Chronic prostatitis- one of the most common diseases in men of mature age. Inflammation of the prostate gland significantly reduces the quality of life, becoming a cause of psychosomatic and sexual disorders. The lack of adequate knowledge about the nature of the disease makes the treatment of chronic prostatitis a difficult task that requires a lot of patience from both the patient and the doctor who treats it.
.jpg)
Welding
The American National Institutes of Health (NIH USA) developed and recommended the followingweldingchronic prostatitis:
- chronic bacterial prostatitis;
- chronic non-bacterial prostatitis (with and without signs of inflammation);
- prostatitis without chronic symptoms.
Modern andrology adheres to this classification in the diagnosis and treatment of inflammatory diseases of the prostate. Acute prostatitis stands out separately. Knowing which category the identified pathology belongs to, the physician will be able to select the optimal therapeutic regimen and achieve significant success in treating the disease.
Causes and risk factors
The division into bacterial and non -bacterial chronic prostatitis is not coincidental. The various causes of the disease determine the tactics of treatment and largely influence the outcome of the disease.
Chronic bacterial prostatitis
Chronic bacterial prostatitis occurs in 10-15% of patients. The immediate cause of disease progression 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 the examination, the following microorganisms are most often detected:
- Escherichia coli (up to 95%);
- Proteus;
- klebsiella;
- pseudomonas.
Representatives 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, etc. ).
Most of the microorganisms detected during the examination are representative of the normal microflora. Under normal circumstances, they do not harm the body and safely exist on the mucous membranes of the urinary system and digestive tract. Under certain conditions, conditionally pathogenic flora grows and multiplies, which leads to inflammation of prostate tissue and the appearance of all symptoms of the disease.
Risk factorsdevelopment of chronic bacterial prostatitis:
- lack of 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 the event of an inflammatory disease of the genital tract. The likelihood of developing prostatitis increases with pre -existing urethritis, cystitis, coliculitis.
Prostatitis is not chronic bacterial
There are several theories of the occurrence of this form of the disease:
- Theory of chemical inflammation. . . Urinating into the prostate during urination leads to venous deposition and the development of inflammation. Urethral-prostatic reflux is facilitated by urethral narrowing (tension) 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. . . Violation of conservation in the pelvic area causes blood stasis in the organs and leads to the development of prostatitis.
In the development of non -bacterial prostatitis, the following points also deserve special attention.risk factors:
- long sedentary work;
- sedentary lifestyle;
- bad habits;
- stress and emotional burden;
- prolonged sexual abstinence.
These risk factors trigger the development of congestion in the prostate, leading to a violation of microcirculation in the pelvic organs. Microbial factors only play a role in the early stages of disease development. In the future, its importance diminishes, and autoimmune processes and trophic disorders in prostate gland tissue appear to the fore.
According to statistics, 85-90% of men have chronic non-bacterial prostatitis (not directly associated with pathogenic or opportunistic bacterial infections).
symptoms
Chronic prostatitis occurs mainly in men aged 25-40 years. With age, the likelihood of developing the disease increases. In old age, inflammation of the prostate gland is often combined with adenomas - benign tumors of the prostate.
Signschronic prostatitis:
- dull aching pain in the lower abdomen;
- radiating pain in the groin, scrotum, perineum, lower back, sacrum;
- increased discomfort during intercourse and during bowel movements.
Urinary disorders are very characteristic:
- frequent urination;
- excretion of urine in small portions;
- feeling of incomplete emptying of the bladder;
- appearance or intensification of pain when urinating;
- slow and intermittent urine flow.
The last symptom is characteristic of prostate adenoma, which often occurs on the background of chronic prostatitis.
With the long 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 erection.
Chronic prostatitis is one of the leading causes of erectile dysfunction, in which a man cannot achieve and maintain an adequate erection for full sexual intercourse. Such conditions greatly disrupt the course of life, can lead to depression and other psychoemotional disorders.
Chronic asymptomatic prostatitis occurs without any 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 provokes the development of such 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 started, the more chances of getting a favorable outcome for the disease.
Diagnostics
The following methods are used to detect chronic prostatitis:
Examination by a urologist
At private appointments, doctors focus on patient 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. In the case of chronic prostatitis, 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 refraining from going to the toilet, a man urinates in two jars - for the first (early) part and for the second (middle) part of urine. In the first part, the contents of the urethra are washed, in the second part - the bladder. The 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 white blood cell count increases in the third part of the urine. Typically, their number does not exceed 10 in the field of view.
Microbiological examination
When conducting a 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 particularly 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.
Detection of opportunistic bacteria in titers greater than 10 is of diagnostic value.3CFU / ml or obvious detection of pathogenic microorganisms in any quantity.
Bacteriological culture of prostate secretion
Before taking the third portion of urine during a prostate massage, the doctor takes the secreted secretions for bacteriological examination. The results obtained also allow you to determine the diagnosis and treatment tactics.
Diagnostic criteria for chronic bacterial prostatitis:
- Identification of opportunistic microorganisms in the third part of urine or prostate secretions in titers exceeding 103CFU / ml.
- Detection of opportunistic bacteria in the third part of urine or prostate secretions, the number is significantly (10 times) higher than 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 will be eliminated. Particular attention is given to lifestyle correction and stimulation of the body’s defenses.
Drug treatment
For the treatment of chronic prostatitis, the following are usedmedicines:
- 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 that increase blood flow in the pelvic organs.
The choice of antibiotic will depend on the pathogen identified. When choosing a drug, one should take into account its ability to penetrate the hematoprostatic barrier and accumulate in the prostate gland tissue. This condition is met by means of a 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 receiving the results of bacteriological research and confirmation of the bacterial nature of the disease, treatment lasts up to 4-6 weeks. This approach allows not only to eliminate the causative agent of the disease, but also to prevent recurrence of prostatitis.
Unfortunately, antibiotic therapy is not always effective. Many microorganisms successfully exist in prostate secretions for a long time and acquire resistance to antibiotics. Bacteria form special biofilms and form colonies of microorganisms covered with complex polysaccharide structures. Most 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 accumulate in it, but also through biofilms 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 the excretion of secretions. The combination of massage and long -term use of antibacterial medications is the main way to relieve a man from 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 beam, radio waves, and electromyostimulation. The prostate shock wave (UHM) sequence is very popular. Physiotherapy is mainly indicated 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).
Consumption of salt is limited to 5 g per day. Preference is given to fresh vegetables and fruits, herbs. Steaming is recommended.
Eating a diet will speed recovery, strengthen your immune system and help your 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 various forums, relying on the advice of friends, relatives and neighbors. Neglect of one’s own health, rejection of rational antibiotic therapy and other traditional methods of exposure threaten the development of complications and deterioration in the general condition. Prostatitis not cured in time can cause erectile dysfunction. Is it worth the risk if you can see a doctor on time and solve the problem with minimal loss?
Of course, among traditional medical methods, there are several aspects that deserve special attention. Modern urology recognizes the effectiveness of many herbs in the treatment of chronic prostatitis. Experts recommend the preparation of herbs based on the following ingredients:
- pumpkin seed oil;
- round -leafed wintergreen;
- parsley garden;
- St. John's wort perforatum;
- canadian goldenrod;
- liquorice;
- echinacea.
Individually or in combination, these components stimulate blood flow in the pelvic organs, relieve congestion and stimulate the immune system.
Herbal remedies will not eliminate pathogenic bacteria from the body, but will help relieve the symptoms of the disease.
In combination with antibacterial drugs and prostate massage, herbal remedies significantly improve the general condition and speed recovery.
Prophylaxis
The following will help reduce the risk of getting chronic prostatitis:proposal:
- Hypothermia of the whole body and the genital area, pelvis and lower part of the legs should not be allowed. In winter, it is worth wearing warm underwear.
- It is necessary to adhere to the rules of intimate hygiene and use condoms to protect against STIs. The best prevention of infection is to avoid casual sex.
- You should pay attention to your health and treat any diseases in the genital area in a timely manner.
- It would not be excessive to follow a diet (leave out spicy, fried and fatty foods), as well as keep your body in good shape (sports, fitness, walking).
All men over the age of 30 are advised to undergo regular checkups by a urologist (at least once a year). If you experience any unpleasant symptoms, you should see your 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 is detected only after examination by a urologist.
Is chronic prostatitis in a partner dangerous for a woman?
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 the general condition allows 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 secretions are fully developed. Before pregnancy, 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, a decrease in libido is noted, the frequency and strength of erections is reduced, 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?
It is not possible to get rid of chronic prostatitis with traditional medicine alone. To achieve the optimal effect, complex treatment is carried out using antibiotics, herbal preparations, anti-inflammatory drugs and physiotherapy methods.