Chronic prostatitis: symptoms and treatment.

Inflammatory processes observed in the prostate tissue for three or more months are called chronic prostatitis.The long course of the disease indicates the beginning of the chronic stage.Statistics show that acute and chronic prostatitis often occurs against the background of complicated urethritis.

A distinctive feature of chronic prostatitis is that in 50-70% of cases the disease does not manifest itself with pronounced symptoms.Only in 20% of cases do patients describe signs indicating a chronic form of prostatitis.The remaining category of men only observesindirect symptoms of the disease, not directly related to prostatitis.Both young and middle-aged and elderly men are not immune to chronic prostatitis.

Those who experience lack of physical activity, are associated with sedentary work and practice sexual abstinence are susceptible to prostatitis.Thus, truck drivers, who spend most of their time behind the wheel, suffer from the effects of negative factors: hypothermia and congestion in the pelvic organs.Representatives of contact sports and weightlifters are prone to microtrauma to the prostate tissue.Men who show little sexual activity become hostages to this unpleasant disease due to stagnation of prostate secretions.They affect the prostate gland, causing acute and chronic prostatitis, various sexually transmitted infections, through the blood or lymph fluid.

Types and stages of chronic prostatitis.

In urological practice, the following are distinguished:forms of chronic prostatitis:

• Bacterial.The cause of the disease lies in an infection or pathogenic bacteria that has penetrated the prostate gland.The most common is chronic prostatitis caused by chlamydia.The danger of this form lies in the possible infertility that awaits a man without timely treatment.
• Abacterial.Chronic prostatitis of a non-infectious nature.Diagnosing the exact cause is quite problematic.Usually this prostatitis develops due to the anatomical features of the prostate of a particular man.The incorrect structure of the organ creates increased pressure on the urethra, which leads to frequent discharge of urine.Autoimmune diseases can also cause degenerative changes in prostate tissue.
• Stagnant.Chronic congestive prostatitis develops when the prostate does not empty completely and excess blood mass forms.Stagnation creates an inflammatory response.
• Constant pelvic pain syndrome.A man complains of constant, unrelenting pain in the perineal area.
• Asymptomatic.Chronic prostatitis occurs latently, without causing pain or discomfort, despite the presence of inflammation.

Chronic prostatitis has its own stages of development.

• Exudation stage.Rapid ejaculation and acute pain in the prostate.
• Alternative stage.Painful sensations are replaced by discomfort, reduced sexual intercourse time and frequent urination.
• Proliferation stage.The frequency of the urge to go to the bathroom increases, but problems with urine production appear.
• Stage of scar changes.Sclerosis of healthy prostate tissue occurs.As a result of morphological transformations, heaviness appears in the area of the sacrum and pubis, the urine stream weakens and potency decreases.Sensations during orgasm are usually blurry.

Causes

• Infection.The source of pathogenic bacteria that enter the prostate is the blood and lymphatic vessels.Urological diseases and inflammation of the rectum are a prerequisite for infection of the prostate tissue.Infection methods:
  • Falling- the infection enters the gland along with urine, which contains microbes.
  • on the rise— The path of microbes entering the prostate begins from the external opening of the urethra.
• Decrease in the protective functions of the body..One of the main culprits of chronic prostatitis is a weakened immune system.This is facilitated by hypothermia, frequent stressful situations, poor nutrition and bad habits.When immunity decreases, the body is exposed to infections that cause inflammation of the prostate.
• poor circulation.A sedentary and sedentary lifestyle is closely related to chronic prostatitis.The internal organ systems of a man suffer from a lack of physical activity: endocrine, cardiovascular, nervous.Blood microcirculation in the pelvis deteriorates, which causes hypoxia of prostate cells.
• Lack of regular sexual life.Both rejection of intimate life and excessive sexual activity cause prostate problems.Many men with a strong sexual constitution engage in vigorous sexual activity.Due to frequent sexual intercourse, your nervous system is exhausted, hormonal disturbances appear, and the erection gradually weakens.Incomplete sexual intercourse causes great damage to prostate health.
• Chronic prostate lesions.The soft tissue of the prostate, which is often injured by excessive stress, shaking and vibration, can periodically become inflamed.
• Transurethral proceduresWithout concomitant antibiotic therapy it can cause prostate infection.
• urethral catheter, which a man is forced to live with for some time, also contributes to prostate infection.

Symptoms of chronic prostatitis.

The symptoms of chronic prostatitis vary.Some of the first signs of chronic prostatitis that attract attention are pain when urinating and impaired sexual function.As a rule, problems in the intimate sphere force a man to seek help from a doctor.If there is discomfort and pain in the pelvic area.do not disappear for more than three months, then with a high probability we can talk about chronic prostatitis.

Most often, the pain syndrome spreads to the perineal area, but the discomfort can be localized in the pubic area and in the groin.A man complains of pain in the anus, scrotum, and glans.The pain radiates to the lumbosacral region.Pain attacks may cover the inner thighs.Pain in one of the testicles does not usually indicate prostatitis.Complaints of pain after ejaculation are specific to the chronic course of the disease.

Common symptoms of chronic prostatitis also include increased sweating, feeling cold, and tremors in the perineum.Poor circulation in the pelvis can causeto changes in skin color.

Chronization of the inflammatory process in the prostate leads to an alteration in its tone.In some cases, prostatorrhea develops.With this pathology, a spontaneous secretion of the gland occurs, which has no relation to arousal or ejaculation.

With chronic prostatitis, men may observe, mainly in the morning, a small purulent or clear discharge from the penis.Some patients find white flakes or threads in their urine.A sign of advanced stone prostatitis is the presence of traces of blood in the semen.

Many patients note the appearance of sexual dysfunction, simultaneously with a decrease in libido and a deterioration in spontaneous erections.It is worth noting that most patients have impotence.has no critical connotation.In the early stages of chronic prostatitis, men experience premature ejaculation, which can become difficult over time.Some patients report a decrease in the intensity of sensations during sexual intercourse.Problems with urination are usually irritative in nature.

Diagnosis of the biological material of a man with chronic prostatitis reveals a quantitative and qualitative violation of the secretion of the prostate.Morphological deviations in ejaculation parameters are rarely associated with male infertility.

During remission, most symptoms disappear and pain decreases.Many men calm down and attribute the situation to self-healing.But without adequate therapy, infectious foci in the prostate persist even during the exacerbation period.symptoms worsen significantly, the low-grade fever persists.

Diagnosis of the disease.

Diagnosing chronic prostatitis is not difficult for an experienced urologist.The most difficult thing here is probably to establish the true cause that caused chronic prostatitis.

To confirm the diagnosiscarry out the following procedures:

• Rectal examination with fingers.A digital examination is performed during a man's initial visit to a urologist.The back of the prostate is in contact with the rectum, which makes it possible to evaluate the condition of the prostate when a finger is inserted into the anus.Palpation of the posterior surface of the gland makes it possible to determine the size and shape, as well as the consistency and pain of the inflamed organ.
• Microscopic examination of prostate secretion.When studying biological material, a laboratory technician may notice an increased number of leukocytes, which indicates the spread of pathogenic bacteria.
• Culture of glandular secretion.on the nutritional medium, type of bacteria and resistance to antibiotics using RIF and PCR methods.
• Cystoscopy.An endoscopic imaging system device is inserted into the bladder cavity.This method of diagnosing chronic prostatitis allows us to exclude cancer, cystitis and bladder lesions.
• Ultrasound.The doctor may prescribe an ultrasound examination before starting treatment for acute prostatitis, so as not to miss the formation of abscesses in the organ.For men with chronic prostatitis, an ultrasound is performed to detect stones and cysts, as well as to evaluate the level of urethral pressure.Today, transrectal ultrasound, in which a sensor is inserted into the rectum, is more effective.
• Uroflowmetric diagnostic method.In this way, the indicators of the urinary process are studied: the duration and speed of urine output.A velocity greater than 10 to 15 ml/s indicates good patency of the urethra.Indicators below this norm indicate poor patency of the urinary canal caused by chronic prostatitis.

Chronic prostatitis: treatment

Each clinical case requiresindividual selection of treatment regimen.When choosing a therapeutic model, the causes of the disease, the duration of the course and the presence of aggravating factors are taken into account.

Pharmacological treatment:

• Antibiotics.Antibacterial therapy is indicated only in cases of prostate infection with a bacterial agent that has been identified in prostate secretions or urine.Antibiotics from the fluoroquinolone group are prescribed.Treatment lasts from two to eight weeks.After antibacterial treatment, the symptoms usually remain completely, provided that the infection factor has been eliminated.
• Alpha blockersprescribed to men to reduce hypertonicity of the bladder muscles and stabilize intraurethral pressure.They are ineffective if the patient has altered muscle innervation and pelvic floor muscular dystrophy.
• Non-steroidal anti-inflammatory drugs.Helps relieve pain syndromes.
• Selective antidepressants.Prescribed for men to improve their emotional background, relieve anxiety and doubts.
• Hormonal medications.Antiandrogens and androgens are used to adjust hormone levels.
• Immunostimulant drugs.Prescribed for proven immunodeficiency.
• Regulators of uric acid level.The appointment is justified if there are sand and stones in the prostate.
• Vitamin complexes.

Auxiliary methods for the treatment of chronic prostatitis.

Some urologists are of the opinion that the physical impact on the prostate significantly alleviates the patient's condition.But most of these therapeutic methods have their contraindications, soprescribed under certain conditions:

• Prostate massage.Contraindicated in prostatic hyperplasia because it can cause acute urinary retention.Additionally, performing a massage can spread the infection throughout the prostate and cause sepsis.Massage should not be performed if there are cystic formations in the prostate or venous stagnation.To relieve stagnation of the gland, natural drainage during ejaculation is considered the best way.
• Bladder gymnastics.The treatment consists of a group of special exercises aimed at improving the muscle tone of the bladder and its sphincter.
• Instillations.Infusion of medicinal solutions deep into the urethra.The procedure is very painful and often causes complications.
• Physiotherapy.Treatment of the prostate with transrectal ultrasound, electrical stimulation, magnetotherapy, and phonophoresis will be beneficial for poor pelvic floor muscle tone.Physiotherapy only brings temporary relief to the patient's condition.A lasting effect can only be achieved after eliminating the causes of prostatitis.
• Traditional medicine recipes.Honey with pumpkin seeds, alcoholic horse chestnut tincture and other folk methods are used after consultation with the attending physician.

Surgical treatment of chronic prostatitis.

Taking into account what pathological process caused prostatitis, they usetransurethral resectionprostate gland.This is a modern surgical treatment method that replaced open surgery.An endoscope is used to drain the formed prostatic cyst and surgical correction of the seminal vesicles is performed in case of obstruction of the outflow of secretions.

Treatment of chronic prostatitis -long process, which requires patience and endurance on the part of a man.So that the disease does not take you by surprise, you need to monitor your health, strengthen your immune system and treat colds in a timely manner.