Chronic prostatitis: symptoms and treatment

Inflammatory processes observed in prostate tissue for three or more months are called chronic prostatitis.The long course of the disease makes it possible to assess the beginning of the chronic stage.Statistics show that acute and chronic prostatitis often occurs against the background of complicated urethritis.

The peculiarity of chronic prostatitis is that in 50-70% of cases the disease does not manifest itself with pronounced symptoms.Only in 20% of cases do patients describe signs that indicate a chronic form of prostatitis.The remaining category of men notes onlyindirect symptoms of the disease, which are not directly related to prostatitis.Young people, as well as middle-aged and older men, are not immune from chronic prostatitis.

Those who lack physical activity, are associated with sedentary work and practice sexual abstinence are susceptible to prostatitis.Thus, truck drivers, who spend most of their time behind the wheel, experience the effects of negative factors: hypothermia and congestion in the pelvic organs.Representatives of contact sports and weightlifters are prone to microtrauma of the prostate tissue.Men who show low sexual activity become hostages of this unpleasant disease due to the stagnation of prostate secretions.They affect the prostate, causing acute and chronic prostatitis, various sexually transmitted infections, through blood or lymph fluid.

Types and stages of chronic prostatitis

In urological practice, the following are distinguished:forms of chronic prostatitis:

• Bacterial.The cause of the disease lies in infection or pathogenic bacteria that have penetrated the prostate.The most common is chronic prostatitis caused by chlamydia.The danger of this form lies in the possible infertility that awaits a man without timely treatment.
• Abacterial.Chronic prostatitis of a non-infectious nature.Diagnosing the exact cause is quite problematic.Usually, such prostatitis develops due to the anatomical characteristics of an individual man's prostate.The irregular structure of the organ creates increased pressure on the urethra, which leads to frequent emptying of urine.Autoimmune diseases can also cause degenerative changes in prostate tissue.
• It stagnates.Congestive chronic prostatitis occurs when the prostate does not empty completely and an excess of blood mass occurs.Stagnation creates an inflammatory response.
• Constant pelvic pain syndrome.A man complains of constant, unrelenting pain in the perineal area.
• Asymptomatic.Chronic prostatitis occurs in a latent form, without causing pain or discomfort, despite the presence of inflammation.

Chronic prostatitis has its own stages of development

• Exudation phase.Rapid ejaculation and sharp pain in the prostate.
• Alternate phase.Painful sensations are replaced by discomfort, a reduction in the time of intercourse and frequent urination.
• Proliferation phase.The frequency of the urge to go to the toilet increases, but there are problems with the excretion of urine.
• Stage of scar changes.Sclerosis of healthy prostate tissue occurs.As a result of morphological transformations, heaviness appears in the area of the sacrum and pubis, the stream of urine weakens and the potency decreases.Feelings during orgasm are often blurred.

Causes

• Infection.The source of pathogenic bacteria entering the prostate are blood and lymphatic vessels.Urological diseases and inflammation in the rectum are a prerequisite for prostate tissue infection.Methods of infection:
  • Descending- the infection enters the gland together with urine, which contains microbes.
  • Rising— The path of microbes that enter the prostate starts from the external opening of the urethra.
• Reduction of the body's protective functions.One of the main culprits of chronic prostatitis is weakened immunity.Hypothermia, frequent stressful situations, poor nutrition and bad habits contribute to this.When immunity decreases, the body becomes open to infections that cause inflammation of the prostate.
• Poor circulation.A sedentary and sedentary lifestyle is closely related to chronic prostatitis.A man's internal organ system suffers from a lack of physical activity: endocrine, cardiovascular, nervous.Blood microcirculation in the pelvis deteriorates, resulting in hypoxia of prostate cells.
• Lack of regular sex life.Both rejection of intimate life and excessive sexual activity lead to problems with the prostate.Many men with a strong sexual constitution engage in vigorous sexual activity.Frequent sexual intercourse exhausts their nervous system, hormonal disorders occur and erection gradually weakens.Incomplete sexual intercourse causes great damage to the health of the prostate.
• Chronic prostate injuries.The soft tissue of the prostate, often susceptible to injury from excessive stress, shaking and vibration, can occasionally become inflamed.
• Transurethral procedureswithout simultaneous antibiotic therapy, it can cause prostate infection.
• Urethral catheter, with which a man is forced to live for some time, also contributes to prostate infection.

Symptoms of chronic prostatitis

Symptoms of chronic prostatitis are different.Some of the first signs of chronic prostatitis that attract attention are pain during urination and impaired sexual function.As a rule, problems in the intimate sphere force a man to seek the help of a doctor.If there is discomfort and pain in the pelvic areathey do not subside for more than three months, then with high probability we can talk about chronic prostatitis.

Most often, the pain syndrome spreads to the perineal area, however, the discomfort can be localized in the pubic and groin area.A man complains of pain in the anus, scrotum and head of the penis.The pain spreads to the lumbosacral region.Attacks of pain can cover the inner thighs.Pain in one of the testicles usually does not indicate prostatitis.Complaints of pain after ejaculation are specific to the chronic course of the disease.

Among the common symptoms of chronic prostatitis are increased sweating, a feeling of coldness and trembling in the perineum.Poor circulation in the pelvis can lead toit changes in skin color.

Chronic inflammatory process in the prostate leads to disturbance of its tone.In some cases, the prostate develops.In this pathology, there is a spontaneous secretion of the gland, which has nothing to do with excitement or ejaculation.

With chronic prostatitis, men can notice, mostly in the morning, a small purulent or clear discharge from the penis.Some patients find white flakes or threads in their urine.A sign of advanced calculous prostatitis is the presence of traces of blood in semen.

Many patients notice the appearance of sexual dysfunction, simultaneously with a decrease in libido and deterioration of spontaneous erection.It is worth noting that most patients have impotenceit has no critical connotation.In the early stages of chronic prostatitis, men experience premature ejaculation, which can become difficult over time.Some patients report a decrease in the intensity of sensations during sex.Problems with urination are most often of an irritating nature.

The diagnosis of the biological material of a man with chronic prostatitis reveals a quantitative and qualitative violation of prostate secretion.Morphological deviations in ejaculate parameters are rarely associated with male infertility.

During remission, most symptoms subside and pain decreases.Many men calm down, attributing the situation to self-healing.But without proper therapy, infectious foci in the prostate persist, and during the period of deteriorationsymptoms worsen significantly, the low temperature persists.

Disease diagnosis

Diagnosing chronic prostatitis is not difficult for an experienced urologist.The most difficult thing here is probably to determine the real cause that led to chronic prostatitis.

To confirm the diagnosiscarry out the following procedures:

• Rectal examination with fingers.A digital examination is performed during a man's first visit to a urologist.The posterior part of the prostate is in contact with the rectum, which allows the evaluation of the condition of the prostate when a finger is inserted through the anus.Palpation of the posterior surface of the gland allows determining the size and shape, as well as the consistency and pain of the inflamed organ.
• Microscopic examination of prostate secretions.When studying biological material, a laboratory technician may notice an increased number of leukocytes - this signals the spread of pathogenic bacteria.
• Culture of secretory glandson nutrient medium, type of bacteria and resistance to antibiotics by RIF and PCR methods.
• Cystoscopy.The device of the endoscopic imaging system is inserted into the bladder cavity.This diagnostic method of chronic prostatitis allows us to rule out cancer, cystitis and bladder injuries.
• Ultrasound.The doctor can prescribe an ultrasound examination before starting the treatment of acute prostatitis, in order not to miss the formation of an organ abscess.In men suffering from chronic prostatitis, ultrasound is performed to detect stones and cysts, as well as to assess the pressure level of the urethra.Today, transrectal ultrasound, in which a sensor is inserted into the rectum, is more effective.
• Uroflowmetric diagnostic method.In this way, indicators of the urinary process are studied: duration and speed of urine outflow.A speed above 10-15 ml/s indicates good urethral patency.Indicators below this norm indicate poor urinary tract patency caused by chronic prostatitis.

Chronic prostatitis: treatment

Each clinical case requiresindividual choice of treatment regimen.When choosing a therapeutic model, the causes of the disease, the duration of the course and the presence of aggravating factors are taken into account.

Drug treatment:

• Antibiotics.Antibacterial therapy is indicated only in cases of prostate infection with a bacterial agent identified in prostate secretions or urine.Antibiotics from the fluoroquinolone group are prescribed.Treatment lasts from two to eight weeks.After an antibacterial course, the full strength of the symptoms often remains, provided that the infectious factor is eliminated.
• Alpha blockersit is prescribed to men to reduce hypertonus of the bladder muscles and stabilize intraurethral pressure.They are ineffective if the patient has impaired muscle innervation and muscular dystrophy of the pelvic floor.
• Nonsteroidal anti-inflammatory drugs.It helps relieve pain syndromes.
• Selective antidepressants.It is prescribed to men to improve their emotional background, relieve anxiety and self-doubt.
• Hormonal drugs.Antiandrogens and androgens are used to adjust hormone levels.
• Immunostimulating drugs.It is prescribed for proven immunodeficiency.
• Uric acid level regulators.The appointment is justified if there is sand and stones in the prostate.
• Vitamin complexes.

Auxiliary methods for the treatment of chronic prostatitis

Some urologists believe that physical impact on the prostate significantly eases the patient's condition.But most of these therapeutic methods have their own contraindications, and so onprescribed under certain conditions:

• Prostate massage.Contraindicated in prostate hyperplasia because it can cause acute urinary retention.In addition, massage can spread the infection through the prostate and cause sepsis.Massage should not be performed if there are cystic formations in the prostate or venous stagnation.To release the gland from stagnation, natural drainage during ejaculation is considered the best way.
• Bladder gymnastics.The treatment consists of a group of special exercises aimed at improving the tone of the bladder muscles and its sphincter.
• Instillations.Infusion of medicinal solutions deep into the urethra.The procedure is very painful and often ends in complications.
• Physiotherapy.Treatment of the prostate with transrectal ultrasound, electrical stimulation, magnetotherapy and phonophoresis will be beneficial for poor pelvic floor muscle tone.Physiotherapy brings only temporary relief of the patient's condition.A lasting effect can be achieved only after the cause of prostatitis has been eliminated.
• Recipes of traditional medicine.Honey with pumpkin seeds, alcohol tincture of horse chestnut and other folk methods are used after consulting a doctor.

Surgical treatment of chronic prostatitis

Given the pathological process that caused prostatitis, they are usedtransurethral resectionprostate.This is a modern surgical method of treatment that has replaced open surgery.The formed prostate cyst is drained with an endoscope, and in the case of difficult outflow of secretions, surgical correction of the seminal vesicles is performed.

Treatment of chronic prostatitis -long process, which requires patience and endurance from a man.So that the disease does not surprise you, you must monitor your health, strengthen the immune system and treat colds in a timely manner.