Chronic prostatitis is a disease that occurs most often in the practice of the urologist-andrologist.It is diagnosed predominantly in men who are at the peak of reproductive, sexual activity and working capacity.Therefore, timely treatment of prostatitis is crucial to restoring men's health, as well as social functions.
Causes of development of chronic prostatitis
The chronic inflammatory process is followed by an acute stage caused by the activity of pathogenic microflora.If the cause is not identified in a timely manner and comprehensive treatment is not carried out, prostatitis turns into a latent form with periodic relapses.
Infection can occur in 3 ways: ascending - through the urinary canal, descending - when urine with pathogenic bacteria enters the bladder, hematogenous - through the circulatory system (the infection is transferred from other inflammatory foci in the body).
Causative agents of chronic prostatitis:
- pathogenic fungi
- coli
- corynebacteria
- gardnerella
- staphylococcus
- Trichomonas
- klebsiella
- mycoplasma
- enterococcus
- gonococci
- chlamydia
- parasites
- virus
- proteus
In the chronic form of prostatitis in men, the inflammatory process can recur even after the elimination of the pathogenic microflora.In such cases, a disruption of innervation in the organ occurs with an autoimmune attack of the tissue against the background of primary inflammation.The examination reveals no infection.Therefore, patients are diagnosed with “chronic abacterial prostatitis”.
Prostate dysfunction is not always caused by an infectious lesion.There are a number of unfavorable factors that provoke diseases.Among the most common:
- decreased immune defense due to hypothermia, inadequate lifestyle, bad habits and overwork.
- poor circulation in the pelvis due to chronic constipation, sedentary work and lack of physical activity
- congestion in the prostatic ducts and other pelvic organs
- chronic infectious diseases (sinusitis, sore throat)
- permanent lesions to the prostate tissue due to increased load on the perineal muscles and physical effort
- irregular sexual contacts, sexual abstinence, interrupted sexual intercourse
- inflammation of the genitourinary system
- poor diet
- previous sexually transmitted diseases
Chronic bacterial prostatitis often becomes a concomitant problem with cystitis, urethritis, pyelonephritis, epididymitis, orchitis.In some cases, the infectious focus is not even in the genitourinary system.It could be tonsillitis, sinusitis, bronchitis, tooth decay, bowel or pneumonia that have not received adequate treatment.
Urologists associate the appearance of a non-bacterial form of chronic prostatitis with congestion of the pelvic organs.When local circulation is compromised, the prostate vessels overflow with blood, causing edema and stagnation of secretions.As a result, the prostate gland cannot produce the necessary amount of secretions and hormones.This leads to the development of an inflammatory process in the tissues.
Main signs of chronic prostatitis
Symptoms of the bacterial form of the pathology are similar to any infectious process.They progress with an increase in pathogenic flora and lead to a serious deterioration of the general condition in the absence of adequate treatment.In the early stages, chronic prostatitis is asymptomatic or has mild symptoms.Therefore, most men ignore the need to contact a urologist for examination.
Postponing a visit to a specialized doctor to identify the cause and begin treatment of prostatitis leads to serious consequences not only for the genitourinary system, but also for the psycho-emotional state.Potency disorders against the background of urination disorders and the gradual deterioration of well-being in many men cause stress, apathy, increased irritability, severe fatigue and lack of appetite.Furthermore, the premature start of treatment causes infertility in 40% of cases.
Symptoms of chronic prostatitis that require contact with a urologist:
- frequent, strong urge to urinate, weakened urine flow
- aching pain radiating to the perineum, groin, rectum, scrotum, glans, and sometimes the sacrum
- painful urination (especially at the beginning and end of intercourse)
- chills, excessive sweating (characteristic endocrine symptoms, since the prostate gland is part of this system)
- change in skin color in the area where the pain is felt
- the release of a small amount of prostatic secretion from the urethra (during physical stress) against the background of a weakening of the tone of the organ
- potency disorder (decreased libido, erection problems, ejaculation due to a decrease in testosterone produced by the gland)
Any of the listed signs may indicate a disease, so a man should promptly contact a urologist to receive medical treatment.Also, do not forget about regular preventive visits to the doctor, because the disease can be asymptomatic.In these cases the diagnosis is made by measuring the number of leukocytes in the prostatic secretion.
Possible complications with chronic prostatitis
Without timely treatment, the inflammatory process spreads.This is fraught with related problems such as:
- epididymitis
- orchitis
- vesiculitis
- urinary incontinence
- formation of stones, cysts in the prostate gland
- reproductive dysfunction
- prostatic adenoma
The most serious complication can be prostate cancer.
Methods for diagnosing chronic prostatitis
Urologists receive the medical information necessary to make a diagnosis and determine the causes of the pathology after conducting a series of tests and instrumental studies.At the first visit, the doctor takes the medical history, questions the man about worrying symptoms and conducts an examination.The presence of discharge from the urethra, skin irritation and rashes in the external genital area is determined visually.Also in this situation a digital rectal examination is indicated to evaluate the size, structure and tenderness of the prostate.
Basic methods for making a diagnosis:
- general urinalysis
- urine bacterial culture, urethral smear
- microscopic examination of prostate secretion
- endoscopic examination of the urinary tract
- Prostate ultrasound (transrectal)
- PCR test for sexually transmitted pathogens
A PSA test for prostatitis is performed to rule out prostate adenoma and cancer.In some cases, to clarify the diagnosis, a tissue biopsy is indicated, followed by histology of the samples taken.If there are problems with reproductive function, men are prescribed a spermogram and MAR test.
Treatment of chronic prostatitis
Neglected conditions are difficult to correct.However, with an integrated approach to treatment, stable, long-term remission can be achieved.To do this, it is necessary to eliminate the cause of the inflammatory process and increase the body's resistance.This effect is achieved through the choice of individual therapy, taking into account the age of the man, the stage of prostatitis, the state of the immune system and the severity of the symptoms.In extreme cases, when there is a risk of serious complications, surgical treatment is recommended to the patient.
Basic therapeutic methods for chronic prostatitis:
- taking antibiotics
- symptomatic therapy
- use of anti-inflammatory drugs
- physiotherapy to normalize blood circulation, relieve swelling
- correction of diet and lifestyle
Completing a full course of treatment for chronic prostatitis allows you to eliminate the causes of the inflammatory process, relieve pain and also improve the general well-being of the man.An essential part of therapy is the restoration of the body's protective resources.If prostatitis has a non-bacterial etiology, taking immunomodulators can prevent autoimmune aggression.
Modern physiotherapy for prostatitis
Physiotherapeutic methods quickly relieve many symptoms and provide stable improvement in most men.At home it is recommended to regularly take warm baths, but the water should not be too hot.
Clinical methods of physiotherapy for chronic prostatitis:
- Ultrasound therapy.Exposure to high frequency waves.
- Ultraphonophoresis.A combination of ultrasound treatment with effective drugs for prostatitis, which are administered during the procedure.
- Magnetotherapy.Low frequency magnetic field therapy.
- UVT.Impact of shock waves on the immediate cause of prostatitis: congestion and inflammatory processes.
- Darsonevaluation.Application of high frequency impulse current.
- Galvanization.Low frequency direct current treatment.
- UHF.A method of relieving the symptoms of chronic prostatitis using the influence of an electric field through the capacitor plates.
Electrophoresis gives a clear result.Accelerates the delivery of drugs to affected tissues.Thanks to this, it is possible to reduce the load on other organs, which is important for overall health, since chronic prostatitis requires serious courses of medication.Shockwave therapy procedures provide a positive effect.After them, most men notice a decrease in prostate discomfort, pain relief and improved erection after the first session.
Physiotherapy is an auxiliary method in the treatment of prostatitis.The reduction in the severity of symptoms, as well as the speed of recovery in general, depends on the individual reaction of the body to the chosen method of exposure.Some courses last several weeks or even months, but help bring chronic prostatitis in men into a stable state of remission.
Qualified urologists in a modern clinic can develop an optimal treatment plan for this pathology.