How is prostatitis treated? Based on the results of clinical and laboratory tests, the urologist-andrologist prepares a treatment plan, which should include a whole series of therapeutic measures. The complete treatment program, as a rule, includes antibacterial and antiviral therapy, treatment with drugs that improve vascular tone. Physiotherapy treatment methods are widely used (magnetic-induction therapy with laser, ultrasound, reflexology, leech therapy), as well as strengthening agents, a series of prostate massage is prescribed. In any case, the choice and tactics of treatment remain with the urologist-andrologist.
The role of the prostate in a man's life
Prostate- a part of the male reproductive system that produces a specific secret that nourishes and protects the sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles contract, the sperm flows into the urethra - ejaculation (ejaculation).
Anatomy:The prostate is located below the bladder and covers the upper part of the urethra, therefore, with increasing size, various disorders of the urinary system develop. The size, shape and density are individual and change with the age of the man. The gland has a complex nervous system and, even with small pathological changes, causes both local and general disorders in it.
Mode:The main function of the prostate is secretory. The secretion (or juice) produced consists of a liquid and dense fraction and contains proteins, carbohydrates, electrolytes, fats and hormones. The gland not only transports sperm, but also thins the sperm, ensuring sperm motility and vitality. The prostate is an important organ involved in regulating testosterone production and also ensures the proper functioning of the erection mechanism.
Classification of prostatitis
- acute;
- asymptomatic inflammation.
- chronic bacterial;
- Inflammatory chronic pelvic pain syndrome.
Complaints about prostatitis
- Various urological disorders associated with urethral stricture:
- Difficulty in starting to urinate
- intermittent urination
- poor urine flow
- urination drop by drop
- feeling of incomplete emptying of the bladder.
- involuntary leakage of urine.
- Symptoms due to irritation of the nerve endings:
- increased urination
- increased urination at night
- urgent urge to urinate
- urination in small portions
- urinary incontinence with urge urination.
- Pain in the lower abdomen, groin, inner thighs or lower back and sexual dysfunction.
Remember that violations of the act of urination and the symptoms of pain can occur not only with prostatitis, but also with adenoma (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is also often diagnosed. This is why, for the early diagnosis of possible prostate pathology, it is recommended that all men after the age of 50 donate blood for a specific antigen (PSA).
Causes of prostatitis
- Sexually transmitted infections: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, Trichomonas, gonococcus, Candida fungus, Escherichia coli can infect the urethra and be detected in prostate tissue.
- violation of blood circulation in the pelvic organs (congestion in the prostate leads to inflammation).
- sedentary lifestyle (drivers, clerks, clerks);
- prolonged sexual abstinence, cessation of sexual intercourse or artificial prolongation of sexual intercourse;
- frequent hypothermia (lovers of extreme leisure: diving, surfing, kayaking and skiing).
- Anxiety: mental and physical overload.
Prostatitis and activity.Inflammation of the prostate itself does not lead to impotence. However, untreated chronic prostatitis, such as inflammation of the sperm, can lead to inhibition of libido, insufficient erection, premature or accelerated ejaculation, pain during ejaculation and the so-called deleted orgasm.
Prostatitis and male infertility.Among other factors, the prostate also affects sperm viability and in some cases, the inflammatory process leads to infertility.
In developed countries, most men who have reached the age of 45 must have regular preventive examinations by a urologist-andrologist. Prostate examination in these countries has become commonplace. Our compatriots have a different position: they go to the doctor only when they "push it completely".
And here is the result: the treatment of prostatitis in our country requires 40 to 60% of men of reproductive age.
Diagnoses of prostatitis
Chronic prostatitis is an insidious disease. Very often, the disease develops latently and gradually becomes chronic. If you do not pay attention in time, then a seemingly insignificant illness can turn into a real nightmare. In the stage of deterioration, sometimes giving a rather high temperature (38-39 ° C), pain in the perineum turns the process of urination and defecation into a feat. An abscess can form, i. e. purulent fusion of prostate tissue, with all the consequent consequences.
In its advanced form, prostatitis leads to the most serious complications that create many problems not only for the man himself, but also for his entire family. With prostatitis, not only does libido decrease and erectile function is affected. Sadly, about 40% of patients are threatened with some form of infertility, as the prostate can no longer produce enough high-quality secretions to ensure sperm motility. This is why it is so important to treat prostatitis in the early stages of development. The success of prostatitis treatment depends largely on it.
Urological examination
- General examination methods for urological patients: blood tests (clinical, biochemical, for HIV, RW and hepatitis B and C markers) and urine tests.
- special methods of examination of urological patients:
- study of prostate secretion
- tests for sexually transmitted infections;
- digital rectal examination;
- Ultrasound of the kidneys, bladder and rectal ultrasound of prostate uroflowmetry (urination test with suspected prostatitis).
- blood test for PSA and prostate biopsy (if appropriate) to rule out prostate cancer.
Treatment of prostatitis
Once all the results have been obtained, the urologist will draw up a treatment plan. This prostatitis treatment plan should include a full range of treatments. The development of prostatitis is always caused by several factors, so it is necessary to act simultaneously in many directions. The complex program for the treatment of prostatitis, as a rule, includes antibiotic therapy, treatment with drugs that improve vascular tone, physiotherapy procedures, as well as general strengthening agents, a course of prostate massage is prescribed.
Massage, despite causing a number of unpleasant sensations, is a necessary process. First, for diagnosis, when you need to get prostate secretion for research. In addition, in some cases, massage is given to relieve congestion in the prostate. Usually this event is approached seriously and selectively.
Prostate adenoma or benign prostatic hyperplasia (BPH) A disease that occurs in 50% of men over 50 years of age. The reasons for prostate tissue proliferation are not yet clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urination becomes more difficult, blood circulation to the bladder wall deteriorates and over time, the bladder wall hardens. These changes are irreversible.
Complications of prostate adenoma
- urinary tract infection?
- acute urinary retention
- bladder stones
- chronic kidney failure.
Various examination methods make it possible to assess the disorders and their degree. Depending on the results of the examination, the doctor together with the patient decide which of the treatment methods to choose. Possible surgical and medical treatment of BPH.
Viral prostatitis
The viruses of herpes, cytomegalovirus, human papilloma are often the cause of the development of urethritis, complicate the course of prostatitis and cause male infertility.
For example, in men without genital herpes on the skin and mucous membranes, the virus can only be detected during laboratory diagnostics on sperm or prostate secretions. The patient infects the sexual partner, develops sperm pathology and, as a result, infertility. Often, patients with non-bacterial prostatitis receive a variety of mass antibiotic therapy without the expected positive effect, when in fact, viruses may be the cause of the disease, which requires completely different treatment regimens (antiviral therapy, immunotherapy, etc. ).
Herpetic:According to several authors, prostatitis is caused or supported by the herpes simplex virus in 2, 9 - 21, 8% of cases. Chronic prostatitis is usually characterized by a frequent and persistent recurrent nature. In clinical practice, the diagnosis of chronic herpetic prostatitis is rarely made by urologists. The reason, obviously, is that virological diagnostic methods are not included in the standard examination of patients with chronic prostatitis. The reason is the stereotype of the doctor thinking and patients are traditionally screened for non-viral genital infections.
In the clinical course of prostatitis, functional changes are observed - reproductive changes, pain (with radiation to the external genitalia, perineum, lower back) and dysuric syndromes. Often, in patients with recurrent genital herpes, prostatitis is subclinical: in these patients, the diagnosis of prostatitis is based on the appearance of leukocytosis in prostate secretion and a decrease in the number of lecithin granules.