Chronic prostatitis is a long-term inflammation of the prostate, diagnosed only in men and indicates a neglected pathological condition in the reproductive organs. The disease leads to a violation of the morphology and functioning of the prostate, is characterized by pain in the pelvis, genitalia with irradiation 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 underlies the onset 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 prostatic secretion. The study reveals an increased level of leukocytes and pathogens, infectious agents.
- Chronic abacterial prostatitis. It manifests itself as an inflammatory process with a symptom complex similar to acute inflammation with the participation of pathogenic microflora. But in fact there are no inflammatory components (pathogen + leukocytes).
- Chronic latent prostatitis. The disease does not have pronounced signs, does not cause discomfort, almost does not disrupt the functioning of the reproductive organs. But when secretly analyzed, products of inflammation are found - leukocytes.
Conventionally, STB (pelvic pain syndrome) can be attributed to the chronicity of the process in the prostate. With it, a symptom complex develops, resembling a prolonged 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 inflammation of the prostate are bacterial in nature, in the rest, a chronic disease is non-bacterial in nature. This means that most problems with the gland in men stem from leading an unhealthy lifestyle.
Causes of chronic infectious prostatitis:
- Penetration into the prostate of uropathogenic microflora (E. coli, Proteus, Staphylococcus aureus, viral, fungal or parasitic particles).
- Violation of blood circulation in the pelvic organs (physical inactivity, poor condition of blood vessels, blood clots).
- Urological diseases (urethritis, cystitis, pyelonephritis).
- The presence of distant foci of infection in the body (bronchitis, tonsillitis, caries).
- Systematic local hypothermia/overheating of the pelvic region.
- Stress, fatigue, chronic sleep deprivation.
- Poor nutrition, including the prevalence of "empty" plates 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.
- Overflow of the prostate with blood (swelling, poor secretion).
- Prolonged abstinence or excessive sexual activity.
- APP practice, prolongation of sexual intercourse.
- chronic intoxication.
Symptoms of nonbacterial inflammation in the prostate almost always appear in men who lead a slow lifestyle. Physical inactivity, overweight, unwillingness to move intensively, laziness - all this affects the work of the prostate, provoking congestive phenomena (stagnation).
It is difficult to prevent the development of chronic prostatitis and 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
Specific signs of chronic prostatitis are weakly expressed and in appearance are often not typical for prostate pathology. The picture changes only during the period of exacerbation, when the general symptoms resemble the course of an acute inflammatory process.
Sensations in a chronic process are a prostatic triad. It is characterized by pains that are constant, aching in nature, and radiate (transfer) to the genitals, pubis, scrotum, rectum, and sacrum. Indeed, a man constantly, during the day, feels discomfort in the pelvic area. The pain does not stop, it just changes intensity and direction.
Typical symptoms of chronic inflammation of the prostate:
- Increased pain at the end of urination.
- Irradiation of unpleasant sensations in the head of the penis, scrotum, sacrum.
- Pain during intercourse, especially during ejaculation.
- Painful and frequent urination.
- Burning in the urethra, false urgency, especially at night.
- Prostatotorrhea (discharge from the urethra, anus during exercise).
- In the groin there are sensations of cold, sweating, burning.
General (visible) disorders associated with chronic prostatitis also include psychological disorders (discomfort prevents a man from working, resting, sleeping and eating normally). Irritability appears, collapses with close people, subordinates, loses the desire to do anything.
In chronic prostatitis, a violation of sexual function is strongly expressed, which does not improve the mood of a man. Painful erections, low libido, incomplete sexual intercourse, erased 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 relaxation period. It can be complicated by vesiculitis, urinary incontinence, stone formation, cysts, sclerosis and prostate cancer.
Diagnosis of chronic prostatitis
A full diagnosis of the state of the body of a man is necessary if a pathology of the prostate gland is suspected. An urologist (andrologist) conducts an initial examination, prescribes laboratory and instrumental diagnostics. After the diagnosis is made, the specialist prescribes the treatment of 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 carrying out many additional studies to exclude diseases similar in symptoms to chronic prostatitis. Its variety of manifestations makes it difficult to make a true diagnosis, so the doctor methodically excludes similar pathologies one by one.
As a differential diagnosis for chronic prostatitis are:
- The inflammation of the prostate is not in the chronicity stage.
- Anogenital symptom complex.
- Vegetative urogenital syndrome.
- Adenoma, prostate cancer.
When making a diagnosis, it is not the patient's feelings or her complaints that matter, but only the actual data obtained through the investigation.
laboratory diagnosis
| Name of the laboratory diagnostic method | Characteristic |
|---|---|
| General inspection | They take note of the patient's appearance, the condition of the skin, genitalia, take note of complaints, collect an anamnesis. |
| Identification of infectious agents | The inflammatory process in the prostate can be the result of a distant focus of infection, the bacterial microflora of which enters the gland through the lymphatic blood. |
| Valla, prostatic secretion study | Through massage of the prostate gland, they examine it and identify / exclude the presence of leukocytes, bacterial microflora, erythrocyturia. |
| Urinalysis, urethral swab, 3-vessel urine sample, RIF, PCR. | They reveal infections of the genital tract (chlamydia, herpes, candidiasis, gonorrhea, etc. ), nonspecific bacterial microflora. |
Instrumental diagnostic methods
The examination is carried out using endoscopic instruments, devices that allow the urologist to "penetrate" closer to the prostate gland and give an accurate assessment of its condition.
| The name of the instrumental diagnostic method. | Characteristic |
|---|---|
| Ultrasound (TRUS) of the prostate | It allows you to assess the state of the gland, its volume, tissues, the presence of foci of inflammation, stones, congestion. |
| Urodynamic examination | It is performed by uroflowmetry, profilometry, cystometry, electromyography. With the help of these techniques, it is possible to exclude stress urinary incontinence, neurogenic bladder, etc. with similar symptoms. |
| Biopsy with morphological examination | Necessary when prostate cancer is suspected. |
Treatment of chronic prostatitis
The course of treatment for chronic prostatitis must be repeated periodically, it is almost impossible to completely cure the disease. The main principle of therapy is to prevent relapse and lengthen the "quiet" phase of the disease. Mainly eliminate the main causes of chronicity and exacerbation periods, if they come from systematic hypothermia, change clothes, try to avoid drafts. Be sure to follow the clinical recommendations of a urologist, exclude foods that cause acute inflammation, physical inactivity, excessive exercise, etc.
Medical treatment
For the treatment of chronic prostatitis, complex treatment is used, since it is impossible to cure with only one type of pill. Men are prescribed medications:
- antibioticsThey are necessary to suppress the pathogenic microflora in the gland, eliminate the cause of a bacterial infection, stop inflammation. Of the popular ones, drugs from the group of penicillins, cephalosporins, aminoglycosides, fluoroquinols, macrolides are prescribed.
- NSAID (non-steroidal anti-inflammatory drug). Medicines of this group eliminate severe inflammation and relieve pain.
- hormonesAssign when other means are powerless, or you need to quickly eliminate an 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 urine to drain completely. Means are prescribed during an exacerbation, the risk of AUR.
- Antispasmodics. Eliminates vasospasm and improves blood flow in the pelvic organs. This reduces the probability of stagnation, stone formation, spasm of the prostatic part of the urethra.
Physiotherapy
One of the effective methods of treatment, its essence is to influence the body with electric current, magnetic field, ultrasound and other natural means. Physiotherapy is not contraindicated in 97% of cases of diagnosis of 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 is a slight congestion. With combined treatment with medicinal solutions, the effect of the latter will be greater.
- Magnet therapy. A man's 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 the tissues and accumulate.
- Laser therapy. The prostate is affected by a laser beam, while inflammation is suppressed, blood circulation is stimulated, and the outflow of prostatic fluid improves.
Chronic prostatitis is treated with ultrasound, the technique involves exposing the body to high-frequency vibrations. Ultraphonophoresis is a variety - ultrasound is combined with the use of drugs.
Home remedies
Here, the treatment of prostatitis in the chronic stage is based on the complex use of decoctions, tinctures, baths and other methods, along with traditional drugs for chronic prostatitis. Herbal preparations help the body to cope with inflammation and prevent relapses, but they cannot completely replace conservative therapy.
It is forbidden to resort to folk methods in critical condition. If a man is indicated for an urgent operation and there is a risk of developing AUR, trying to stop the disease with herbs means further starting the pathological condition.
What folk methods are used for chronic prostatitis:
- Herbal decoctions. They help cleanse the body of toxins, relieve general inflammation, lower temperature.
- Vaginal douching, enemas. To do this, make hot infusions, decoctions of nettle, oak bark, wormwood, calendula. A solution is injected into the previously cleaned intestine, this contributes to the rapid relief of inflammation in the prostate.
- compressesFor its preparation, propolis oil, mustard powder or herbal decoctions are used. The application is only external, it is done at night, so that after them it does not go out and does not get cold.
- rectal ovules. They are made from propolis, beeswax, cocoa butter, lard, bee bread and royal jelly. Apply rectally after a cleansing enema, insert pessaries 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, reduce the effect of hypodynamia if a man's work is sedentary.
For chronic inflammation of the prostate, the following exercises are recommended:
- Kegel gymnastics. Its essence is to strengthen the muscles of the pelvic floor, perineum. This is achieved by regular contraction/tension (up to 150 times/day) of the muscles in the anus and between the scrotum and the penis.
- Carrying a tennis ball. It is placed in the crotch area, sits on the floor and rocks, moving from side to side massaging and tightening the desired area.
- Steps on the buttocks. The essence of the exercise is to sit on your buttocks and roll from side to side to move forward (duck step). You can't help with your hands, they stretch out in front of you and try to walk at least 3-5 meters.
- Pair of scissors. The well-known complex is to give a load to the press, pelvic muscles, thighs.
With the exacerbation of chronic prostatitis, any exercise is prohibited. Resume physical education when the acute syndrome is relieved.
Surgical intervention
The duration of conservative treatment does not always relieve chronic prostatitis, it is regularly recalled with relapses. In critical condition, the andrologist recommends an operation, although he does not rule out recurrence if the man does not comply with disease prevention measures.
List of surgical techniques for the treatment of chronic prostatitis:
- prostate resection. With severe inflammation or areas of sclerosis, a part of the affected prostate is removed using an endoscope.
- prostatectomyThis is a complete removal of the prostate, performed in a critical situation, when inflammation and changes in the gland interfere with normal urination.
- Drainage of a cyst, abscess. If an abscess or cystic formation has formed in the prostate, a puncture is performed with an endoscope, ultrasound or manipulation through the urethra.
- Incision of the urinary neck. Do with sclerosis, bladder obstruction, to improve urine output and ejaculation.
Diet
The main principle of proper nutrition in chronic prostatitis is the exclusion of harmful foods and a change in diet with a predominance of "clean" foods. Any semi-finished products, spicy, spicy dishes with artificial preservatives, alcohol, strong tea or coffee are eliminated from the diet.
The body must receive a sufficient amount of protein in the form of boiled fish, meat and dairy products. Vegetables, fruits and natural juices: instead of fast food, soft drinks. Overcooked dishes are replaced with steam, boiled ones, and those that create increased gas formation in the intestines are also prohibited.
Prevention
Chronic prostatitis is mostly incurable, so the main point of prevention is to prevent the disease in the first place. To do this, it is necessary to treat any infectious pathology in a timely manner, not to get too cold, always remember sexually transmitted diseases and follow the principles of healthy sexual intercourse.
Physical inactivity is a precursor to stagnation, so daily exercise and an active lifestyle will help prevent prostatitis. Follow a healthy lifestyle, undergo an examination by a urologist once a year, contact a specialist at the slightest problems with the genitourinary system, and do not try to treat yourself. Not being overweight and not abusing alcohol, cigarettes.
consequences and complications
Only a specialist can determine the degree of complications, but as is common in chronicity, there are:
- Androgen deficiency.
- Violation of sexual and reproductive functions.
- Vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis and orchiepididymitis.
- 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%, the treatment of chronic prostatitis will require surgical intervention. If conservative treatment is carried out in a timely manner at the stage of chronicity, and then relapses are regularly prevented, the course of the disease can be improved and the periods of exacerbations leveled out.