Chronic prostatitis is a long-term inflammation of the prostate, often without symptoms, which is why 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 this is quite rare in practice.As a rule, inflammatory chronic prostatitis begins gradually, without any unpleasant symptoms or sensations;the course of the disease is often discovered accidentally in a patient during an ultrasound examination.
Young men and middle-aged and older people are also susceptible to the chronic form.Prostatitis also threatens those who, due to the nature of their work, lead an inactive lifestyle, feel excessive physical stress on the perineum and observe sexual abstinence.
Classification
According to the modern classification of prostatitis, developed in 1995, there are several categories of the disease:
- 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 the typical 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 pelvic area.An elevated temperature accompanied by chills may occur.
- Chronic bacterial prostatitis is a disease with typical symptoms of chronic inflammation and an increased number of bacteria and leukocytes in urine and prostate secretions after massage.
- Chronic prostatitis (CP) is the most common form of prostatitis.In most cases, it is a consequence of acute bacterial prostatitis (untreated or poorly treated).If there are symptoms, they appear in the form of pain in the genitals or pelvis, 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 discovered by chance, during a visit to 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 non-bacterial chronic prostatitis occurs in 90-95% of all cases, and only in 10-5% - bacterial.
Reasons
Numerous 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 be detected in prostate tissue;
- Poor circulation in the pelvic organs (congestion of the prostate leads to its inflammation);
- Sedentary lifestyle (drivers, office workers, clerks);
- 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.
The presence and activity of pathogenic microorganisms are not so important for the development of chronic prostatitis, but the condition of the pelvic organs and blood circulation in them, the presence of accompanying diseases and the level of protective mechanisms.
Symptoms of chronic prostatitis
Most often, with the development of a chronic form of prostatitis, the symptoms practically do not bother a man.In this case, all signs of acute prostatitis will not manifest at all or will manifest to a much lesser extent.
The most common symptoms of chronic prostatitis in men are:
- periodic pain and discomfort in the perineum;
- discomfort during bowel movements and urination;
- radiation to the anus, thigh, testicles;
- urethral discharge.
Changes in the course of the disease, which are not very pronounced anyway, can be so insignificant that patients with chronic prostatitis do not pay special attention to them.
Exacerbation of chronic prostatitis
Worsening 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 defecation.
According to some doctors, psychological symptoms of chronic prostatitis can also be recognized, which include increased irritability, anxiety, fatigue, irritability, sleep disorders, obsession and depression.
It is almost impossible to determine all symptoms in a patient at once, because a man usually shows only 2-3 signs of the disease.For example, the most common are erectile dysfunction and pain in the lower abdomen.
Why can prostatitis cause infertility?
The fact is that the prostate produces a special secretion that ensures sperm viability.With inflammation, the secretory function of the prostate deteriorates, which inevitably affects sperm quality.
In addition, the prostate is actively involved in the regulation of testosterone production and the erection process.Therefore, chronic prostatitis causes reduced erectile function, even impotence.However, these scenarios for 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;
- microscopy of prostate secretions;
- prostate secretion culture for sensitivity to antibiotics;
- sexually transmitted disease tests;
- transrectal ultrasound.
Sometimes additional endoscopic and urodynamic studies are performed.
How to treat chronic prostatitis
If a man is diagnosed with chronic prostatitis, treatment is always long and difficult.Its duration directly depends on the stage of the disease in which the patient consulted a specialist.Therapy includes an integrated approach, i.e. a combination of several methods at the same time:
- antibacterial therapy;
- prostate massage;
- physiotherapeutic procedures;
- correction of diet and lifestyle;
- use of folk remedies;
- surgical treatment.
Additionally, in the treatment of chronic forms of the disease, anti-inflammatory and antispasmodic agents are used.
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.
Also, 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 that affect the metabolism of urate and citrate.
Physiotherapy
Certain physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasound phonophoresis and others, also help to improve prostate tissue trophism and accelerate the healing process.
Also, with chronic prostatitis, therapeutic warm baths, mud therapy and special enemas can be prescribed.
Prostate massage
It improves the drainage of prostate secretions and microcirculation at the level of this organ, which in turn contributes to a faster recovery of the patient.
Prostate massage cannot be performed in case of acute prostatitis, hemorrhoids or rectal fissures.Prostate massage is usually combined with antibiotic therapy.Numerous clinical studies have shown the high efficiency of this treatment.
Operation
With a surgical procedure, it is possible to remove areas of the prostate affected by bacteria.Transurethral resection is an operation performed under epidural or intravenous barbiturate anesthesia.The postoperative recovery period does not last more than a week.
The methods required for the treatment of chronic prostatitis are determined by the urologist based on diagnostic data and his practical experience.Conducting self-therapy at home based on reviews on the Internet is fraught with consequences.