Chronic prostatitis: symptoms and treatment

Inflammatory processes observed in the prostate tissue for three or more months are called chronic prostatitis.The long course of the disease makes one judge the beginning of the chronic phase.Statistics show that acute and chronic prostatitis often occurs against the background of complicated urethritis.

A distinctive feature of chronic prostatitis is that in 50-70% of cases the disease does not manifest itself with pronounced symptoms.Only in 20% of cases do patients describe signs that indicate a chronic form of prostatitis.The remaining category of men only knownindirect symptoms of the disease, not directly related to prostatitis.Both young, middle-aged and older men are not immune to chronic prostatitis.

Those who experience a lack of physical activity, are associated with sedentary work and practice sexual abstinence are susceptible to prostatitis.Therefore, truck drivers, who spend most of their time behind the wheel, experience the effects of negative factors: hypothermia and congestion of the pelvic organs.Representatives of contact sports and weightlifters are subject to microtraumas of the prostate tissue.Men who show poor sexual activity become hostages of this unpleasant disease due to stagnation of prostate secretions.They affect the prostate gland, causing acute and chronic prostatitis, various infections transmitted sexually, through blood or lymphatic fluid.

Types and stages of chronic prostatitis

In urological practice we distinguish:forms of chronic prostatitis:

• Bacterial.The cause of the disease lies in an infection or pathogenic bacteria that have penetrated the prostate gland.The most common is chronic prostatitis caused by chlamydia.The danger of this form lies in the possible infertility that awaits a man without timely treatment.
• Bacterial.Chronic prostatitis of a non-infectious nature.Diagnosing the exact cause is quite problematic.Typically, such prostatitis develops due to the anatomical characteristics of the prostate of an individual man.The incorrect structure of the organ creates increased pressure on the urethra, which leads to frequent urine secretions.Autoimmune diseases can also cause degenerative changes in prostate tissue.
• Stagnant.Chronic congestive prostatitis develops when the prostate does not empty completely and excess blood mass forms.Stagnation creates an inflammatory response.
• Constant pelvic pain syndrome.A man complains of constant, unrelenting pain in the perineal area.
• Asymptomatic.Chronic prostatitis occurs in a latent form, without causing pain or discomfort, despite the presence of inflammation.

Chronic prostatitis has its own stages of development

• Exudation phase.Rapid ejaculation and acute prostate pain.
• Alternative phase.Painful sensations are replaced by discomfort, reduction in the duration of sexual intercourse and frequent urination.
• Proliferation phase.The frequency of urge to go to the toilet increases, but problems with urine production appear.
• Stage of scar changes.Sclerosis of healthy prostate tissue occurs.As a result of morphological transformations, heaviness appears in the area of the sacrum and pubis, the flow of urine weakens and potency decreases.Sensations during orgasm are often blurry.

Causes

• Infection.The source of pathogenic bacteria entering the prostate gland is blood and lymph vessels.Urological diseases and inflammation of the rectum are a prerequisite for infection of the prostate tissue.Methods of infection:
  • Descending- the infection enters the gland together with urine, which contains microbes.
  • On the rise— The path of microbes entering the prostate begins at the external opening of the urethra.
• Decreased protective functions of the body.One of the main culprits of chronic prostatitis is weakened immunity.This is facilitated by hypothermia, frequent stressful situations, poor nutrition and bad habits.When immunity decreases, the body is exposed to infections that cause inflammation of the prostate.
• Poor circulation.A sedentary and sedentary lifestyle is closely related to chronic prostatitis.The internal organ systems of a man suffer from lack of physical activity: endocrine, cardiovascular, nervous.Blood microcirculation in the pelvis deteriorates, causing hypoxia of prostate cells.
• Lack of a regular sex life.Both refusal of intimate life and excessive sexual activity lead to prostate problems.Many men with a strong sexual constitution engage in vigorous sexual activity.Due to frequent sexual intercourse, their nervous system is depleted, hormonal disorders appear, and erection gradually weakens.Incomplete sexual intercourse causes serious damage to prostate health.
• Chronic lesions of the prostate.The soft tissues of the prostate, often subject to injury due to excessive stress, tremors and vibrations, can periodically become inflamed.
• Transurethral procedureswithout concomitant antibiotic therapy it can cause a prostate infection.
• Urethral catheter, which a man is forced to live with for some time, also contributes to prostate infection.

Symptoms of chronic prostatitis

The symptoms of chronic prostatitis vary.Some of the first signs of chronic prostatitis that attract attention are pain when urinating and impaired sexual function.As a rule, problems in the intimate sphere force a man to seek help from a doctor.If discomfort and pain in the pelvic areado not decrease for more than three months, so with a high probability we can talk about chronic prostatitis.

Most often, the pain syndrome spreads to the perineal area, however, the discomfort can be localized in the pubic and inguinal area.A man complains of pain in the anus, scrotum and glans.The pain radiates to the lumbosacral region.Attacks of pain may cover the inside of the thighs.Pain in one of the testicles usually does not indicate prostatitis.Complaints of pain after ejaculation are specific to the chronic course of the disease.

The most common symptoms of chronic prostatitis also include increased sweating, a feeling of cold and tremors in the perineum.It can lead to poor circulation in the pelvisto changes in skin color.

Chronicization of the inflammatory process in the prostate leads to disruption of its tone.In some cases, prostatorrhea develops.With this pathology, spontaneous secretion of the gland occurs, which has no connection with arousal or ejaculation.

With chronic prostatitis, men may observe, especially in the morning, small purulent or clear discharge from the penis.Some patients find white flakes or strings in their urine.A sign of advanced stone prostatitis is the presence of traces of blood in the semen.

Many patients notice the appearance of sexual dysfunction, simultaneously with a decrease in libido and a deterioration of spontaneous erections.It is worth noting that most patients suffer from impotenceit has no critical connotation.In the early stages of chronic prostatitis, men experience premature ejaculation, which can become difficult over time.Some patients report a decrease in the intensity of sensations during sex.Problems with urination are often irritative in nature.

Diagnosis of the biological material of a man with chronic prostatitis reveals a quantitative and qualitative violation of the secretion of the prostate gland.Morphological deviations in ejaculate parameters are rarely associated with male infertility.

During remission, most symptoms subside and pain decreases.Many men calm down, attributing the situation to self-healing.But without adequate therapy, infectious foci in the prostate persist and during the period of exacerbationsymptoms worsen significantly, mild fever persists.

Diagnosis of the disease

Diagnosing chronic prostatitis is not difficult for an experienced urologist.The most difficult thing here is most likely to establish the real cause that led to chronic prostatitis.

To confirm the diagnosiscarry out the following procedures:

• Rectal exam using fingers.A digital examination is carried out during a man's first visit to a urologist.The back of the prostate gland is in contact with the rectum, which allows you to evaluate the condition of the prostate when inserting a finger through the anus.Palpation of the posterior surface of the gland allows you to determine the size and shape, as well as the consistency and pain of the inflamed organ.
• Microscopic examination of prostatic secretion.While studying biological material, a laboratory technician may notice an increase in the number of leukocytes: this signals the spread of pathogenic bacteria.
• Culture of gland secretionon the nutrient medium, type of bacteria and antibiotic resistance using RIF and PCR methods.
• Cystoscopy.An endoscopic imaging system device is inserted into the bladder cavity.This diagnostic method of chronic prostatitis allows us to exclude cancer, cystitis and bladder lesions.
• Ultrasound.The doctor may prescribe an ultrasound examination before starting treatment for acute prostatitis, so as not to miss the formation of an abscess in the organ.For men suffering from chronic prostatitis, ultrasound is performed to detect stones and cysts, as well as to evaluate the level of urethral pressure.Today, transrectal ultrasound, in which a sensor is inserted into the rectum, is more effective.
• Uroflowmetric diagnostic method.In this way, indicators of the urinary process are studied: the duration and speed of urine outflow.A velocity greater than 10–15 ml/s indicates good urethral patency.Indicators below this norm indicate poor patency of the urinary canal caused by chronic prostatitis.

Chronic prostatitis: treatment

Each clinical case requiresindividual selection of treatment regimen.When choosing a therapeutic model, the causes of the disease, the duration of the course and the presence of aggravating factors are taken into account.

Drug treatment:

• Antibiotics.Antibacterial therapy is indicated only in cases of prostate infection with a bacterial agent identified in prostatic secretions or urine.Antibiotics from the fluoroquinolone group are prescribed.Treatment lasts from two to eight weeks.After an antibacterial course, the full extent of symptoms often remains, provided that the infectious factor has been eliminated.
• Alpha blockersprescribed to men to reduce hypertonicity of the bladder muscles and stabilize intraurethral pressure.They are ineffective if the patient has impaired muscle innervation and suffers from pelvic floor muscular dystrophy.
• Non-steroidal anti-inflammatory drugs.Helps relieve painful syndromes.
• Selective antidepressants.Prescribed to men to improve their emotional background, relieve anxiety and insecurity.
• Hormonal drugs.Antiandrogens and androgens are used to regulate hormone levels.
• Immunostimulating drugs.Prescribed for confirmed immunodeficiency.
• Uric acid level regulators.The appointment is justified if sand and stones are present in the prostate gland.
• Vitamin complexes.

Auxiliary methods for the treatment of chronic prostatitis

Some urologists are of the opinion that the physical impact on the prostate significantly alleviates the patient's condition.But most of these therapeutic methods have their contraindicationsprescribed under certain conditions:

• Prostate massage.Contraindicated in prostatic hyperplasia because it can cause acute urinary retention.Also, by doing a massage, you can spread the infection throughout the prostate and cause sepsis.The massage should not be performed if there are cystic formations in the prostate or venous stagnation.To free the gland from stagnation, natural drainage during ejaculation is considered the best way.
• Bladder gymnastics.The treatment consists of a group of special exercises aimed at improving the muscle tone of the bladder and its sphincter.
• Instillations.Infusion of medicinal solutions deep into the urethra.The procedure is very painful and often ends in complications.
• Physiotherapy.Prostate treatment with transrectal ultrasound, electrical stimulation, magnetotherapy and phonophoresis will be useful in case of poor tone of the pelvic floor muscles.Physiotherapy only brings temporary relief to the patient's condition.A lasting effect can be achieved only after eliminating the causes of prostatitis.
• Traditional medicine recipes.Honey with pumpkin seeds, alcoholic tincture of horse chestnut and other folk methods are used after consultation with the attending physician.

Surgical treatment of chronic prostatitis

Considering what pathological process provoked prostatitis, they usetransurethral resectionprostate gland.This is a modern method of surgical treatment that has replaced open surgery.An endoscope is used to drain the prostatic cyst that has formed and surgical correction of the seminal vesicles is performed in case of obstructed outflow of secretions.

Treatment of chronic prostatitis -long process, which requires patience and endurance from a man.To prevent the disease from taking you by surprise, you need to monitor your health, strengthen your immune system and treat colds in a timely manner.