Chronic prostatitis is a long-term inflammation of the prostate that often causes no symptoms, which is why most of the male population is unaware of this disease.
The development of chronic prostatitis is the result of an acute process, although in fact this is quite rare.Typically, inflammatory chronic prostatitis begins gradually without any unpleasant symptoms or sensations; patients' course is often discovered incidentally during ultrasound examinations.
Young men and middle-aged and elderly people are susceptible to chronic diseases.Prostatitis also threatens those who have an inactive lifestyle due to the nature of their job, experience excessive physical pressure on the perineum, and are abstinent from sex.
Classification
According to the modern classification of prostatitis established in 1995, the disease is divided into the following categories:
- Acute bacterial prostatitis (ABP) is the most common type 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.Fever with chills may occur.
- Chronic bacterial prostatitis is a disease with chronic inflammation as the typical symptom, and an increase in bacteria and white blood cells in prostate urine and secretions after massage.
- Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, this is the result of acute bacterial prostatitis (untreated or poorly treated).If symptoms occur, they may include pain in the genital or pelvic area, difficulty urinating, or painful urination and ejaculation.
- Asymptomatic inflammatory prostatitis - In this form of the disease, the typical symptoms of prostatitis are absent, and the disease itself is discovered incidentally during a visit to the clinic for other reasons.
When an infectious component is present, they call it bacterial (infectious) chronic prostatitis; in the absence of microbial pathogens - about non-bacterial (non-infectious) prostatitis.It is believed that 90-95% of cases are non-bacterial chronic prostatitis and only 10-5% are bacterial chronic prostatitis.
reason
Many factors can lead to the development of chronic prostatitis.First, this:
- Sexually transmitted infections: Chlamydia, Ureaplasma, mycoplasma, herpes virus, cytomegalovirus, Trichomonas, gonococcus, Candida, and Escherichia coli can infect the urethra and be detected in prostate tissue;
- Poor circulation in the pelvic organs (congestion of the prostate leading to inflammation);
- Sedentary lifestyle (drivers, office workers, officials);
- Long-term abstinence, interruption of sexual intercourse or artificially prolonged sexual intercourse;
- Frequent hypothermia (extreme recreational enthusiasts: diving, surfing and skiing);
- Stress: Mental and physical overload.
For the development of chronic prostatitis, what is important is not the presence and activity of pathogenic microorganisms, but the state of the pelvic organs and their blood circulation, the presence of accompanying diseases and the level of protective mechanisms.
Symptoms of chronic prostatitis
Most of the time, as chronic prostatitis develops, the symptoms don't actually bother men.In this case, all the symptoms of acute prostatitis will not appear at all, or will appear to a much smaller extent.
The most common symptoms of chronic prostatitis in men are:
- Cyclic perineal pain and discomfort;
- Discomfort during defecation and urination;
- Irradiation of the anus, thighs, and testicles;
- Expelled from the urethra.
Changes in the course of the disease are not obvious to begin with, but they may be so insignificant that patients with chronic prostatitis do not pay special attention to them.
Chronic prostatitis worsens
Exacerbations of the disease are often accompanied by the following symptoms:
- urethral pain and burning;
- increased urge to urinate;
- Lower abdominal, perineal, and rectal pain;
- Signs of reduced sexual activity in men;
- Pain during bowel movements.
Some doctors believe that psychological symptoms of chronic prostatitis can also be recognized, including irritability, anxiety, fatigue, bad temper, sleep disorders, obsessive-compulsive disorder and depression.
It is almost impossible to identify all of a patient's symptoms at once, as a man usually shows only 2-3 signs of the disease.For example, the most common ones are erectile dysfunction and lower abdominal pain.
Why does prostatitis cause infertility?
In fact, the prostate produces a special secretion to ensure sperm motility.With inflammation, the secretory function of the prostate will deteriorate, which will inevitably affect the quality of sperm.
In addition, the prostate is actively involved in the regulation of testosterone production and the erectile process.This is why chronic prostatitis can lead to decreased erectile function and even impotence.However, with prompt and effective treatment, the progression of these diseases can be avoided.
diagnosis
The following procedures are needed to help establish/refute the diagnosis:
- Rectal examination;
- Microscopic examination of prostate secretions;
- Culture of prostate secretions to detect antibiotic susceptibility;
- STD testing;
- Transrectal ultrasonography.
Additional endoscopic and urodynamic studies are sometimes performed.
How to treat chronic prostatitis
If a man is diagnosed with chronic prostatitis, treatment is always long and difficult.Its duration depends directly on the stage of the disease at the time of presentation.Treatment involves an integrated approach, which combines several methods simultaneously:
- Antimicrobial treatment;
- prostate massage;
- physical therapy procedures;
- correct diet and lifestyle;
- using folk remedies;
- Surgical treatment.
In addition, anti-inflammatory and antispasmodic agents 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 treat infectious chronic prostatitis, 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: α1-blockers, 5-α-reductase inhibitors, cytokine inhibitors, immunosuppressants, drugs affecting urate and citrate metabolism.
physical therapy
Certain physical therapy procedures, such as laser therapy, electrophoresis, transrectal microwave thermotherapy, phonophoresis, etc., can also help improve the nutrition of prostate tissue and speed up the healing process.
In addition, chronic prostatitis can be treated with warm baths, mud therapy and special enemas.
prostate massage
Improves the drainage of prostate secretions and the microcirculation of this organ, thus contributing to the patient's rapid recovery.
Patients with acute prostatitis, hemorrhoids, and rectal fissures cannot undergo prostate massage.Prostate massage is often combined with antibiotic treatment.Numerous clinical studies have shown this treatment to be highly effective.
operate
Surgery can remove areas of the prostate affected by bacteria.Transurethral resection is a procedure performed under epidural or intravenous barbiturate anesthesia.The postoperative recovery period does not exceed one week.
The methods required to treat chronic prostatitis are determined by the urologist based on diagnostic information and practical experience.Self-treatment at home based on reviews on the Internet can have many consequences.