Chronic prostatitis is one of the most common diseases in adult men. Inflammation of the prostate gland significantly reduces the quality of life, becoming a cause of psychosomatic and sexual disorders. The lack of sufficient information about the nature of the disease makes the treatment of chronic prostatitis a difficult task that requires a lot of patience from the patient and his doctor.
Prostatitis is an inflammatory degenerative lesion of the prostate gland.
Welding
The American National Institutes of Health (NIH USA) has 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 separately. By knowing the pathology categories identified, physicians will be able to select the optimal therapeutic regimen and achieve significant success in treating the disease.
Causes and risk factors
The division into chronic bacterial and non -bacterial prostatitis is unintentional. The various causes of the disease determine the tactics of treatment and greatly influence the outcome of the disease.
Chronic bacterial prostatitis
Chronic bacterial prostatitis occurs in 10-15% of patients. The immediate cause of the development of this 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 inspection, the following microorganisms are most often detected:
- Escherichia coli (up to 95%);
- Proteus;
- klebsiella;
- pseudomonas.
Representations of gram -positive flora (staphylococci, streptococci) are relatively rare. In some cases, the growth of two or more microorganisms is observed (mixed infection). Possible infection with pathogenic flora (chlamydia, Trichomonas, gonococcus and others).
A large number of microorganisms detected during the examination are representative of the normal microflora. Under normal circumstances, they do not harm the body and are found safely on the mucous membranes of the urinary system and digestive tract. Under certain conditions, the growth and reproduction of conditional pathogenic flora occurs, which causes inflammation of the prostate tissue and the appearance of all symptoms of the disease.
Risk factors for developing chronic bacterial prostatitis:
- not adhering to personal hygiene;
- hypothermia;
- genital trauma;
- inflammatory diseases of the urinary system;
- the presence of STIs.
All this leads to a decrease in local and general immunity and 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 tract. The likelihood of developing prostatitis increases in the presence of urethritis, cystitis, colicitis.
Prostatitis is not chronic bacterial
There are several theories about the occurrence of this disease:
- Theory of chemical inflammation. . . Urinating into the prostate during urination causes vein deposition and expansion of inflammation. Urethro-prostate reflux is facilitated by urethral narrowing (narrowing) and other developmental disorders.
- Immune theory. . . This version is based on autoimmune damage to prostate gland tissue as a result of exposure to bacterial antigens. Hereditary predisposition to this form of pathology is considered.
- Neurogenic theory. . . Violations of the nerves in the pelvic area cause blood stasis in the organs and lead to the development of prostatitis.
In the development of non -bacterial prostatitis, the following risk factors also need special attention:
- long short work;
- inactive lifestyle;
- bad habits;
- stress and emotional burden;
- prolonged sexual abstinence.
These risk factors provoke the development of congestion in the prostate, causing a violation of microcirculation in the pelvic organs. Microbial factors play a role only in the early stages of the development of the disease. In the future, its importance diminishes, and autoimmune processes and trophic disorders of prostate gland tissue appear.
According to statistics, 85-90% of men have chronic non-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 chances of this disease increase. In old age, inflammation of the prostate gland is often combined with adenomas - benign prostate tumors.
Signs of chronic prostatitis:
- dull pain in the lower abdomen;
- radiating pain in the groin area, scrotum, perineum, lower back, sacrum;
- increased discomfort during sexual intercourse and during defecation.
Urinary disorders are very characteristic:
- frequent urination;
- excretion of urine in small portions;
- feeling of incomplete emptying of the bladder;
- appearance or increase of pain when urinating;
- slow and intermittent urine flow.
The last symptom is characteristic of prostate adenoma, which often occurs against the background of chronic prostatitis.
With the long -term course of the disease, there are disorders in the sexual sphere:
- decreased libido;
- erectile dysfunction;
- reduction in the duration of intercourse;
- premature ejaculation;
- pulling pain in the lower abdomen after ejaculation;
- lack of spontaneous morning erections.
Chronic prostatitis is one of the leading causes of erectile dysfunction, in which a man is unable to achieve and maintain an adequate erection for full sexual intercourse. Such conditions disrupt the course of life, can lead to depression and other psychoemotional disorders.
Chronic asymptomatic prostatitis occurs without clinical manifestations. The disease was detected incidentally during an examination by a urologist. Although there are no symptoms, inflammation of the prostate gland can lead to serious complications, erectile dysfunction and other health problems.
Complications
Launched prostatitis causes the development of conditions such as:
- prostate abscess;
- cystitis and pyelonephritis (inflammation of the bladder and kidneys);
- vesiculitis (inflammation of the seminal vesicles);
- erectile dysfunction;
- infertility.
The earlier the disease is detected and treatment started, the more chances there are of getting better disease outcomes.
Diagnostics
The following methods are used to detect chronic prostatitis:
Examination by a urologist
At private appointments, doctors focus on the patient’s complaints. The external genitalia are examined, and a digital rectal examination of the prostate is performed. On palpation, the doctor assesses the size and shape of the gland. If prostatitis is chronic, the organs will be slightly enlarged. This procedure is combined with the collection of prostate secretions for microbiological examination.
Sample four glasses
The main method that allows you to identify the inflammatory process in the prostate and distinguish it from other diseases. Material accumulation occurs in several stages. In the morning, after 5-6 hours of not going to the toilet, a man urinates in two jars - for the first part (early) and for the second part (middle) of urine. In the first part, the contents of the urethra are washed, in the second part - the bladder. A third part of the urine is collected after a prostate massage and allows you to assess the condition of the prostate gland. Prostate gland secretions were collected separately for bacteriological cultures.
In urine analysis, two parameters were assessed: number of leukocytes and erythrocytes. With prostate disease, the number of white blood cells increases in the third part of the urine. Typically, their number does not exceed 10 in the field of view.
Microbiological examination
During the three -glass test, not only the number of leukocytes was assessed, but material was also taken for bacteriological inoculation. If you suspect chronic prostatitis, the doctor is very interested in the third part of the urine. Based on the results of the examination, the doctor can identify the causative agent of the disease and select the optimal antibiotic therapy.
Identification of opportunistic bacteria in titers greater than 10 has diagnostic value.3CFU / ml or obvious detection of pathogenic microorganisms in any quantity.
Bacteriological culture of prostate secretion
Bacteriological inoculation of prostate fluid makes it possible to assess the nature of the process (infectious or not) and determine the type of pathogen.
Before taking a third portion of urine during a prostate massage, the doctor takes the secreted secretions for bacteriological examination. The results obtained also make it possible to determine the tactics of diagnosis and treatment.
Diagnostic criteria for chronic bacterial prostatitis:
- Detection of opportunistic microorganisms in the third part of urine or prostate secretion in titers above 103CFU / ml.
- Detection of opportunistic bacteria in the third part of urine or prostate secretions, the amount of which is much higher (10 times) than in the second part of urine.
- Identification of pathogenic microorganisms in the third part of urine or prostate secretions.
Ultrasound
Ultrasound examination allows you to assess the size of the organ and identify the corresponding pathology. Often, chronic prostatitis is combined with prostate adenoma - a benign tumor.
Principles of treatment
The goal of therapy for chronic prostatitis is to eliminate the inflammatory process, activate blood flow and improve organ nutrition. When pathogenic or opportunistic microorganisms are detected in high titers, they are eliminated. Particular attention is given to lifestyle correction and stimulation of the body’s defenses.
Drug treatment
The following medications are used to treat chronic prostatitis:
- Antibacterial drugs are selected taking into account the pathogens identified.
- Anti-inflammatory drugs to reduce inflammation and relieve pain.
- Means that facilitate urination (alpha-blockers, which relax the urethral muscles and stimulate the outflow of urine).
- Means to increase blood flow in the pelvic organs
The choice of antibiotic depends on the pathogen identified. When choosing a drug, one should consider its ability to penetrate the hematoprostatic barrier and accumulate in the prostate gland tissue. This condition is met through a group of fluoroquinolones. Macrolides and tetracycline are also used to treat chronic prostatitis.
According to the recommendations of the European Urological Association, the course of antibacterial therapy is no later than 2 weeks after the initial diagnosis is established.
After receiving the results of bacteriological research and confirmation of the bacterial nature of the disease, treatment lasts up to 4-6 weeks. This approach makes it possible not only to get rid of the causative agent of the disease, but also to prevent the recurrence of prostatitis.
Unfortunately, antibiotic therapy is not always effective. Many microorganisms successfully exist in the secretions of the prostate for a long time and gain resistance to antibiotics. Bacteria form special biofilms and form colonies of microorganisms covered with complex polysaccharide structures. A large number of antibacterial drugs are unable to penetrate this biological barrier, which significantly reduces the effectiveness of therapy. This problem can be avoided with the use of modern antibiotics, which can not only penetrate into the tissue of the prostate gland and heat up in it, but also pass through the biofilm and infect bacteria that are under serious protection.
Non -drug therapy
Among non -drug treatments, special attention is given to prostate massage. This procedure stimulates the blood supply to the prostate gland, relieves congestion and facilitates bowel movements. The combination of massage and the use of long -term antibacterial medications is a key method for relieving men of the unpleasant symptoms of chronic prostatitis.
Methods of physiotherapeutic influence are used in the treatment of chronic prostatitis along with medical effects. Good effects are seen from the use of ultrasound, laser beams, radio waves, and electromyostimulation. The prostate shock wave (UHM) sequence is very popular. Physiotherapy is indicated mainly in the presence of erectile dysfunction as one of the complications of prostatitis.
Particular attention is paid to diet in 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 intake is limited to 5 g per day. Preference is given to fresh vegetables and fruits, herbs. Steaming is recommended.
Eating food will speed recovery, strengthen immunity, and help the body cope with the stress caused by antibiotics while treating illness.
ethnoscience
Not all men go to the doctor when symptoms of prostatitis appear. Often, men prefer to be treated with folk methods, using knowledge bases from many forums, relying on the advice of friends, relatives and neighbors. Ignoring a person’s health, rejection of rational antibiotic therapy and other traditional methods of exposure threaten the development of complications and deterioration of the general condition. Prostatitis that does not heal in time can cause erectile dysfunction. Is it worth it if you see a doctor on time and solve the problem with minimal loss?
Of course, among traditional medical methods, there are some aspects that need special attention. Modern urologists are aware of the effectiveness of many ingredients in the treatment of chronic prostatitis. Experts recommend herbal preparations based on the following ingredients:
- pumpkin seed oil;
- round -leafed winter green;
- parsley garden;
- St. John's wort perforatum;
- goldenrod Canada;
- licorice root;
- echinacea.
Individually or in combination, these components stimulate blood flow in the pelvic organs, relieve congestion and stimulate the immune system.
Phytopreparations will not eliminate pathogenic bacteria in the body, but will help eliminate the symptoms of the disease.
In combination with antibacterial medications and prostate massage, herbal remedies can improve the general condition and speed recovery.
prevention
The following suggestions will help reduce the risk of chronic prostatitis:
- Hypothermia of the whole body and the genital area, pelvis and lower legs should not be allowed. In winter, it is necessary to wear thermal underwear.
- You need to follow the rules of intimate hygiene and use condoms to protect against STIs. The best prevention of infection is the rejection of casual sex.
- You should take care of your health and treat diseases in the genital area in a timely manner.
- No need to follow a diet (give up spicy, fried and fatty foods), as well as keep your body in good shape (play sports, fitness, walk).
All men aged 30 and over are advised to undergo regular checkups by a urologist (at least once a year). If you experience any unpleasant symptoms, you should see a doctor as soon as possible.
Frequently asked questions
Can chronic prostatitis be cured?
Contrary to popular belief, chronic prostatitis can be treated successfully. If you follow all the recommendations of the doctor, you can get rid of the unpleasant symptoms of prostatitis and significantly improve the quality of life.
Can chronic prostatitis be asymptomatic?
Yes, this variant of the disease can only be detected after examination by a urologist.
Is chronic prostatitis in couples dangerous for women?
Sexually transmitted infections are often the cause of chronic prostatitis. If a pathogenic agent is identified, both partners must undergo treatment. Otherwise, there is a risk of infection, and the effectiveness of therapy is reduced due to recurrence of the disease.
Is it possible to have sex with chronic prostatitis?
Yes, if general conditions allow and there are no problems in the sexual sphere (erectile dysfunction).
Is it possible to conceive a child with chronic prostatitis?
Yes, if prostate function is preserved and its secretion is fully developed. Before becoming pregnant, it is recommended to undergo examination and treatment by a urologist. The infection that causes the development of prostatitis is easily transmitted to a woman. Intrauterine infections in the fetus can cause developmental abnormalities and termination of pregnancy.
How does chronic prostatitis affect potency?
Chronic inflammation of the prostate gland threatens the development of erectile dysfunction. With such pathology, there is a decrease in libido, the frequency and strength of erections decreases, orgasm becomes painful. In further cases, sexual activity becomes impossible.
Can chronic prostatitis be cured without antibiotics?
Antibiotic therapy is considered one of the main treatments for chronic prostatitis. In most cases, it is impossible to overcome the disease without antibiotics.
Can chronic prostatitis be cured with folk remedies?
Getting rid of chronic prostatitis with traditional medicine alone will not be successful. To achieve optimal effect, complex treatments are performed using antibiotics, herbal preparations, anti-inflammatory drugs and physiotherapy methods.