Chronic prostatitis is a disease that occurs most often in the practice of urologist-andrologist.It is predominantly diagnosed in men who are at the peak of reproductive, sexual activity and ability to work.Therefore, timely treatment of prostatitis is crucial for 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 transforms 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
- viruses
- Proteus
In the chronic form of prostatitis in men, the inflammatory process can recur even after the pathogenic microflora is eliminated.In such cases, there is a disruption of innervation in the organ with an autoimmune attack of tissue against the background of primary inflammation.The examination does not reveal any infection.Therefore, patients are diagnosed with “abacterial chronic 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, poor lifestyle, bad habits, and overwork.
- poor circulation in the pelvis as a result of chronic constipation, sedentary work, and lack of physical activity
- congestion in the prostate ducts and other pelvic organs
- chronic infectious diseases (sinusitis, sore throat)
- permanent injury to prostate tissue due to increased loads on the perineal muscles and physical strain
- irregular sexual contacts, sexual abstinence, interrupted sexual intercourse
- inflammation of the genitourinary system
- poor diet
- previous STDs
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.This could be tonsillitis, sinusitis, bronchitis, caries, intestines or pneumonia that have not received proper treatment.
Urologists associate the occurrence of a non-bacterial form of chronic prostatitis with congestion in the pelvic organs.When local circulation is impaired, the prostate vessels overflow with blood, causing edema and stagnation of secretions.As a result, the prostate gland cannot produce the required amount of secretions and hormones.This leads to the development of an inflammatory process in tissues.
Main signs of chronic prostatitis
Symptoms of the bacterial form of pathology are similar to any infectious process.They progress with an increase in the amount of pathogenic flora and lead to a serious deterioration in the general condition in the absence of adequate treatment.In the initial 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 for 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 gradual deterioration of well-being in many men provoke stress, apathy, increased irritability, severe fatigue, and lack of appetite.In addition, untimely initiation of treatment results in infertility in 40% of cases.
Symptoms of chronic prostatitis that require contacting a urologist:
- frequent, strong urge to urinate, weakened urine stream
- aching pain radiating to the perineum, groin, rectum, scrotum, glans penis and, sometimes, 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 pain is felt
- the release of a small amount of prostate secretion from the urethra (during physical stress) against the background of a weakening of the tone of the organ
- potency disorder (decreased libido, problems with erection, ejaculation due to a decrease in testosterone produced by the gland)
Any of the listed signs may indicate an illness, so a man needs to promptly contact a urologist to receive medical care.Also, do not forget about regular preventive visits to the doctor, because the disease can be asymptomatic.In such 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
- prostate adenoma
The most serious complication can be prostate cancer.
Methods for diagnosing chronic prostatitis
Urologists receive the necessary medical information to make a diagnosis and determine the causes of pathology after conducting a set of tests, as well as instrumental studies.At the first consultation, the doctor collects anamnesis, questions the man about disturbing symptoms, and conducts an examination.The presence of discharge from the urethra, skin irritation and rashes in the external genital area is visually determined.Also in this situation, a digital rectal examination is indicated to assess the size, structure, and tenderness of the prostate.
Basic methods for making a diagnosis:
- general urine test
- bacterial culture of urine, urethral smear
- microscopic examination of prostate secretion
- endoscopic examination of the urinary tract
- Ultrasound of the prostate gland (transrectal)
- PCR test for STD pathogens
A PSA test for prostatitis is performed to exclude adenoma and prostate 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 a MAR test.
Treatment of chronic prostatitis
Neglected conditions are difficult to correct.However, with an integrated approach to treatment, stable and 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 selection of individual therapy, taking into account the man’s age, stage of prostatitis, the state of the immune system and the severity of symptoms.In extreme cases, when there is a threat of serious complications, surgical treatment is recommended for 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, lifestyle
Completing a comprehensive course of treatment for chronic prostatitis allows you to eliminate the causes of the inflammatory process, relieve pain, and also improve a man’s overall well-being.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 the majority of men.At home, it is recommended to take warm baths regularly, 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 drugs effective 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.
- Darsonvalization.Application of high frequency pulse current.
- Galvanization.Low frequency direct current treatment.
- UHF.A method of relieving symptoms of chronic prostatitis using the influence of an electric field through capacitor plates.
Electrophoresis gives a clear result.It accelerates the delivery of medications 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.Shock wave therapy procedures provide a positive effect.After them, most men note a decrease in discomfort in the prostate, pain relief, and an improvement in 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, depend on the individual reaction of the body to the chosen method of exposure.Some courses take several weeks or even months, but help bring chronic prostatitis in men into a state of stable remission.
Qualified urologists at a modern clinic can develop an optimal treatment plan for this pathology.