Chronic prostatitis- is one of the most common diseases among adult men. Inflammation of the prostate gland causes psychosomatic and sexual disorders, significantly reducing the quality of life. Lack of knowledge about the nature of this disease makes the treatment of chronic prostatitis a difficult task that requires a lot of patience from both the patient and the treating physician.
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Classification
The American National Institutes of Health (NIH USA) developed and recommended the followingclassificationchronic prostatitis:
- chronic bacterial prostatitis;
- chronic non-bacterial prostatitis (with and without signs of inflammation);
- chronic asymptomatic prostatitis.
Modern andrologists follow this classification in the diagnosis and treatment of inflammatory diseases of the prostate. Acute prostatitis is different. By knowing the category of the identified pathology, the doctor will be able to choose the optimal therapy regimen and achieve significant success in the treatment of the disease.
Causes and risk factors
The division into bacterial and non-bacterial chronic prostatitis is not accidental. Different causes of the disease determine the tactics of treatment and mainly affect the outcome of the disease.
Chronic bacterial prostatitis
Chronic bacterial prostatitis occurs in 10-15% of patients. The direct cause of the development of the disease is the penetration of pathogenic and opportunistic flora into the prostate. By definition, the prostate gland is free of bacteria. Infection of the prostate is possible through the urethra, as well as hematogenous and lymphogenic. The following microorganisms are most often found during the examination:
- Escherichia coli (up to 95%);
- Proteus;
- klebsiella;
- pseudomonas.
Representatives of Gram-positive flora (staphylococci, streptococci) are very rare. In some cases, the development of two or more microorganisms is noted (mixed infection). Possible infection with pathogenic flora (chlamydia, trichomonas, gonococcus, etc. ).
Most of the microorganisms found during the examination are representatives of the normal microflora. Under normal conditions, they do not harm the body and are present peacefully in the mucous membranes of the urinary system and digestive system. Under certain conditions, conditionally pathogenic flora grows and multiplies, which leads to inflammation of the prostate tissue and the appearance of all the symptoms of the disease.
Risk factorsDevelopment of chronic bacterial prostatitis:
- lack of personal hygiene;
- hypothermia;
- genital trauma;
- inflammatory diseases of the urinary system;
- Presence of CYBEs.
All this leads to a decrease in local and general immunity and the natural proliferation of opportunistic flora in the prostate. In inflammatory diseases of the genitals, it is possible that the infection can pass through the urethra. Existing urethritis, cystitis, coliculitis increase the likelihood of developing prostatitis.
Chronic non-bacterial prostatitis
There are several theories about the occurrence of this form of the disease:
- Chemical inflammation theory. . . Urinary excretion in the prostate during urination leads to the collapse of urate and the development of inflammation. Urethro-prostatic reflux is facilitated by narrowing (narrowing) of the urethra and other developmental abnormalities.
- Immune theory. . . The version is based on autoimmune damage to prostate tissue as a result of exposure to bacterial antigens. Hereditary predisposition to this form of pathology is taken into account.
- Neurogenic theory. . . Disruption of innervation in the pelvic region leads to blood stasis in the organs and the development of prostatitis.
In the development of non-bacterial prostatitis, the following also deserve special attention.risk factors:
- long sedentary work;
- sedentary lifestyle;
- bad habits;
- stress and emotional overload;
- refrain from sexual intercourse for a long time.
These risk factors lead to the development of obstruction in the prostate, leading to disruption of microcirculation in the pelvic organs. The microbial factor plays a role only in the early stages of the disease. In the future, its importance decreases, autoimmune processes and trophic disorders in the tissues of the prostate gland come to the fore.
According to statistics, 85-90% of men have non-bacterial chronic prostatitis (not directly related to infection with pathogenic or opportunistic bacteria).
Symptoms
Chronic prostatitis mainly affects men aged 25-40 years. With age, the likelihood of developing the disease increases. In old age, inflammation of the prostate gland is often associated with adenoma - a benign tumor of the prostate.
Symbolschronic prostatitis:
- dull pains in the lower abdomen;
- radiating pain in the groin, scrotum, perineum, lower back, sacrum;
- increased anxiety during sexual intercourse and during bowel movements.
Disorders of urinary excretion are very characteristic:
- frequent urination;
- urinary excretion in small portions;
- feeling of incomplete emptying of the bladder;
- appearance or intensification of pain when urinating;
- slow and intermittent urine flow.
The latter symptom is characteristic of prostate adenoma, which often occurs against the background of chronic prostatitis.
With a long course of the disease there are disorders in the sexual sphere:
- decreased libido;
- deterioration of erection;
- reduction of sexual intercourse;
- premature ejaculation;
- pulling pains in the lower abdomen after ejaculation;
- lack of spontaneous morning erection.
Chronic prostatitis is one of the main causes of erectile dysfunction, in which a man is unable to maintain and maintain an erection for full sexual intercourse. Such a situation significantly disrupts the course of life and can lead to depression and other psycho-emotional disorders.
Chronic asymptomatic prostatitis occurs without any clinical manifestations. The disease is discovered by chance during a urologist's examination. Although there are no symptoms, inflammation of the prostate gland can lead to serious complications, erectile dysfunction and other health problems.
Complications
Onset prostatitis causes the development of the following conditions:
- prostate abscess;
- cystitis and pyelonephritis (inflammation of the bladder and kidneys);
- vesiculitis (inflammation of the seminal vesicles);
- erectile dysfunction;
- infertility.
The sooner the disease is detected and treatment is started, the better the chances of a favorable outcome of the disease.
Diagnostics
The following methods are used to detect chronic prostatitis:
Examined by a urologist
In a personal meeting, the doctor pays attention to the patient's complaints. External genitalia are examined, prostate digital rectal examination is performed. During palpation, the doctor assesses the size and shape of the gland. In chronic prostatitis, the body will grow slightly. The procedure is combined with the collection of prostate secretions for microbiological examination.
Four glass sample
The main method that allows you to identify the inflammatory process in the prostate gland and distinguish it from other diseases. The collection of material takes place in several stages. After refraining from going to the toilet for 5-6 hours in the morning, the man urinates in two jars - for the first (primary) and second (middle) part of the urine. In the first part, the contents of the urethra are washed, in the second - the bladder. A third of the urine is collected after a prostate massage and allows you to assess the condition of the prostate gland. The secret of the prostate gland is collected separately for bacteriological culture.
Urine analysis evaluates two parameters: the number of leukocytes and erythrocytes. With prostate disease, the number of white blood cells in the urine increases in the third part. Normally, their number does not exceed 10 in the field of view.
Microbiological examination
In a three-vial test, not only the number of leukocytes is assessed, but also the material for bacteriological inoculation. If you suspect chronic prostatitis, your doctor is especially interested in the third part of the urine. Based on the results of the examination, the doctor can determine the cause of the disease and choose the optimal antibiotic therapy.
Detection of opportunistic bacteria in more than 10 titers is of diagnostic value.3Unambiguous detection of pathogenic microorganisms in CFU / ml or any amount.
Bacteriological culture of prostate secretion
Before taking a third of the urine during a prostate massage, the doctor takes the secretion secreted for bacteriological examination. The result allows to determine both diagnosis and treatment tactics.
Diagnostic criteria for chronic bacterial prostatitis:
- Detection of opportunistic microorganisms in the third part of urine or prostate secretion at titers above 103CFU / ml.
- Detection of opportunistic bacteria in the third part of the urine or prostate secretion, their number is significantly higher (10 times) than in the second part of the urine.
- Detection of pathogenic microorganisms in the third part of urine or prostate secretion.
Ultrasound
Ultrasound examination allows you to assess the size of the body and identify the accompanying pathology. Often chronic prostatitis is associated 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 pathogens or opportunistic microorganisms are detected at high titers, they are eliminated. Particular attention is paid to lifestyle correction and stimulation of the body's defenses.
Drug treatment
The following are used to treat chronic prostatitismedicines:
- Antibacterial drugs are selected taking into account the identified pathogen.
- Anti-inflammatory drugs to reduce inflammation and relieve pain.
- Means that facilitate urination (alpha-blockers that relax the muscles of the urinary tract and stimulate urine flow).
- Means that increase blood flow in the pelvic organs.
The choice of antibiotic will depend on the identified pathogen. When choosing a drug, its ability to penetrate the hematoprostatic barrier and accumulate in the tissues of the prostate gland should be taken into account. These conditions are met by means of the group of fluoroquinolones. Macrolides and tetracyclines are also used to treat chronic prostatitis.
According to the recommendations of the European Urological Association, the course of antibacterial therapy should be at least 2 weeks after the initial diagnosis.
After the results of bacteriological examination and confirmation of the bacterial nature of the disease, treatment lasts up to 4-6 weeks. This approach not only gets rid of the causative agent of the disease, but also prevents the recurrence of prostatitis.
Unfortunately, antibiotic therapy is not always effective. Many microorganisms are successfully present in prostate secretion for a long time and become resistant to antibiotics. Bacteria form special biofilms and form colonies of microorganisms covered by a complex polysaccharide structure. Most antibacterial drugs cannot cross this biological barrier, which significantly reduces the effectiveness of therapy. With the use of modern antibiotics, this problem can be avoided, as they can not only penetrate the tissue of the prostate gland and accumulate there, but also infect bacteria that are under such strict protection through biopiles.
Non-drug therapy
Among non-pharmacological treatments, special attention is paid to prostate massage. The procedure stimulates the blood supply to the prostate gland, relieves congestion and facilitates the excretion of secretions. The combination of massage and long-term use of antibacterial drugs is the main way to relieve a man of the unpleasant symptoms of chronic prostatitis.
In the treatment of chronic prostatitis, in addition to drug effects, physiotherapeutic methods are also used. Good results are seen with the use of ultrasound, laser beams, radio waves and electromyostimulation. Prostate shock wave massage (UHM) is very popular. Physiotherapy is especially indicated when erectile dysfunction is one of the complications of prostatitis.
In the treatment of prostatitis, special attention is paid to diet. The following foods should be excluded from the diet:
- alcohol;
- spicy, spicy food;
- fried and fatty foods (including fatty meat and fish).
Salt consumption is limited to 5 g per day. Fresh vegetables, fruits and herbs are preferred. It is recommended to steam.
Eating a diet will speed up recovery, strengthen the immune system and help the body cope with the stress caused by antibiotics during treatment.
ethnoelm
Not all men see a doctor when they have symptoms of prostatitis. Men often rely on the advice of friends, relatives and neighbors, using a database of numerous forums, and prefer to receive treatment with folk remedies. Neglect of one's own health, abandonment of rational antibiotic therapy and other traditional methods of exposure threaten the development of complications and worsening of the general condition. Untreated prostatitis can cause erectile dysfunction. Is it worth the risk if you can see a doctor in time and solve the problem with minimal loss?
Of course, there are some points in traditional medicine that deserve special attention. Modern urology recognizes the effectiveness of many herbs in the treatment of chronic prostatitis. Experts recommend herbal preparations based on the following ingredients:
- pumpkin seed oil;
- round-leafed winter green;
- garden parsley;
- St. John's wort perforatum;
- canada goose outlet;
- licorice root;
- exinasya.
Separately or together, these components stimulate blood flow in the pelvic organs, relieve congestion and stimulate the immune system.
Herbal remedies will not save the body from pathogenic bacteria, but will help eliminate the symptoms of the disease.
Combined with antibacterial drugs and prostate massage, herbal remedies significantly improve the overall condition and accelerate recovery.
Prophylaxis
The following will help reduce the risk of developing chronic prostatitis:recommendations:
- Hypothermia of the whole body and genital area, pelvis and lower extremities should not be allowed. It is worth wearing thermal underwear in the cold season.
- In order to protect against STIs, it is necessary to follow the rules of intimate hygiene and use condoms. The best way to prevent infection is to avoid casual sex.
- You should take care of your health and treat any diseases of the genital area in a timely manner.
- It is no longer necessary to follow a diet (avoid spicy, fried and fatty foods), as well as to keep your body in good shape (exercise, fitness, walking).
It is recommended that all men over the age of 30 have regular urological examinations (at least once a year). If you experience any unpleasant symptoms, you should consult a doctor as soon as possible.
Frequently Asked Questions
Can chronic prostatitis be treated?
Contrary to popular belief, chronic prostatitis can be successfully treated. If you follow all the recommendations of your doctor, you can get rid of the unpleasant symptoms of prostatitis and significantly improve your quality of life.
Can chronic prostatitis be asymptomatic?
Yes, this variant of the disease is detected only after examination by a urologist.
Is chronic prostatitis in a partner dangerous for a woman?
Chronic prostatitis is often caused by sexually transmitted infections. If a pathogenic agent is identified, both partners should be treated. Otherwise, there is a risk of infection and the effectiveness of therapy is reduced due to relapses of the disease.
Is it possible to have sex with chronic prostatitis?
Yes, if the general condition allows and there are no problems in the sexual sphere (erectile dysfunction).
Is it possible to get pregnant with a child with chronic prostatitis?
Yes, if the function of the prostate is preserved and its secretion is fully developed. It is recommended that a child be examined and treated by a urologist before becoming pregnant. The infection, which causes the development of prostatitis, is easily transmitted to women. Intrauterine infection of the fetus can lead to 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 a pathology, a decrease in libido is noted, the frequency and intensity of erections decreases, and orgasm becomes painful. In advanced cases, sexual activity becomes impossible.
Can chronic prostatitis be treated without antibiotics?
Antibiotic therapy is one of the main treatments for chronic prostatitis. In most cases, it is impossible to cope with the disease without antibiotics.
Can chronic prostatitis be treated with folk remedies?
It will not be possible to get rid of chronic prostatitis with traditional medicine alone. To achieve the optimal effect, a complex treatment is carried out using antibiotics, herbal medicines, anti-inflammatory drugs and physiotherapy.