Chronic prostatitis: symptoms and treatment

The symptoms of chronic prostatitis are usually mild and treatment is not carried out in the initial stage. However, the problem can be solved if you take it seriously.

What it is

Many patients learn what chronic prostatitis is when they visit the doctor for a completely different reason. Meanwhile, this disease is very dangerous and is a long-term inflammatory process that occurs in the prostate gland. If left untreated, serious complications can occur: impotence, infertility, vesiculitis, prostate cysts, adenomas and prostate cancer.

There are several forms of the disease:

• Acute bacterial prostatitis, caused by the penetration of infectious pathogens into the prostate gland. Characterized by typical pain in the lower abdomen and during urination;

• chronic bacterial prostatitis, which, along with the clinical picture of the acute form of the pathology, is accompanied by the presence of bacteria and an increased level of leukocytes in the urine and secretions of the prostate;

• chronic prostatitis, which is a consequence of a previous bacterial form of the disease with ineffective treatment or its absence;

• Asymptomatic inflammatory prostatitis, characterized by the absence of symptoms, but manifested during laboratory diagnostic methods.

More than 90% of cases of the disease are chronic nonbacterial prostatitis, which is asymptomatic, causing a delay in treatment.

Is it possible to cure?

The diagnosis itself indicates that the disease has been progressing in the body for a long time. It is often difficult for men to go to the doctor for such an urgent problem until the situation becomes critical. Meanwhile, the sooner a man seeks medical help (at the first signs of poor health), the more effective the treatment will be and the greater the chance of completely getting rid of the disease. In its advanced form, chronic prostatitis is almost impossible to cure, but with adequate and regular therapy, the symptoms will be less pronounced. That is why timely consultation with a doctor is so important.

Causes

The disease occurs in men between 20 and 50 years old and depends on a series of prerequisites:

1. Infectious pathogens. They enter the prostate in several ways:

   • ascending (along the urethra);

   • descending (through infected urine);

   • lymphogen (through lymphatic channels);

   • hematogenous (through blood).

   Examples of pathogenic microflora that provoke the bacterial form of prostatitis are staphylococci, Escherichia coli, enterococci, Proteus, pathogens of a viral, fungal, parasitic nature, as well as chlamydia, gonococci, gardnerella and others.

2. Disturbance of normal blood circulation in the pelvic organs. This may be due to a sedentary lifestyle, sedentary work (drivers, office workers) and poor nutrition. As a result, congestion and swelling occur in the tissues of the prostate gland and incomplete expulsion of secretions from the cavity of the organ is observed. All this leads to partial or complete dysfunction of the gland.

3. Prolonged sexual abstinence or practice of interrupted sexual relations. These actions also cause inflammatory processes in the prostate.

4. Accompanying diseases. First of all, these are pathologies of a urological nature: cystitis, urethritis, pyelonephritis, acute untreated prostatitis. However, the cause of chronic prostatitis can also be other diseases: chronic bronchitis, pneumonia, sinusitis, etc.

5. Frequent and prolonged stay in the cold, in conditions of high ambient temperature or high humidity, constant psycho-emotional stress.

Symptoms

The clinical picture of chronic prostatitis is poorly expressed in the initial stage. A man, as a rule, does not feel any discomfort or does not pay attention to the appearance of signs of the disease, if they do not interfere with his normal lifestyle. Over time, the general condition worsens and is accompanied by the following symptoms:

1. The appearance of pain in the perineum, genitals, groin. The pain can be weak, aching, or quite intense when urinating, defecating, after sexual intercourse, and during ejaculation. Often, the pain syndrome spreads to the sacrum, anus, scrotum and testicles.

2. Changes when urinating and defecating. In the first case, the process is characterized by frequent, painful urges and burning in the urethra. The presence of threadlike formations in the urine is observed. During defecation, discharge from the urethra may occur, which indicates insufficient tone of the prostate.

3. Sexual function disorders. In men suffering from chronic prostatitis, decreased libido, unstable erection or its absence, pain during and after sexual intercourse, hemospermia and infertility are observed.

4. Lack of sleep, irritability, increased nervousness, fatigue, depression.

5. Increased body temperature. It can be observed during an exacerbation of the disease and have small deviations from the norm.

The symptoms may not appear all at once, but they may be constant.

Diagnosis

Diagnostic studies make it possible to refute or confirm a presumptive diagnosis, determine what type of disease it is and how possible it is to be cured.

The main diagnostic procedures are:

• general urine analysis;

• analysis of prostate secretion to detect the presence/absence of pathogenic microflora, as well as to determine deviations of physiological parameters from normal values (increased number of leukocytes, etc. );

• bacteriological culture of urine and urethral smear;

• a three-glass urine sample to determine the area of localization of inflammation;

• analysis to identify pathogens of genital tract infections;

• Prostate ultrasound;

• study of spermogram data, MAR test (for reproductive anomalies);

• urodynamic and endoscopic examinations;

• determination of prostate specific antigen (PSA).

Treatment of chronic prostatitis.

The answer to the question of how to treat chronic prostatitis depends on the severity of the pathology and its type. The disease requires an integrated approach for its elimination or stable relief of symptoms.

Pharmacotherapy

It involves taking medications from the following groups:

1. Antibiotics, which are necessarily prescribed when diagnosing a bacterial form of pathology. However, such therapy may also be indicated for chronic nonbacterial prostatitis if a persistent positive effect is observed. Medicines from the group of penicillins, cephalosporins, tetracyclines, aminoglycosides and fluoroquinolones are taken strictly according to the doctor's instructions for at least two weeks.

2. Antispasmodics that help eliminate painful spasms in the perineum.

3. Anti-inflammatories, analgesics.

4. Alpha1 blockers are used to reduce prostate hypertonicity and normalize motility.

5. Immunostimulant medications.

The medication regimen is selected individually according to the characteristics of the diagnosis and intolerance to individual medications (if present).

Non-pharmacological treatment

In this case, the positive effect of therapy is achieved through physical influence of a different nature on the diseased area. Patients may be prescribed:

1. Prostate massage. Activates the total expulsion of secretions from the prostate, improves blood circulation and normalizes the tone of the organ. Massage together with antibiotics is especially effective in treating chronic bacterial prostatitis. However, there are contraindications to its use if the patient is diagnosed with:

   • acute bacterial prostatitis;

   • concomitant diseases of the gonads (vesiculitis, cooperitis);

   • the presence of stones in the prostate;

   • prostate cysts;

   • HPB;

   • cancer of an organ or suspicion thereof;

   • prostate abscess;

   • hemorrhoids, rectal fissures and other disorders.

2. Electrophoresis. The physiotherapy procedure involves the therapeutic effect on the pathological area with a small electrical current (no more than 50 μA). In this way, recovery reactions are stimulated, pain is relieved and blood flow in the gland tissues is optimized. Electrophoresis promotes deep penetration of antibiotics into the structures of the prostate, thus increasing the effectiveness of their action.

3. Ultrasound. The method is widely used in the treatment of chronic prostatitis, as it has a pronounced anti-inflammatory effect, restores sexual function and suppresses pain. Prostate tumors are successfully treated using ultrasound.

4. Ultraphonophoresis is the use of ultrasound therapy along with medications. This method allows drugs to penetrate the deep layers of the affected organ and act there more effectively.

5. Magnetotherapy. The physiotherapy procedure has a comprehensive restorative effect on the genitourinary system, improves metabolic processes and neurogeneration.

6. Laser magnetotherapy. Laser exposure also effectively treats the manifestations of the disease, eliminating the risk of possible complications.

7. Inductometry is exposure to a high-frequency alternating magnetic field.

8. Instillations in the urethra, mud therapy, therapeutic enemas, hot baths.

Physiotherapy together with drug treatment makes it possible to obtain a long-lasting therapeutic effect and, in most cases, completely defeat the disease at the initial stage.

Surgical intervention

Indicated in cases where it is impossible to help the patient with other methods.

1. Prostatectomy is the partial or complete removal of the prostate gland while maintaining erectile function.

2. Transurethral resection (TUR) is an operation to remove or remove overgrown glandular tissue. Prescribed for prostate adenoma or cancer.

3. Laser surgery. The operation consists of removing tissue from the affected organ using a laser beam. In this case, the blood vessels are "sealed", eliminating bleeding.

4. Prostate abscess drainage. This surgery allows pus to be removed from the gland cavity using a rubber drain that is inserted through the perineum or rectum, cutting the skin tissue.

5. Transurethral incision of the prostate. The surgery consists of making several cuts in the prostate to relieve the pressure of the affected organ on the urethra and restore urination.

After surgical intervention, the patient requires rehabilitation, the time interval of which, depending on the type of surgery performed, ranges from 2-3 days to several months.

Home remedies

Herbal remedies are also effective medications in the complex treatment of chronic prostatitis. Tinctures, decoctions, food mixtures or ointments are used for these purposes, including:

• Pumpkin seeds;

• aspen bark;

• hazel leaves and bark;

• chestnut shells;

• parsley;

• honey, propolis;

• Kalanchoe, etc.

Regular use of medicinal herbs helps to eliminate unpleasant symptoms, restore impaired functions and have a long-term preventive effect.

Chronic prostatitis is a disease that should be paid attention to at the first signs to eliminate dangerous complications and cure it in time.