Chronic prostatitis is a long-term inflammation of the prostate gland, with often no symptoms, which is why most of the male population is unaware of this disease.
The development of a chronic form of prostatitis is the result of an acute process, although in practice this is quite rare.As a rule, chronic inflammatory prostatitis begins gradually, without any unpleasant symptoms or sensations;the course of the disease is often found in patients by chance during an ultrasound examination.
Both young and middle-aged men and the elderly are susceptible to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead a sedentary lifestyle, feel excessive physical pressure on the perineum, and observe sexual abstinence.
Classification
According to the modern classification of prostatitis, which was 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 an increase in the number of bacteria and leukocytes in the urine and prostate secretions after massage.
- Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, it is the result of acute bacterial prostatitis (untreated or poorly treated).If there are symptoms, they occur in the form of pain in the genital or 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 visiting the clinic for other reasons.
With the presence of an infectious component, they talk about bacterial (infectious) chronic prostatitis;if there are no microbial pathogens - about non-bacterial (non-infectious) prostatitis.It is believed that in 90-95% of all cases of chronic prostatitis non-bacterial occurs and only in 10-5% - bacterial.
Reason
Several factors can contribute to the occurrence of chronic prostatitis.First of all, this:
- STI: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungi, Escherichia coli can infect the urethra and are detected in prostate tissue;
- Poor circulation in the pelvic organs (congestion in the prostate leads to its inflammation);
- Sedentary lifestyle (drivers, office workers, officials);
- Prolonged sexual abstinence, interrupted sexual intercourse or artificial prolongation of sexual intercourse;
- Normal hypothermia (fans of extreme recreation: diving, surfing and skiing);
- Stress: mental and physical burden.
For the development of chronic prostatitis, not only the presence and activity of pathogenic microorganisms are important, but the condition of the pelvic organs and blood circulation in them, the presence of concomitant diseases, and the level of protective mechanisms.
Symptoms of chronic prostatitis
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 show themselves at a lower level.
The most common symptoms of chronic prostatitis in men are:
- periodic pain and discomfort in the perineum;
- discomfort during bowel movements and urination;
- irradiation to the anus, thighs, testicles;
- discharge from the urethra.
Changes in the course of the disease, which are already not so bright, can be so insignificant that patients with chronic prostatitis do not pay special attention to them.
Severity of chronic prostatitis
The severity 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 when defecating.
According to some doctors, psychological symptoms of chronic prostatitis can also be identified, including increased irritability, anxiety, fatigue, irritability, sleep disturbances, obsessions and depression.
It is almost impossible to determine all the symptoms in a patient at once, 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 is that the prostate gland produces a special secretion that ensures sperm viability.With inflammation, the secretory function of the prostate gland deteriorates, which inevitably affects sperm quality.
In addition, the prostate gland is actively involved in the regulation of testosterone production and the erection process.This is the reason why chronic prostatitis causes a decrease in erectile function, even impotence.However, the scenario for the development of this disease can be avoided if timely and efficient treatment is carried out.
Diagnostics
The following procedures are required to help establish/disprove the diagnosis:
- rectal examination;
- microscopy of prostate secretion;
- culture of prostate secretions for sensitivity to antibiotics;
- tests for sexually transmitted diseases;
- transrectal ultrasound.
Sometimes additional endoscopic and urodynamic studies are performed.
How to treat chronic prostatitis
If a man is diagnosed with chronic prostatitis, treatment is always long and difficult.The duration directly depends on the stage of the disease at which the patient consults a specialist.Therapy involves an integrated approach, which is a combination of several methods simultaneously:
- antibacterial therapy;
- prostate massage;
- physiotherapeutic procedures;
- diet and lifestyle correction;
- the use of folk remedies;
- surgical treatment.
In addition, anti-inflammatory and antispasmodic agents are used in the treatment of chronic forms of the disease.
Drug treatment
The choice of medicine depends on the cause and symptoms of the disease.To cure chronic prostatitis of infectious etiology, antibacterial drugs are used:
- fluoroquinolones;
- macrolides;
- tetracycline.
To eliminate inflammation and pain, analgesics and non-hormonal anti-inflammatory drugs are used.
Also, in recent years, the treatment of chronic prostatitis has been carried out using drugs that were not used before for this purpose: alpha1 blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect the metabolism of urate and citrate.
Physiotherapy
Certain physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis and others, also help increase prostate tissue trophism and speed up the healing process.
Also, for chronic prostatitis, therapeutic warm baths, mud therapy, and special enemas can be prescribed.
Prostate massage
Improves the flow of prostate secretions and microcirculation at the level of this organ, which in turn contributes to the quick recovery of the patient.
Prostate massage should not be performed in case of acute prostatitis, hemorrhoids, or rectal fissure.Prostate massage is usually combined with antibiotic therapy.Many clinical studies have shown the high effectiveness of this treatment.
Operation
Surgery is possible to remove the area of the prostate gland affected by the bacteria.Transurethral resection is surgery performed under epidural or intravenous barbiturate anesthesia.The recovery period after the operation lasts no more than a week.
The methods required for the treatment of chronic prostatitis are determined by the urologist based on diagnostic information and his practical experience.Conducting self-therapy at home based on reviews on the Internet is fraught with consequences.