Chronic prostatitis is a long-term inflammation of the prostate gland that often has no 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 occurs quite rarely.As a rule, inflammatory chronic prostatitis begins gradually, without unpleasant symptoms or sensations;The course of the disease is often discovered in a 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, 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 form of prostatitis.It is usually caused by a bacterial infection and is easy to diagnose due to its typical symptoms.Acute bacterial prostatitis can occur at any age.Symptoms include painful urination, inability to completely empty the bladder, and pain in the lower abdomen, back, or pelvic area.There may be fever with 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 secretion 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 manifest themselves in the form of pain in the genital or pelvic area, difficulty urinating or pain when urinating and ejaculating.
- Asymptomatic inflammatory prostatitis – in this form of the disease, the classic symptoms of prostatitis are absent and the disease itself is discovered accidentally when visiting the clinic for another reason.
If an infectious component is present, it is referred to as bacterial (infectious) chronic prostatitis;in the absence of microbial pathogens - about nonbacterial (noninfectious) prostatitis.It is believed that nonbacterial chronic prostatitis occurs in 90-95% of cases and bacterial in only 10-5%.
Reasons
A number of factors can contribute to the occurrence of chronic prostatitis.First of all, this:
- STIs: Chlamydia, Ureaplasma, Mycoplasma, Herpesvirus, Cytomegalovirus, Trichomonas, Gonococci, Candida fungus, Escherichia coli can infect the urethra and be detected in prostate tissue;
- Poor blood circulation in the pelvic organs (blockage of the prostate leads to its inflammation);
- lack of exercise (drivers, office workers, civil servants);
- 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 are important, but rather the condition of the pelvic organs and their blood flow, the presence of concomitant diseases and the extent of protective mechanisms.
Symptoms of chronic prostatitis
Most often, when a chronic form of prostatitis develops, the symptoms practically do not bother the man.In this case, all signs of acute prostatitis do not appear at all or appear to a much lesser extent.
The most common symptoms of chronic prostatitis in men are:
- periodic pain and discomfort in the perineum;
- Difficulty with bowel movements and urination;
- Irradiation of the anus, thigh, testicles;
- Discharge from the urethra.
Changes in the course of the disease, which are already not very noticeable, can be so insignificant that patients with chronic prostatitis do not pay them special attention.
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 reduced sexual activity in men;
- Pain during bowel movements.
According to some doctors, psychological symptoms of chronic prostatitis can also be noted, which include increased irritability, anxiety, fatigue, irascibility, sleep disorders, obsessive ideas and depression.
It is almost impossible to determine all of a patient's symptoms at once, since a man usually has only 2-3 signs of the disease.The most common, for example, are erectile dysfunction and pain in the lower abdomen.
Why can prostatitis cause infertility?
The fact is that the prostate produces a special secretion that ensures sperm viability.When inflammation occurs, the secretory function of the prostate deteriorates, which inevitably affects sperm quality.
In addition, the prostate is actively involved in regulating testosterone production and the erection process.For this reason, chronic prostatitis leads to reduced erectile function, even impotence.However, these disease development scenarios can be avoided if timely and competent treatment is carried out.
diagnosis
The following procedures are necessary to establish/refute the diagnosis:
- rectal examination;
- Microscopy of prostate secretion;
- culture of prostate secretion for sensitivity to antibiotics;
- sexually transmitted disease testing;
- 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 lengthy and difficult.Their duration directly depends on the stage of the disease at which the patient consults a specialist.The therapy is an integrated approach, i.e. a combination of several methods at the same time:
- antibacterial therapy;
- prostate massage;
- physiotherapeutic procedures;
- correction of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
In addition, anti-inflammatory and antispasmodics are used to treat chronic forms of the disease.
Drug treatment
The choice of medication 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.
In addition, in recent years, the treatment of chronic prostatitis has been carried out with 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 to improve the trophism of prostate tissue and accelerate the healing process.
Even with chronic prostatitis, therapeutic warm baths, mud therapy and special enemas can be prescribed.
Prostate massage
Improves the outflow of prostate secretions 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 cases 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 affected by bacteria.Transurethral resection is a surgery performed under epidural or intravenous barbiturate anesthesia.The postoperative recovery period lasts no more than a week.
The methods required to treat 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 has consequences.