Chronic prostatitis is a long-term inflammation of the prostate, diagnosed only in men, indicating the presence of a neglected pathological condition in the reproductive organs. The disease results in a violation of the morphology and function of the prostate, characterized by pelvic pain, irradiated genitalia in the groin, urinary disturbances, sexual dysfunction. Long-term treatment includes stabilization of general condition, excluding relapse and AUR.
Types of chronic prostatitis
Chronic forms of prostatitis can be of several types, depending entirely on the basis of the onset of the disease. According to the classification, the following diseases can be distinguished:
- Chronic prostatitis of bacterial origin. The cause of the inflammatory process of the gland is the penetration of bacterial flora along descending or ascending paths (abscesses, through the urethra, caries, etc. ).
- Timed with inflammatory components secreted by the prostate. The study revealed elevated levels of white blood cells and pathogens, infectious agents.
- Chronic nonbacterial prostatitis. It manifests as an inflammatory process with complex symptoms, similar to acute inflammation, involving the pathogenic microbiota. But in reality, there is no inflammatory component (pathogen + leukocytes).
- Latent chronic prostatitis. The disease has no visible signs, causes no discomfort, and rarely disrupts the functioning of the reproductive organs. But when secretly analyzed, the products of inflammation—white blood cells—are found.
Traditionally, STB (pelvic pain syndrome) has been attributed to chronicity of prostatic processes. What ensues is a complex symptomatic, prostatitis-like long course, over 3 months, with clear signs of infection.
Causes of chronic prostatitis
According to the World Health Organization, only 5-10% of prostate inflammation cases are bacterial in nature, the rest - chronic diseases - are non-bacterial in nature. This means that most problems with male glands come from an unhealthy lifestyle.
Causes of infectious chronic prostatitis:
- Uropathogenic flora (Escherichia coli, Proteus, Staphylococcus aureus, viral, fungal or parasitic particles) infiltrate the prostate.
- Violation of blood circulation in the pelvic organs (physical inactivity, poor condition of blood vessels, blood clots).
- Urinary system diseases (urethritis, cystitis, pyelonephritis).
- Distant foci of infection (bronchitis, tonsillitis, caries) are present in the body.
- Systemic localized hypothermia/hyperthermia in the pelvis.
- Stress, fatigue, chronic sleep deprivation.
- Malnutrition, including "empty" dishes that don't have enough vitamins and minerals predominate.
- Rare urination.
The clinical picture of nonbacterial (noninfectious) prostatitis is related to the stasis process in the body:
- Violation of the drainage of the prostate acini.
- Poor venous circulation in the pelvis.
- Prostate fills with blood (swollen, poorly secreted).
- Prolonged abstinence or excessive sexual activity.
- PPA practice, prolonged sexual intercourse.
- Chronic poisoning.
Men with slow lifestyles almost always experience symptoms of nonbacterial inflammation of the prostate. Physical inactivity, being overweight, reluctance to exercise vigorously, laziness, all of these can affect the work of the prostate, triggering the phenomenon of congestion (stasis).
It is difficult to prevent the development of chronic prostatitis and men employed in production associated with constant vibration. Other causes are lesions of the pelvic organs, nerves, blood vessels, hemorrhoids, frequent constipation, androgen deficiency, and BPH.
Signs and symptoms of chronic prostatitis
The specific symptoms of chronic prostatitis are less pronounced and are usually not typical of prostate pathology in appearance. The picture changes only during exacerbations, when the general symptoms resemble the course of an acute inflammatory process.
The sensation in the chronic process is the prostate triad. It is characterized by persistent pain, pain in nature that radiates (metastasizes) to the genitals, pubis, scrotum, rectum, and sacrum. In fact, a man often experiences discomfort in the pelvic area during the day. The pain doesn't stop, it just changes in intensity and direction.
Typical symptoms of chronic inflammation of the prostate:
- Pain worsens at the end of urination.
- Unpleasant sensation of irradiating the head of the penis, scrotum, sacrum.
- Pain during sex, especially during ejaculation.
- Pain and frequent urination.
- Urethral burning, false urges, especially at night.
- Prostatitis (discharge from the urethra, anus during exercise).
- A cold, sweaty, burning sensation in the groin.
Common (visible) illnesses associated with chronic prostatitis also include mental illness (discomfort that prevents men from working, resting, sleeping, and eating properly). Irritability arises, he collapses with people close to him, subordinates, and he loses the desire to do anything.
In chronic prostatitis, there is a strong manifestation of a violation of sexual function, which does not improve the mood of men. Painful erections, low libido, incomplete intercourse, loss of orgasm, infertility—all these are the visual manifestations of chronic prostatitis.
If chronic prostatitis is not treated, the disease will recur, and acute prostatitis will recur continuously with brief periods of relaxation. It can be complicated by seminal vesiculitis, urinary incontinence, stone formation, cysts, sclerosis, and prostate cancer.
Diagnosis of chronic prostatitis
If prostate lesions are suspected, a full diagnosis of the male's physical condition is necessary. A urologist (andrologist) performs an initial examination, prescribes laboratory and instrumental diagnosis. Once diagnosed, specialist doctors prescribe treatment of chronic prostatitis, including the use of drugs, physical therapy, the use of folk and specific methods to prevent recurrence of the disease.
Differential diagnosis
It includes conducting many additional studies to rule out diseases that have similar symptoms to chronic prostatitis. Its manifestations are diverse and difficult to make a true diagnosis, so doctors methodically rule out similar lesions one by one.
As a differential diagnosis of chronic prostatitis is:
- Prostatitis is not in the chronic phase.
- Anogenital symptoms are complex.
- Phytogenitourinary syndrome.
- Adenoma, prostate cancer.
When making a diagnosis, what matters is not how the patient feels or his complaints, but the actual data obtained through research.
laboratory diagnosis
| name of laboratory diagnostic method | feature |
|---|---|
| ordinary inspection | They document the patient's appearance, skin condition, genitals, record complaints, and collect medical records. |
| Identification of Infectious Pathogens | Inflammatory processes in the prostate may be the result of distant foci of infection, i. e. the entry of bacterial microbiota into the gland via lymphatic blood. |
| Palisade, a study of prostate secretion | By massaging the prostate, they examine it and identify/exclude the presence of white blood cells, bacterial flora, red blood cell urine. |
| Urinalysis, urethral swab, 3-cup urine sample, RIF, PCR. | Reveals genital tract infections (chlamydia, herpes, candidiasis, gonorrhea, etc. ), non-specific bacterial flora. |
Instrument Diagnostic Methods
The examination is performed using endoscopic instruments that allow the urologist to "penetrate" closer to the prostate and make an accurate assessment of its condition.
| Instrument Diagnosis Method Name | feature |
|---|---|
| Prostate Ultrasound (TRUS) | Allows you to assess gland status, volume, tissue, presence of inflammatory lesions, stones, congestion. |
| Urodynamic tests | It is performed using uroflowmetry, profilometry, cystometry, electromyography. With these techniques, stress incontinence, neurogenic bladder, etc. , with similar symptoms, can be ruled out. |
| Biopsy and Morphological Examination | Required for suspected prostate cancer. |
Treat chronic prostatitis
The course of treatment of chronic prostatitis must be repeated regularly, and it is almost impossible to completely cure the disease. The main principles of treatment are to avoid recurrence and prolong the "quiet" phase of the disease. Mainly eliminate the main cause of chronic and exacerbation phases, if they are caused by systemic hypothermia, change clothes and try to avoid drafts. Be sure to follow your urologist's clinical recommendations to exclude foods that cause acute inflammation, lack of exercise, excessive exercise, etc.
medical treatement
For the treatment of chronic prostatitis, complex treatments are used, as it is impossible to cure with just one pill. Men's Prescription Drugs:
- antibiotic. They are needed to suppress pathogenic microbial communities in the glands, eliminate the cause of bacterial infections, and stop inflammation. Among the popular drugs, penicillins, cephalosporins, aminoglycosides, fluoroquinolones, and macrolides are prescribed.
- Non-steroidal anti-inflammatory drugs (NSAIDs). This group of drugs reduces severe inflammation and relieves pain.
- hormones. Assigned when other means fail, or you need to quickly eliminate acute relapses. Prescription drugs for patients with chronic prostatitis are ampoules and tablets.
- Alpha blockers. They are designed to relax smooth muscles, reduce tension and allow urine to pass completely. The means are prescribed during the exacerbation period, the risk of the AUR.
- Antispasmodic. Eliminates vasospasm and improves blood flow to the pelvic organs. This reduces the likelihood of stagnation, stone formation, spasm in the prostatic portion of the urethra.
physiotherapy
One of the effective treatment methods, its essence is to affect the body with natural means such as electric current, magnetic field, ultrasound. Physical therapy has no contraindications and does not cause side effects in 97% of the disease diagnoses. Use the following method:
- Electric current (electrophoresis). Electrical stimulation of the prostate with direct current or alternating current may be useful if the glands are lowered in pitch and slightly hyperemic. Combined treatment with liquid medicine, the effect of the latter will be higher.
- Magnetic therapy. The human body is affected by magnetic fields of different frequencies. When this process is chronic, vasodilation occurs, blood flow improves and congestion is eliminated, and the drug penetrates better into the tissue and builds up.
- Laser Treatment. The prostate is affected by the laser beam, which simultaneously suppresses inflammation, stimulates blood circulation, and improves the outflow of prostatic fluid.
Chronic prostatitis is treated with ultrasound, a technique that involves exposing the body to high-frequency vibrations. There are many types of sonication—ultrasound is used in combination with drugs.
folk remedies
Here, the treatment of chronic prostatitis is based on the comprehensive use of decoctions, tinctures, bathing and other methods, plus traditional medicines for the treatment of chronic prostatitis. Herbal preparations help the body deal with inflammation and prevent recurrence, but they are not a complete replacement for conservative treatments.
It is strictly forbidden to resort to folk methods in critical situations. If a person is required to undergo emergency surgery and is at risk of developing AUR, then trying to stop the disease with herbal medicine means starting the pathological condition even more.
What are the folk methods for chronic prostatitis:
- Herbal Soup. They help remove toxins from the body, relieve general inflammation, and lower temperatures.
- Rinse, enema. To do this, use warm infusions and decoctions with nettle, oak bark, wormwood, and calendula. The solution is injected into the pre-cleansed bowel, which can help quickly relieve inflammation of the prostate.
- compression. To prepare them, use propolis oil, mustard powder or herbal decoction. The application is external only and done at night, so you don't go out or cool off after them.
- Rectal suppository. They are made from propolis, beeswax, cocoa butter, lard, bee bread and royal jelly. Apply rectally after a cleansing enema and insert suppositories at night or during the day, but you need to lie down for at least 40 minutes.
Exercise
With the help of daily exercise, you can increase the tone of smooth muscles, improve blood circulation to the pelvic organs, remove congestion from the prostate, and reduce the effects of sedentary men.
For chronic inflammation of the prostate, the following exercises are recommended:
- Gymnastics Kegel. Its essence is to strengthen the muscles of the pelvic floor and perineum. This is achieved by regular (up to 150/day) contractions/tensions of the muscles of the anus and the muscles between the scrotum and penis.
- Recharge with tennis balls. It is placed on the crotch area, sitting on the floor and rocking, massaging back and forth and tightening the desired area.
- Step on the buttocks. The essence of the exercise is to sit on the hips and roll side to side to move forward (step like a duck). You cannot help with your hands; they are pulled in front of you and try to walk at least 3-5 meters.
- Scissors. Well-known complexes apply loads to the press, pelvic muscles, thighs.
As chronic prostatitis worsens, any exercise is prohibited. Physical education classes resume when the acute syndrome resolves.
Surgical treatment
The duration of conservative treatment does not always relieve chronic prostatitis, it periodically reminds itself of recurrence. In critical cases, andrologists recommend surgery, but recurrence is not ruled out if the man does not comply with disease prevention measures.
List of surgical techniques for the treatment of chronic prostatitis:
- Prostatectomy. For severely inflamed or hardened areas, an endoscope is used to remove part of the affected prostate.
- Prostatectomy. This is a complete removal of the prostate, performed in critical situations when inflammation and changes in the gland interfere with normal urination.
- Draining cysts, abscesses. If an abscess or cyst forms on the prostate, a puncture with an endoscope, ultrasound, or through the urethra is done.
- Urinary neck incision. Used to harden, block the bladder to improve the flow of urine and ejaculate.
diet
The main principles of proper nutrition for chronic prostatitis are to exclude harmful foods and to change a diet based on "clean" foods. Any semi-finished, spicy, spicy dishes with artificial preservatives, alcohol, strong tea or coffee are removed from the diet.
The body should consume adequate amounts of protein in the form of boiled fish, meat, and dairy products. Vegetables, fruits and natural juices - not fast food, soda. Overcooked dishes are replaced with steamed, overcooked dishes, and dishes that produce more gas in the intestines are also prohibited.
prevention
Chronic prostatitis is mostly incurable, so prevention focuses on preventing the disease in the first place. For this, it is necessary to treat any contagious diseases promptly, not to be too calm, always remember sexually transmitted diseases and follow the principles of healthy sexual relations.
Physical inactivity is a precursor to stagnation, so daily exercise and an active lifestyle will help avoid prostatitis. Adhere to a healthy lifestyle, and be checked by a urologist once a year. If you have minor problems with the genitourinary system, please contact a specialist, and do not try to treat yourself. Don't be overweight, don't abuse alcohol, cigarettes.
Consequences and Complications
Only a specialist can determine the extent of complications, but as common as chronic conditions are:
- Androgen deficiency.
- Violation of sexual and reproductive functions.
- Seminal vesiculitis, pyelonephritis.
- Erectile dysfunction (impotence), urethritis, cystitis, and epididymo-orchitis.
- psychological problems.
- Prostate necrosis.
forecast
The prognosis depends on when the patient sees a doctor. Treatment of chronic prostatitis will require surgical intervention in advanced cases and in 97% of cases where age-related factors are present. Timely conservative treatment in the chronic phase and regular prevention of recurrence can improve the course of the disease and level the exacerbation phase.