Chronic prostatitis is a long-term inflammation of the prostate gland, which often has no symptoms, so the majority of the male population is not aware of the disease.
The development of a chronic form of prostatitis is a consequence of an acute process, although in practice this is quite rare.As a rule, chronic inflammatory prostatitis begins gradually, without symptoms and unpleasant sensations;The course of the disease is often discovered in the patient by chance during an ultrasound examination.
Both young men 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 a sedentary lifestyle, feel excessive physical tension in the perineum and observe sexual abstinence.
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 pain when urinating, inability to empty the bladder completely, and pain in the lower abdomen, back, or pelvic area.There may be fever accompanied by chills.
- Chronic bacterial prostatitis is a disease with typical symptoms of chronic inflammation and an increased number of bacteria and leukocytes in the urine and secretions of the prostate after massage.
- Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, it is a consequence of acute bacterial prostatitis (untreated or poorly treated).If there are symptoms, they present in the form of pain in the genitals or pelvic area, difficulty urinating, or pain during urination and ejaculation.
- Asymptomatic inflammatory prostatitis - in this form of the disease, the classic symptoms of prostatitis are absent, and the disease itself is detected by chance, when visiting the clinic for another reason.
In the presence of an infectious component, we speak of chronic bacterial (infectious) prostatitis;in the absence of microbial pathogens, on non-bacterial (non-infectious) prostatitis.It is believed that in 90-95% of all cases chronic non-bacterial prostatitis occurs and only in 10-5%, bacterial.
Reasons
Several factors can contribute to the appearance of chronic prostatitis.First of all, this:
- STIs: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungi, Escherichia coli can infect the urethra and be detected in prostate tissue;
- Poor circulation in the pelvic organs (congestion in the prostate causes its inflammation);
- Sedentary lifestyle (drivers, office workers, civil servants);
- Prolonged sexual abstinence, interrupted sexual intercourse or artificial prolongation of sexual intercourse;
- Regular hypothermia (for fans of extreme activities: diving, surfing and skiing);
- Stress: mental and physical overload.
For the development of chronic prostatitis, what is important is not so much the presence and activity of pathogenic microorganisms, but rather the state of the pelvic organs and blood circulation in them, the presence of concomitant diseases and the level of protective mechanisms.
Symptoms of chronic prostatitis.
Very often, with the development of a chronic form of prostatitis, the symptoms practically do not bother the man.In this case, all signs of acute prostatitis will not manifest themselves at all or will manifest themselves to a much lesser extent.
The most common symptoms of chronic prostatitis in men are:
- periodic pain and discomfort in the perineum;
- discomfort when defecating and urinating;
- irradiation to the anus, thigh, testicles;
- discharge from the urethra.
Changes in the course of the disease, which are no longer very bright, may 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 need to urinate;
- 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, including increased irritability, anxiety, fatigue, bad temper, sleep disturbances, obsession and depression.
It is almost impossible to determine all the symptoms of a patient at once, since a man usually has only 2-3 signs of the disease.For example, the most common are erectile dysfunction and pain in the lower abdomen.
Why can prostatitis cause infertility?
The fact is that the prostate produces a special secretion that ensures the viability of sperm.With inflammation, the secretory function of the prostate deteriorates, which inevitably affects sperm quality.
In addition, the prostate is actively involved in regulating testosterone production and the erection process.This is why chronic prostatitis causes decreased erectile function, even impotence.However, these scenarios of disease development can be avoided if timely and competent treatment is carried out.
Diagnosis
The following procedures are necessary to help establish/refute the diagnosis:
- rectal examination;
- prostate secretion microscopy;
- culture of prostate secretion to detect sensitivity to antibiotics;
- testing for sexually transmitted diseases;
- Transrectal ultrasound.
Additional endoscopic and urodynamic studies are sometimes 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 at which the patient consulted a specialist.Therapy involves an integrated approach, that is, a combination of several methods simultaneously:
- antibacterial therapy;
- prostate massage;
- physiotherapeutic procedures;
- diet and lifestyle correction;
- use of home remedies;
- surgical treatment.
Additionally, anti-inflammatory and antispasmodic agents are used in the treatment of chronic forms of the disease.
Pharmacological treatment
The choice of medications depends on the cause and symptoms of the disease.To cure chronic prostatitis of infectious etiology, antibacterial drugs are used:
- fluoroquinolones;
- macrolides;
- tetracyclines.
To eliminate inflammation and pain, non-hormonal analgesics and anti-inflammatories are used.
Furthermore, in recent years, the treatment of chronic prostatitis has been carried out with drugs that were not previously used for this purpose: alpha1 blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect the metabolism of urate and citrate.
Physiotherapy
Certain physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis and others, also help to improve the trophism of prostate tissue and accelerate the healing process.
Additionally, for chronic prostatitis, warm therapeutic baths, mud therapy and special enemas can be prescribed.
prostate massage
It improves the drainage of prostate secretions and microcirculation at the level of this organ, which in turn contributes to a speedy recovery of the patient.
Prostate massage cannot be performed in case of acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is often combined with antibiotic therapy.Numerous clinical studies have demonstrated the high effectiveness of this treatment.
Operation
Surgery is possible to remove areas of the prostate gland affected by bacteria.Transurethral resection is an operation performed under epidural anesthesia or intravenous barbiturates.The postoperative recovery period lasts no more than a week.
The necessary methods for the treatment of chronic prostatitis are determined by the urologist based on diagnostic information and his practical experience.Self-therapy at home based on reviews on the Internet has many consequences.