Chronic prostatitis is a long-term inflammation of the prostate, it is diagnosed only in men and indicates a neglected pathological condition in the reproductive organs. The disease leads to violations of the morphology and functioning of the prostate, it is characterized by pain in the pelvis, genitals with radiation to the groin, urination disorders, sexual disorders. Long-term treatment consists of stabilizing the general condition, excluding relapses and AUR.
Types of chronic prostatitis
The chronic form of prostatitis can be of several types, it all depends on what is the basis 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 along the descending or ascending path (abscesses, through the urethra, caries, etc. ).
- Chronization with inflammatory components of prostate secretion. The study reveals increased levels of leukocytes and pathogens, infectious agents.
- Chronic abacterial prostatitis. It manifests as an inflammatory process with a complex of symptoms similar to acute inflammation with the participation of pathogenic microflora. But in fact, there are no inflammatory components (pathogen + leukocytes).
- Latent chronic prostatitis. The disease has no pronounced signs, does not cause discomfort, almost does not interfere with the work of the reproductive organs. But when secretly analyzed, the products of inflammation are found - leukocytes.
Conventionally, STB (pelvic pain syndrome) can be attributed to the chronicity of the process in the prostate. In addition, a complex of symptoms develops, resembling a long 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 prostatitis are bacterial in nature, in the rest - chronic disease is abacterial in nature. This means that most gland problems in men come from leading an unhealthy lifestyle.
Causes of infectious chronic prostatitis:
- Penetration of uropathogenic microflora into the prostate (E. coli, Proteus, Staphylococcus aureus, viral, fungal or parasitic particles).
- Disorders of blood circulation in the pelvic organs (physical inactivity, poor condition of blood vessels, blood clots).
- Urological diseases (urethritis, cystitis, pyelonephritis).
- Presence of distant foci of infection in the body (bronchitis, tonsillitis, caries).
- Systematic local hypothermia / pelvic region overheating.
- Stress, fatigue, chronic sleep deprivation.
- Poor diet, 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:
- Violation of drainage in the acini of the prostate.
- Poor venous circulation in the pelvis.
- Blood transfusion of the prostate (swelling, poor secretion).
- Prolonged abstinence or excessive sexual activity.
- PPA practice, prolonging sexual intercourse.
- chronic intoxication.
Symptoms of abacterial inflammation of the prostate almost always occur in men who lead a sluggish lifestyle. Physical inactivity, overweight, unwillingness to move intensively, laziness, all this affects the work of the prostate, causing congestive (stagnation) phenomena.
It is difficult to prevent the development of chronic prostatitis in men employed in 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 weakly expressed, and externally they are often not typical of prostate pathology. The picture changes only in the period of exacerbation, when the general symptoms are reminiscent of the course of an acute inflammatory process.
Sensations in the chronic process are a prostatic triad. It is characterized by pain that is constant, painful in nature and radiates (passes) into the genitals, pubis, scrotum, rectum and sacrum. In fact, a man constantly feels discomfort in the pelvic area during the day. The pain doesn’t stop, it just changes intensity and direction.
Typical symptoms of chronic prostatitis:
- Increased pain at the end of urination.
- Radiation of unpleasant sensations in the head of the penis, scrotum, sacrum.
- Pain during intercourse, especially during ejaculation.
- Painful and frequent urination.
- Roasting in the urethra, false urge, especially at night.
- Prostatotorrhea (discharge from the urethra, anus during exercise).
- Feelings of cold, sweating, tingling occur in the groin.
General (visible) disorders associated with chronic prostatitis include mental disorders (discomfort prevents a person from working, resting, sleeping, and eating normally). Irritability appears, he breaks down with close people, subordinates, he loses the desire for anything.
In chronic prostatitis, there is a strong violation of sexual function, which does not improve a man's mood. Painful erections, low libido, unfinished sexual intercourse, deleted orgasms, infertility - all these are visual manifestations of chronic prostatitis.
If chronic prostatitis is not treated, the disease will recur with constant relapses of acute prostatitis with a short period of relaxation. It can be complicated by vesiculitis, urinary incontinence, stone formation, cysts, sclerosis and prostate cancer.
Diagnosis of chronic prostatitis
A complete diagnosis of the condition of a man's body is necessary if prostate pathology is suspected. The urologist (andrologist) performs the initial examination, prescribes laboratory and instrumental diagnostics. After the 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 conducting many additional studies to rule out diseases similar in symptoms to chronic prostatitis. Its variety of manifestations makes it difficult to make the right diagnosis, so the doctor methodically excludes similar pathologies one by one.
As a differential diagnosis for chronic prostatitis are:
- Inflammation of the prostate is not in the chronic stage.
- Complex anogenital symptoms.
- Vegetative urogenital syndrome.
- Adenoma, prostate cancer.
When making a diagnosis, it is not the patient's feelings or complaints that are important, but only the actual data obtained from the research.
Laboratory diagnostics
> zxtable border = "1" cellpadding = "0" >Instrumental diagnostic methods
The examination is performed with the help of endoscopic instruments, devices that enable the urologist to "penetrate" closer to the prostate and to accurately assess its condition.
> zxtable border = "1" cellpadding = "0" >Treatment of chronic prostatitis
The course of treatment of chronic prostatitis must be repeated periodically, it is almost impossible to completely cure the disease. The main principle of therapy is to avoid recurrence and prolong the "quiet" phase of the disease. First of all, eliminate the main causes of chronicity and periods of exacerbation, if they occur due to systematic hypothermia, change clothes, try to avoid drafts. Be sure to follow the clinical recommendations of the urologist, exclude foods that cause acute inflammation, physical inactivity, excessive exercise, etc.
Treatment
Complex treatment is used to treat chronic prostatitis because it is impossible to cure just one type of pill. Men are prescribed drugs:
- Antibiotics. They are needed to suppress pathogenic microflora in the gland, eliminate the causes of bacterial infection and stop inflammation. Of the popular ones, drugs of the penicillin group, cephalosporins, aminoglycosides, fluoroquinolones, macrolides are prescribed.
- NSAIDs (non-steroidal anti-inflammatory drugs). Drugs of this group eliminate severe inflammation and relieve pain.
- Hormones. Assign when other means are powerless or you need to quickly eliminate the acute relapse. Patients with chronic prostatitis are prescribed drugs in ampoules, tablets.
- Alpha blockers. They are designed to relax smooth muscles, reduce tone and allow complete drainage of urine. Means are prescribed during exacerbation, risk of AUR.
- Antispasmodics. Eliminate vasospasm and improve blood flow in the pelvic organs. This reduces the likelihood of stagnation, stone formation, spasm of the prostatic part of the urethra.
Physiotherapy
One of the effective methods of treatment, the essence of which is the action on the body with electric current, magnetic field, ultrasound and other natural means. Physiotherapy is not contraindicated in 97% of cases diagnosed with the disease, it 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 congestions. With combined treatment with medical solutions, the effect of the latter will be greater.
- Magnetotherapy. The human body is affected by a magnetic field of 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 laser beam affects the prostate, suppresses inflammation, stimulates blood circulation and improves the outflow of prostate fluid.
Chronic prostatitis is treated with ultrasound, the technique consists of exposing the body to high-frequency vibrations. Ultraphonophoresis is versatility - 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, along with traditional remedies for chronic prostatitis. Herbal preparations help the body cope with inflammation and prevent recurrence, but they cannot completely replace conservative therapy.
It is forbidden to use folk methods in critical condition. If a person is indicated for emergency surgery and there is a risk of developing AUR, trying to stop the disease with herbs means even more triggering a pathological condition.
What folk methods are used for chronic prostatitis:
- Herbal decoctions. They help cleanse the body of toxins, alleviate general inflammation, lower temperature.
- Rinse, enema. To do this, make warm infusions, decoctions of nettle, oak bark, wormwood, calendula. The solution is injected into a previously cleaned bowel, which contributes to the rapid relief of 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 outside after them and do not cool down.
- Rectal suppositories. They are made from propolis, beeswax, cocoa butter, lard, bee bread and royal jelly. Apply rectally after cleansing enemas, insert suppositories at night or during the day, but you must lie down for at least 40 minutes.
Exercises
With the help of daily exercises you can increase the tone of smooth muscles, improve blood circulation in the pelvic organs, eliminate congestion in the prostate and reduce the effect of hypodynamics if a man's job is sitting.
The following exercises are recommended for chronic inflammation of the prostate:
- 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 anal muscles and between the scrotum and the penis.
- Charging with a tennis ball. It is placed in the groin, sitting on the floor and rocking, moving back and forth, massaging and straining the desired area.
- Steps on the buttocks. The essence of the exercise is to sit on your buttocks and roll from one side to the other to move forward (step like a duck). You can't help it with your hands, they are pulled out in front of you and try to walk at least 3-5 meters.
- Scissors. A well-known complex is the load on the press, pelvic muscles, thighs.
With exacerbation of chronic prostatitis, any exercise is prohibited. Continue physical education when the acute syndrome subsides.
Surgical intervention
The duration of conservative treatment does not always alleviate chronic prostatitis, it regularly reminds itself of relapses. In critical condition, the andrologist recommends surgery, but does not rule out recurrence if the man does not adhere to disease prevention measures.
List of surgical techniques for the treatment of chronic prostatitis:
- prostate resection. In severe inflammation or sclerosis, part of the affected prostate is removed with an endoscope.
- prostatectomy. This is a complete removal of the prostate, which is performed in a critical situation, when inflammation and changes in the glands interfere with normal urination.
- Cyst drainage, abscess. If an abscess or cystic formation has formed on the prostate, endoscopic puncture, ultrasound, or manipulation through the urethra is performed.
- Urine neck incision. Work with sclerosis, bladder obstruction, to improve the outflow of urine and ejaculate.
Diet
The main principle of proper nutrition in chronic prostatitis is the exclusion of harmful foods and dietary changes with a predominance of "pure" foods. All semi-finished products, spicy, spicy dishes with artificial preservatives, alcohol, strong tea or coffee are removed from the diet.
The body needs to get enough protein in the form of cooked fish, meat, dairy products. Vegetables, fruits and natural juices - instead of fast food, soda. Overcooked dishes are replaced by steamed, cooked, and those that create increased gas production in the intestines are also prohibited.
Prevention
Chronic prostatitis is mostly incurable, so the main purpose of prevention is to prevent the disease from the very beginning. To do this, it is necessary to timely treat all infectious pathologies, not to catch colds, always remember sexually transmitted diseases and follow the principles of healthy sexual relations.
Physical inactivity is a precursor to stagnation, so daily exercise and an active lifestyle will help avoid prostatitis. Adhere to a healthy lifestyle, go to a urologist once a year, consult a specialist for the least 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 usual for chronicity, there are:
- Androgen deficiency.
- Violation of sexual and reproductive functions.
- Vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis and epididymoarrhythmia.
- 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-related factors in 97%, treatment of chronic prostatitis will require surgical intervention. If conservative treatment is carried out in a timely manner in the chronic stage, and then recurrences are regularly prevented, the course of the disease can be improved and periods of exacerbations can be equalized.