help of these techniques, it is possible to exclude stress urinary incontinence, neurogenic bladder, etc. , similar in symptoms. |
| Biopsy with morphological examination | Required for suspected prostate cancer. |
Chronic prostatitis treatment
The course of treatment of chronic prostatitis must be repeated periodically, it is almost impossible to completely cure the disease. The main principle of therapy is to prevent 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 a urologist's clinical recommendations, exclude foods that cause acute inflammation, physical inactivity, excessive exercise, etc.
Medical treatment
For the treatment of chronic prostatitis, a complex treatment is used, as it is impossible to cure it using only one type of pill. Men are prescription drugs:
- Antibiotics. They are needed to suppress pathogenic microflora in the gland, eliminate the cause of a bacterial infection and stop inflammation. Of the popular, drugs from the group of penicillins, cephalosporins, aminoglycosides, fluoroquinols, macrolides are prescribed.
- NSAIDs (non-steroidal anti-inflammatory drugs). Medications in this group eliminate severe inflammation and relieve pain.
- hormones. Assign when other means are powerless 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 muscles, reduce tone and allow urine to drain completely. Means are prescribed during an exacerbation, the risk of AUR.
- Antispasmodics. Eliminate vasospasm and improve blood flow in Organs pelvic organs. This reduces the likelihood of stagnation, formation of stones, spasm of the prostatic part of the urethra.
Physiotherapy
One of the effective methods of treatment, its essence is to influence 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 is mild congestion. With treatment combined 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 penetrate tissues better and accumulate.
- Lasertherapy. The prostate is affected by a laser beam, while inflammation is suppressed, blood circulation is stimulated and the flow 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 phase is based on the complex use of decoctions, tinctures, baths and other methods along with traditional medicines for chronic prostatitis. Herbal preparations help the body deal with inflammation and prevent relapse, but they cannot completely replace conservative therapy.
It is forbidden to resort to popular methods in critical condition. If a man is referred for an urgent operation and there is a risk of developing AUR, trying to stop the disease with herbs means starting the pathological picture even further.
What popular methods are used for chronic prostatitis:
- Herbal decoctions. They help to cleanse the body of toxins, relieve general inflammation, lower the temperature.
- Showers, enemas. To do this, make hot infusions, decoctions of nettle, oak bark, wormwood, calendula. A solution is injected into the pre-cleaned intestine, which contributes to the rapid relief of inflammation in the prostate.
- compresses. For its preparation, propolis oil, mustard powder or herbal decoctions are used. The application is only external, made at night, so that after them you don't go out and don't get cold.
- Rectal suppositories. They are made from propolis, beeswax, cocoa butter, lard, bee bread and royal jelly. Apply rectally after a cleansing enema, insert suppositories at night or during the day, but you need 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 Organs pelvic organs, remove congestion in the prostate and reduce the effect of hypodynamia if a man's work is sedentary.
For chronic inflammation of the prostate, the following exercises are recommended:
- Kegel Gymnastics. Its essence is to strengthen the muscles of the pelvic floor, perineum. This is achieved by regular contraction/tension (up to 150 times/day) of the muscles in the anus and between the scrotum and the penis.
- Charge with a tennis ball. It is placed in the groin area, sit on the floor and rock, moving back and forth massaging and stretching the desired area.
- Footsteps 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 cannot help with your hands; they are pulled 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, all exercises are prohibited. Resume physical education when the acute syndrome is relieved.
Surgical intervention
Duration of conservative treatment does not always relieve chronic prostatitis, it is regularly recalled with relapses. In a critical condition, the andrologist recommends an operation, although it does not exclude recurrence if the man does not comply with the measures to prevent the disease.
List of surgical techniques for the treatment of chronic prostatitis:
- prostate resection. With severe inflammation or areas of sclerosis, a part of the affected prostate is removed using an endoscope.
- prostatectomy. This is a complete removal of the prostate, 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 in the prostate, a puncture is performed using an endoscope, ultrasound, or manipulation is done through the urethra.
- Urinary incision in the neck. Do with sclerosis, bladder obstruction, to improve urine output and ejaculate.
Diet
The main principle of adequate nutrition in chronic prostatitis is the exclusion of harmful foods and a change in the diet with a predominance of "clean" foods. Any semi-finished products, spicy dishes and flavored with artificial preservatives, alcohol, strong tea or coffee are removed from the diet.
The body must receive a sufficient amount of protein in the form of cooked fish, meat, dairy products. Vegetables, fruits and natural juices - instead of fast food, soda. Overcooked dishes are replaced with steamed, boiled and those that increase the formation of gas in the intestines are also prohibited.
Prevention
Chronic prostatitis is mostly incurable, so the main point of prevention is to prevent the disease early on. To do this, it is necessary to treat any infectious pathology in a timely manner, do not get too cold, always remember about sexually transmitted diseases and adhere to the principles of healthy sexual relations.
Physical inactivity is a precursor to stagnation, so daily exercise and an active lifestyle will help prevent prostatitis. Adhere to a healthy lifestyle, have an examination by a urologist once a year, contact a specialist for minor problems with the genitourinary system, and do not try to treat yourself. 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:
- Androgen deficiency.
- Violation of sexual and reproductive functions.
- Vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis and orchiepididymitis.
- Psychological problems.
- Prostate necrosis.
Forecast
The prognosis depends on when the patient went to the doctor. In advanced cases and in the presence of age-related factors in 97%, treatment of chronic prostatitis will require surgical intervention. If conservative treatment is carried out in a timely manner in the chronicity stage and relapses are regularly avoided, the course of the disease can be improved and periods of exacerbations can be evened out.