Prostatitis is a disease that causes problems with urination, sexual dysfunction, pain in the perineum and lower abdomen. The cause of these symptoms is inflammation of the prostate gland.
The prostate is a walnut-sized gland that is part of the male reproductive system. This organ is located under a man's bladder and in front of the rectum. The prostate consists of glandular and connective tissue. Its function is to produce fluid, which partly consists of ejaculate. This fluid carries sperm during ejaculation (ejaculation) and protects the sperm as they travel to the woman's egg.
Prostatitis can be acute or chronic. Chronic prostatitis develops gradually and may not go away for months or even years. The acute form of the disease appears suddenly and lasts a maximum of several weeks. It is usually easy to treat, but sometimes becomes chronic.
Unlike acute prostatitis, chronic prostatitis is very difficult to cure forever. But with proper treatment, there is every chance of achieving long-term remission and significantly improving the patient’s quality of life. We figured out how to understand that you have chronic prostatitis and what to do next.
What is chronic prostatitis
In total, there are four types of prostatitis: acute, chronic bacterial (infectious), chronic non-bacterial (chronic pelvic pain syndrome), asymptomatic. Of these, non-bacterial chronic prostatitis is the most common. And he is the worst to treat.
A disease is considered chronic if symptoms do not go away for more than 3 months. However, they develop slowly and are less pronounced than in the acute form.
Another characteristic feature of chronic inflammation of the prostate is its recurrent course. This means that symptoms may disappear for a while and then reappear. Without treatment, this condition can bother the patient for a very long time.
The bacterial and non-bacterial forms have common symptoms. They usually include problems with urination, sexual function, perineal and pelvic pain.
Epidemiology
Prostatitis is one of the most common diseases in men. Moreover, the chronic form is much more common than the acute form. The reason for about 25% of visits to a urologist is related to chronic prostatitis.
Pathology can appear at any age, but the chronic form most often develops in men after 50 years of age.
Causes of chronic prostatitis
Chronic prostatitis can be bacterial (infectious) or non-bacterial. These types of diseases have common symptoms but different causes.
Chronic bacterial prostatitis
When in the prostate secretion during analysisdiscoveredleukocytes and pathogens
The inflammatory process causes a bacterial infection from the urinary tract to enter the prostate. The provoking factor may be: acute form of prostatitis, UTI (urinary tract infection), STI. The causative agents of the inflammatory process in the prostate are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Enterococcus, Enterobacter, Proteus, Serration.
Chronic nonbacterial prostatitis (chronic pelvic pain syndrome)
When in the prostate secretion during analysisnot detectedleukocytes and pathogens
Researchers have not established the causes of chronic pelvic pain syndrome. With this form, there is no infection in the prostate gland. What causes disturbances in this case is not known exactly. There is an assumption that this may be due to several factors:
- stagnation due to sedentary work, lack of movement, irregular sex life;
- the patient already had prostatitis and chronic pain remained despite treatment;
- urine entering the prostate due to bladder problems;
- nerve damage;
- damage to the urinary tract due to injury or surgery;
- stress
Symptoms of chronic prostatitis
With chronic prostatitis, the symptoms bother the patient for a long time - for several months or even years. The disease is characterized by a relapsing course, that is, problems appear and disappear.
Infectious and non-infectious prostatitis have common symptoms and include:
- urination disorders: frequent and sudden urges, difficulty urinating, pain;
- pain in the penis, testicles, pelvic area, lower back;
- pain during sexual intercourse;
- pain during ejaculation (ejaculation);
- decreased sexual desire (libido);
- fever, chills;
- nausea, vomiting
The disease also affects the general condition of the patient. Some people experience irritability, increased fatigue, lethargy, and anxiety.
If you have these signs, consult a urologist. Some of them may indicate other more serious diseases that require urgent medical attention. If treatment is delayed, there is a risk of developing life-threatening complications: bacterial blood poisoning, prostate abscess, epididymitis, infertility, depression.
Diagnosis of chronic prostatitis
At the first signs of the disease, you need to make an appointment with a urologist. This doctor specializes in the diagnosis and treatment of the male reproductive system and the urinary system in both men and women.
The initial consultation includes several stages:
- History taking.
The urologist will ask you about the reason for your visit, previous illnesses, and medications you have taken now and in the past. - Examination of the genital organs
- Digital rectal examination.
During the procedure, the urologist inserts a finger into the patient's anus to feel the surface of the prostate gland. The test allows you to determine the size of the prostate and check for swelling and tenderness. - Other studies.
The doctor may prescribe one or more diagnostic procedures, some of which can be done immediately at the appointment, some later.
Diagnosis usually includes laboratory and instrumental studies.
Laboratory research methods
- General urine analysis
Allows you to see signs of infection. This can be indicated by pathogenic bacteria in the general analysis. - Blood test for PSA (prostate specific antigen)
Helps assess the condition of the prostate gland. An elevated PSA level indicates an inflammatory process in the prostate or neoplasms. - Microscopy of prostate secretion
Prostate secretion is a fluid produced by the prostate gland. With changes in the organ, the composition of the secretion also changes. For example, during an inflammatory process, white blood cells will be increased, and a high level of pathogenic bacteria may indicate a bacterial infection in the prostate. Microscopic examination of the fluid will help to see these changes. - Prostate secretions are collected using prostate massage. Massage can be combined with a digital rectal examination.
Instrumental research methods
- Cystoscopy. Examination of the inner surface of the bladder using an endoscope - a thin flexible tube with a camera. The device is inserted into the bladder through the urethra. The study allows you to see problems with the urinary tract.
- TRUS (transrectal ultrasound examination of the prostate). For the examination, the specialist will carefully insert an ultrasound probe into the rectum. TRUS shows structural and functional changes in the prostate.
- MRI (magnetic resonance imaging) of the pelvis. Helps assess the condition of prostate tissue. It may be necessary to see foci of prostate inflammation and rule out prostate cancer.
There is no special preparation for an appointment with a urologist. But to make the consultation as effective as possible, follow a few simple recommendations:
- For intimate hygiene, you should not use special products before use; just warm water is enough.
- Do not go to the toilet 2 hours before your clinic visit. Then, at your appointment, if necessary, you can immediately take tests or undergo an ultrasound.
- If you regularly take any medications, write down their names in your diary or notes in your phone.
- Take the results of previous studies with you so that the specialist can see the full picture of the disease.
- Make a list of questions you want to ask the doctor at your appointment.
Treatment of chronic prostatitis
There is no universal method to get rid of prostatitis. For different forms of the disease and manifestations, different treatments are indicated.
To determine the type of chronic prostatitis, you need to undergo diagnostics. Based on its results, the doctor will prescribe therapy that will give results specifically in your case.
Unlike the acute form, chronic inflammation of the prostate cannot be cured forever. The doctor’s goal is to achieve long-term remission and reduce symptoms.
Bacterial form: Treatment will include antibiotic therapy and other methods to relieve symptoms.
Non-bacterial form: Treatment is symptomatic. That is, each method is aimed at combating a specific symptom.
Recommendations for outpatient treatment
Lifestyle changes:
- Diet restrictions
It is worth giving up alcohol, coffee, spicy and sour foods. These products irritate the bladder and worsen the patient's condition. - Warm sitz baths, warm showers
Water procedures will help reduce the manifestations of the disease. - More water
Drink enough fluids. More frequent trips to the toilet will help flush out pathogenic bacteria from the bladder. - Pillows for chairs
When sitting, place a soft pillow under you. - Physical activity
Regular walks and exercise will help reduce pain and get rid of congestion. - Regular sex life
Sexual activity is useful for preventing congestion.
The methods listed will complement the therapy prescribed to you, but do not replace it.
Drug treatment
- Antibiotics. Antibacterial therapy is indicated for the infectious form. The drugs destroy bacteria that cause inflammation in the prostate. Different types of pathogenic microorganisms require different antibiotics, so before prescribing, you need to undergo a study of prostate secretions and determine their type. When treating the chronic form, antibiotics are prescribed for several months.
- Alpha blockers. Helps with urinary disorders. The drugs relax the organs of the urinary system and this relieves symptoms. Most often, alpha blockers are used for non-infectious chronic prostatitis, but to improve the patient’s well-being they can also be prescribed for an infectious form of the inflammatory process.
- NSAIDs (non-steroidal anti-inflammatory drugs). Prescribed to relieve pain and reduce swelling of the prostate gland.
- Muscle relaxants. Used when you need to relieve spasm of the pelvic muscles.
- Antidepressants. Indicated for depression, which can develop due to stress and prolonged pain.
- Drugs for the treatment of erectile dysfunction. Used if prostatitis causes problems in your sexual life.
- Laxatives. They may prescribe it if symptoms include pain during bowel movements.
Treatment with herbal remedies
Herbal remedies.Herbal medicines do not work as the main method of treatment. They can be used as a supplement to reduce prostate inflammation. For this purpose, medications are prescribed with quercetin, a substance found in vegetables, fruits and berries.
Non-drug treatment
- Physiotherapy and prostate massage. The methods are used to relax the pelvic floor muscles, relieve pain and prevent congestion. For a therapeutic effect, the patient undergoes a massage course of several sessions. Massage is contraindicated in the development of complications of pathology: abscess, stones in the tissues of the prostate gland.
- Bladder catheterization. May be needed if you have problems with your bladder.
- Psychotherapy. Due to chronic pain, patients with prostatitis may develop depression and anxiety disorders. Psychological problems have a negative impact on the patient’s well-being and worsen the pain syndrome. In such cases, consulting a psychotherapist will help.
- Biofeedback programs. May help reduce pelvic muscle tension.
Surgical treatment of chronic prostatitis
Surgical methods are rarely used. They may be needed if complications develop.
Types of operations:
- TUR (transurethral resection) of the prostate.Indicated for the appearance of stones in the tissues of the prostate gland
- Prostatectomy. Removal of the prostate gland in some cases is carried out in case of an abscess (accumulation of pus) or serious disturbances in the functioning of the bladder.
Exercises for the treatment of chronic prostatitis
Kegel exercises can help treat chronic prostatitis. They strengthen the pelvic floor muscles and alleviate symptoms associated with urinary disorders. How to do the exercises:
- Sit comfortably.
- Tighten your pelvic muscles for 5 seconds. To do this, imagine that you are trying to stop urinating.
- Relax your muscles.
- Repeat this 10-15 times.
- Gradually you can increase the number of repetitions and strain the muscles for a longer time.
- You should do 2-3 approaches a day.
Changes can only be noticed with regular exercise.
Treatment prognosis
It is very difficult to cure chronic prostatitis forever. In some cases, the disease is incurable, but there is always a chance to achieve long-term remission and return the patient to the previous quality of life. To do this, it is important to undergo a thorough diagnosis to determine the form of the disease. If the cause of the inflammatory process is infection, antibacterial therapy will help. And for non-infectious chronic prostatitis - well-chosen symptomatic therapy.
Complications of chronic prostatitis may include:
- Bacteremia (bacterial blood poisoning). Bacteria entering the bloodstream. May be a consequence of bacterial forms of pathology. Bacteremia develops suddenly and can lead to sepsis. This condition is life-threatening.
- Epididymitis (inflammation of the epididymis). The disease may cause severe pain in the scrotum.
- Prostate abscess (accumulation of pus in tissue). In case of an abscess, surgery is performed to cleanse and drain the purulent focus; in rare cases, the prostate can be removed.
- Infertility. Problems with conception can occur when there is a lack of sperm due to an inflammatory process in the prostate.
- Spread of infection to the spine and pelvic bone
- Depressive disorder. Chronic pathologies increase the risk of developing depression.
- Erectile dysfunction (impotence). Erectile dysfunction is associated with a decrease in a man's quality of life and his emotional state.
To prevent prostatitis it is important:
- Use barrier contraception (condoms): STIs are a factor that increases the risk of developing prostatitis
- Visit a urologist annually if you are over 40 years old
- If you have symptoms of a UTI, contact your doctor immediately