Chronic prostatitis is a long-term inflammation of the prostate gland, 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, inflammatory chronic prostatitis begins gradually, without unpleasant symptoms or sensations.the course of the disease is often discovered in the patient accidentally during an ultrasound examination.
Both young men and middle-aged and elderly men are susceptible to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead an inactive lifestyle, feel excessive physical pressure on the perineum and observe sexual abstinence.
Classification
According to the modern classification of prostatitis, developed in 1995, there are several categories of the disease:
- 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 empty the bladder completely, and pain in the lower abdomen, back, or pelvic area.There may be a fever accompanied by chills.
- Chronic bacterial prostatitis is a disease with typical symptoms of chronic inflammation and increased numbers 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 in the 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, when you visit the clinic for another reason.
In the presence of an infectious component, they speak of bacterial (infectious) chronic prostatitis.absence of microbial pathogens - regarding non-bacterial (non-infectious) prostatitis.It is believed that in 90-95% of all cases, non-bacterial chronic prostatitis occurs, and only in 10-5% - bacterial.
Reasons
A number of factors can contribute to chronic prostatitis.First this:
- STDs: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonad, gonococcus, Candida fungus, Escherichia coli can infect the urethra and be detected in prostate tissue.
- Poor circulation in the pelvic organs (congestion in the prostate leads to its inflammation).
- Sedentary lifestyle (drivers, office workers, employees).
- Prolonged sexual abstinence, cessation of sexual intercourse or artificial prolongation of sexual intercourse.
- Regular hypothermia (fans of extreme recreation: diving, surfing and skiing).
- Stress: mental and physical overload.
For the development of chronic prostatitis, the presence and activity of pathogenic microorganisms is not so important, but the condition of the pelvic organs and blood circulation in them, the presence of accompanying 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 the man.In this case, all signs of acute prostatitis will not manifest at all or will manifest 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.
- radiation to the anus, thigh, testicles.
- discharge from the urethra.
Changes in 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 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, which include increased irritability, anxiety, fatigue, short temper, sleep disturbances, obsession and depression.
It is almost impossible to determine all the symptoms in a patient at the same time, since 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 is that the prostate gland produces a special secretion that ensures the viability of sperm.With inflammation, the secretory function of the prostate gland deteriorates, which inevitably affects the quality of sperm.
In addition, the prostate gland actively participates in the regulation of testosterone production and the erection process.This is why chronic prostatitis causes reduced erectile function and even impotence.However, these scenarios for the development of the disease can be avoided if timely and appropriate treatment is carried out.
Diagnostics
The following procedures are necessary to help establish/disprove the diagnosis:
- rectal examination;
- microscopy of prostate secretion.
- culture of prostate secretion for antibiotic sensitivity.
- tests for sexually transmitted diseases;
- rectal ultrasound.
Sometimes additional endoscopic and urodynamic studies are done.
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.The treatment includes an integrated approach, i.e. a combination of several methods at the same time:
- antibacterial treatment;
- prostate massage;
- physiotherapy procedures;
- correction of diet and lifestyle.
- use of folk remedies.
- surgical treatment.
In addition, anti-inflammatory and anticonvulsant agents are used in the treatment of chronic forms of the disease.
Pharmaceutical treatment
The choice of drugs depends on the cause and symptoms of the disease.For the treatment of chronic prostatitis of infectious etiology, antibacterial drugs are used:
- fluoroquinolones;
- macrolides?
- tetracyclines.
To eliminate inflammation and pain, analgesics and non-hormonal anti-inflammatory drugs are used.
Also, in recent years, the treatment of chronic prostatitis is carried out with drugs that were not previously used for this purpose: alpha-blockers, 5-α-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect the metabolism of uric and citrate salts.
Physiotherapy
Certain physical therapy procedures, such as laser therapy, electrophoresis, rectal microwave hyperthermia, ultrasound phonophoresis and others, also help to improve prostate tissue trophism and speed up the healing process.
Also, for chronic prostatitis, therapeutic hot baths, mud therapy and special enemas can be prescribed.
Prostate massage
It improves the drainage of prostate secretions and microcirculation at the level of this organ, which in turn contributes to the rapid recovery of the patient.
Prostate massage cannot be performed in case of acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is usually combined with antibiotic treatment.Numerous clinical studies have shown the high effectiveness of this treatment.
Operation
Surgery is possible to remove areas of the prostate gland that are affected by bacteria.Transurethral resection is a procedure performed under epidural or intravenous barbiturate anesthesia.The postoperative recovery period does not last more than a week.
The methods required for the treatment of chronic prostatitis are determined by the urologist based on his diagnostic information and practical experience.Conducting self-treatment at home based on Internet reviews is fraught with consequences.