Chronic prostatitis: symptoms and treatment

Inflammatory processes observed in the prostate tissue for three or more months are called chronic prostatitis.The long course of the disease makes one judge the beginning of the chronic stage.Statistics show that acute and chronic prostatitis often occurs against the background of complicated urethritis.

A distinctive feature of chronic prostatitis is that in 50–70% of cases the disease does not make itself felt by pronounced symptoms.Only in 20% of cases do patients describe signs that indicate a chronic form of prostatitis.The remaining category of men notes onlyindirect symptoms of the disease, not directly related to prostatitis.Both young people and middle-aged and elderly men are not immune from chronic prostatitis.

Those who experience a lack of physical activity, are associated with sedentary work, and practice sexual abstinence are susceptible to prostatitis.Thus, truck drivers, who spend most of their time behind the wheel, experience the effects of negative factors: hypothermia and congestion in the pelvic organs.Representatives of contact sports and weightlifters are prone to microtrauma of prostate tissue.Men who show low sexual activity become hostage to this unpleasant disease due to stagnation of prostate secretions.They affect the prostate gland, causing acute and chronic prostatitis, various sexually transmitted infections, through blood or lymphatic fluid.

Types and stages of chronic prostatitis

In urological practice, the following are distinguished:forms of chronic prostatitis:

• Bacterial.The cause of the disease lies in an infection or pathogenic bacteria that has penetrated the prostate gland.The most common is chronic prostatitis caused by chlamydia.The danger of this form lies in the possible infertility that awaits a man without timely treatment.
• Abacterial.Chronic prostatitis of a non-infectious nature.Diagnosing the exact cause is quite problematic.Typically, such prostatitis develops due to the anatomical features of the prostate of an individual man.The incorrect structure of the organ creates increased pressure on the urethra, which leads to frequent discharge of urine.Autoimmune diseases can also cause degenerative changes in prostate tissue.
• Stagnant.Congestive chronic prostatitis develops when the prostate does not empty completely and excess blood mass forms.Stagnation creates an inflammatory response.
• Constant pelvic pain syndrome.A man complains of constant, unrelenting pain in the perineal area.
• Asymptomatic.Chronic prostatitis occurs in a latent form, without causing pain or discomfort, despite the presence of inflammation.

Chronic prostatitis has its own stages of development

• Exudation stage.Rapid ejaculation and sharp pain in the prostate.
• Alternative stage.Painful sensations are replaced by discomfort, a reduction in the time of sexual intercourse, and frequent urination.
• Proliferation stage.The frequency of the urge to go to the toilet increases, but problems with urine output appear.
• Stage of scar changes.Sclerosis of healthy prostate tissue occurs.As a result of morphological transformations, heaviness appears in the area of the sacrum and pubis, the stream of urine weakens and potency decreases.The sensations during orgasm are often blurry.

Causes

• Infection.The source of pathogenic bacteria entering the prostate gland is the blood and lymphatic vessels.Urological diseases and inflammation in the rectum are a prerequisite for infection of prostate tissue.Methods of infection:
  • Descending- the infection enters the gland along with urine, which contains microbes.
  • Rising— The path of microbes entering the prostate begins from the external opening of the urethra.
• Decreased protective functions of the body.One of the main culprits of chronic prostatitis is weakened immunity.This is facilitated by hypothermia, frequent stressful situations, poor nutrition, and bad habits.When immunity decreases, the body becomes open to infections that provoke inflammation in the prostate.
• Poor circulation.A sedentary and sedentary lifestyle is closely related to chronic prostatitis.A man’s internal organ systems suffer from a lack of physical activity: endocrine, cardiovascular, nervous.Blood microcirculation in the pelvis deteriorates, resulting in hypoxia of prostate cells.
• Lack of regular sex life.Both refusal of intimate life and excessive sexual activity lead to prostate problems.Many men with a strong sexual constitution engage in vigorous sexual activity.From frequent sexual intercourse, their nervous system is exhausted, hormonal disturbances appear and the erection gradually weakens.Incomplete sexual intercourse causes great harm to prostate health.
• Chronic prostate injuries.The soft tissue of the prostate, often subject to injury due to excessive stress, shaking and vibration, can periodically become inflamed.
• Transurethral procedureswithout concomitant antibiotic therapy can cause prostate infection.
• Urethral catheter, with which a man is forced to live for some time, also contributes to infection of the prostate.

Symptoms of chronic prostatitis

The symptoms of chronic prostatitis vary.Some of the first signs of chronic prostatitis that attract attention are pain when urinating and impaired sexual function.As a rule, problems in the intimate sphere force a man to seek the help of a doctor.If discomfort and pain in the pelvic areado not subside for more than three months, then with a high probability we can talk about chronic prostatitis.

Most often, the pain syndrome spreads to the perineal area, however, discomfort can be localized in the pubic and groin area.A man complains of pain in the anus, scrotum, and glans penis.The pain radiates to the lumbosacral region.Attacks of pain can cover the inner thighs.Pain in one of the testicles usually does not indicate prostatitis.Complaints of pain after ejaculation are specific to the chronic course of the disease.

Among the common symptoms of chronic prostatitis are also increased sweating, a feeling of coldness and trembling in the perineum.Poor circulation in the pelvis can lead toto changes in skin color.

Chronization of the inflammatory process in the prostate leads to disruption of its tone.In some cases, prostatorrhea develops.With this pathology, spontaneous secretion of the gland occurs, which has no connection with arousal or ejaculation.

With chronic prostatitis, men may observe, mainly in the morning, small purulent or clear discharge from the penis.Some patients find white flakes or threads in their urine.A sign of advanced calculous prostatitis is the presence of traces of blood in the semen.

The appearance of sexual dysfunction, simultaneously with a decrease in libido and a deterioration in spontaneous erections, is noted by many patients.It is worth noting that the majority of patients have impotencehas no critical connotation.In the early stages of chronic prostatitis, men experience premature ejaculation, which can become difficult over time.Some patients report a decrease in the intensity of sensations during sex.Problems with urination are most often irritative in nature.

Diagnosis of the biological material of a man with chronic prostatitis reveals a quantitative and qualitative violation of the secretion of the prostate gland.Morphological deviations in ejaculate parameters are rarely associated with male infertility.

During remission, most symptoms subside and pain decreases.Many men calm down, attributing the situation to self-healing.But without proper therapy, infectious foci in the prostate persist, and during the period of exacerbationsymptoms become significantly worse, low-grade fever persists.

Diagnosis of the disease

Diagnosing chronic prostatitis is not difficult for an experienced urologist.The most difficult thing here is most likely to establish the true cause that led to chronic prostatitis.

To confirm the diagnosiscarry out the following procedures:

• Rectal examination using fingers.A digital examination is carried out during a man’s initial visit to a urologist.The back of the prostate gland is in contact with the rectum, which makes it possible to assess the condition of the prostate when a finger is inserted through the anus.Palpation of the posterior surface of the gland makes it possible to determine the size and shape, as well as the consistency and soreness of the inflamed organ.
• Microscopic examination of prostate secretion.While studying biological material, a laboratory technician may note an increased number of leukocytes - this signals the spread of pathogenic bacteria.
• Culture of gland secretionon the nutrient medium, type of bacteria and resistance to antibiotics using RIF and PCR methods.
• Cystoscopy.An endoscopic imaging system device is inserted into the bladder cavity.This diagnostic method of chronic prostatitis allows us to exclude cancer, cystitis and bladder injuries.
• Ultrasound.The doctor may prescribe an ultrasound examination before starting treatment for acute prostatitis, so as not to miss abscess formation of the organ.For men suffering from chronic prostatitis, ultrasound is done to detect stones and cysts, as well as to assess the level of urethral pressure.Today, transrectal ultrasound is more effective, in which a sensor is inserted into the rectum.
• Uroflowmetric diagnostic method.In this way, indicators of the urinary process are studied: the duration and speed of urine outflow.A rate above 10–15 ml/s indicates good patency of the urethra.Indicators below this norm indicate poor patency of the urinary canal caused by chronic prostatitis.

Chronic prostatitis: treatment

Each clinical case requiresindividual selection of treatment regimen.When choosing a therapeutic model, the causes of the disease, the duration of the course and the presence of aggravating factors are taken into account.

Drug treatment:

• Antibiotics.Antibacterial therapy is indicated only in cases of infection of the prostate with a bacterial agent that has been identified in prostate secretions or urine.Antibiotics from the fluoroquinolone group are prescribed.Treatment lasts from two to eight weeks.After an antibacterial course, the full extent of symptoms often remains, provided that the infection factor has been eliminated.
• Alpha blockersprescribed to men to reduce hypertonicity of the bladder muscles and stabilize intraurethral pressure.They are ineffective if the patient has impaired muscle innervation and has pelvic floor muscular dystrophy.
• Non-steroidal anti-inflammatory drugs.Help relieve pain syndromes.
• Selective antidepressants.Prescribed to men to improve their emotional background, relieve anxiety and self-doubt.
• Hormonal drugs.Antiandrogens and androgens are used to adjust hormonal levels.
• Immunostimulating drugs.Prescribed for proven immunodeficiency.
• Uric acid level regulators.The appointment is justified if there is sand and stones in the prostate gland.
• Vitamin complexes.

Auxiliary methods for the treatment of chronic prostatitis

Some urologists are of the opinion that physical impact on the prostate significantly alleviates the patient’s condition.But most of these therapeutic methods have their contraindications, so theyprescribed under certain conditions:

• Prostate massage.Contraindicated in prostatic hyperplasia because it can cause acute urinary retention.In addition, by doing a massage, you can spread the infection throughout the prostate and cause sepsis.Massage should not be performed if there are cystic formations in the prostate or venous stagnation.To relieve the gland from stagnation, natural drainage during ejaculation is considered the best way.
• Bladder gymnastics.Treatment consists of a group of special exercises aimed at improving the muscle tone of the bladder and its sphincter.
• Instillations.Infusion of medicinal solutions deep into the urethra.The procedure is very painful and often ends in complications.
• Physiotherapy.Treatment of the prostate with transrectal ultrasound, electrical stimulation, magnetotherapy and phonophoresis will be beneficial for poor tone of the pelvic floor muscles.Physiotherapy brings only temporary relief to the patient's condition.A lasting effect can be achieved only after eliminating the causes of prostatitis.
• Traditional medicine recipes.Honey with pumpkin seeds, alcohol tincture of horse chestnut and other folk methods are used after consultation with the attending physician.

Surgical treatment of chronic prostatitis

Considering what pathological process provoked prostatitis, they usetransurethral resectionprostate gland.This is a modern surgical treatment method that replaced open surgery.An endoscope is used to drain the formed prostate cyst, and surgical correction of the seminal vesicles is performed in case of obstructed outflow of secretions.

Treatment of chronic prostatitis -long process, requiring patience and endurance from a man.To prevent illness from taking you by surprise, you need to monitor your health, strengthen your immune system, and treat colds in a timely manner.