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 violations of the morphology and function of the prostate, characterized by pain in the pelvis, genitals with irradiation to the groin, urinary disorders, sexual disorders. Long -term treatment consists of stabilizing the general condition, excluding relapse and AUR.
Types of chronic prostatitis
Chronic forms of prostatitis can be of several types, all depending 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 the bacterial microflora along the descending or ascending pathway (abscess, through the urethra, caries, etc. ).
- Synchronization with the inflammatory component of prostate secretion. The study revealed increased levels 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. But in fact, there is no inflammatory component (pathogens + leukocytes).
- Chronic latent prostatitis. The disease has no obvious signs, does not bring discomfort, almost does not interfere with the function of the reproductive organs. But when analyzed in secret, the product of inflammation - leukocytes - is found.
Conventionally, STB (pelvic pain syndrome) can be associated with chronic processes in the prostate. Thus, a complex of symptoms develops, resembling 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, the rest - chronic diseases are abacterial in nature. This means that most of the problems with the glands in men come from living an unhealthy lifestyle.
Causes of chronic infectious prostatitis:
- Penetration into the prostate of uropathogenic microflora (E. coli, Proteus, Staphylococcus aureus, viral particles, fungi or parasites).
- Violation of blood circulation in the pelvic organs (physical inactivity, poor blood vessel condition, blood clotting).
- Urological diseases (urethritis, cystitis, pyelonephritis).
- The presence of foci of infection deep in the body (bronchitis, tonsillitis, caries).
- Systematic local hypothermia/overheating of the pelvic area.
- Stress, fatigue, chronic sleep deprivation.
- Poor nutrition, including the dominance of "empty" meals without adequate vitamins and minerals.
- Rarely urinate.
The clinic of abacterial (non -infectious) prostatitis is associated with stagnant processes in the body:
- Drainage violations in the prostate acini.
- Poor venous circulation in the pelvis.
- Overflow of prostate with blood (swelling, weak secretions).
- Prolonged abstinence or excessive sexual activity.
- PPA practice, prolong sexual intercourse.
- chronic intoxication.
Symptoms of abacterial inflammation in the prostate almost always appear in men who lead a sluggish lifestyle. Physical inactivity, overweight, reluctance to move intensively, laziness, all this affects the work of the prostate, provokes the phenomenon of congestion (stagnation).
It is difficult to prevent the development of chronic prostatitis and men working in production associated with constant vibration. Additional etiological factors are pathology of pelvic organs, nerves, blood vessels, hemorrhoids, common constipation, androgen deficiency and BPH.
Signs and symptoms of chronic prostatitis
The specific signs of chronic prostatitis are poorly expressed, and externally are often not typical for prostate pathology. The picture changes only during the period of exacerbation, when the general symptoms resemble an acute inflammatory process.
Sensation in the chronic process is the prostate triad. It is characterized by persistent pain, aching naturally and radiating (moving) to the genitals, pubis, scrotum, rectum and sacrum. In fact, a man always, during the day, feels uncomfortable in the pelvic area. The pain doesn’t stop, it just changes intensity and direction.
Common symptoms of chronic prostate inflammation:
- Increased pain at the end of urination.
- Radiation of unpleasant sensations in the head of the penis, scrotum, sacrum.
- Pain during intercourse, especially during ejaculation.
- Pain and frequent urination.
- Burning in the urethra, false urination, especially at night.
- Prostatothorrhoea (discharge from the urethra, anus during exercise).
- In the groin there is a cold, sweaty, burning sensation.
Common (visible) disorders associated with chronic prostatitis also include psychological disorders (discomfort preventing a man from working, resting, sleeping and eating normally). Irritation appears, he splits 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 mood of men. Painful erections, low libido, unfinished sexual intercourse, extinguished orgasms, infertility - all these are visual manifestations of chronic prostatitis.
If chronic prostatitis is not treated, the disease will recur with recurrence of persistent acute prostatitis with a short rest period. It can be complicated by vesiculitis, urinary incontinence, calculus formation, cysts, sclerosis, and prostate cancer.
Diagnosis of chronic prostatitis
A complete diagnosis of a man's body condition is necessary if prostate gland pathology is suspected. The urologist (andrologist) conducts an initial examination, prescribes laboratory and instrumental diagnostics. After the diagnosis is made, the specialist prescribes treatment of chronic prostatitis, which includes the use of medications, physiotherapy, the use of folk and specialized methods to prevent recurrence of the disease.
Differential diagnosis
It consisted of conducting many additional studies to exclude diseases similar to the symptoms of chronic prostatitis. The diversity of its manifestations makes it difficult to make a correct diagnosis, so doctors methodically exclude the same pathology one by one.
As a differential diagnosis for chronic prostatitis are:
- Inflammation of the prostate is not in the chronic stage.
- Complex of anogenital symptoms.
- Vegetative urogenital syndrome.
- Adenoma, prostate cancer.
When making a diagnosis, it is not the patient’s feelings or his or her complaints that matter, but only the actual data obtained through research.
Laboratory diagnostics
| Name of laboratory diagnostic method | Features |
|---|---|
| General inspection | They observe the patient's appearance, skin condition, genitals, note complaints, collect anamnesis. |
| Identification of infectious agents | The inflammatory process in the prostate may be due to a distant focus of infection, the bacterial microflora that enters the gland through the lymphatic blood. |
| Fence, a study of prostate secretion | Through the sequence 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. | Exposing infections of the genital tract (chlamydia, herpes, candidiasis, gonorrhea, etc. ), non -specific bacterial microflora. |
Instrumental diagnostic methods
The examination is performed using an endoscopic instrument, a device that allows the urologist to "penetrate" closer to the prostate gland and provide an accurate assessment of its condition.
| Name of instrumental diagnostic method | Features |
|---|---|
| Ultrasound (TRUS) of the prostate | Allows you to assess the condition of the glands, their volume, tissues, the presence of inflammatory foci, stones, congestion. |
| Urodynamic examination | It is performed using uroflowmetry, profilometry, cystometry, electromyography. With the help of this technique, it is possible to exclude stress urinary incontinence, neurogenic bladder, etc. , similar in symptoms. |
| Biopsy with morphological examination | Needed for suspected prostate cancer. |
Treatment of chronic prostatitis
The course of treatment for chronic prostatitis needs to be repeated periodically, it is almost impossible to cure the disease completely. The main principle of therapy is to prevent recurrence and make the "calm" phase of the disease long. Especially eliminate the main causes of chronic and period of deterioration, if it arises from systemic hypothermia, change clothes, try to avoid drafts. Be sure to follow the urologist’s clinical recommendations, excluding foods that cause acute inflammation, physical inactivity, excessive exercise, etc.
Medical treatment
For the treatment of chronic prostatitis, complex treatment is used, as it is impossible to cure using only one type of pill. Men given drugs:
- Antibiotics. They are needed to block the pathogenic microflora in the glands, eliminate the cause of bacterial infections, and stop inflammation. Of the popular ones, drugs of the penicillin group, cephalosporins, aminoglycosides, fluoroquinols, macrolides are prescribed.
- NSAIDs (non-steroidal anti-inflammatory). Drugs in this group eliminate severe inflammation and relieve pain.
- Hormones. Set when other means are ineffective, or you need to quickly remove the acute relapse. Patients with chronic prostatitis are given the drug in ampoules, tablets.
- Alpha blocker. It is designed to relax smooth muscles, reduce tone and allow urine to flow completely. Means prescribed during exacerbations, the risk of AUR.
- Antispasmodic. Eliminates vasocular spasms and improves blood flow in the pelvic organs. This reduces the possibility of stagnation, stone formation, spasm of the prostate part of the urethra.
Physiotherapy
One of the effective treatment methods, the essence of which is to influence the body with electric currents, magnetic fields, ultrasound and other natural means. Physiotherapy is not contraindicated in 97% of cases of disease diagnosis, 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 little congestion. With combined treatment with a drug solution, the second effect will be higher.
- Magnetotherapy. The male body is affected by magnetic fields with different frequencies. When the process is chronic, vasodilation occurs, blood flow is improved and congestion is eliminated, the drug penetrates better into the tissue and accumulates.
- Laser therapy. The prostate is affected by the laser beam, while inflammation is suppressed, blood circulation is stimulated, and prostate fluid outflow is improved.
Chronic prostatitis is treated with ultrasound, this technique consists of exposing the body to high frequency vibrations. Ultraphonophoresis is diverse - ultrasound is combined with the use of drugs.
Restoration of the people
Here, the treatment of prostatitis at the chronic stage is based on the use of complex decoctions, tinctures, baths and other methods, coupled with traditional medicine for chronic prostatitis. Herbal preparations help the body overcome inflammation and prevent relapse, but they cannot completely replace conservative therapy.
It is forbidden to turn to the method of the people in critical situations. If a man is indicated for immediate surgery and there is a risk of developing AUR, trying to stop the disease with herbs means starting the pathological condition with more.
What are the folk methods used for chronic prostatitis:
- Herbal decoction. They help cleanse the body of toxins, relieve general inflammation, lower the temperature.
- Douching, enema. To do this, make a warm infusion, decoctions of nettle, oak bark, wormwood, calendula. The solution is injected into the cleansed intestine, this contributes to the rapid relief of inflammation in the prostate.
- Compressing. For their preparation, propolis oil, mustard powder or herbal decoctions are used. Application is only external, done in the evening, so that after them you do not go outside and not cold.
- Rectal suppositories. It is made from propolis, beeswax, cocoa butter, lard, bee bread and royal jelly. Apply rectally after a cleansing enema, insert the suppository at night or during the day, but you need to lie down for at least 40 minutes.
Exercise
With the help of daily exercise, you can improve smooth muscle tone, improve blood circulation in the pelvic organs, relieve congestion in the prostate and reduce the effects of hypodynamia if a man's work is inactive.
For chronic inflammation of the prostate, the following exercises are recommended:
- Kegel Gymnastics. The essence is to strengthen the muscles of the pelvic floor, perineum. This is achieved with frequent (up to 150 times / day) contraction / tension of the anal muscles and between the scrotum and penis.
- Charging with a tennis ball. It is placed on the crotch area, sitting on the floor and swaying, moving back and forth massaging and tightening the desired area.
- Stepping on the back. The essence of the exercise is to sit on your back and roll from side to side to move forward (duck -like steps). 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 put a load on the press, pelvic muscles, thighs.
With the exacerbation of chronic prostatitis, any exercise is prohibited. Resume physical education when the acute syndrome is relieved.
Surgical intervention
The period of conservative treatment does not always relieve chronic prostatitis, it always reminds itself of a relapse. In critical situations, andrologists recommend surgery, although it does not exclude recurrence if the man does not adhere to disease prevention measures.
List of surgical techniques for the treatment of chronic prostatitis:
- prostate resection. With severe inflammation or sclerotic areas, part of the affected prostate is removed using an endoscope.
- prostatectomy. This is the complete removal of the prostate gland, performed in critical conditions, when inflammation and changes in the gland interfere with normal urination.
- Drainage cysts, abscesses. If an abscess or cyst has formed on the prostate, puncture is performed using endoscopy, ultrasound or manipulation is performed through the urethra.
- Pieces of urine neck. Do with sclerosis, bladder obstruction, to improve urine outflow and ejaculation.
Diet
The main principles of proper nutrition in chronic prostatitis are the exclusion of harmful foods and changes in diet with the predominance of "clean" foods. Any semi-finished product, spicy, spicy dish with artificial preservatives, alcohol, strong tea or coffee is removed from the diet.
The body must 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 replaced with steam, which are boiled, and which result in increased gas formation in the intestines are also prohibited.
Prevention
Chronic prostatitis is mostly incurable, so the main thing of prevention is to prevent the disease from the very beginning. To do this, it is necessary to treat any infectious pathology in a timely manner, not too cold, always remember about venereal diseases and follow the principles of healthy sexual intercourse.
Physical inactivity is a precursor to stagnation, so daily exercise and an active lifestyle will help prevent prostatitis. Adhere to a healthy lifestyle, undergo 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 is common with chronic, there are:
- Androgen deficiency.
- Violation of sexual and reproductive function.
- Vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis and epididymo-orchitis.
- Psychological problems.
- Prostate necrosis.
Prediction
The prognosis depends on when the patient goes to the doctor. In advanced cases and with 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 at the chronic stage and then recurrence is periodically prevented, the course of the disease can be improved and the period of exacerbation can be flattened.