Details about the symptoms and treatment of chronic prostatitis

Chronic prostatitis is one of the most common diseases in mature men. Inflammation of the prostate significantly reduces the quality of life, making it the cause of psychosomatic and sexual disorders. The lack of sufficient information about the nature of this disease makes the treatment of chronic prostatitis a difficult task that requires a lot of patience from both the patient and his doctor.

Prostatitis is an inflammatory-degenerative lesion of the prostate.

Classification

The American National Institutes of Health (NIH USA) developed and proposed the following classification of chronic prostatitis:

• chronic bacterial prostatitis
• chronic non-bacterial prostatitis (with and without signs of inflammation)
• chronic asymptomatic prostatitis.

Modern andrologists adhere to this classification in the diagnosis and treatment of inflammatory diseases of the prostate. Acute prostatitis stands out. Knowing which category the recognized pathology belongs to, the doctor will be able to choose the optimal treatment regimen and achieve significant success in the treatment of the disease.

Causes and risk factors

The division into bacterial and non-bacterial chronic prostatitis is not accidental. Various causes of the disease determine the tactics of treatment and greatly affect the outcome of the disease.

Chronic bacterial prostatitis

Chronic bacterial prostatitis occurs in 10-15% of patients. The immediate cause of the development of the disease is the penetration of pathogenic and opportunistic flora into the prostate. By definition, the prostate gland is free of bacteria. Prostate infection is possible through the urethra, as well as hematogenous and lymphogenic. During the test, the following microorganisms are most often identified:

• Escherichia coli (up to 95%)
• Proteus;
• κλεψίγια;
• pseudo-monk.

Representatives of the gram-positive flora (staphylococci, streptococci) are quite rare. In some cases, two or more microorganisms (mixed infection) develop. Possible infection with pathogenic flora (chlamydia, Trichomonas, gonococcus and others).

Most of the microorganisms detected during the examination are representatives of the normal microflora. Under normal circumstances, they do not harm the body and exist peacefully in the mucous membranes of the urinary tract and digestive system. Under certain conditions, the growth and reproduction of conditionally pathogenic flora occurs, which leads to inflammation of the prostate tissues and the appearance of all the symptoms of the disease.

Risk factors for developing chronic bacterial prostatitis:

• non-observance of personal hygiene;
• hypothermia?
• genital trauma
• inflammatory diseases of the urinary system
• the presence of STI.

All this leads to a reduction in local and general immunity and to the natural reproduction of opportunistic flora in the prostate. It is not excluded that the infection can enter through the urethra in inflammatory diseases of the genital system. The chance of developing prostatitis increases with existing urethritis, cystitis, colic.

Chronic non-bacterial prostatitis

There are many theories about the occurrence of this form of the disease:

1. Theory of chemical inflammation. . . Dropping urine into the prostate when urinating leads to the deposition of urea and the development of inflammation. Recurrence of the urethra-prostate is facilitated by urethral stricture (stenosis) and other developmental abnormalities.
2. Immune theory. . . The version is based on autoimmune damage to prostate gland tissues as a result of exposure to bacterial antigens. Hereditary predisposition to this form of pathology is taken into account.
3. Neurogenic theory. . . Violation of the nerve in the pelvic area causes blood stasis in the organs and leads to the development of prostatitis.

In the development of non-bacterial prostatitis, the following risk factors also deserve special attention:

• long sedentary work
• sedentary life?
• Bad Habits;
• stress and emotional overload
• prolonged sexual abstinence.

These risk factors cause the development of congestion in the prostate, leading to a violation of the microcirculation in the pelvic organs. The microbial factor plays a role only in the early stages of disease development. In the future, its importance decreases and autoimmune processes and eating disorders in the tissues of the prostate gland come to the fore.

According to statistics, 85-90% of men have chronic bacterial prostatitis (not directly related to infection with pathogenic or opportunistic bacteria).

Symptoms

Chronic prostatitis occurs mainly in men aged 25-40 years. With age, the likelihood of developing the disease increases. In old age, inflammation of the prostate is often associated with an adenoma - a benign tumor of the prostate.

Signs of chronic prostatitis:

• dull pains in the lower abdomen
• radiation pain in the groin area, scrotum, perineum, lower back, sacrum
• increased discomfort during intercourse and during bowel movements

Urinary disorders are very typical:

• frequent urination;
• excretion of urine in small portions.
• feeling of incomplete emptying of the bladder.
• the appearance or intensity of pain when urinating.
• slow and intermittent urine flow.

The latter symptom is characteristic of prostate adenoma, which often occurs in the context of chronic prostatitis.

With a long course of the disease, there are disorders in the sexual sphere:

• decreased libido
• deterioration of the erection
• reducing the duration of sexual intercourse;
• premature ejaculation
• pulling pains in the lower abdomen after ejaculation
• lack of spontaneous morning erection.

Chronic prostatitis is one of the leading causes of erectile dysfunction, in which a man can not achieve and maintain an erection adequate for full sexual intercourse. Such a condition significantly disrupts the course of life, can cause depression and other psychomotor disorders.

Chronic asymptomatic prostatitis occurs without clinical manifestations. The disease is detected randomly during the examination by a urologist. Despite the absence of symptoms, inflammation of the prostate can lead to serious complications, erectile dysfunction and other health problems.

Complications

The onset of prostatitis causes the development of such conditions:

• prostate abscess
• cystitis and pyelonephritis (inflammation of the bladder and kidneys).
• cystitis (inflammation of the seminal vesicles).
• erectile dysfunction
• infertility.

The earlier the disease is detected and treatment started, the more likely a favorable outcome of the disease is.

Diagnostics

The following methods are used to detect chronic prostatitis:

Examination by a urologist

In a personal appointment, the doctor focuses on the patient's complaints. The external genitalia are examined and a digital rectal examination of the prostate is performed. On palpation, the doctor evaluates the size and shape of the gland. In case of chronic prostatitis, the organ will swell slightly. The procedure is combined with the collection of prostate secretions for microbiological examination.

Sample of four glasses

The main method that allows you to detect the inflammatory process in the prostate and distinguish it from other diseases. The collection of material takes place in various stages. In the morning, after 5-6 hours of abstinence from the toilet, a man urinates in two jars - for the first (initial) and for the second (middle) part of the urine. In the first part, the contents of the urethra are rinsed, in the second - the bladder. The third part of the urine is collected after the prostate massage and allows you to assess the condition of the prostate. Prostate secretion is collected separately for bacteriological culture.

In the analysis of urine, two parameters are evaluated: the number of leukocytes and erythrocytes. With prostate disease, the number of white blood cells in the third part of the urine increases. Normally, their number does not exceed 10 in the field of view.

Microbiological examination

When performing a three-glass test, not only is the leukocyte count estimated, but bacterial vaccine material is also obtained. If you suspect chronic prostatitis, your doctor is particularly interested in the third part of your urine. Based on the test results, the doctor can determine the causative agent of the disease and choose the optimal antibiotic treatment.

The identification of opportunistic bacteria in a titer of more than 10 has diagnostic value.³CFU / ml or detection of undoubtedly pathogenic microorganisms in any quantity.

Bacteriological culture of prostate secretion

Bacteriological seeding of prostate fluid makes it possible to assess the nature of the process (infectious or not) and determine the type of pathogen.

Before taking the third part of the urine during a prostate massage, the doctor takes the secreted secretion for bacteriological examination. The resulting result also makes it possible to determine the regular diagnosis and treatment.

Diagnostic criteria for chronic bacterial prostatitis:

• Detection of opportunistic microorganisms in the third part of urine or prostate secretion over 10³CFU / ml.
• Detection of opportunistic bacteria in the third part of the urine or prostate secretion, the number of which is significantly (10 times) higher than in the second part of the urine.
• Identification of pathogenic microorganisms in the third part of urine or prostate secretion.

Ultrasound

Ultrasound examination allows you to estimate the size of the organ and detect pathology at the same time. Chronic prostatitis is often associated with prostate adenoma - a benign tumor.

Principles of treatment

The goal of treatment for chronic prostatitis is to eliminate the inflammatory process, activate blood flow and improve organ nutrition. When high-grade pathogens or opportunistic microorganisms are identified, they are eliminated. Particular attention is paid to lifestyle adjustments and stimulating the body's defenses.

Drug treatment

The following drugs are used to treat chronic prostatitis:

• Antibacterial drugs are selected taking into account the identified pathogen.
• Anti-inflammatory drugs to reduce inflammation and relieve pain.
• Means that facilitate urination (alpha-blockers, which relax the muscles of the urethra and stimulate the outflow of urine).
• Means that increase blood flow to the pelvic organs.

The choice of antibiotic will depend on the identified pathogen. When choosing a drug, its ability to penetrate the hematopoietic barrier and accumulate in prostate tissues should be taken into account. These conditions are met through the group of fluoroquinolones. Macrolides and tetracyclines are also used to treat chronic prostatitis.

According to the recommendations of the European Union of Urology, the course of antibacterial treatment should be at least 2 weeks after the start of the preliminary diagnosis.

Upon receipt of the results of the bacteriological examination and confirmation of the bacterial nature of the disease, the treatment lasts up to 4-6 weeks. This approach allows not only to get rid of the causative agent of the disease, but also to prevent the recurrence of prostatitis.

Unfortunately, antibiotic treatment is not always effective. Many microorganisms are successfully present in the prostate secretion for a long time and become resistant to antibiotics. Bacteria form specific biofilms and form colonies of microorganisms covered with a complex polysaccharide structure. Most antibacterial drugs cannot penetrate this biological barrier, which significantly reduces the effectiveness of treatment. This problem can be avoided by using modern antibiotics, which can not only penetrate and heat the prostate tissue, but also pass through biofilm and infect bacteria that are so severely protected.

Non-drug treatment

Among the non-drug treatments, special attention is paid to prostate massage. The procedure stimulates the blood supply to the prostate, eliminates congestion and facilitates the excretion of secretions. The combination of massage and long-term use of antibacterial drugs is the main way to relieve a man from the unpleasant symptoms of chronic prostatitis.

Physiotherapeutic methods of influence are used in the treatment of chronic prostatitis together with medicinal effects. A good result is shown by the use of ultrasound, laser beams, radio waves and electromusculation. Shockwave prostate (UHM) massage is very popular. Physiotherapy is particularly indicated in the presence of erectile dysfunction as one of the complications of prostatitis.

Particular attention is paid to diet for the treatment of prostatitis. The following foods should be excluded from the diet:

• alcohol;
• spicy, spicy food;
• fried and fatty foods (including fatty meats and fish).

Salt consumption is limited to 5 g per day. Priority is given to fresh vegetables and fruits, herbs. Steam is recommended.

The diet will speed up recovery, boost immunity and help the body deal with the stress caused by antibiotics in the treatment of an illness.

ethnoscience

Not all men see a doctor when they develop symptoms of prostatitis. Men often prefer to be treated with popular methods, using the knowledge base from many forums, relying on the advice of friends, relatives and neighbors. Neglect of the individual's health, rejection of rational antibiotic therapy and other traditional methods of exposure threatens the development of complications and worsening of the general condition. Untreated prostatitis can cause erectile dysfunction. Is it worth the risk if you can see a doctor in time and solve the problem with minimal losses?

Of course, among the methods of traditional medicine, there are some aspects that deserve special attention. Modern urology recognizes the effectiveness of many herbs in the treatment of chronic prostatitis. Experts recommend herbal preparations based on the following ingredients:

• Pumpkin seed oil
• round green
• garden parsley?
• St John's word perforatum;
• Canadian gold bars?
• licorice root?
• echinacea.

Individually or in combination, these ingredients stimulate blood flow to the pelvic organs, eliminate congestion and stimulate the immune system.

Herbal preparations will not rid the body of pathogenic bacteria, but will help eliminate the symptoms of the disease.

In combination with antibacterial drugs and prostate massage, herbal medicines significantly improve the general condition and speed up recovery.

Prevention

The following recommendations will help reduce the risk of developing chronic prostatitis:

1. Hypothermia of the whole body and the area of the genitals, pelvis and lower extremities should not be allowed. In the cold season, it is worth wearing thermal underwear.
2. It is necessary to follow the rules of proper hygiene and use condoms to protect against STDs. The best prevention of infection will be the rejection of casual sex.
3. You need to take care of your health and treat any diseases of the genital area in time.
4. It will not be unnecessary to follow a diet (to give up spicy, fried and fatty foods), as well as to keep your body in good condition (playing sports, fitness, walking).

It is recommended that all men over 30 have regular urological examinations (at least once a year). If you experience any unpleasant symptoms, you should see your doctor as soon as possible.

Frequent questions

Can chronic prostatitis be cured?

Contrary to popular belief, chronic prostatitis can be successfully treated. If you follow all the doctor's recommendations, you can get rid of the unpleasant symptoms of prostatitis and significantly improve your quality of life.

Can chronic prostatitis be asymptomatic?

Yes, this variant of the disease is detected only after examination by a urologist.

Is chronic prostatitis in a partner dangerous for a woman?

Sexually transmitted infections are often the cause of chronic prostatitis. If a pathogen is detected, both partners should be treated. Otherwise, there is a risk of infection and the effectiveness of treatment is reduced due to recurrences of the disease.

Is it possible to have sex with chronic prostatitis?

Yes, if the general condition allows and there are no problems in the sexual sphere (erectile dysfunction).

Is it possible to conceive a child with chronic prostatitis?

Yes, if the prostate function is maintained and its secretion is fully developed. Before conceiving a child, it is recommended that you be examined and treated by a urologist. The infection that caused the development of prostatitis is easily transmitted to a woman. Intrauterine infection of the fetus can cause developmental abnormalities and termination of pregnancy.

How does chronic prostatitis affect activity?

Chronic inflammation of the prostate gland threatens the development of erectile dysfunction. With such a pathology, there is a decrease in libido, the frequency and endurance of the erection decreases, orgasms become painful. In advanced cases, sexual activity becomes impossible.

Can chronic prostatitis be treated without antibiotics?

Antibiotic treatment is considered one of the main treatments for chronic prostatitis. In most cases, it is impossible to treat the disease without antibiotics.

Can chronic prostatitis be treated with folk remedies?

Getting rid of chronic prostatitis with traditional medicine alone will not work. To achieve the best result, the complex treatment is carried out using antibiotics, herbal preparations, anti-inflammatory drugs and physiotherapy methods.