Chronic prostatitis is a long-lasting inflammation of the prostate, with symptoms often absent, which is why most of the male population does not know about the disease.
The development of the chronic form of prostatitis is a consequence of an acute process, although in practice this is rare. As a rule, inflammatory chronic prostatitis begins gradually, without any unpleasant symptoms and sensations, quite often the course of the disease is detected in the patient by chance, when examining ultrasound.
Chronic form affects both young men, and people of middle and old age. Also, prostatitis threatens those who, by their activities, have a low-activity lifestyle, feel excessive physical exertion on the crotch, and abstain from sexual abstinence.
Classification
According to the modern classification of prostatitis, developed in 1995, there are several categories of the disease:
- Acute bacterial prostatitis(OBP) is the most common and easily diagnosed type of prostatitis. It is usually caused by a bacterial infection and is easily diagnosed due to typical symptoms. Acute bacterial prostatitis can occur at any age. Symptoms include painful urination, inability to completely empty the bladder, pain in the lower abdomen, back, or pelvic area. There may be a fever accompanied by chills.
- Chronic bacterial prostatitis- a disease with typical symptoms of chronic inflammation and an increased number of bacteria and leukocytes in the urine and the secretion of the prostate after its massage.
- Chronic prostatitis(CP) is the most common form of prostatitis. It is in most cases a consequence of acute bacterial prostatitis (not treated or poorly treated). If there are symptoms, they proceed in the form of pain in the genitals or pelvic region, difficulty in urinating or painful urination and ejaculation.
- Asymptomatic inflammatory prostatitis- With this form of the disease, the classic symptoms of prostatitis are absent, and the disease itself is detected by accident, when you contact the clinic for another reason.
In the presence of an infectious component, one speaks of a bacterial (infectious) chronic prostatitis; in the absence of microbial pathogens - about non-bacterial (non-infectious) prostatitis. It is believed that 90-95% of all cases have non-bacterial chronic prostatitis and only 10-5% - bacterial.
Causes
The emergence of chronic prostatitis can contribute to a number of factors. First of all, it is:
- STIs: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, fungus of the genus Candida, E. coli (Escherichia coli) can affect the urethra and be detected in the prostate tissue;
- Violation of blood circulation in the organs of the small pelvis (congestion in the prostate leads to its inflammation);
- A sedentary lifestyle (drivers, office employees, officials);
- Prolonged sexual abstinence, interrupted sexual intercourse or artificial lengthening of sexual intercourse;
- Regular hypothermia (lovers of extreme rest: diving, surfing, canoeing and skiing);
- Stresses: mental and physical overload.
For the development of chronic prostatitis, it is important not so much the presence and activity of pathogenic microorganisms as the state pelvic organs and circulation in them, the presence of concomitant diseases, the level of protective mechanisms.
Symptoms of chronic prostatitis
Most often, with the development of a chronic form of prostatitis, the symptoms are almost without disturbing a man. In this case, all the signs of acute prostatitis will not manifest itself in any way or manifest to a much lesser extent.
The most common symptoms of chronic prostatitis in men are:
- periodic pains and discomfort in the perineum;
- unpleasant sensations in defecation and urination;
- irradiation in the anus, thigh, testicles;
- discharge from the urethra.
Changes in the picture of the course of the disease, which is already not very bright, can be so insignificant that patients with chronic prostatitis do not pay much attention to them.
Exacerbation of chronic prostatitis
The aggravation of the disease, as a rule, is 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 a decrease in men's sexual activity;
- pain during the act of defecation.
According to some doctors, it is also possible to identify the psychological symptoms of chronic prostatitis, which include increased irritability, anxiety, fatigue, short temper, sleep disorders, obsessive and depressed.
Determine all the symptoms at once in the patient is almost impossible, because a man usually shows 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 that the prostate gland produces a special secret that ensures the viability of spermatozoa. In inflammation, the secretory function of the prostate gland worsens, which inevitably affects the quality of sperm.
In addition, the prostate gland is actively involved in the regulation of testosterone production and the erection process. That's why chronic prostatitis causes a decrease in erectile function, up to impotence. However, these scenarios of the development of the disease can be avoided if we conduct timely and competent treatment.
Diagnostics
The following procedures are needed to help diagnose / disprove the diagnosis:
- rectal examination;
- microscopy of prostate secretion;
- sowing the secretion of the prostate for sensitivity to antibiotics;
- analyzes for sexually transmitted diseases;
- transrectal ultrasound.
Sometimes endoscopic and urodynamic studies are additionally carried out.
How to treat chronic prostatitis
If a man has chronic prostatitis, treatment is always lengthy and difficult. Its duration directly depends on the stage of the ailment, on which the patient turned to the specialist. Therapy assumes an integrated approach, that iscombination of several methods:
- antibacterial therapy;
- massage of the prostate gland;
- physiotherapeutic procedures;
- correction of diet and lifestyle;
- use of folk remedies;
- surgery.
Additionally, anti-inflammatory and antispasmodic agents are used in the therapy of the chronic form of the disease.
Medication
The choice of medicines depends on the cause and symptoms of the disease. To cure chronic prostatitis of infectious etiologyantibacterial drugs are used:
- fluoroquinolones;
- macrolides;
- tetracyclines.
Analgesics and non-hormonal anti-inflammatory drugs are used to eliminate inflammatory phenomena and pain syndrome.
Also in recent years, the treatment of chronic prostatitis is carried out using drugs previously not used for this purpose: alpha1-adrenoblockers (terazosin), inhibitors of 5-a-reductase (finasteride), inhibitors of cytokines, immunosuppressors (cyclosporine), drugs affecting the exchange of urate (allopurinol) and citrates.
Physiotherapy
To improve the trophism of the prostate tissues and speed up the healing process, certain physiotherapeutic procedures, such as as: laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis and others.
Also, with chronic prostatitis, therapeutic warm baths, mud therapy, special enemas can be prescribed.
Massage of the prostate
Improves the drainage of the prostate secretion and microcirculation at the level of this organ, which in turn contributes to the speedy recovery of the patient.
Massage of the prostate can not be done with acute prostatitis, hemorrhoids, cracks in the rectum. Prostate massage is usually combined with antibiotic therapy. Numerous clinical studies have shown high effectiveness of such treatment.
Operation
Possible surgical intervention to remove the affected areas of the prostate gland.
- Transurethral resection is an operation that is performed under epidural or intravenous barbiturate anesthesia. Postoperative recovery period lasts no more than a week.
The methods, which involves the treatment of chronic prostatitis, are determined by a urologist on the basis of diagnostic information and his practical experience. To conduct independent therapy at home based on feedback on the Internet is fraught with consequences.
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