Chronic prostatitis is a long-term inflammation of the prostate gland, diagnosed only in men and shows a neglected pathological condition in the reproductive organs. The disease leads to a violation of the morphology and functioning of the prostate, is characterized by pelvic pain, genital irradiation in the groin, urinary disorders, sexual disorders. Long-term treatment consists in stabilizing the general condition, with the exception of relapses and AUR.
Types of chronic prostatitis
The chronic form of prostatitis can be of several types, it all depends on what is at the root 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 in the descending or ascending way (abscesses, through the urethra, caries, etc. ).
- Chronic with inflammatory components of prostate secretion. The study revealed elevated levels of leukocytes and pathogens, infectious agents.
- Chronic abacterial prostatitis. It manifests itself as an inflammatory process with a symptom complex similar to acute inflammation involving pathogenic microflora. But in fact there are no inflammatory components (pathogen + leukocytes).
- Latent chronic prostatitis. The disease has no obvious signs, does not cause discomfort, almost does not impair the functioning of the reproductive organs. But when analyzed secretly, inflammatory products are found - leukocytes.
Usually STB (pelvic pain syndrome) can be attributed to the chronicity of the process in the prostate. He develops a symptom complex 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 inflammation of the prostate are bacterial in nature, in the rest - chronic disease is nonbacterial. This means that most glandular problems in men come from leading 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).
- Disorders of blood circulation in the pelvic organs (physical absence, 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).
- Systemic local hypothermia / pelvic overheating.
- Stress, fatigue, chronic insomnia.
- Poor nutrition, including the predominance of "empty" meals without enough vitamins and minerals.
- Rare urination.
The clinic of abacterial (non-infectious) prostatitis is associated with stagnant processes in the body:
- Impaired drainage in the acinus of the prostate.
- Poor venous circulation in the pelvis.
- Overflow of the prostate with blood (swelling, poor secretion).
- Prolonged abstinence or excessive sexual activity.
- PPA practice, prolong sexual intercourse.
- chronic intoxication.
Symptoms of abacterial inflammation in the prostate almost always occur in men who lead a slow lifestyle. Physical deprivation, overweight, reluctance to move intensively, laziness, all this affects the work of the prostate, provokes stagnation (stagnation).
It is difficult to prevent the development of chronic prostatitis and men engaged in the 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
The specific signs of chronic prostatitis are mild and often not typical of prostate pathology. The picture changes only in the period of exacerbation, when the general symptoms resemble the course of an acute inflammatory process.
The sensations of a chronic process are a prostate triad. It is characterized by pain that is constant, pain in nature and radiating (transmitted) to the genitals, pubis, scrotum, rectum and sacrum. In fact, a person constantly, during the day, experiences discomfort in the pelvic area. The pain does not stop, but only changes its 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.
- Pain during intercourse, especially during ejaculation.
- Painful and frequent urination.
- Burning in the urethra, false urges, especially at night.
- Prostatitis (leakage from the urethra, anus during exercise).
- In the groin there are sensations of cold, sweating, burning.
Common (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 down with close people, subordinates, he loses the desire to do anything.
In chronic prostatitis is a pronounced violation of sexual function, which does not improve the mood of men. Painful erections, low libido, unfinished intercourse, deleted orgasms, infertility - all these are visual manifestations of chronic prostatitis.
If chronic prostatitis is not treated, the disease will recur with persistent recurrences of acute prostatitis with a short period of relaxation. It can be complicated by vesiculitis, urinary incontinence, tartar formation, cysts, sclerosis and prostate cancer.
Diagnosis of chronic prostatitis
A complete diagnosis of the condition of the man's body is needed if prostate pathology is suspected. Urologist (andrologist) conducts an initial examination, prescribes laboratory and instrumental diagnostics. After diagnosis, the specialist prescribes treatment for chronic prostatitis, which includes the use of drugs, physiotherapy, the use of folk and specific methods to prevent recurrence of the disease.
Differential diagnosis
It consists of many additional studies to rule out diseases similar in symptoms to chronic prostatitis. Its variety of manifestations makes it difficult to make a true diagnosis, so the doctor methodically excludes such pathologies one by one.
As a differential diagnosis for chronic prostatitis are:
- Inflammation of the prostate is not in the chronic stage.
- Anogenital symptom complex.
- Vegetative urogenital syndrome.
- Adenoma, prostate cancer.
The patient's feelings or complaints are not important in the diagnosis, only the actual data obtained through examination.
Laboratory diagnostics
> zxtable border = "1" cellpadding = "0" >Instrumental diagnostic methods
The examination is performed with the help of endoscopic instruments, devices that allow the urologist to "penetrate" closer to the prostate gland and give an accurate assessment of its condition.
> zxtable border = "1" cellpadding = "0" >Treatment of chronic prostatitis
The course of treatment of chronic prostatitis should be repeated periodically, it is almost impossible to completely cure the disease. The main principle of therapy is to avoid recurrence and to make the "quiet" phase of the disease long. First of all, eliminate the main causes of chronicity and periods of exacerbation, if they result from systemic hypothermia, change clothes, try to avoid currents. Remember to follow the clinical recommendations of a urologist, exclude foods that cause acute inflammation, lack of physical activity, excessive exercise and more.
Medical treatment
Complex treatment is used to treat chronic prostatitis, as it is impossible to cure with just one type of pill. Men are prescribed drugs:
- Antibiotics. They are needed to suppress the pathogenic microflora in the gland, eliminate the cause of bacterial infection and stop inflammation. Among the popular drugs are prescribed from the group of penicillins, cephalosporins, aminoglycosides, fluoroquinolones, macrolides.
- NSAIDs (non-steroidal anti-inflammatory drugs). Drugs from this group eliminate severe inflammation and relieve pain.
- Hormones. Appoint when other means are powerless or you need to quickly eliminate acute recurrence. 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. The drugs are prescribed during exacerbations, risk of AUR.
- Antispasmodics. Eliminate vasospasm and improve pelvic blood flow. This reduces the likelihood of stagnation, stone formation, spasm of the prostate urethra.
Physiotherapy
One of the effective methods of treatment, the essence of which is to affect the body with electric current, magnetic field, ultrasound and other natural remedies. Physiotherapy is not contraindicated in 97% of cases diagnosed with the disease, 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 are slight congestion. In combination treatment with drug solutions the effect of the latter will be higher.
- Magnetic therapy. The human body is affected by a magnetic field with different frequencies. When 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 affected by a laser beam, suppressing inflammation, stimulating blood circulation and improving the outflow of prostate fluid.
Chronic prostatitis is treated with ultrasound, the technique consists of exposing the body to high frequency vibrations. Ultraphonophoresis is a variant - ultrasound is combined with the use of drugs.
Folk remedies
Here, the treatment of chronic prostatitis is based on the complex use of decoctions, tinctures, baths and other methods combined with traditional drugs for chronic prostatitis. Herbal remedies help the body cope with inflammation and prevent recurrence, but they cannot completely replace conservative therapy.
It is forbidden to turn to folk methods in critical condition. If the man is indicated for emergency surgery and is at risk of developing AUR, trying to stop the disease with herbs means even more start of the pathological condition.
What folk methods are used for chronic prostatitis:
- Decoctions of herbs. They help cleanse the body of toxins, relieve general inflammation, lower the temperature.
- Showering, enemas. To do this, make warm infusions, decoctions of nettle, oak bark, wormwood, calendula. The solution is injected into the pre-cleansed intestine, which helps to quickly relieve inflammation in the prostate.
- Compresses. Propolis oil, mustard powder or herbal decoctions are used for their preparation. The application is only external, it is done in the evening so that you do not go out after them and do not get cold.
- Rectal suppositories. They are made from propolis, beeswax, cocoa butter, lard, bee bread and royal jelly. Apply rectally after a cleansing enema, apply suppositories at night or during the day, but you should lie down for at least 40 minutes.
Exercises
With the help of daily exercise you can increase the tone of smooth muscles, improve blood circulation in the pelvic organs, remove congestion in the prostate and reduce the effect of hypodynamics if a man's work is stuck.
In 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 (up to 150 times a day) contraction / tension of the muscles of the anus and between the scrotum and penis.
- Loading with a tennis ball. It is placed in the crotch area, sits on the floor and swings, moving back and forth, massaging and tensing the desired area.
- Steps on the ass. The essence of the exercise is to sit on your ass and roll from one side to the other to move forward (step like a duck). You can't 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 load the press, pelvic muscles, thighs.
In case of exacerbation of chronic prostatitis, all exercises are prohibited. Continue physical education when the acute syndrome is relieved.
Surgical intervention
The duration of conservative treatment does not always relieve chronic prostatitis, it regularly reminds itself of relapses. In critical condition, the andrologist recommends surgery, although it does not rule out recurrence if the man does not follow the measures to prevent the disease.
List of surgical techniques for the treatment of chronic prostatitis:
- prostate resection. In severe inflammation or areas of sclerosis, part of the affected prostate is removed with an endoscope.
- prostatectomy. This is a complete removal of the prostate gland, performed in a critical situation where inflammation and changes in the gland interfere with normal urination.
- Cyst drainage, abscess. If an abscess or cystic formation has formed on the prostate, a puncture is performed using an endoscope, ultrasound or manipulation through the urethra.
- Incision of the neck of the urine. Do with sclerosis, bladder obstruction, to improve the flow 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 with a predominance of "pure" food. All semi-finished products, spicy, spicy dishes 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. Boiled dishes are replaced by steamed, boiled, and those that create increased gas in the intestines are also prohibited.
Prevention
Chronic prostatitis is mostly incurable, so the main goal of prevention is to prevent the disease from the beginning. To do this, it is necessary to promptly treat any infectious diseases, not to catch a cold, always remember about sexually transmitted 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 avoid prostatitis. Stick to a healthy lifestyle, see a urologist once a year, contact a specialist for the smallest 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 in chronicity, there are:
- Androgen deficiency.
- Sexual and reproductive disorders.
- Vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis and epididymo-orchitis.
- 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 factors in 97% the treatment of chronic prostatitis will require surgery. If conservative treatment is carried out in time in the chronic stage and then recurrences are regularly prevented, the course of the disease can be improved and the periods of exacerbations can be equalized.