Chronic prostatitis is a long-term inflammation of the prostate, often without symptoms, which is why most of the male population is unaware 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 or unpleasant sensations;the course of the disease is often discovered in the patient by chance during an ultrasound scan.
Young men as well as middle-aged and elderly people are susceptible to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead an inactive lifestyle, experience excessive physical stress on the perineum and observe sexual abstinence.
Ranking
According to the modern classification of prostatitis, developed in 1995, there are several categories of diseases:
- Acute bacterial prostatitis (ABP) is the most common type of prostatitis.It is usually caused by a bacterial infection and is easily diagnosed due to its typical symptoms.Acute bacterial prostatitis can occur at any age.Symptoms include painful urination, inability to completely empty the bladder, 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 increase in the number of bacteria and leukocytes in urine and prostate secretions 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 appear in the form of pain in the genitals or pelvic area, difficulty urinating, or painful 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, during a visit to 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 - about 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
A number of factors can contribute to the development of chronic prostatitis.First of all, this:
- STIs: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococci, Candida fungus, Escherichia coli can infect the urethra and be detected in prostate tissue;
- Poor circulation in the pelvic organs (prostate congestion leads to inflammation);
- Sedentary lifestyle (drivers, office workers, civil servants);
- Prolonged sexual abstinence, interrupted sexual intercourse, or artificially prolonged sexual intercourse;
- Regular hypothermia (extreme leisure enthusiasts: diving, surfing and skiing);
- Stress: mental and physical overload.
For the development of chronic prostatitis, it is not so much the presence and activity of pathogenic microorganisms that is important, but 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
Most often, with the development of a chronic form of prostatitis, the symptoms practically do not bother a 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 during bowel movements and urination;
- irradiation of the anus, thigh, testicles;
- discharge from the urethra.
Changes during the disease, which are already not very bright, can 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 urge 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, short temper, sleep disturbances, obsession and depression.
It is almost impossible to determine all the symptoms of a patient at once, because 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 sperm viability.With inflammation, the secretory function of the prostate deteriorates, which inevitably affects the quality of sperm.
In addition, the prostate actively participates in the regulation of testosterone production and the erection process.This is why chronic prostatitis leads to a reduction in erectile function and 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;
- microscopy of prostate secretion;
- culture of prostate secretions for antibiotic sensitivity;
- tests for sexually transmitted diseases;
- transrectal ultrasound.
Sometimes additional endoscopic and urodynamic studies are performed.
How to treat chronic prostatitis
If a man is diagnosed with chronic prostatitis, 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;
- correction of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
Additionally, anti-inflammatory and antispasmodic agents are used in the treatment of chronic forms of the disease.
Drug 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-inflammatory drugs are used.
Moreover, in recent years, the treatment of chronic prostatitis has been carried out using drugs that were not previously used for this purpose: alpha1-blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect urate and citrate metabolism.
Physiotherapy
Some 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.
In addition, for chronic prostatitis, therapeutic warm baths, mud therapy and special enemas can be prescribed.
Prostate massage
Improves the drainage of prostate secretions and microcirculation in this organ, which contributes to a speedy recovery of the patient.
Prostate massage cannot be performed in cases of acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is generally combined with antibiotic therapy.Numerous clinical studies have shown the great effectiveness of this treatment.
Functioning
Surgery is possible to remove areas of the prostate affected by bacteria.Transurethral resection is an operation performed under epidural or intravenous barbiturate anesthesia.The postoperative recovery period lasts no more than a week.
The methods necessary for the treatment of chronic prostatitis are determined by the urologist based on diagnostic information and his practical experience.Carrying out self-therapy at home based on reviews on the Internet is fraught with consequences.