Chronic prostatitis is a long-term inflammation of the prostate gland, often asymptomatic, which is why the majority 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, chronic inflammatory prostatitis begins gradually, without any unpleasant symptoms or sensations;the course of the disease is often discovered in the patient by chance during an ultrasound examination.
Both young, middle-aged and elderly people are susceptible to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead an inactive lifestyle, experience excessive physical stress 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 thanks to its typical symptoms.Acute bacterial prostatitis can occur at any age.Symptoms include painful urination, inability to completely empty the bladder, and pain in the lower abdomen, back, or pelvic area.There may be 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 manifest themselves in the form of pain in the genitals 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 another reason.
In the presence of an infectious component we speak of chronic bacterial (infectious) prostatitis;in the absence of microbial pathogens - on non-bacterial (non-infectious) prostatitis.It is believed that in 90-95% of all cases chronic non-bacterial prostatitis occurs, and only in 10-5% bacterial.
Reasons
Numerous factors can contribute to the onset of chronic prostatitis.First this:
- Sexually transmitted diseases: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungus, Escherichia coli can infect the urethra and be detected in prostatic tissue;
- Poor circulation in the pelvic organs (congestion of the prostate leads to its inflammation);
- Sedentary lifestyle (drivers, office workers, officials);
- Prolonged sexual abstinence, interrupted sexual intercourse or artificial prolongation of sexual intercourse;
- Regular hypothermia (enthusiasts of extreme recreation: diving, surfing and skiing);
- Stress: mental and physical overload.
For the development of chronic prostatitis, it is not so much the presence and activity of pathogenic microorganisms that are important, but the state of the pelvic organs and blood circulation in them, the presence of concomitant diseases and the level of protective mechanisms.
Symptoms of chronic prostatitis
Very 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 themselves at all or will manifest themselves 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;
- irradiation to the anus, thigh, testicles;
- discharge from the urethra.
Changes in the course of the disease, which is already not very noticeable, can be so insignificant that patients with chronic prostatitis do not pay special attention to them.
Exacerbation of chronic prostatitis
An 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, the psychological symptoms of chronic prostatitis can also be identified, including increased irritability, anxiety, tiredness, short temper, sleep disturbances, obsession and depression.
It is almost impossible to simultaneously determine all the symptoms of a patient, since a man usually shows only 2-3 signs of the disease.For example, the most common are erectile dysfunction and lower abdominal pain.
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.
Furthermore, the prostate gland is actively involved in the regulation of testosterone production and the erection process.This is why chronic prostatitis causes decreased erectile function and even impotence.However, these scenarios for the development of the disease can be avoided if timely and competent treatment is carried out.
Diagnostics
The following procedures are necessary to help establish/disprove the diagnosis:
- rectal exam;
- microscopy of prostatic secretion;
- culture of prostatic secretion for antibiotic sensitivity;
- testing 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, the treatment is always long and difficult.Its duration directly depends on the stage of the disease at which the patient consulted a specialist.The therapy involves an integrated approach, that is, a combination of several methods simultaneously:
- antibacterial therapy;
- prostate massage;
- physiotherapeutic procedures;
- correction of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
In addition, anti-inflammatory and antispasmodic agents are used in the treatment of chronic forms of the disease.
Pharmacological treatment
The choice of drugs depends on the cause and symptoms of the disease.To treat 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.
In addition, in recent years, the treatment of chronic prostatitis has been carried out using drugs previously not used for this purpose: alpha1-blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect the metabolism of urate and citrate.
Physiotherapy
Some physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis and others, also help to improve the trophism of the prostate tissue and accelerate 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 prostatic secretions and microcirculation at the level of this organ, which in turn contributes to a speedy recovery of the patient.
Prostate massage cannot be performed in cases of acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is usually combined with antibiotic therapy.Numerous clinical studies have demonstrated the high effectiveness of this treatment.
Operation
Areas of the prostate gland affected by bacteria can be removed with surgery.Transurethral resection is an operation performed under epidural or intravenous anesthesia with barbiturates.The postoperative recovery period lasts no more than a week.
The necessary methods for the treatment of chronic prostatitis are determined by the urologist based on diagnostic information and his practical experience.Carrying out self-therapy at home based on reviews on the Internet is fraught with consequences.