Chronic prostatitis is a long-term inflammation of the prostate gland, diagnosed only in men and indicating a neglected pathological condition of the reproductive organs. The disease leads to a violation of the morphology and function of the prostate, is characterized by pain in the pelvis, genitals with irradiation of the groin, urination disorders, sexual dysfunction. Long-term treatment consists of stabilization of general condition, excluding relapses and AUR.
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 diseases 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, tooth decay, etc. ).
- Chronization with inflammatory components of the prostate secretion. The study shows an increased level of leukocytes and pathogens, infectious agents.
- Chronic abacterial prostatitis. It manifests itself as an inflammatory process with a complex of symptoms similar to acute inflammation with the participation of pathogenic microflora. In fact, however, there are no inflammatory components (pathogens + leukocytes).
- Latent chronic prostatitis. The disease has no pronounced signs, does not bring discomfort, almost does not disrupt the functioning of the reproductive organs. However, with a clandestine analysis, inflammatory products - leukocytes - are found.
Traditionally, STB (pelvic pain syndrome) can be attributed to the chronification of the process in the prostate. With it, a complex of symptoms similar to a protracted course of prostatitis lasting more than 3 months with obvious signs of infection develops.
Causes of chronic prostatitis
According to WHO statistics, only 5-10% of cases of prostatitis are bacterial in nature, the rest - a chronic disease of an abacterial nature. This means that most problems with the gland in men are due to an unhealthy lifestyle.
Causes of infectious chronic prostatitis:
- Penetration into the prostate of uropathogenic microflora (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, tooth decay).
- 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 non-bacterial (non-infectious) prostatitis is associated with stagnant processes in the body:
- Violation of drainage in the acini of the prostate.
- Poor venous blood flow in the pelvis.
- Overflowing of the prostate with blood (swelling, poor secretion).
- Prolonged abstinence or excessive sexual activity.
- PPA practice, prolongation of sexual intercourse.
- chronic poisoning.
Symptoms of abacterial inflammation in the prostate almost always appear in men leading a sluggish lifestyle. Physical inactivity, excess weight, unwillingness to engage in intensive physical activity, laziness, all this affects the work of the prostate and provokes congestive (stagnation) phenomena.
It is difficult to prevent the development of chronic prostatitis and men engaged in production associated with constant vibration. Additional etiological factors are pathologies of the pelvic organs, nerves, blood vessels, hemorrhoids, regular constipation, androgen deficiency and BPH.
Signs and symptoms of chronic prostatitis
Specific signs of chronic prostatitis are weakly expressed and outwardly often not typical for the pathology of the prostate. 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 pain that is constant, aching and radiating (transferring) to the genitals, pubic bone, scrotum, rectum and sacrum. In fact, a man constantly feels uncomfortable in the pelvic area during the day. The pain doesn't stop, it just changes in 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.
- Painful sexual intercourse, especially when ejaculating.
- Painful and frequent urination.
- Burning in urethra, false urging, especially at night.
- Prostatothorrhea (discharge from the urethra, anus during physical exertion).
- In the groin there are feelings of coldness, sweating, burning.
The general (visible) disorders associated with chronic prostatitis also include mental disorders (discomfort prevents a man from working, resting, sleeping and eating normally). Irritability appears, he breaks down with close people, subordinates, he loses the desire to do anything.
With chronic prostatitis, a violation of sexual function is strongly expressed, which does not improve a man's mood. Painful erections, low libido, incomplete sexual intercourse, deleted orgasms, infertility - all these are visual manifestations of chronic prostatitis.
If chronic prostatitis is not treated, the disease recurs in constant flare-ups of acute prostatitis with a brief relaxation phase. It can be complicated by vesiculitis, urinary incontinence, tartar build-up, cysts, sclerosis, and prostate cancer.
Diagnosis of chronic prostatitis
If there is a suspicion of pathology of the prostate, a complete diagnosis of the condition of a man's body is necessary. A urologist (andrologist) conducts an initial examination, prescribes laboratory and instrumental diagnostics. After the diagnosis is made, the specialist prescribes treatment for chronic prostatitis, which includes the use of drugs, physiotherapy, the use of folklore and specific methods to prevent the disease from recurring.
differential diagnosis
It consists in conducting many additional studies to exclude diseases that are similar in symptoms to chronic prostatitis. The variety of manifestations makes it difficult to establish a real diagnosis, so the doctor methodically excludes similar pathologies one by one.
The differential diagnoses for chronic prostatitis are:
- Inflammation of the prostate is not in the chronification stage.
- Anogenital symptom complex.
- Vegetative urogenital syndrome.
- adenoma, prostate cancer.
The diagnosis does not depend on the patient's feelings or complaints, but only on the 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 any 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 of which enters the gland through the lymphatic blood. |
| Fence, examination of prostate secretion | By massaging the prostate, they examine it and identify / rule out the presence of leukocytes, bacterial microflora, erythrocyturia. |
| Urinalysis, urethral swab, 3-glass urine sample, RIF, PCR. | Show infections of the genital tract (chlamydia, herpes, candidiasis, gonorrhea, etc. ), nonspecific bacterial microflora. |
Instrumental diagnostic methods
The examination is performed using endoscopic instruments, devices that allow the urologist to "get 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 condition of the gland, its volume, tissues, the presence of foci of inflammation, stones and congestion. |
| Urodynamic investigation | It is carried out using uroflowmetry, profilometry, cystometry, electromyography. With the help of these techniques it is possible to exclude stress urinary incontinence, neurogenic bladder etc. with similar symptoms. |
| Biopsy with morphological examination | Necessary if prostate cancer is suspected. |
Treatment of chronic prostatitis
Treatment of chronic prostatitis must be repeated regularly, complete cure of the disease is almost impossible. The main principle of therapy is to avoid relapse and make the "quiet" period of the disease long. First of all, eliminate the main causes of chronification and periods of exacerbation, if they arise from systematic hypothermia, change clothes, try draftsBe sure to follow the clinical recommendations of a urologist, exclude foods that cause acute inflammation, physical inactivity, excessive exercise, etc.
Medical treatment
Complex treatment is used to treat chronic prostatitis, since it is impossible to cure with just one type of pill. Men are prescribed drugs:
- antibiotics. They are needed to suppress pathogenic microflora in the gland, eliminate the cause of bacterial infection, stop inflammation. Of the popular ones, drugs of the penicillin group, 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 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 of the risk of AUR.
- antispasmodics. Eliminate vasospasm and improve blood flow in the pelvic organs. This reduces the likelihood of stagnation, the formation of stones and spasms of the prostatic part of the urethra.
physical therapy
One of the most effective methods of treatment 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, does not cause side effects. The following methods are used:
- Electric current (electrophoresis). Electrostimulation of the prostate with direct or alternating current makes sense when the tone of the gland is reduced or there is slight congestion. With a combined treatment with medicinal solutions, the effect of the latter is higher.
- magnetotherapy. The human body is influenced by a magnetic field of different frequencies. If the process is chronic, vasodilation occurs, blood flow improves and congestion is eliminated, drugs penetrate better into tissues and accumulate.
- laser therapy. The prostate is attacked by a laser beam, inflammation is suppressed, blood circulation is stimulated and the drainage of prostate fluid is improved.
Chronic prostatitis is treated with ultrasound, the technique consists in exposing the body to high-frequency vibrations. Ultraphonophoresis is a variety - ultrasound is combined with the use of drugs.
home remedies
Here, the treatment of prostatitis in the chronic stage is based on the complex use of decoctions, tinctures, baths and other methods, coupled with traditional drugs for chronic prostatitis. Herbal supplements help the body cope with inflammation and prevent recurrence, but cannot completely replace conservative therapy.
It is forbidden to turn to folk methods in critical condition. If a man is indicated for urgent surgery 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:
- decoctions of herbs. They help cleanse the body of toxins, reduce general inflammation, and lower the temperature.
- showers, enemas. To do this, make warm infusions, decoctions of nettle, oak bark, wormwood, calendula. A solution is injected into the pre-cleaned intestines, which contributes to the rapid relief of inflammation in the prostate.
- compressed. Propolis oil, mustard powder or herbal decoction are used to make them. It is only used externally in the evening so that you don't go outside afterwards 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 smooth muscle tone, improve blood flow to the pelvic organs, eliminate prostate congestion, reduce the effect of hypodynamia when a man's work is sedentary.
For chronic prostate inflammation, the following exercises are recommended:
- Gymnastic Kegel. Its essence is to strengthen the muscles of the pelvic floor and perineum. This is achieved by regularly (up to 150 times/day) contracting/tensing the muscles of the anus and between the scrotum and penis.
- Charging with a tennis ball. It is placed in the crotch area, sitting on the floor and swaying, moving back and forth, massaging and tightening 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 cannot help with your hands, they are stretched out in front of you, trying to walk at least 3-5 meters.
- Scissors. The well-known complex is to strain the press, pelvic muscles and thighs.
With exacerbation of chronic prostatitis, all exercises are prohibited. Resume physical education classes when acute syndrome is relieved.
Surgical intervention
The duration of conservative treatment does not always relieve chronic prostatitis, it periodically recalls flare-ups. In a critical condition, the andrologist recommends an operation, but does not rule out its recurrence if the man does not comply with disease prevention measures.
List of surgical techniques for the treatment of chronic prostatitis:
- resection of the prostate. In the case of severe inflammation or sclerosed areas, part of the affected prostate is removed with an endoscope.
- prostate removal. 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 with an endoscope, ultrasound or manipulation through the urethra is performed.
- urinary incision. Do 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, giving priority to "clean" foods. All semi-finished products, spicy, spicy dishes with artificial preservatives, alcohol, strong tea or coffee are removed from the diet.
The body should receive a sufficient amount of protein in the form of boiled fish, meat and dairy products. Vegetables, fruit and natural juices - instead of fast food soda. Overcooked dishes are replaced with steam, boiled and those that lead to increased gas formation in the intestines are also prohibited.
prevention
Chronic prostatitis is usually not curable, so the main point of prevention is to prevent the disease from occurring in the first place. For this it is necessary to treat all infectious pathologies in a timely manner, not to overcool, always remember about sexually transmitted diseases and follow the principles of healthy sexual relations.
Physical inactivity is a precursor to stagnation, so daily exercise and an active lifestyle will help avoid prostatitis. Adhere to a healthy lifestyle, be examined by a urologist once a year, contact a specialist for the slightest problem with the genitourinary system and do not try to self-medicate. Do not be overweight and do not abuse alcohol or cigarettes.
consequences and complications
Only a specialist can determine the degree of complications, but, as is usual with chronification, there are:
- androgen deficiency.
- Violation of sexual and reproductive functions.
- vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis and epididymitis.
- 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%, the treatment of chronic prostatitis requires surgical intervention. If, in the chronification stage, conservative treatment is given in good time and then regular relapses are prevented, the course of the disease can be improved and phases of exacerbation can be compensated for.