Chronic prostatitis is a long-lasting inflammation of the prostate, with symptoms often absent, which is why most of the male population does not know about the disease.
The development of the chronic form of prostatitis is a consequence of an acute process, although in practice this is rare. As a rule, the inflammatory chronic prostatitis begins gradually, without any unpleasant symptoms and sensations, quite often the course of the disease is detected in the patient by accident, when examining ultrasound.
Chronic form affects both young men, and people of middle and old age. Also, prostatitis threatens those who, by their activities, have a low-activity lifestyle, feel excessive physical exertion on the crotch, and abstain from sexual abstinence.
Classification of
According to the modern classification of prostatitis, developed in 1995, there are several categories of the disease:
- Acute bacterial prostatitis ( OBP) is the most common and easily diagnosed type of prostatitis. It is usually caused by a bacterial infection and is easily diagnosed due to typical symptoms. Acute bacterial prostatitis can occur at any age. Symptoms include painful urination, inability to completely empty the bladder, 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 increased number of bacteria and leukocytes in the urine and the secretion of the prostate after its massage.
- Chronic prostatitis ( CP) is the most common form of prostatitis. It is in most cases a consequence of acute bacterial prostatitis( not treated or poorly treated).If there are symptoms, they proceed in the form of pain in the genitals or pelvic region, difficulty in urinating or painful urination and ejaculation.
- Asymptomatic inflammatory prostatitis - with this form of the disease, the classic symptoms of prostatitis are absent, and the disease itself is detected by accident, when you contact the clinic for another reason.
In the presence of an infectious component, they speak of a bacterial( infectious) chronic prostatitis;in the absence of microbial pathogens - about non-bacterial( non-infectious) prostatitis. It is believed that 90-95% of all cases have non-bacterial chronic prostatitis and only 10-5% - bacterial.
Causes of
A number of factors can contribute to the onset of chronic prostatitis. First of all, it is:
- STIs: chlamydia, ureaplasma, mycoplasma, herpesvirus, cytomegalovirus, trichomonads, gonococcus, Candida fungus, E. coli( Escherichia coli) can affect the urethra and be detected in the prostate tissue;
- Circulatory failure in the pelvic organs( congestion in the prostate leads to its inflammation);
- Inactive way of life( drivers, office employees, officials);
- Prolonged sexual abstinence, interrupted sexual intercourse or artificial lengthening of sexual intercourse;
- Regular supercooling( lovers of extreme rest: diving, surfing, canoeing and skiing);
- Stresses: mental and physical overload.
For the development of chronic prostatitis it is important not so much the presence and activity of pathogenic microorganisms, as the state of the pelvic organs and circulation in them, the presence of concomitant diseases, the level of protective mechanisms.
Symptoms of chronic prostatitis
Most often, with the development of a chronic form of prostatitis, the symptoms are almost without disturbing a man. In this case, all the signs of acute prostatitis will not manifest itself in any way or 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;
- irradiation into the anus, thigh, testicles;
- discharge from the urethra.
Changes in the picture of the course of the disease, which is already not very bright, may be so insignificant that patients with chronic prostatitis do not pay much attention to them.
Exacerbation of chronic prostatitis
Exacerbation of the disease is usually accompanied by the following symptoms:
- pain and burning in the urethra;
- increased urge to urinate process;
- pain in the lower abdomen, perineum and rectum;
- signs of a decrease in men's sexual activity;
- pain during the act of defecation.
According to some doctors, it is also possible to identify the psychological symptoms of chronic prostatitis, which include increased irritability, anxiety, fatigue, short temper, sleep disorders, obsessive and depressed.
It is almost impossible to identify all the symptoms at once in a patient, as 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 that the prostate gland produces a special secret that ensures the viability of spermatozoa. In inflammation, the secretory function of the prostate gland worsens, which inevitably affects the quality of sperm.
In addition, the prostate gland is actively involved in the regulation of testosterone production and the erection process. That's why chronic prostatitis causes a decrease in erectile function, up to impotence. However, these scenarios of the development of the disease can be avoided if we conduct timely and competent treatment.
Diagnosis
The following procedures are required to help diagnose / disprove the diagnosis:
- rectal examination;
- prostate secretion microscopy;
- sowing of the prostate secretion on susceptibility to antibiotics;
- analyzes for sexually transmitted diseases;
- transrectal ultrasound.
Sometimes, endoscopic and urodynamic studies are additionally carried out.
How to treat chronic prostatitis
If a man has chronic prostatitis, treatment is always lengthy and difficult. Its duration directly depends on the stage of the ailment, on which the patient turned to the specialist. Therapy involves an integrated approach, that is, the combination of several methods simultaneously:
- antibiotic therapy;
- massage of the prostate;
- physiotherapy procedures;
- correction of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
Additionally, anti-inflammatory and antispasmodic agents are used in the therapy of the chronic form of the disease.
Drug treatment
The choice of medicines depends on the cause and symptoms of the disease. To cure chronic prostatitis of infectious etiology antibacterial drugs are used:
- fluoroquinolones;
- macrolides;
- tetracyclines.
For the elimination of inflammatory phenomena and pain syndrome, analgesics and non-hormonal anti-inflammatory drugs are used.
In recent years, the treatment of chronic prostatitis is carried out using drugs previously not used for this purpose: alpha1-adrenoblockers( terazosin), 5-a-reductase inhibitors( finasteride), cytokine inhibitors, immunosuppressants( cyclosporine), drugs affecting metabolismurates( allopurinol) and citrates.
Physiotherapy
To improve the trophism of prostate tissues and speed up the healing process, certain physiotherapeutic procedures, such as: laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis, and others, also help.
Also for chronic prostatitis, therapeutic warm baths, mud therapy, special enemas can be prescribed.
Massage of the prostate
Improves the drainage of the prostate secretion and microcirculation at the level of this organ, which in turn contributes to the speedy recovery of the patient.
Prostate massage can not be performed with acute prostatitis, hemorrhoids, rectal fissures. Prostate massage is usually combined with antibiotic therapy. Numerous clinical studies have shown high effectiveness of such treatment.
Operation
Surgical intervention is possible to remove the affected areas of the prostate gland.
- Transurethral resection is an operation that is performed under epidural or intravenous barbiturate anesthesia. Postoperative recovery period lasts no more than a week.
Methods, which involves the treatment of chronic prostatitis, is determined by a urologist on the basis of diagnostic information and his practical experience. To conduct independent therapy at home based on feedback on the Internet is fraught with consequences.