Chronic prostatitis is a long-term inflammation of the prostate gland, often without symptoms, which is why the majority of the male population is unaware 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 accidentally 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, experience 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 fever accompanied by chills.
- Chronic bacterial prostatitis is a disease with characteristic 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 untreated).If there are symptoms, they appear in the form of pain in the genitals or pelvic area, difficulty urinating or painful urination and ejaculation.
- Asymptomatic inflammatory prostatitis - this form of the disease lacks the classic symptoms of prostatitis, and the disease itself is discovered by chance, during a visit to the clinic for another reason.
In the presence of an infectious component, we speak of bacterial (infectious) chronic prostatitis;in the absence of microbial pathogens - for non-bacterial (non-infectious) prostatitis.It is estimated 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 onset of chronic prostatitis.First of all this:
- STIs: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungi, Escherichia coli can infect the urethra and be found in prostate tissue;
- Poor circulation in the pelvic organs (stasis in the prostate leads to its inflammation);
- Sedentary lifestyle (drivers, office workers, employees);
- Prolonged sexual abstinence, interrupted intercourse or artificial prolongation of intercourse;
- Regular hypothermia (fans of extreme vacation: diving, surfing and skiing);
- Stress: mental and physical overload.
For the development of chronic prostatitis, the presence and activity of pathogenic microorganisms is not so important as the condition 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 signs of acute prostatitis will not appear at all or will appear 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 of the anus, thigh, testicles;
- discharge from the urethra.
Changes in the course of the disease, which is no longer very bright, can be so insignificant that patients with chronic prostatitis do not pay special attention to them.
Exacerbation of chronic prostatitis
The 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 disorders, obsession and depression.
It is almost impossible to determine all the symptoms in a patient at once, since a person usually shows 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.In case of 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.That is why chronic prostatitis causes reduced erectile function, even impotence.However, these scenarios of disease development can be avoided if timely and competent treatment is carried out.
Diagnosis
The following procedures are necessary to help establish/disprove the diagnosis:
- rectal examination;
- microscopy of prostatic 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 person is diagnosed with chronic prostatitis, treatment is always long and difficult.Its duration depends directly on the stage of the disease at which the patient consulted a specialist.Therapy includes an integrated approach, i.e.a combination of several methods at the same time:
- antibacterial therapy;
- prostate massage;
- physiotherapy procedures;
- correction of diet and lifestyle;
- use of public funds;
- surgical treatment.
In addition, in the treatment of chronic forms of the disease, anti-inflammatory and antispasmodic agents are used.
Drug treatment
The choice of drugs depends on the cause and symptoms of the disease.Antibacterial drugs are used to treat chronic prostatitis with an infectious etiology:
- fluoroquinolones;
- macrolides;
- tetracyclines.
Analgesics and non-hormonal anti-inflammatory agents are used to eliminate inflammation and pain.
Also, in recent years, the treatment of chronic prostatitis is carried out with drugs that were not previously used for this purpose: alpha1-blockers, 5-α-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs that affect the metabolism of urates and citrates.
Physiotherapy
Some physical therapy procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis, and others, also help to improve prostate tissue trophicity and accelerate the healing process.
Also, for chronic prostatitis, therapeutic warm baths, mud treatment and special enemas can be prescribed.
Prostate massage
It improves the drainage of prostatic secretion and microcirculation at the level of this organ, which in turn contributes to the rapid recovery of the patient.
Prostate massage cannot be performed in acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is usually combined with antibiotic therapy.Numerous clinical studies show 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 necessary methods of treatment of chronic prostatitis are determined by the urologist based on diagnostic information and his practical experience.Conducting self-therapy at home based on reviews on the Internet is fraught with consequences.