Chronic prostatitis is a long-term inflammation of the prostate gland, which is often asymptomatic, so 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.Inflammatory chronic prostatitis usually begins gradually, without unpleasant symptoms or sensations;the course of the disease is often discovered accidentally in the patient during an ultrasound examination.
Both young men and middle-aged and elderly people are prone to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead an inactive lifestyle, feel excessive physical strain on the barrier, and observe sexual abstinence.
Classification
According to the modern classification of prostatitis developed in 1995, the disease has several categories:
- 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 characteristic 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 pelvis.Fever accompanied by chills may occur.
- Chronic bacterial prostatitis is a disease with symptoms typical of chronic inflammation, and the number of bacteria and leukocytes in urine and prostatic secretions increases after massage.
- Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, it is the result of acute bacterial prostatitis (untreated or poorly treated).If there are symptoms, they appear in the form of pain in the genital 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 accidentally 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 90-95% of cases of chronic prostatitis are not bacterial, and only 10-5% - bacterial.
Reasons
Many factors can contribute to the development 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 can be detected in prostate tissue;
- Poor circulation in the pelvic organs (congestion of the prostate leads to its inflammation);
- Sedentary lifestyle (managers, 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 their blood circulation, the presence of accompanying diseases, and the level of defense mechanisms.
Symptoms of chronic prostatitis
Most often, with the development of a chronic form of prostatitis, the symptoms practically do not bother a person.In this case, all the signs of acute prostatitis are not manifested at all or to a much lesser extent.
The most common symptoms of chronic prostatitis in men are:
- periodic pain and discomfort in the perineum;
- discomfort during defecation and urination;
- irradiation of the anus, thigh, testicles;
- discharge from the urethra.
Changes in the course of the disease, which are not very bright anyway, can be so insignificant that patients with chronic prostatitis do not pay much attention to them.
Exacerbation of chronic prostatitis
The aggravation 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 identified, which include increased irritability, anxiety, fatigue, low mood, sleep disturbances, obsessions and depression.
It is almost impossible to determine all the symptoms in one patient at the same time, since a man usually shows only 2-3 symptoms of the disease.For example, erectile dysfunction and pain in the lower abdomen are the most common.
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 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 reduced erectile function and even impotence.However, these scenarios of the development of the disease can be avoided if timely and competent treatment is carried out.
Diagnostics
The following procedures are necessary to establish/disprove the diagnosis:
- rectal examination;
- microscopic examination of prostate secretion;
- culture of prostate secretion for sensitivity to antibiotics;
- testing for sexually transmitted diseases;
- transrectal ultrasound.
Sometimes additional endoscopic and urodynamic tests are performed.
How to treat chronic prostatitis
If a man is diagnosed with chronic prostatitis, the treatment is always long and difficult.The duration of this depends directly on the stage of the disease in which the patient consulted a specialist.The therapy involves an integrated approach, i.e. a simultaneous combination of several methods:
- antibacterial therapy;
- prostate massage;
- physiotherapy procedures;
- correction of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
In addition, anti-inflammatory and antispasmodic drugs are used to treat chronic forms of the disease.
Drug treatment
The choice of drugs depends on the cause and symptoms of the disease.Antibacterial drugs are used to treat chronic prostatitis of infectious etiology:
- fluoroquinolones;
- macrolides;
- tetracyclines.
Analgesics and non-hormonal anti-inflammatory drugs are used to eliminate inflammation and pain.
In addition, in recent years, chronic prostatitis has been treated with drugs that were not previously used for this purpose: alpha1-blockers, 5-a-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs affecting the metabolism of urates and citrates.
Physiotherapy
Certain physiotherapy procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis, and others, also contribute to improving prostate tissue trophism and speeding up the healing process.
In addition, in case of chronic prostatitis, therapeutic warm baths, mud therapy and special enemas may be prescribed.
Prostate massage
It improves the drainage of prostate secretions and microcirculation at the level of this organ, which in turn contributes to the patient's rapid recovery.
Prostate massage cannot be performed in case of acute prostatitis, hemorrhoids, or rectal fissure.Prostate massage is usually combined with antibiotic therapy.Numerous clinical trials have proven the high efficiency of this treatment.
Operation
Areas of the prostate affected by bacteria can be removed with surgery.Transurethral resection is an operation performed under epidural or intravenous barbiturate anesthesia.The recovery period after surgery 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 practical experience.Doing home self-therapy based on internet reviews is fraught with consequences.