Chronic prostatitis (bacterial) is characterized by constant or recurrent symptoms with bacterial infection confirmed in the prostate gland.
Prostatitis in this category is not frequent in approximately 10% of cases of all prostatitis cases.The question - if atypical pathogens can, such as ureaplasma urealiticum), cause prostate inflammation - is discussed.They may be present in a man's body and no signs of inflammation and complaints.
The causes of chronic prostatitis
The causes of chronic prostatitis are mainly similar to the causes of the development of acute bacterial prostatitis.In most cases, the entry of prostate microorganisms occurs through the urethra - as a result of the urine cast in the prostate gland duct.
Chronic bacterial prostatitis develops due to inappropriate treatment or a short course of acute bacterial prostatitis.
Symptoms
- Discomfort or pain - in the groin, lower abdomen, groin, scrotum, penis, during ejaculation
- Changes in urination - Difficulty of urination, rapid urination in small portions, a feeling of incomplete emptying of the bladder.
The patient may complain of various symptoms and any symptoms separately.An increase in body temperature is uncommon (or slightly).
Important:
Many men associate erectile dysfunction with prostatitis.This is often facilitated by non -professional media publications and dubious drug advertising.The fact that an erection can remain even with a complete removal of a prostate (due to the presence of an evil organ tumor) suggests that it does not play a role in maintaining an erection.
According to many authoritarian urologists, erectile dysfunction in patients with chronic prostatitis is due to psychogenic and neurotic problems.
Diagnosis
For primary evaluation, a questionnaire is used - an index of symptoms of chronic prostatitis.In it, you can objectify the patient's complaints.
The standard method for diagnosing prostatitis is sample performance.This is a microscopic and bacteriological study of urine samples obtained from different parts of the genitourinary tract and prostate gland secretion.However, the test method is quite laborious and at the moment the samples are most often used.A possible alternative is the delivery of ejaculars (sperm) to a microscopic and bacteriological examination, since the partially ejaculated (at least 1/3) consists of a prostate gland secretion.This method is more comfortable for patients, especially if they categorically refuse a rectal examination or perform a diagnostic prostate massage to get a prostate secret.However, ejaculated surrender has lower information and reliability compared to breakage.
Ejaculated delivery to a bacteriological examination is included in the diagnostic algorithm for male genital infections and when examining a man over infertility.
The results of laboratory tests (general urine analysis, a general blood test, a biochemical blood test, a sperm and other general clinical tests) in the case of chronic prostatitis are not informative.Most likely, these tests will show the "norm".
During a rectal examination of changes indicating the inflammatory process in the prostate, in patients with chronic prostatitis, far from always observed.That is, it is impossible to trust the result of a rectal study for the diagnosis of chronic prostatitis.
The same goes for the diagnosis of UZ: make a diagnosis of chronic prostatitis, focusing only on ultrasound data, is incorrect.The European and American Association of Urologists is not recommended to make an ultrasound for the diagnosis of prostatitis.The type of execution in this case is not important through the anterior abdominal wall - the lower abdomen or confidence - through the rectum.Write in the conclusion of the study of “chronic prostatitis” ultrasound, “ultrasonic signs of chronic prostatitis”, “signs of prostatitis” are wrong.The prerogative of the installation of this diagnosis has only one urologist who determines it based on complaints, anamnesis, laboratory tests and - only after - ultrasound.
The most frequent ultrasonic signal, according to which the diagnosis of chronic prostatitis is established - diffuse changes called in the prostate gland associated with the transferred inflammatory process or other changes in prostate parenchyma.This is a type of fibrous process, replacing the normal prostate parenchyma with a scar tissue.However, there are no correlations of the number of fibrous prostate changes with the presence of complaints.At age, the chances of appearing from such "scars" in the organ are increasing, but a man can live a lifetime, without feeling any discomfort in the groin or pubic area.However, as soon as these changes are found in an ultrasound, some "experts" will diagnose prostatitis.And some men will feel that they are really seriously sick, they start to hear themselves, to feel all the symptoms described on the internet.
For many men over 30, ultrasound can show diffuse changes in the prostate gland.However, the fibrous process does not indicate the presence of prostatitis.
The diagnosis of chronic prostatitis is established based on the exclusion of other diseases of the genitourinary system - mainly urethritis, prostate hyperplasia, urethra stenosis, neurogenic disturbance of urination, prostate cancer and bladder cancer.
There is no specific image for chronic prostatitis based on the results of a routine exam.
Treatment of chronic prostatitis
Ftikinolone group antibiotics are ideal antimicrobial drugs for the treatment of chronic bacterial prostatitis.The recommended course of antibacterial therapy is 4 to 6 weeks.Such a long course is justified by scientific data indicating a decrease in the probability of relapse of the disease.
If sexually transmitted infections (STDs), such as chlamydia, received an antibiotic group of macrolycid groups.
There is data on a decrease in bladder neck relaxation in patients with chronic prostatitis, which leads to reflux urine in the urethra ducts and causes inflammation of prostate and pain tissue.These patients are recommended by appointing alpha blockers.
In the treatment of chronic prostatitis, it is advisable for patients to refrain from tempting sentences by the use of plant -based medicines.One feature of food supplements and vegetable additives is the instability of plant components in one part of the matter, they can differ even in the medicine of the same manufacturer.Moreover, from the point of view of evidence -based medicine, the benefits of herbal medicine cannot support criticism.
Prostate massage, which in the mid -twentieth century was used as the basis of therapy today, thanks to new approaches and scientific classification, remains an important tool for the diagnosis of prostatitis, but not to its treatment.You do not need to use prostate massage as a therapeutic procedure (the effect is not proven).There are assumptions that frequent ejaculation in its properties is similar to sessions of prostate therapeutic massage.
For other methods whose effectiveness has been proven as a result of only one or more studies or is still being studied: Relate:
- MUSCULAR TRAINING TRAINING TRAIN - Some data indicate the effectiveness of special exercises to reduce the symptoms of chronic prostatitis and chronic pelvic pain syndrome;
- Acupuncture - A small amount of studies indicates the advantage of acupuncture compared to placebo in patients with chronic prostatitis;
- Extracorporeal therapy of shockwaves on the effects of acoustic impulses of significant amplitude on connective and bone tissue is widely used to treat musculoskeletal system diseases recently used in urology, its effectiveness is under study;
- Behavioral therapy and psychological support - such as chronic prostatitis is associated with poor quality of life and depression development, these methods can improve the patient's psychological state and help reduce some symptoms of the disease.
Separately, it is worth mentioningAsymptomatic chronic (asymptomatic) prostatitis).The diagnosis is most often established according to the results of histological conclusion - after prostate gland biopsy or after surgical treatment of the prostate.The frequency of inflammation detection in prostate tissues ranges from 44% (with prostate biopsy) to 98-100% (after surgical treatment of the prostate).Scientists have suggested that inflammatory changes revealed in this way are nothing more than an age -related physiological feature.No one is involved in diagnoses especially in this category of prostatitis, this is a type of random finding.It does not need treatment, it does not require any additional action from the doctor and the patient.