How is prostatitis treated? Based on the results of clinical and laboratory examinations, urologists-andrologists create a treatment program, which should include various therapeutic measures. Comprehensive treatment program, as a rule, includes antibacterial and antiviral therapy, therapy with drugs that improve vascular tone. Physiotherapeutic treatment methods are widely used (magnet-laser-inductotherapy, ultrasound, reflexology, leech therapy), as well as strengthening agents, prostate massage treatment is prescribed. In each case, the choice and tactics of treatment remain the property of the urologist-andrologist.
The role of the prostate in a man's life
Prostate- the part of the male reproductive system that produces special secretions that fertilize and protect sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles contract, semen is released into the urethra - ejaculation (ejaculation).
Anatomy:The prostate gland is located below the bladder and covers the upper part of the urethra, therefore, with increasing size, various urinary disorders develop. Size, shape and density are individual and change with male age. The gland has a complex neural apparatus and, even with small pathological changes, causes local and general disorders in it.
Function:The main function of the prostate is secretion. The secretions (or juices) it produces consist of liquid and solid fractions and include proteins, carbohydrates, electrolytes, fats and hormones. The glands not only transport sperm, but also dilute the sperm, ensuring the movement and viability of the sperm. The prostate is an important organ involved in the regulation of testosterone production, and also ensures the normal functioning of the erectile mechanism.
Classification of prostatitis
- acute;
- asymptomatic inflammation;
- chronic bacteria;
- chronic pelvic pain inflammatory syndrome.
Complaints with prostatitis
- Various urinary disorders associated with narrowing of the urethral lumen:
- Difficulty starting to urinate
- intermittent urination;
- poor urine flow;
- urinate gradually;
- feeling of incomplete emptying of the bladder;
- accidental leakage of urine.
- Symptoms due to nerve endings:
- increased urination;
- increased urination at night;
- urgent urge to urinate;
- urinate in small portions;
- urinary incontinence with desire to urinate
- Pain in the lower abdomen, groin area, inner thighs or lower back, and various sexual disorders can occur.
Remember that violations of the action of urination and pain symptoms can occur not only with prostatitis, but also with adenoma (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is often diagnosed as well. That is why, for the early diagnosis of possible prostate pathology, all men over the age of 50 are encouraged to donate blood for prostate -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 can be detected in prostate tissue;
- violation of blood circulation in the pelvic organs (congestion in the prostate causes inflammation);
- inactive lifestyle (drivers, office workers, officers);
- prolonged sexual abstinence, interrupted sexual intercourse or prolongation of artificial sexual intercourse;
- frequent hypothermia (fans of extreme recreation: diving, surfing, kayaking and skiing);
- stress: mental and physical load.
Prostatitis and potency.Inflammation of the prostate itself does not cause impotence. However, untreated chronic prostatitis, such as inflammation of the seminal tubercle, can lead to libido inhibition, insufficient erection, premature or accelerated ejaculation, pain during ejaculation, and what is referred to as orgasmic elimination.
Prostatitis and male infertility.Among other factors, the prostate also affects sperm resistance and in some cases, the inflammatory process causes infertility.
In developed countries, most men who have reached the age of 45 must undergo regular preventive examinations by urologists-andrologists. Examination of the prostate gland in these countries is common. Our compatriots have a different position: they go to the doctor only when they "press it completely"
And here is the result: the treatment of prostatitis in our country requires 40 to 60% of men of reproductive age.
Diagnostics of prostatitis
Chronic prostatitis is a dangerous disease. Often, the disease develops latently and gradually becomes chronic. If you don’t pay attention in a timely manner, then the seemingly insignificant malaise can develop into a real nightmare. At the stage of exacerbation, sometimes giving a relatively high temperature (38-39 ° C), pain in the perineum transforms the process of urination and defecation into performance. Abscesses can form, i. e. the fusion of purulent prostate gland tissue, with all its consequences.
In its advanced form, prostatitis leads to the most serious complications that cause many problems not only for the man himself, but also for his entire family. With prostatitis, libido not only decreases and erectile function is impaired. The saddest thing is that about 40% of patients are threatened with some form of infertility, because the prostate gland is no longer able to produce enough high -quality secretions to ensure sperm movement. Therefore, it is very important to treat prostatitis in the early stages of its development. The success of prostatitis treatment depends heavily on this.
Urological examination
- general methods of examination of urological patients: blood tests (clinical, biochemical, for HIV, RW and markers of hepatitis B and C) and urine tests.
- special methods of examination of urological patients:
- study of prostate gland secretion;
- testing for sexually transmitted infections;
- digital rectal examination;
- Ultrasound of the kidneys, bladder and transrectal ultrasound of the prostate gland uroflowmetry (examination of urine with suspected prostatitis);
- blood tests for PSA and prostate biopsy (if indicated) to rule out prostate cancer.
Treatment of prostatitis
Once all the results are received, the urologist will create a treatment program. This prostatitis treatment program should include a variety of therapeutic measures. The development of prostatitis is always provoked by several factors, so it is necessary to act in several directions at once. Complex programs for the treatment of prostatitis, as a rule, include antibiotic therapy, therapy with drugs that improve vascular tone, physiotherapeutic procedures, as well as general strengthening agents, a course of prostate massage is prescribed.
Massage, despite the fact that it causes some unpleasant sensations, is a necessary procedure. First, for diagnostics, when you need to take the secretions of the prostate gland for research. Also, in some cases, massage is done to relieve congestion in the prostate gland. Usually these events are approached seriously and selectively.
Prostate adenoma or benign prostate hyperplasia (BPH) A disease that occurs in 50% of men over the age of 50 years. The causes of prostate tissue proliferation are still not clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine outflow becomes more difficult, blood circulation in the bladder wall deteriorates, and over time, the bladder wall becomes hard. This change cannot be undone.
Complications of prostate adenoma
- urinary tract infections;
- acute urinary retention;
- bladder stones;
- chronic renal failure.
Various screening methods make it possible to assess which disorders are occurring and to what extent. Depending on the results of the examination, the doctor together with the patient decides which method of treatment to choose. Possible surgical and medical treatment of BPH.
Prostatitis virus
Herpes virus, cytomegalovirus, human papillomavirus are often the cause of the development of urethritis, complicating the course of prostatitis and causing male infertility.
For example, in men without manifestations of genital herpes on the skin and mucous membranes, the virus can only be detected during laboratory diagnostics in semen or prostate secretions. The patient infects a sexual partner, he develops sperm pathology and, as a consequence, infertility. Often, patients with non-bacterial forms of prostatitis receive a variety of massive antibiotic therapies without the expected positive effects, while in fact, viruses can be the cause of the disease, requiring completely different tactics in treatment (antiviral treatment, immunotherapy, etc. -lain. ).
Herpetic:According to various authors, prostatitis is caused or supported by the herpes simplex virus in 2, 9 - 21, 8% of cases. Typically, chronic prostatitis is characterized by a recurrent and persistent nature. In clinical practice, the diagnosis of chronic herpetic prostatitis is rarely made by a urologist. The reason, apparently, virological diagnostic methods are not included in the standard of examination of patients with chronic prostatitis. The reason is a stereotype of physician 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 irradiation to the external genitalia, perineum, lower back) and disurik syndrome. Often, in patients with recurrent genital herpes, prostatitis is subclinical: in these patients, the diagnosis of prostatitis is made based on the appearance of leukocytosis in prostate secretions and a decrease in the amount of lecithin grains.