Prostatitis is a disease that causes urination problems, sexual dysfunction, pain in the perineum and lower abdomen. The cause of these symptoms is inflammation of the prostate.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located under the male bladder and in front of the rectum. The prostate is made up of glandular and connective tissue. Its function is to produce liquid, partly made up of ejaculate. This fluid carries sperm during ejaculation (ejaculation) and protects the sperm as they travel to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not go away for months or even years. The acute form of the disease appears suddenly and lasts a maximum of several weeks. It is usually easy to treat, but sometimes becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure permanently. But with proper treatment, there is every chance of achieving long-term remission and significantly improving the patient's quality of life. We figured out how to understand that you have chronic prostatitis and what to do next.
What is chronic prostatitis
In total, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Of these, chronic nonbacterial prostatitis is the most common. And he's the worst to deal with.
A disease is considered chronic if the symptoms do not disappear for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its recurrent course. This means that symptoms may disappear for a while and then return. Without treatment, this pathology can bother the patient for a very long time.
Bacterial and nonbacterial forms have common symptoms. They usually include problems with urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases among men. In addition, the chronic form is much more common than the acute form. The cause of approximately 25% of visits to a urologist is related to chronic prostatitis.
The pathology can appear at any age, but the chronic form most often develops in men after 50 years.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of illnesses have common symptoms but different causes.
Chronic bacterial prostatitis
When in the prostate secretion during analysisdiscoveredleukocytes and pathogens
The inflammatory process causes a bacterial urinary tract infection to enter the prostate. The provoking factor can be: an acute form of prostatitis, a urinary tract infection (urinary tract infection), an STI. The causative agents of the inflammatory process of the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic nonbacterial prostatitis (chronic pelvic pain syndrome)
When in the prostate secretion during analysisundetectedleukocytes and pathogens
Researchers have not established the causes of chronic pelvic pain syndrome. With this form, there is no infection in the prostate. It is not clear what exactly causes disruptions in this case. It is speculated that this may be due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- the patient already suffered from prostatitis and chronic pain persisted despite treatment;
- urine enters the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- stress
Symptoms of chronic prostatitis
With chronic prostatitis, the symptoms bother the patient for a long time - for several months or even years. The disease is characterized by a recurrent course, that is, problems appear and disappear.
Infectious and non-infectious prostatitis have common symptoms and include:
- urination disorders: frequent and sudden urges, difficulty urinating, pain;
- pain in the penis, testicles, pelvic region, lower back;
- pain during sexual intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- nausea Vomiting
The disease also affects the general condition of the patient. Some people experience irritability, increased fatigue, lethargy and anxiety.
If you have these signs, consult a urologist. Some of these may indicate other, more serious illnesses requiring urgent medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you should make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive tract and urinary system in men and women.
The first consultation includes several stages:
- History taking.
The urologist will ask you the reason for your visit, previous illnesses and medications you have taken now and in the past. - Examination of the genitals
- Digital rectal exam.
During the procedure, the urologist inserts a finger into the patient's anus to palpate the surface of the prostate. The test allows you to determine the size of the prostate and check for swelling and tenderness. - Other studies.
The doctor may prescribe one or more diagnostic procedures, some of which can be performed immediately during the appointment, others later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urine analysis
Allows you to see signs of infection. This can be indicated by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate specific antigen)
Helps assess the condition of the prostate. An elevated PSA level indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostate secretion
Prostatic secretion is a fluid produced by the prostate. With changes in the organ, the composition of the secretion also changes. For example, during an inflammatory process, the number of white blood cells will increase and a high level of pathogenic bacteria may indicate a bacterial infection of the prostate. Microscopic examination of the fluid will help see these changes. - Prostatic secretions are collected by prostate massage. The massage can be combined with a rectal exam.
Instrumental research methods
- Cystoscopy. Examination of the inner surface of the bladder using an endoscope - a thin flexible tube with a camera. The device is inserted into the bladder through the urethra. The study reveals problems with the urinary tract.
- TRUS (transrectal ultrasound of the prostate). For the examination, the specialist will carefully insert an ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
- MRI (magnetic resonance imaging) of the pelvis. Helps assess the condition of prostate tissue. It may be necessary to detect foci of prostate inflammation and exclude prostate cancer.
There is no special preparation for an appointment with a urologist. But to make the consultation as effective as possible, follow a few simple recommendations:
- For intimate hygiene, you should not use special products before use, just lukewarm water is enough.
- Do not go to the toilet 2 hours before your clinic visit. Then, during your appointment, if necessary, you can immediately take tests or have an ultrasound.
- If you take medications regularly, write their names in your diary or in notes on your phone.
- Take the results of previous studies with you so that the specialist can have a complete picture of the disease.
- Make a list of questions you want to ask the doctor during your appointment.
Treatment of chronic prostatitis
There is no universal method for getting rid of prostatitis. For different forms and manifestations of the disease, different treatments are indicated.
To determine the type of chronic prostatitis, you must undergo diagnosis. Based on his results, the doctor will prescribe a treatment that will give results specifically in your case.
Unlike the acute form, chronic inflammation of the prostate cannot be permanently cured. The doctor's goal is to achieve long-term remission and reduce symptoms.
Bacterial form: Treatment will include antibiotic therapy and other methods to relieve symptoms.
Non-bacterial form: Treatment is symptomatic. In other words, each method aims to combat a specific symptom.
Recommendations for outpatient treatment
Lifestyle changes:
- Dietary restrictions
It is worth giving up alcohol, coffee, spicy and sour foods. These products irritate the bladder and worsen the patient's condition. - Hot sitz baths, hot showers
Water procedures will help reduce the manifestations of the disease. - More water
Drink enough fluids. More frequent trips to the bathroom will help flush disease-causing bacteria from the bladder. - Pillows for chairs
When you are seated, place a soft pillow under you. - Physical activity
Regular walks and exercise will help reduce pain and clear congestion. - Regular sex life
Sexual activity is helpful in preventing congestion.
The listed methods will complement the therapy prescribed to you, but will not replace it.
Medical treatment
- Antibiotics. Antibiotic therapy is indicated for the infectious form. The medications destroy the bacteria that cause prostate inflammation. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, you should undergo a study of prostate secretions and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary disorders. Medications relax the organs of the urinary system, which relieves symptoms. Most often, alpha blockers are used for chronic non-infectious prostatitis, but to improve the patient's well-being, they can also be prescribed for an infectious form of the inflammatory process.
- NSAIDs (non-steroidal anti-inflammatory drugs). Prescribed to relieve pain and reduce swelling of the prostate.
- Muscle relaxers. Used when you need to relieve pelvic muscle spasms.
- Antidepressants. Indicated for depression, which can develop due to stress and prolonged pain.
- Medications for the treatment of erectile dysfunction. Used if prostatitis is causing problems in your sex life.
- Laxatives. They may prescribe it if symptoms include pain during bowel movements.
Treatment with medicinal plants
Herbal remedies.Medicinal plants are not the main method of treatment. They can be used as a supplement to reduce prostate inflammation. For this purpose, medications are prescribed based on quercetin, a substance found in vegetables, fruits and berries.
Non-drug treatment
- Physiotherapy and prostate massage. The methods are used to relax the pelvic floor muscles, relieve pain and prevent congestion. For a therapeutic effect, the patient undergoes a massage course of several sessions. Massage is contraindicated in the event of the development of complications of pathology: abscesses, stones in the prostate tissues.
- Bladder catheterization. May be necessary if you have bladder problems.
- Psychotherapy. Due to chronic pain, prostatitis patients may develop depressive and anxiety disorders. Psychological problems have a negative impact on the patient's well-being and aggravate the pain syndrome. In such cases, consulting a psychotherapist will be helpful.
- Biofeedback programs. May help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be necessary if complications arise.
Types of operations:
- TUR (transurethral resection) of the prostate. Indicated for the appearance of stones in prostate tissue
- Prostatectomy. Removal of the prostate is carried out in certain cases in cases of abscess (accumulation of pus) or serious disorders in the functioning of the bladder.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and alleviate symptoms associated with urinary disorders. How to do the exercises:
- Sit comfortably.
- Contract your pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
- Relax your muscles.
- Repeat this operation 10 to 15 times.
- Gradually, you can increase the number of repetitions and work the muscles for longer.
- You should do 2-3 approaches per day.
Changes can only be noticed with regular exercise.
Treatment prognosis
It is very difficult to permanently cure chronic prostatitis. In some cases, the disease is incurable, but there is always a chance to achieve long-term remission and return the patient to their previous quality of life. To do this, it is important to carry out a thorough diagnosis to determine the form of the disease. If the cause of the inflammatory process is an infection, antibacterial treatment will be useful. And for chronic non-infectious prostatitis - well-chosen symptomatic therapy.
Complications of chronic prostatitis may include:
- Bacteremia (bacterial blood poisoning). Bacteria entering the bloodstream. May be a consequence of bacterial forms of pathology. Bacteremia develops suddenly and can lead to sepsis. This condition is life-threatening.
- Epididymitis (inflammation of the epididymis). The disease can cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in the tissues). In the event of an abscess, surgical intervention is carried out to clean and drain the purulent focus; In rare cases, the prostate may be removed.
- Infertility. Problems with conception can occur if there is a lack of sperm due to an inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bones
- Depression. Chronic pathologies increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and his emotional state.
To prevent prostatitis, it is important:
- Use barrier contraception (condoms): STIs are a factor that increases the risk of developing prostatitis
- See a urologist every year if you are over 40
- If you have symptoms of a urinary tract infection, contact your doctor immediately.