Chronic prostatitis is a long-term inflammation of the prostate gland, with often no symptoms, which is why most of the male population is not aware of the disease.
The development of a chronic form of prostatitis is a consequence of an acute process, although in practice this is quite rare.As a rule, inflammatory chronic prostatitis begins gradually, without any unpleasant symptoms or sensations; the course of the disease is often discovered in the patient by chance during an ultrasound examination.
Both young men and middle-aged and elderly people are susceptible to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead an inactive lifestyle, feel excessive physical stress on the perineum, and observe sexual abstinence.
Classification
According to the modern classification of prostatitis, developed in 1995, there are several categories of the disease:
- Acute bacterial prostatitis (ABP) is the most common type of prostatitis.It is usually caused by a bacterial infection and is easily diagnosed due to its typical symptoms.Acute bacterial prostatitis can occur at any age.Symptoms include painful urination, inability to empty the bladder completely, and pain in the lower abdomen, back, or pelvic area.There may be a fever accompanied by chills.
- Chronic bacterial prostatitis is a disease with typical symptoms of chronic inflammation and an increased number of bacteria and leukocytes in the urine and secretions of the prostate after massage.
- Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, it is a consequence of acute bacterial prostatitis (untreated or poorly treated).If there are symptoms, they occur in the form of pain in the genitals or pelvic area, difficulty urinating or painful urination and ejaculation.
- Asymptomatic inflammatory prostatitis - in this form of the disease, the classic symptoms of prostatitis are absent, and the disease itself is detected by chance, when visiting the clinic for another reason.
In the presence of an infectious component, they speak of bacterial (infectious) chronic prostatitis;in the absence of microbial pathogens - about non-bacterial (non-infectious) prostatitis.It is believed that in 90-95% of all cases non-bacterial chronic prostatitis occurs and only in 10-5% - bacterial.
Reasons
A number of factors can contribute to the occurrence of chronic prostatitis.First of all, this:
- STIs: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungus, Escherichia coli can infect the urethra and be detected in prostate tissue;
- Poor circulation in the pelvic organs (congestion in the prostate leads to its inflammation);
- Sedentary lifestyle (drivers, office workers, officials);
- Prolonged sexual abstinence, interrupted sexual intercourse or artificial prolongation of sexual intercourse;
- Regular hypothermia (fans of extreme recreation: diving, surfing and skiing);
- Stress: mental and physical overload.
For the development of chronic prostatitis, it is not so much the presence and activity of pathogenic microorganisms that is important, but the state of the pelvic organs and blood circulation in them, the presence of concomitant diseases, and the level of protective mechanisms.
Symptoms of chronic prostatitis
Most often, with the development of a chronic form of prostatitis, the symptoms practically do not bother the man.In this case, all the signs of acute prostatitis will not manifest themselves at all or will manifest themselves to a much lesser extent.
The most common symptoms of chronic prostatitis in men are:
- periodic pain and discomfort in the perineum;
- discomfort during bowel movements and urination;
- irradiation to the anus, thigh, testicles;
- discharge from the urethra.
Changes in the course of the disease, which is already not very bright, can be so insignificant that patients with chronic prostatitis do not pay special attention to them.
Exacerbation of chronic prostatitis
An exacerbation of the disease is usually accompanied by the following symptoms:
- pain and burning in the urethra;
- increased urge to urinate;
- pain in the lower abdomen, perineum and rectum;
- signs of decreased sexual activity in men;
- pain during defecation.
According to some doctors, psychological symptoms of chronic prostatitis can also be identified, which include increased irritability, anxiety, fatigue, short temper, sleep disturbances, obsession and depression.
It is almost impossible to determine all the symptoms in a patient at once, since a man usually exhibits only 2-3 signs of the disease.For example, the most common are erectile dysfunction and pain in the lower abdomen.
Why can prostatitis cause infertility?
The fact is that the prostate gland produces a special secretion that ensures the viability of sperm.With inflammation, the secretory function of the prostate gland deteriorates, which inevitably affects the quality of sperm.
In addition, the prostate gland is actively involved in the regulation of testosterone production and the erection process.This is why chronic prostatitis causes decreased erectile function, even impotence.However, these scenarios for the development of the disease can be avoided if timely and competent treatment is carried out.
Diagnostics
The following procedures are necessary to help establish/refute the diagnosis:
- rectal examination;
- microscopy of prostate secretion;
- culture of prostate secretion for sensitivity to antibiotics;
- tests for sexually transmitted diseases;
- transrectal ultrasound.
Sometimes additional endoscopic and urodynamic studies are performed.
How to treat chronic prostatitis
If a man is diagnosed with chronic prostatitis, treatment is always long and difficult.Its duration directly depends on the stage of the disease at which the patient consulted a specialist.Therapy involves an integrated approach, that is, a combination of several methods simultaneously:
- antibacterial therapy;
- prostate massage;
- physiotherapeutic procedures;
- correction of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
Additionally, anti-inflammatory and antispasmodic agents are used in the treatment of chronic forms of the disease.
Drug treatment
The choice of medications depends on the cause and symptoms of the disease.To cure chronic prostatitis of infectious etiology, antibacterial drugs are used:
- fluoroquinolones;
- macrolides;
- tetracyclines.
To eliminate inflammation and pain, analgesics and non-hormonal anti-inflammatory drugs are used.
Also, in recent years, treatment of chronic prostatitis has been carried out using drugs that were not previously used for this purpose: alpha1-blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect the metabolism of urates and citrates.
Physiotherapy
Certain physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis and others, also help improve the trophism of prostate tissue and speed up the healing process.
Also, for chronic prostatitis, therapeutic warm baths, mud therapy, and special enemas can be prescribed.
Prostate massage
Improves drainage of prostate secretions and microcirculation at the level of this organ, which in turn contributes to a speedy recovery of the patient.
Prostate massage cannot be performed in case of acute prostatitis, hemorrhoids, or rectal fissures.Prostate massage is usually combined with antibiotic therapy.Numerous clinical studies have shown the high effectiveness of this treatment.
Operation
Surgery is possible to remove areas of the prostate gland affected by bacteria.Transurethral resection is an operation that is performed under epidural or intravenous barbiturate anesthesia.The postoperative recovery period lasts no more than a week.
The methods required for the treatment of chronic prostatitis are determined by the urologist based on diagnostic information and his practical experience.Carrying out self-therapy at home based on reviews on the Internet is fraught with consequences.