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 suggests the beginning of the chronic phase.Statistics show that acute and chronic prostatitis often occur against the background of complicated urethritis.

A distinctive feature 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 registers onlyindirect symptoms of the disease, not directly related to prostatitis.Both young, middle-aged and elderly men are not immune to chronic prostatitis.

Those who experience a lack of 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 microtraumas in the prostate tissue.Men who have low sexual activity become hostage to this unpleasant disease due to stagnation of prostate secretions.They affect the prostate, causing acute and chronic prostatitis, various sexually transmitted infections, through the blood or lymphatic 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 an infection or pathogenic bacteria that has 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.Typically, this prostatitis develops due to the anatomical features of the prostate gland of a particular man.The incorrect structure of the organ increases pressure in the urethra, which leads to frequent urine discharge.Autoimmune diseases can also cause degenerative changes in prostate tissue.
• Stagnant.Chronic congestive prostatitis develops when the prostate does not empty completely and excess blood mass forms.Stagnation creates an inflammatory response.
• Constant pelvic pain syndrome.A man complains of constant, unrelenting pain in the perineal region.
• Asymptomatic.Chronic prostatitis occurs latently, without causing pain or discomfort, despite the presence of inflammation.

Chronic prostatitis has its own stages of development

• Exudation stage.Rapid ejaculation and sharp pain in the prostate.
• Alternative stage.Painful sensations are replaced by discomfort, reduced intercourse time and frequent urination.
• Proliferation stage.The frequency of the urge to go to the bathroom increases, but problems with urine production appear.
• Stage of cicatricial changes.Sclerosis of healthy prostate tissue occurs.As a result of morphological transformations, heaviness appears in the region of the sacrum and pubis, the stream of urine weakens and potency decreases.Sensations during orgasm are often confusing.

Causes

• Infection.The source of pathogenic bacteria entering the prostate is the blood and lymphatic vessels.Urological diseases and inflammation in the rectum are prerequisites for prostate tissue infection.Infection methods:
  • Descendant- the infection enters the gland along with urine, which contains microbes.
  • Ascending— The path of microbes entering the prostate begins at the external opening of the urethra.
• Decreased protective functions of the body.One of the main culprits of chronic prostatitis is weakened immunity.This is facilitated by hypothermia, frequent stressful situations, poor nutrition and bad habits.When immunity decreases, the body is open to infections that cause inflammation in the prostate.
• Poor circulation.A sedentary and sedentary lifestyle is closely related to chronic prostatitis.A man's internal organic systems suffer 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 refusal of intimate life and excessive sexual activity lead to prostate problems.Many men with a strong sexual constitution engage in vigorous sexual activity.Due to frequent sexual intercourse, the nervous system becomes exhausted, hormonal disorders appear and the erection gradually weakens.Incomplete sexual intercourse causes great damage to prostate health.
• Chronic prostate lesions.The soft tissue of the prostate, often prone to injury due to excessive stress, tremors and vibrations, can periodically become inflamed.
• Transurethral procedureswithout concomitant antibiotic therapy may cause prostate infection.
• Urethral catheter, which a man is forced to live with for some time, also contributes to prostate infection.

Chronic prostatitis symptoms

Symptoms of chronic prostatitis vary.Some of the first signs of chronic prostatitis that attract attention are pain when urinating and impaired sexual function.As a rule, problems in the intimate sphere force a man to seek medical help.If discomfort and pain in the pelvic regiondo not decrease for more than three months, then with a high probability we can talk about chronic prostatitis.

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

Common symptoms of chronic prostatitis also include increased sweating, a feeling of cold and tremors in the perineum.Poor circulation in the pelvis can lead tochanges in skin color.

The chronization of the inflammatory process in the prostate leads to a disturbance in its tone.In some cases, prostatorrhea develops.With this pathology, there is spontaneous secretion of the gland, which is unrelated to excitement or ejaculation.

In chronic prostatitis, men may notice, especially in the morning, 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 the semen.

The appearance of sexual dysfunction, simultaneously with a decrease in libido and deterioration of spontaneous erections, is noticed by many patients.It is worth noting that most patients have impotencehas no critical connotation.In the early stages of chronic prostatitis, men experience premature ejaculation, which may become difficult over time.Some patients report a decrease in the intensity of sensations during sex.Problems with urination are usually irritative in nature.

Diagnosis of biological material from a man with chronic prostatitis reveals a quantitative and qualitative violation of prostate secretion.Morphological deviations in ejaculation parameters are rarely associated with male infertility.

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

Diagnosis of the disease

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

To confirm the diagnosiscarry out the following procedures:

• Rectal examination using fingers.A digital exam is performed during the man's initial visit to the urologist.The back of the prostate is in contact with the rectum, which allows the state of the prostate to be assessed when a finger is inserted through the anus.Palpation of the posterior surface of the gland allows you to determine the size and shape, as well as the consistency and pain of the inflamed organ.
• Microscopic examination of prostate secretion.When studying biological material, a laboratory technician may notice an increase in the number of leukocytes - this signals the spread of pathogenic bacteria.
• Glandular secretion culturein the nutrient medium, type of bacteria and resistance to antibiotics by RIF and PCR methods.
• Cystoscopy.An endoscopic imaging system device is inserted into the bladder cavity.This method of diagnosing chronic prostatitis makes it possible to exclude cancer, cystitis and bladder damage.
• Ultrasound.The doctor may prescribe an ultrasound examination before starting treatment for acute prostatitis, so as not to miss the formation of an abscess in the organ.For men suffering from chronic prostatitis, ultrasound is done to detect stones and cysts, as well as to assess the level of urethral pressure.Today, transrectal ultrasound is more effective, in which a sensor is inserted into the rectum.
• Uroflowmetric diagnostic method.In this way, indicators of the urinary process are studied: the duration and speed of urine output.A rate above 10–15 ml/s indicates good urethral patency.Indicators below this norm indicate poor patency of the urinary canal caused by chronic prostatitis.

Chronic prostatitis: treatment

Each clinical case requiresindividual selection of the treatment regimen.When choosing the 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 caused by 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 treatment, the full extent of symptoms usually remains, as long as the infecting factor has been eliminated.
• Alpha blockersprescribed to men to reduce hypertonicity of bladder muscles and stabilize intraurethral pressure.They are ineffective if the patient has impaired muscle innervation and pelvic floor muscular dystrophy.
• Nonsteroidal anti-inflammatory drugs.Help relieve pain syndromes.
• Selective antidepressants.Prescribed to men to improve their emotional background, relieve anxiety and doubts.
• Hormonal drugs.Antiandrogens and androgens are used to adjust hormone levels.
• Immunostimulating drugs.Prescribed for proven immunodeficiency.
• Uric acid level regulators.The consultation is justified if there are sand and stones in the prostate.
• Vitamin complexes.

Auxiliary methods in the treatment of chronic prostatitis

Some urologists consider that physical impact on the prostate gland significantly alleviates the patient's condition.But most of these therapeutic methods have their contraindications, soprescribed under certain conditions:

• Prostate massage.Contraindicated in prostatic hyperplasia because it can cause acute urinary retention.Furthermore, when you have a massage, you can spread the infection throughout the prostate and cause sepsis.Massage should not be performed if there are cystic formations in the prostate or venous stagnation.To relieve gland stagnation, natural drainage during ejaculation is considered the best way.
• Bladder gymnastics.The treatment consists of a set of special exercises that aim to improve the muscle tone of the bladder and its sphincter.
• Instillations.Infusion of medicinal solutions deep into the urethra.The procedure is very painful and often ends in complications.
• Physiotherapy.Prostate treatment with transrectal ultrasound, electrical stimulation, magnetotherapy and phonophoresis will be beneficial for poor pelvic floor muscle tone.Physiotherapy only brings temporary relief to the patient's condition.A lasting effect can only be achieved after eliminating the causes of prostatitis.
• Traditional medicine recipes.Honey with pumpkin seeds, alcohol tincture of horse chestnut and other folk methods are used after consultation with the attending physician.

Surgical treatment of chronic prostatitis

Considering which pathological process provoked prostatitis, they usetransurethral resectionprostate.This is a modern method of surgical treatment that has replaced open surgery.An endoscope is used to drain the formed prostatic cyst and surgical correction of the seminal vesicles is performed in case of obstructed exit of secretions.

Treatment of chronic prostatitis -long process, requiring patience and endurance from a man.To prevent illnesses from taking you by surprise, you need to monitor your health, strengthen your immune system and treat colds in a timely manner.