Features of symptoms, diagnosis and treatment of chronic prostatitis

If you do not want to prevent chronic prostatitis, carefully study the causes of the development of the disease, pay attention to the signs of chronic course and read the rules for diagnosis and treatment.Read about all this in our article.

Chronic prostatitis is characterized by long-lasting inflammatory processes in the prostate, which lead to morphological and functional disorders of the prostate.It is difficult to get rid of the pathology, the complications are serious, so it is easier to prevent the disease if you know the causes of its development.

Causes

The main reason for the chronic course is untreated prostatitis, which passes into the next phase.The following reasons and factors may contribute to this:

1. Infection of the genitourinary tract by mycoplasmas, chlamydia, herpes, ureaplasmas, candida, E. coli, cytomegalovirus or trichomonas.
2. Congestion in the pelvic organs, which occurs against the background of a sedentary lifestyle, impaired blood supply, poor nutrition and bad habits.
3. Frequent hypothermia (the risk group includes people involved in surfing, diving, skiing and so on).
4. Prolonged abstinence from sexual intercourse, interrupted acts.
5. Obesity due to high-fat foods.
6. Disorders in the endocrine system.
7. Inflammatory processes throughout the body, especially chronic ones.
8. Weak immune system.
9. Injury to the genital organ.
10. Constant constipation.
11. Depression, stress, overwork.

Special attention should be paid to bad habits - drinking alcohol, drugs, smoking.The harmful substances released by these products lead to vasospasm, reducing the level of blood circulation.Consequently, the nutrition of all organs deteriorates.

Symptoms

In chronic prostatitis, the prostate enlarges, which compresses the elements of the genitourinary system and narrows the urethra.As the disease progresses, the gland completely envelops the urethra, severely compressing the canal.This is why problems arise with urine production.

How to recognize chronic prostatitis:

• pain periodically occurs in the pelvis and perineum;
• discomfort when urinating and evacuating;
• discharge from the urethra is observed;
• pain spreads to thighs, testicles, anus;
• problems with urination occur;
• intense burning and itching in the urethra;
• frequent desire;
• decreased libido and erection;
• rapid ejaculation with the presence of pain;
• if an infection occurs, body temperature increases and the condition worsens;
• after a year, infertility appears;
• the occurrence of pain after normal physical activity;
• acute urinary retention and false urges;
• slow urine stream.

In the initial stages, symptoms appear slowly, but as they progress, they intensify.The pain syndrome becomes very powerful, radiating to nearby organs and areas.Special attention should be paid to the process and frequency of urination.Against the background of such changes, a man experiences psycho-emotional problems, which manifest themselves as follows:

• severe anxiety;
• depression or, conversely, aggressiveness;
• insomnia at night;
• obsessions;
• fear of sexual intercourse and urination;
• hot temper and irritability.

Classification

The current requirements for the classification of chronic prostatitis were developed in the 95th year of the last century.Based on this, the disease is divided into:

1. Chronic bacterial prostatitis.It occurs in the context of an untreated acute bacterial illness.It manifests itself with typical symptoms, but with an increase in body temperature, chills and fever.When examined, an increased number of leukocytes and pathogenic microorganisms are detected in secretions and urine.
2. Chronic prostatitis occurs most frequently.
3. Asymptomatic inflammatory prostatitis is characterized by the absence of specific signs.Most often discovered by chance.

Based on statistics, the most common form is non-bacterial prostatitis.Much less common (in a maximum of 10 cases out of 100) is the bacterial form.This is due to the fact that when infected, the symptoms are always pronounced, which is why the patient, as a rule, undergoes timely examination and treatment.

Possible complications and consequences

In chronic prostatitis, alternating exacerbations and remissions occur, and inflammatory processes quickly destroy the prostate gland, resulting in the following complications, which are considered the most dangerous for human life:

1. Adenoma.It is formed in the prostate.Inflammatory processes that occur over a long period of time lead to intense cell division.At the same time, the glandular epithelium in the ducts hyperplasias, increasing the size of the organ.Against this background, benign hyperplasia develops.
2. Cancerous growth in the prostate.It occurs most often after prostate adenoma.At an early stage of the appearance of an oncological tumor, recognizing cancer is problematic.This is due to the fact that men with chronic prostatitis have the same symptoms.For this reason, the patient must undergo appropriate urological examinations to detect prostate-specific antigen in the blood.
3. Significant decrease in erection and greater impotence.This is the most common unpleasant consequence.The disease develops in a certain sequence.At first, the erection is slightly weakened, after which it does not appear regularly and ejaculation occurs very quickly.Furthermore, sexual desire decreases and the patient feels pain during ejaculation.Then comes impotence.
4. Infertility.It occurs within a year after the chronic course of prostatitis.The fact is that chronic inflammatory processes lead to a decrease in the number of sperm, slower sperm motility and the destruction of their tails and heads.Infertility can be determined using a spermogram.
5. Vesiculitis.Inflammation occurs in the seminal vesicles, which contain sperm.
6. Swelling of the sphincter in the bladder, against the background of acute urinary retention, leading to death.
7. Prostatic sclerosis.The disease is manifested by the replacement of the prostate with connective tissue.In other words, cords of connective tissue are formed, which leads to sexual dysfunction.

Other consequences:

• cyst formation;
• prostate stones;
• hemorrhoids;
• cystitis;
• psychological instability that needs to be treated.

If a man is diagnosed with chronic bacterial prostatitis, he should only have sex with a condom, as the disease leads to infection of his partner.The bacteria penetrate the fallopian tubes, genital tract and organs, which leads to disease and female infertility.

Which doctor is treating you?

A urologist treats a man's genitourinary system.But if you are visiting the clinic for the first time with a similar problem, you first need to visit a therapist.

As diagnostic measures are carried out, consultation with other highly specialized doctors will also be required - an infectious disease specialist, a psychologist, depending on the cause of the disease.

Diagnosis

At the initial visit to the andrologist, the doctor initially collects an anamnesis, which includes the following:

• study the history of urological, infectious, chronic and other diseases;
• interview the patient about lifestyle and bad habits;
• identification of factors that contribute to the pathology;
• Question the patient about the nature, type and duration of symptoms.

After that, the doctor visually and palpably examines the man and sends him for further tests.

Laboratory methods

What is being done:

1. Collection of fluids secreted from the urethral canal.Pathogenic microflora, mucus and leukocytes are determined.
2. PCR – scraping of the urethra.Pathological agents are identified.
3. Microscopic examination of prostate secretion.Macrophages, amyloid and Trousseau-Lallement bodies, and leukocytes are counted.
4. Immunological examination to assess the level of nonspecific antibodies.
5. Take blood fluid to determine PSA levels.If high levels are detected, a prostate biopsy will also be prescribed, which will rule out or confirm a cancerous tumor.

Instrumental methods

Instrumental diagnostics are as follows:

1. Ultrasound examination of the prostate.Typically, the transrectal method is performed (the sensor is inserted into the rectum).The stage of the disease and its form are clarified by studying the size and echostructure of the prostate, the density and uniformity of the seminal vesicles.
2. Myography of the pelvic floor muscles and urodynamic study.Neurogenic disorders and bladder outlet obstruction are determined.
3. Magnetic resonance imaging and computed tomography.Pathological disorders in the pelvic organs, as well as cancerous tumors, are detected.After that, a differential diagnosis is established.

Differential diagnosis

The establishment of a differential diagnosis is necessary, as it allows the timely identification of diseases such as:

• prostate cancer;
• bladder dysfunction of neurogenic etiology;
• disorders of the detrusor-sphincter system;
• pseudodysdysynegria;
• bladder stenosis;
• bladder neck hypertrophy;
• cystitis;
• adenoma;
• prostate sclerosis and so on.

Treatment of chronic prostatitis

Therapy for chronic prostatitis is carried out comprehensively - medications, massages, physiotherapeutic procedures and exercises are used.Of particular importance is the correction of the patient's own life - complete abandonment of bad habits, proper nutrition, normalization of sexual relations.In some cases, the help of a psychotherapist and psychologist is required.One treatment method cannot be used without the other, as each method complements each other.

Indications for hospitalization

Treatment of chronic prostatitis is carried out on an outpatient basis, but some patients are hospitalized - when serious complications are detected, an advanced form of the disease and the absence of a positive result during therapy.

Antibiotics

Antibacterial medications are used for chronic bacterial prostatitis.The choice of medication depends on the type of pathogen.The duration of therapy is 2 to 8 weeks.Antibiotics are aimed at destroying the pathogenic microorganism and reducing the inflammatory process.

Different groups are used:

1. Aminopenicillin group.
2. Cephalosporin medications.
3. Macrolides.
4. Fluoroquinolone group.

Alpha blockers

This is a group that blocks adrenergic receptors in the tissues of the pelvic organs, thereby stopping spasms in the bladder, improving urine flow and facilitating the urination process.In addition, the functioning of the muscular system and sphincter is normalized.

Nonsteroidal anti-inflammatory drugs

Chronic prostatitis is characterized by inflammatory processes in the prostate gland, therefore, non-steroidal anti-inflammatory drugs are necessarily prescribed.They aim to relieve pain and eliminate inflammation.In addition, non-steroids normalize the permeability of the walls of the circulatory system, restore blood circulation, against which existing inflammatory mediators are not absorbed.

Products are used in the form of gels, tablets, injections.

Hormone therapy

If non-steroidal (non-hormonal) medications do not have a positive effect or if the patient has a hormonal imbalance, hormonal medications will be prescribed.They eliminate inflammation, help stimulate erectile function and tissue regeneration.

Restoration of blood circulation

Since prostatitis worsens the microcirculation process in the genitourinary system, the doctor prescribes appropriate medications.When blood circulation returns to normal, regeneration processes begin and local metabolism accelerates.Consequently, the patient quickly gets rid of unpleasant symptoms.In addition, many products strengthen the walls of blood vessels and reduce blood viscosity.

Other drugs

Also, for chronic prostatitis, other groups of medications are used:

1. Muscle relaxants aim to relax muscles, relieve pain, accelerate blood circulation and reduce the tone of the smooth muscles of the genital organ.
2. Immunomodulators correct immunological changes, but are mainly prescribed when the patient has immunodeficiency.
3. If prostate stones are found, the patient must take medications that regulate uric acid.
4. To destroy the formed adhesions and accelerate the process of action of non-steroidal anti-inflammatory drugs and antibiotics, enzyme medications are prescribed.
5. Vitamin and mineral therapy is indicated to strengthen the immune system.The medicine is selected based on the lack of a particular vitamin or mineral.
6. To restore prostate metabolism and regenerate damaged tissue, bioregulatory peptides are used, produced from the prostate removed from cattle.
7. If the disease is accompanied by anxiety, depression, aggressiveness and other mental disorders, sedative medications or selective antidepressants are prescribed: valerian tincture, motherwort.

Surgery

Surgical intervention in chronic prostatitis is rarely resorted to, only in cases where the operation is justified and does not present a risk of complications.In addition, after surgical actions, a rather long period of rehabilitation occurs.

In what cases is surgery prescribed:

• in the absence of a positive result after complex conservative treatment;
• prostate abscess;
• tissue suppuration;
• inability to urinate:
• benign prostatic hyperplasia;
• cancerous tumors;
• other complications.

Prostatectomy

This operation involves removing the prostate and, in some cases, lymph nodes.Radical prostatectomy according to the surgical method can be of the following types:

• robotic type - several small incisions are made in the lower abdomen, after which the prostate is removed (actions are controlled by a special robotic device);
• open type - an incision is made in the lower abdomen;
• laparoscopic - a small incision is made into which a microscopic camera and instruments are inserted.

Peculiarities:

1. Any type of operation is performed under general or local anesthesia (spinal anesthesia).
2. The duration of the procedure is 2 to 3 hours.
3. The rehabilitation period is one and a half months.
4. The patient's stay in hospital is a maximum of three days.
5. The beginning of sexual life occurs in one and a half to two months.
6. In many cases, a urinary catheter is placed for a week.
7. Complications are rare but treatable.

Transurethral resection of the prostate

The surgery involves cutting the tissue surrounding the prostate, making urination easier.For this, a resectoscope is used, which is inserted into the urethra.The operation is indicated in the absence of urination, as well as to prevent such complications - hematuria, inflammatory processes in the kidneys and bladder, stones, urinary incontinence.

Peculiarities:

• duration of intervention – from one hour to one and a half hours;
• stay at the clinic – 2 days;
• catheter use – 5-7 days;
• recovery period – one and a half months;
• the onset of sexual activity occurs after 6 weeks.

Abscess drainage

The operation is used for prostate abscess, which occurs as a complication.With this disease, a large amount of purulent exudate accumulates in the prostate gland, which must be removed from the body.During the operation, a puncture needle is inserted into the gland under the control of ultrasound equipment.The method resembles a puncture.

Before injection procedures, the urological surgeon palpates the prostate with his index finger, inserting it into the rectal opening.After suctioning the pus, antiseptic treatment and drainage with rubber tubes are performed.If the patient has an extensive abscess, the purulent liquid is pumped perineally, that is, through the rectum.

Peculiarities:

• The duration of the procedure is one and a half hours;
• the maximum residence time in the drainage cavity is 72 hours;
• rehabilitation period – one month.

laser surgery

Laser treatment is an innovative and more common technique, as the operation is considered low-traumatic, safe and with minimal recovery time.During the operation, a laser instrument is installed in the urethral canal, the beam of which removes excess tissue.In this case, no incision is made.

Removal is carried out in 2 ways - ablative (excess tissue is burned) and enucleation (tissue is cut).Based on the type of removal, laser surgery is divided into the following types:

1. Photoselective vaporization - the laser vaporizes the tissue.
2. Holmium laser ablation - the procedure is identical to the previous one, but a holmium laser is used.
3. Holmium laser enucleation – prostate tissue is crushed with a morcellator and then removed.

Peculiarities:

• minimum number of contraindications;
• absence of adverse reactions (bleeding, etc.);
• You can go home immediately after the operation;
• the period of use of the urinary catheter is 24 hours;
• recovery period – maximum 7 days;
• The only negative is that it cannot be used for cancer.

What consequences can occur after any type of surgery:

• bleeding;
• temporary problems with urination;
• infection;
• urinary incontinence;
• reverse ejaculation (when sperm enters the bladder);
• tissue swelling;
• weakening of the erection;
• inguinal hernia;
• reduction in the length of the penis (only when part of the urethral canal is removed).

To avoid complications, you must strictly follow all the surgeon's recommendations during the recovery period.You cannot self-medicate.

Physiotherapy

Thanks to physiotherapeutic procedures, the level of inflammation is reduced, pain is relieved, tissue swelling is eliminated and the effectiveness of medications increases.What is used:

• phonophoresis;
• electrophoresis;
• laser therapy;
• transrectal microwave hyperthermia.

Massage

Massage is one of the mandatory procedures in the treatment of chronic prostatitis.It is advisable to do it with a specialist, but if this is not possible it can be done at home (but someone else must do the massage movements, as the patient is relaxed).

Contraindications for massage:

• hyperplastic changes in the prostate;
• the presence of stones in the organ;
• venous stagnation;
• formation of cysts and other tumors.

Procedure progress:

1. The man should expose the lower part of the body and lie down on his side, with his knees drawn up to his abdominal region.
2. There is another pose - knee-elbow.
3. The person doing the massage should wash their hands thoroughly, wear medical gloves and lubricate their index finger with petroleum jelly or another emollient.
4. The masseur inserts a finger into the anus (the man becomes relaxed).
5. Massage the prostate with gentle movements.
6. The duration of the procedure is 2 to 5 minutes.

If a man lives alone and cannot visit a massage therapist, special urological massagers can be used.The treating urologist will help you choose the ideal model for you.

Diet therapy

The patient with prostatitis must follow a special diet to prevent the formation of cholesterol plaques, constipation and increased gas formation.Dishes must be steamed or boiled.Baking is allowed, but without using oil.

Authorized products:

• seafood;
• pumpkin seeds;
• fruits and vegetables that do not cause gas;
• porridge;
• fermented dairy products;
• dried fruits;
• lean meat and fish.

Prohibited products:

• any beans;
• cabbage;
• carbonated drinks;
• alcohol;
• spicy and savory dishes;
• strong tea and coffee;
• yeast baked goods.

Folk remedies

Traditional medicine recipes are used exclusively in agreement with the andrologist, as many of them may have contraindications.

Revenues:

1. Eat around 30 to 40 pumpkin seeds daily, preferably on an empty stomach.
2. You can drink pear compote, but without added sugar.
3. Take a medicinal bath three times a week.To do this, make a decoction of herbs in equal proportions: chamomile, sage, pine needles, calendula.Prepare according to the standard scheme (for a glass of water - 2 tablespoons of the mixture).Pour into the bathtub, add sea salt in free proportion and take a sitz bath for 15 minutes.The water temperature does not exceed 40 degrees.
4. Use parsley - add to salad, squeeze out the juice and drink.The seed part can also be used.
5. Make your own rectal suppositories.To do this, combine propolis in equal proportions with butter and cocoa powder.Use your hands to form a candle shape, wrap each suppository in plastic wrap and place in the refrigerator.Every night before bed, administer 1 suppository for 30 days.

Forecast

If we talk about the prognosis, it directly depends on many circumstances - the degree of negligence, the form of the disease, the adequacy of therapy, the behavior of the patient himself.If you notice the development of a chronic form and carry out treatment in a timely and correct manner, the prognosis is quite favorable.

However, it is necessary to know that complete cure of the disease occurs in very rare cases, but it is possible to achieve a stable remission, during which symptoms do not appear.

Throughout life, the patient must strictly follow preventive measures, undergo periodic examinations and take medication.

Prevention measures

To prevent the development of chronic prostatitis and its exacerbation during remission, follow simple rules:

• contact a urologist in a timely manner;
• lead a healthy and active lifestyle (eliminate bad habits, practice moderate sports);
• eat right;
• having sex should be regular - at least 3 times a week;
• monitor the state of the immune system;
• don't get too cold;
• exclude casual sex;
• train the muscles of the genitourinary system - do special exercises.

If you have chronic prostatitis, don't be alarmed, as this is not a death sentence.With the correct therapeutic approach and regular visits to the andrologist, you can lead an active sex life without experiencing unpleasant symptoms.