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How is chronic prostatitis in men treated? Effective treatment of chronic prostatitis. Laboratory signs of chronic prostatitis

Chronic prostatitis is a long-term inflammation of the prostate gland, with often no symptoms, which is why most 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 in practice this is quite rare. As a rule, inflammatory chronic prostatitis begins gradually, without any unpleasant symptoms and sensations, often the course of the disease is detected in a patient by chance during an ultrasound examination.

The chronic form affects both young men and people of middle and old age. Also, prostatitis threatens those who, by the nature of their activities, lead an inactive lifestyle, feel excessive physical exercise on the perineum, observes sexual abstinence.

Classification

According to the modern classification of prostatitis, developed in 1995, there are several categories of the disease:

Acute bacterial prostatitis(AKP) is the most common and easily diagnosed 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, inability to completely empty bladder, back or pelvic area. There may be fever accompanied by chills.
Chronic bacterial prostatitis- a disease with typical symptoms of chronic inflammation and an increased number of bacteria and leukocytes in the urine and secretion of the prostate after its massage.
(CP) is the most common form of prostatitis. It in most cases is a consequence of acute bacterial prostatitis (untreated or poorly treated). If there are symptoms, then they proceed in the form of pain in the genitals or pelvic region, difficulty in urination, or painful urination and ejaculation.
Asymptomatic inflammatory prostatitis- with this form of the disease, there are no classic symptoms of prostatitis, and the disease itself is detected by chance, when contacting 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 in 90-95% of all cases there is non-bacterial chronic prostatitis and only in 10-5% - bacterial.

Causes

A number of factors can contribute to the occurrence of chronic prostatitis. First of all, it is:

STIs: Trichomonas, Candida fungus, E. coli (Escherichia coli) can affect the urethra and be detected in the prostate tissue;
Violation of blood circulation in the pelvic organs (congestion in the prostate leads to its inflammation);
Sedentary lifestyle (drivers, office workers, officials);
Prolonged sexual abstinence, interrupted sexual intercourse or artificial lengthening of sexual intercourse;
Regular hypothermia (fans of extreme recreation: diving, surfing, kayaking and skiing);
Stress: mental and physical overload.

For the development of chronic prostatitis, it is important not so much the presence and activity of pathogenic microorganisms as the state of the pelvic organs and blood circulation in them, the presence of concomitant diseases, 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 disturb the man. AT this case all signs of acute prostatitis will not manifest themselves in any way or manifest themselves to a much lesser extent.

The most common symptoms of chronic prostatitis in men are:

periodic pain and discomfort in the perineum;
discomfort during defecation and urination;
irradiation in anus, thigh, testicles;
discharge from the urethra.

Changes in the picture of the course of the disease, already not very bright, can be so insignificant that patients with chronic prostatitis do not pay much attention to them.

Exacerbation of chronic prostatitis

Exacerbation of the disease, as a rule, is 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 a decrease in sexual activity in men;
pain during the act of defecation.

According to some doctors, it is also possible to distinguish the psychological symptoms of chronic prostatitis, which include increased irritability, anxiety, fatigue, irascibility, sleep disturbances, obsession and depression.

It is almost impossible to determine all the symptoms in a patient at once, since a man usually has 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 gland produces a special secret that ensures the viability of spermatozoa. With inflammation, the secretory function of the prostate deteriorates, which inevitably affects the quality of sperm.

In addition, the prostate gland is actively involved in the regulation of testosterone production and the erection process. That is why chronic prostatitis causes a decrease in erectile function, up to 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 needed to help establish / refute the diagnosis:

rectal examination;
microscopy of prostate secretion;
seeding prostate secretion for sensitivity to antibiotics;
tests for sexually transmitted diseases;
transrectal ultrasound.

Sometimes additional endoscopic and urodynamic studies are performed.

How to treat chronic prostatitis

If a man has chronic prostatitis, treatment is always long and difficult. Its duration directly depends on the stage of the disease at which the patient turned to a specialist. Therapy involves an integrated approach, that is, combination of several methods at the same time:

antibacterial therapy;
prostate massage;
physiotherapy procedures;
diet and lifestyle modifications;
the use of folk remedies;
surgery.

Additionally, in the treatment of the chronic form of the disease, anti-inflammatory and antispasmodic drugs are used.

Medical treatment

Choice medicines depends on the cause and symptoms of the disease. To cure chronic prostatitis of infectious etiology antibiotics are used:

fluoroquinolones;
macrolides;
tetracyclines.

To eliminate inflammation and pain syndrome, analgesics and non-hormonal anti-inflammatory drugs are used.

also in last years treatment of chronic prostatitis is carried out using drugs that have not previously been used for this purpose: alpha1-blockers (terazosin), 5-a-reductase inhibitors (finasteride), cytokine inhibitors, immunosuppressants (cyclosporine), drugs that affect urate metabolism (allopurinol) and citrates.

Physiotherapy

Certain physiotherapeutic procedures, such as laser therapy, electrophoresis, transrectal microwave hyperthermia, ultrasonic phonophoresis and others, also help to improve the trophism of prostate tissues and speed up the healing process.

Also, with chronic prostatitis, therapeutic warm baths, mud therapy, special enemas can be prescribed.

prostate massage

It improves the drainage of prostate secretion and microcirculation at the level of this organ, which in turn contributes to the speedy recovery of the patient.

Prostate massage should not be performed with acute prostatitis, hemorrhoids, rectal fissures. Prostate massage is usually combined with antibiotic therapy. Numerous clinical studies have shown high efficiency such treatment.

Operation

Surgical intervention 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 lasts no more than a week.

The methods that involve the treatment of chronic prostatitis are determined by the urologist based on diagnostic information and his practical experience. Conducting self-therapy at home based on reviews on the Internet is fraught with consequences.

Prostatitis- This is a urological disease, accompanied by inflammation of the tissues of the prostate gland. Damage to the prostate can be caused by an infection transmitted through the blood, lymph or unprotected intercourse. The development of prostatitis in men is facilitated by injuries and impaired blood supply to the pelvic organs, constant hypothermia, low physical activity, hormonal imbalance and other factors. Prostatitis may be accompanied by vesiculitis, urethritis and other infectious and inflammatory diseases of the reproductive and urinary organs.

Incidence statistics

Prostatitis is one of the most widespread diseases of the male genitourinary system in the world. According to various sources, it is observed in 60-80% of sexually mature men. According to official medical statistics, over 30% of young people of reproductive age suffer from chronic prostatitis in Russia. In about a third of cases, it occurs in men older than 20 and younger than 40 years. According to WHO, urologists diagnose chronic prostatitis in every tenth patient.

Percentage of men with chronic prostatitis (%) according to Mehik A. et al., 2010

The dependence of the prevalence of all categories of prostatitis on age (the number of cases per 1000 person-years) according to the study by Roberts R. et al. 2008

Causes of prostatitis

Infections. Pathogenic and opportunistic bacteria enter the prostate through the lymphatic and blood vessels. Secondary infection of the prostate is often a complication of inflammatory diseases of the rectum and urethra.

Types of infection:

ascending- microbes rise to the gland from the external urethral opening;
descending- microbes enter the prostate along with the flow of infected urine.

Conditionally pathogenic microorganisms that provoke the disease (according to the Research Institute of Urology, 1997-1999)

Microorganisms	Number of studies
Microorganisms	%	abs
Staphylococcus epidermidis	42,3	55
S.saprophyticus	17,6	23
S. aureus	4,6	6
S. haemolyticus	3,1	4
S. hominis	0,8	1
S. warneri	1,5	2
Staphylococcus spp.	3,1	4
Enterococcus faecalis	11,6	15
Streptococcus spp.	3,1	4
TOTAL (gp.+)	87,6	114
P. aeruginosa	3,7	5
E. coli	4,7	6
Enterobacter spp.	2,3	3
Proteus spp.	1,5	2
TOTAL (gr.-)	12,3	16

Weakened immunity. One of the causes of inflammation of the prostate is the weakening of the body's immune defenses. This can be facilitated by frequent stress, unbalanced diet, overwork, smoking, drinking alcohol. With reduced immunity, the body is most vulnerable to infections leading to the development of prostate disease.

Blood supply disorders. The development of chronic prostatitis may be the result of a sedentary, sedentary lifestyle. With a constant lack of motor activity, the work of the endocrine, cardiovascular and nervous systems, as well as blood circulation in the pelvic organs. The result of this is oxygen starvation of prostate tissues.

Irregular sexual activity. The appearance of prostatitis can contribute to both prolonged sexual abstinence and immoderate sexual activity. Many men leading a stormy sexual life, there is nervous exhaustion, hormonal imbalance, impaired secretion of the gonads, as well as a gradual fading of potency. Interrupted sexual intercourse has a negative impact on the health of the prostate gland.

Chronic injuries of the prostate. Chronic prostatitis can develop due to frequent trauma to the soft tissues of the prostate gland. Most often this is observed in patients whose professional activities are related to driving vehicles. The cause of prostatitis in this case is constant shaking, vibration and excessive stress on the muscles of the perineum.

The main syndromes of prostatitis

Pain. With prostatitis in men, aching and cutting pains are observed in the lower abdomen and lower back, as well as aches throughout the body. This symptom may be aggravated by ejaculation, especially during intercourse after prolonged abstinence.

Dysuria. Typical signs of prostatitis in men are frequent urge to urinate, burning and pain when emptying the bladder, pulling pain after urination in the perineum. Another symptom of inflammation of the prostate is difficulty urinating. If left untreated, acute urinary retention may occur.

Sexual disorders. With uncomplicated prostatitis, accelerated ejaculation, orgiastic sensations are erased, pain during ejaculation, partial or complete decrease in sexual desire. A symptom of chronic prostatitis is also a prolonged erection at night.

External manifestations. With prostatitis, some patients experience purulent or clear discharge from the urethra, which is most abundant in the morning. Patients may also notice a symptom such as the presence of white flakes or threads in the urine.

Types of prostatitis

Acute bacterial. Acute prostatitis develops as a result of infection of the prostate gland with Staphylococcus aureus, Escherichia coli, Enterococcus and other pathogenic bacteria. If left untreated, this disease can cause blood poisoning. In this case, the man needs to be urgently hospitalized.

Symptoms observed in the disease of this type of prostatitis:

chills and fever (38 ° C and above);
sharp or pulling pains in the groin, lower back and perineum;
frequent urge to urinate;
painful urination;
difficulty urinating and acute urinary retention;
white or colorless discharge from the urethra.

Chronic bacterial. The recurrent form of the disease occurs as a result of infection entering the gland. Chronic hypothermia, prolonged sexual abstinence, untimely urination contribute to the development of prostatitis. Chronic prostatitis, if untreated, can provoke cystitis, since the focus of inflammation in the prostate is a reservoir of bacteria that infect the genitourinary tract.

Symptoms of chronic prostatitis:

pain in the scrotum, lower abdomen, perineum;
dysuria;
potency disorders.

Chronic non-bacterial. The causes of the disease include the entry of viruses or bacteria into the prostate (tuberculosis bacillus, trichomonas, chlamydia), autoimmune processes, penetration into the gland of urine. Chronic prostatitis accounts for up to 95% of all types of inflammation of the prostate.

Signs of prostatitis are:

chronic pain in the pelvic area (troubling a man for at least 3 months);
intermittent pain in the groin;
absence of symptoms of inflammation in urine, semen and prostate secretion.

Chronic asymptomatic. Asymptomatic chronic prostatitis is not associated with bacterial infection and symptomatic prostatic syndromes. There is an assumption that this disease is an age-related physiological feature.

Symptoms of chronic prostatitis of this type:

absence of the main syndromes of the disease;
increased levels of leukocytes and bacteria in the urine.

The main symptom of the disease - the presence of an infection in the gland - can only be detected using a biopsy or during surgical operations in the treatment of various pathologies of the prostate (adenoma, cancer).

stagnant. Prostatitis develops not only against the background of anatomical and physiological changes in the venous and other body systems. The main cause of the disease is an irregular sexual life.

Signs of prostatitis:

aching pain in the perineum, radiating to the sacrum;
frequent urination in the morning;
a slight obstruction of the outflow of urine (a symptom is observed in the chronic form of the disease);
weakening of erection;
decreased libido;
"Paleness" of orgiastic sensations during ejaculation.

Diagnosis of acute and chronic prostatitis

To select the correct method of treatment, the doctor prescribes a comprehensive diagnosis of the state of the genitourinary system, including the following methods.

Digital rectal examination. If prostatitis is suspected, the urologist conducts a digital examination. The posterior surface of the prostate is adjacent to the rectum, so when a finger is inserted through the anus, the doctor can determine the condition of the gland. During the study, its dimensions, consistency and shape, surface condition, pain are established.

Signs of prostatitis in men include:

soft, inelastic consistency of the prostate;
pain on palpation;
enlarged gland;
immobility of the rectal mucosa over the prostate.

Ultrasound procedure. Ultrasound of the prostate is prescribed before the start of treatment for acute prostatitis in order to identify / exclude an abscess of the gland, and in the chronic course of the disease - to detect cysts and stones of the prostate, as well as the degree of compression of the urethra. Most effective method is an ultrasound through the rectum.

Uroflowmetry. This method of diagnosing prostatitis is used to study the indicators of the process of urination: the duration of this physiological act and the rate of urine outflow. If the rate is 15 ml/s or more, this indicates normal urethral patency. A sign of prostatitis is a decrease in this value below 10 ml / s. This speed is a consequence of poor patency of the urinary tract.

Cystoscopy. For examination, an endoscopic imaging system is inserted into the bladder. This method of diagnosing acute and chronic prostatitis is used when diseases such as cancer, cystitis, or bladder injury are suspected.

To diagnose and determine the microorganism that caused the disease, in the presence of symptoms of chronic prostatitis or acute inflammation conduct a study of urine and prostate secretion. A sign of the presence of pathogenic microflora is an increased number of leukocytes in the biological material. To make an effective course of treatment, the type of bacteria is determined by PCR, RIF and seeding on a nutrient medium.

Interpretation of laboratory results

	prostate secret		Third urine (after prostate massage)
HP form	The number of leukocytes, uv. x 400	results sowing	The number of leukocytes, uv. x 400	Seeding results
Bacterial	>10	+		+
Inflammatory syndrome of chronic pelvic pain	>10	-	The difference between the number of leukocytes in the third portion of urine and the second portion of urine ≥ 10	-
Non-inflammatory chronic pelvic pain syndrome	<10	-	-	-

Prevention of prostatitis

Physical activity. For the prevention and treatment of prostate disease, a man must avoid physical inactivity. Recommended:

hiking (4 km per day or more);
exercises (squats, jumps, tilts);
training of the muscles of the perineum and buttocks (10 tensions and relaxations each).

Proper nutrition. For the prevention of acute and chronic prostatitis, men should include foods high in zinc and vitamin B in their diet. It is recommended to eat:

seafood (oysters, seaweed);
meat;
pumpkin seeds;
walnuts;
bran;
kefir;
Rye bread.

Regular sex life. In the prevention and treatment of the disease, a man needs:

lead a rhythmic sex life;
avoid interrupted sexual intercourse;
avoid random connections.

Treatment of acute and chronic prostatitis

Treatment of inflammation of the prostate is carried out using the following methods.

Antibacterial therapy. If the prostatitis is bacterial, then treatment involves taking antibiotics. The doctor selects a group of drugs depending on the type of microbes that caused the disease, the sensitivity of the pathogen to various drugs, and the presence of contraindications in the patient.

Characteristics of drugs

A drug	Advantages	disadvantages
Fluoroquinolones	Excellent bioavailability Equivalent to oral and parenteral pharmacokinetics Active against typical and atypical pathogens	affect the central nervous system Phototoxic May cause allergies
macrolides	Moderately active against Gram-positive bacteria Penetrates well into prostate tissue Low toxicity	Insufficiently active against gram-negative bacteria
Tetracyclines	Active against atypical pathogens	Inactive against Pseudomonas aeruginosa Insufficiently active against staphylococci, Escherichia coli

hormone therapy. Hormone treatment is necessary to restore the normal hormonal balance between androgens and estrogens. Drugs with antiandrogenic activity reduce inflammation of the gland tissues and prevent the transition of the disease to more severe stages.

Prostate massage. This method of treatment of chronic prostatitis can only be used outside of exacerbations. A man needs to take an inclined position, rest his palms on a couch or table, spread his legs shoulder-width apart. The doctor conducting the treatment puts sterile gloves on his hands, applies an ointment or gel (in some cases, a drug with an anesthetic component) to the index finger of his right hand and injects it through the anus into the rectum. Massage is performed by applying slight pressure until the secretion of the prostate is separated through the opening of the urethra. Treatment involves at least 10 massage sessions.

Physiotherapy. To treat the symptoms of prostatitis, methods are used to normalize and increase blood circulation in the pelvic area. This allows you to eliminate congestion, as well as increase the effectiveness of drug therapy. Treatment is performed by exposing the gland to ultrasonic waves, electromagnetic vibrations, and elevated temperatures (microclysters with warm water).

Surgical intervention. Surgical interventions for prostate disease are rarely used. Such treatment is mandatory for developed complications of acute or chronic prostatitis.

Indications for prostate surgery:

acute urinary retention as a result of a strong narrowing of the urethra;
abscess (the appearance of suppuration on the surface of the gland);
sclerosis of the gland;
adenoma, not amenable to conservative treatment.

Complications of prostatitis

Vesiculitis. Untreated prostatitis can cause inflammation in the seminal vesicles. Symptoms of the disease are pains deep in the pelvis, radiating to the sacrum, aggravated by erection and ejaculation, frequent urination, the appearance of blood and / or pus in semen and urine.

Colliculitis and urethritis. Due to its proximity to the excretory streams of the prostate, the seminal tubercle often becomes inflamed as a result of infection from the infected gland. If left untreated, the symptoms of prostatitis are complemented by a characteristic sign of urethritis - burning or tickling in the urethra when urinating. There is also pain during ejaculation as a result of convulsive contraction of the urethra.

Prostate abscess. The appearance of purulent cavities on the surface of the gland is due to pathogenic bacteria that caused prostatitis. A characteristic symptom of the disease is general weakness, impaired consciousness, delirium, a sharp increase in temperature, increased sweating, chills. Prostate abscess is a severe septic disease, the treatment of which must be carried out in a hospital.

Sclerosis of the prostate. Sclerosis of the prostate develops against the background of regular exacerbations of chronic prostatitis as a result of non-compliance with the treatment prescribed by the urologist. This disease can form over several years, however, if the hormonal balance in the body of a man is disturbed, rapid development is possible. With sclerosis of the prostate, pain is observed during the emptying of the bladder, intermittent and sluggish urine stream.

Formation of cysts and stones. The appearance of cysts in the gland is one of the likely options for the progression of chronic prostatitis. Infection of neoplasms can cause an abscess and greatly complicate the treatment of the disease. Single and multiple stones can also form in the prostate. With this disease, in addition to the usual symptoms of chronic prostatitis, there are violations of the outflow of urine, frequent urination, pain in the perineum.

Infertility. In chronic prostatitis, the production and motor function of spermatozoa is disrupted. If left untreated, this disease also affects the vas deferens and seminal vesicles, making them impassable to sperm, so they are not thrown into the urethra during ejaculation. As a result, men who have chronic prostatitis often suffer from infertility.

- this is inflammation of the prostate tissue, which is observed for about three months or more. Thus, it is possible to judge the long course of the disease, which has passed into the chronic stage. In most cases, prostatitis is preceded by, and already against its background, prostatitis occurs - acute or chronic. A feature of chronic prostatitis is that the disease in seventy percent of cases is asymptomatic. And only fifteen percent of patients feel signs that accurately indicate prostatitis. In the rest of the category of patients, doctors note only indirect signs of prostatitis, which in most cases the patient does not associate with prostatitis.

Chronic prostatitis affects both young men and middle-aged and elderly people. Also, prostatitis threatens those who, by the nature of their activities, lead an inactive lifestyle, feel excessive physical exertion on the perineum, and observe sexual abstinence. For example, in truck drivers who spend a long time behind the wheel, the factor of hypothermia and stagnation of blood in the pelvic organs plays an important role. Athletes who lift weights, go in for contact sports, are prone to injuries and microtrauma of prostate tissues. And men who lead a weak sex life become victims of prostatitis due to stagnation of the secretion of the prostate gland.

Prevalence

Chronic prostatitis is the third most important disease for the male reproductive system. Undoubted leadership holds prostate cancer and benign prostatic hyperplasia, but prostatitis is no less serious disease than all of the above ailments. Among diseases of the male genitourinary system, chronic prostatitis accounts for about twenty percent of the total number of patients. According to medical statistics, every third man, every third male patient suffers from inflammation of the prostate gland, and every fifth suffers from its chronic form.

Most often, prostatitis occurs as a result of an infectious lesion of the genitourinary system, and in second place among the causes are inflammatory processes provoked by hormonal changes in the body of men.

The statistics of recent years gives us alarming data - most often young people and middle-aged people suffer from prostatitis, which is associated with the sexual infections they have suffered (trichomonas, gonococcus, chlamydia). Such patients - eighty-five percent of all people suffering from prostatitis. Prostatitis in young people is characterized by frequent periods of exacerbation, which indicates the need for careful selection of treatments for this disease.

Speaking about the treatment of prostatitis, narrow specialists note that in clinics this disease is often diagnosed incorrectly, confusing it with prostatopathy, autonomic dysfunction and other pathologies. Accordingly, the treatment is selected deliberately erroneous.

Classification of chronic prostatitis

As in all classifications of inflammatory diseases, prostatitis is divided into acute and chronic stages. Note that prostatitis is considered chronic, the symptoms of which are observed in a patient for three months or more. Let us consider in more detail the subspecies of chronic prostatitis, proposed by the Institute of Health of the United States of America, which is considered the most universal for this pathology. The classification is based on the following features:

the presence or absence of leukocytes in the urine;
the presence or absence of pathogenic microorganisms in the secretion of the prostate, ejaculate and urine.

According to this classification, the following types of prostatitis are distinguished:

Acute bacterial prostatitis- an acute inflammatory process localized in the tissues of the prostate and proceeding with all the symptoms of inflammation - an increase in the number of leukocytes, the detection of bacteria in the urine, signs of infection of the body (intoxication, fever).
Chronic bacterial prostatitis- a disease with typical symptoms of chronic inflammation and an increased number of bacteria and leukocytes in the urine and secretion of the prostate after its massage.
Chronic pelvic pain syndrome- this symptom can be considered the main clinical symptom of latent chronic prostatitis, since after prostate massage no pathogenic microbes are found in its secret. In order to diagnose chronic prostatitis, the patient must have chronic pelvic pain syndrome for three months or more. A subspecies of this disease is the inflammatory syndrome of chronic pelvic pain, in which there are the following symptoms: pain syndrome, symptoms of prostatitis, an increase in the number of leukocytes in the prostate secretion, urine and ejaculate after prostate massage. In this case, pathogenic microorganisms are not detected. Non-inflammatory chronic pelvic pain syndrome has the following symptoms: pain syndrome, symptoms of prostatitis, but the number of leukocytes is not increased, and pathogenic microorganisms are not detected.
Asymptomatic inflammatory prostatitis- with this form of the disease, there are no classic symptoms of prostatitis, and the disease itself is detected by chance, when contacting the clinic for another reason.

Reasons for the development of the disease

Chronic prostatitis can be caused by a number of reasons. The main reason is the penetration of pathogenic bacteria. These include E. coli, Klebsiella, Proteus, Pseudomonas aeruginosa, Enterococcus. Possible causative agents of prostatitis are chlamydia, ureaplasma, Trichomonas, genital mycoplasma and staphylococcus aureus. Bacterial prostatitis is transmitted in three ways:

urethral, through the urethra (due to impaired excretion of urine and its reflux into the ducts of the gland);
hematogenous - through the blood (infection can penetrate even with distant foci of inflammation, such as tonsillitis, cholecystitis, etc.);
lymphogenous - through a network of lymphatic vessels (for example, when the pathogen is localized in the intestine, since the intestines and pelvic organs have a common lymph flow);

In practical medicine, doctors are faced with the fact that ninety percent of the chronic form of prostatitis are complications of urethritis and acute prostatitis.

Among factors that cause disease in men include:

intraprostatic reflux;
urinary tract infection;
phimosis;
anal sex without a condom;
the facts of catheterization of the bladder or the installation of a catheter for a certain period;
instrumental interventions for the purpose of carrying out diagnostic measures (for example, cystoscopy).

Pathogenic microorganisms, penetrating into the tissues of the prostate, are undoubtedly a threat to the health of a man. However, their penetration into the prostate gland will not always cause an inflammatory process. In the etiology of the disease, factors that weaken the body and enable bacteria to realize their pathogenic potential play a significant role. These factors include frequent colds, intoxication of the body, circulatory disorders in the pelvic organs, stagnation of prostatic secretion in the gland, violation of the mechanism of its excretion.

Despite the fact that doctors associate prostatitis with urethritis, inflammation of the prostate can be caused by bacteria other than those that caused urethritis.

Also, the factors provoking prostatitis include the presence of stones in the kidneys and bladder, in the prostate gland itself. Stones lead to constant relapses of the disease. Another predisposing factor is the narrowing of the urethra and its ducts, leading to an increase in local pressure.

Symptoms of chronic prostatitis

Chronic prostatitis is characterized by a variety of manifestations. The most common of them are excessive irritability, loss of appetite, anxiety, sleep disorders, and decreased performance. In some patients, the symptoms are opposite - isolation, lethargy, fatigue.

Local symptoms include urination disorders soreness. To begin with, patients feel frequent urge to urinate, pain at the beginning and urination and at the end, aching constant pain radiating to the groin, subpubic region, sacrum, perineum, glans penis, scrotum, rectum. Some patients report worsening pain during intercourse. The nature of the pain and its intensity may not depend on the degree of the pathological process, and in some cases. Symptoms of chronic prostate include excessive sweating, a feeling of trembling and coldness in the perineum. Due to impaired blood circulation in the pelvic organs, the skin may change its color. Due to the weakening of the tone of the prostate gland in patients with tension in the muscles of the pelvis, discharge from the penis may appear.

Disorders in the genital area are quite painfully tolerated by patients. Disorders of sexual function in chronic prostatitis are observed quite often, although such phenomena are not observed in acute prostatitis. But in chronic prostatitis, inflammatory and congestive changes affect the nerve endings that transmit impulses to the brain. As a result of pathological changes in the prostate, the processes of ejaculation and erection suffer. Usually, patients experience premature ejaculation, then the erection becomes weaker, the sensations from orgasm decrease. If normally men can ejaculate some time after the onset of sexual intercourse, then in patients with chronic prostatitis this happens much earlier, already when the penis is inserted into the vagina. Although for the sake of justice it is worth noting that premature ejaculation is observed not only in chronic prostatitis, so this symptom should be taken into account conditionally. And with a long course of prostatitis, the production of testosterone also decreases, the attraction to the opposite sex weakens.

Penile erectile dysfunction is a common symptom in chronic prostatitis. Usually men are very painful to endure the lack of erection. In such patients, ejaculation does not bring sexual satisfaction.

In such a situation, men feel fear of sexual intimacy, become unsure of their abilities, and become irritable. Such situations lead to sexual neuroses.

It is quite difficult to cure chronic prostatitis. In particular, the treatment is affected by the duration of the disease, the degree of pathological changes in the prostate gland. Practice shows that the absence of symptoms does not always indicate recovery - they may appear during an exacerbation of the disease, which indicates a latent course of chronic prostatitis. The most severe complication is scarring of the prostate, which leads to its wrinkling. Often the process may involve the back wall of the bladder, the urethra.

Diagnosis of chronic prostatitis

It is not difficult for a specialist to recognize chronic prostatitis. However, in the asymptomatic course of the disease, there is a need to conduct additional studies in order to finally establish the diagnosis.

Of great importance is the completion of a questionnaire by the patient, which will shed light on questions about the intensity and frequency of pain, sexual disorders, urination disorders, and the patient's attitude to his condition. In addition to the questionnaire, methods of laboratory diagnostics and instrumental diagnostics are used.

In the diagnosis of chronic prostatitis, the main role is played by the so-called. "gold standard", introduced by American scientists back in 1961. This standard includes the presence of ten to fifteen white blood cells visible to the eye. Laboratory diagnostic methods make it possible to identify pathological microflora or a virus. The diagnosis of chronic prostatitis is made when the secretion of the prostate or the fourth portion of urine contains bacteria or more than ten leukocytes.

When analyzing scrapings from the mucosa by the polymerase chain reaction, the presence of pathological microorganisms that caused the disease will be determined. When examining the secret of the prostate under a microscope, the number of leukocytes, amyloid bodies, macrophages is determined.

When examining the secret of the prostate after its massage, the nature of chronic prostatitis is determined - bacterial or non-bacterial.

In addition to laboratory methods, instrumental diagnostic methods are widely used. One of the most revealing methods is transurethral ultrasound. This study allows you to establish the form of the disease and its stage, to differentiate one disease from another. Ultrasound allows you to assess the size of the prostate, its volume, echostructure.

Differential Diagnosis

Most of the success in the treatment of the disease depends on its correct diagnosis. Quite often, chronic inflammation of the prostate masks various disorders of the innervation of the organ, its contractility. Chronic non-bacterial prostatitis must be distinguished from neuropsychiatric disorders, sexual dysfunction, inflammatory diseases of other pelvic organs, with diseases of the rectum.

Treatment of chronic prostatitis

Treatment of the disease should be based on a comprehensive sequential approach. First of all, it is necessary to have a conversation with the patient about his disease, set him up for a long-term treatment of the disease and the need for strict adherence to all doctor's prescriptions. You also need to eliminate all factors that contribute to the aggravation of the disease - appoint daily walks, adjust nutrition, talk about sexual partners, the need for protected sex.

Hospitalization for prostatitis

Usually the symptoms of prostatitis are not life-threatening, and in most patients they are generally erased or absent. Chronic prostatitis is not an indication for hospitalization if the patient's condition is satisfactory. Another thing is acute prostatitis, or exacerbation of the disease on the background of chronic prostatitis. In order to avoid the development of complications, patients are urgently hospitalized, detoxified, antibiotic therapy is carried out, the patient's health is monitored until the moment when outpatient treatment can be prescribed. If there is a need for surgical intervention, then it is carried out either urgently or planned.

Medical treatment

For effective treatment of the disease, it is important to prescribe a complex therapy that would affect various parts of the pathological process, stopping the spread of infection, restoring blood circulation in the pelvic organs, normalizing hormonal levels and body reactivity. Based on these tasks, doctors prioritize the following groups of drugs: antibacterial agents, anticholinergics, non-steroidal anti-inflammatory drugs, immunomodulators, vasodilators, angioprotectors, prostate massage. Recent medical studies have shown the effectiveness of such drugs in relation to chronic prostatitis: terazosin, finasteride, cyclosporine, allopurinol and others.

The basis in the treatment of chronic prostatitis is the isolation of the causative agent of infection and the determination of its sensitivity to a particular drug.

However, antibiotic therapy is not effective in all cases of prostatitis. In chronic inflammation caused by bacteria, in ninety percent of cases it is possible to neutralize the causative agent of the disease, provided that the antibiotic therapy was chosen correctly, and the doses of the drugs were correctly determined. With prostatitis of non-bacterial origin, antibiotic therapy is carried out in a short course, but with improved results, it can be continued. The effectiveness of antibiotic therapy in such cases is forty percent, which indicates the presence of certain pathogens not detected by laboratory methods. If there is a need to establish a fork of pathological flora, then a histological examination of the prostate biopsy can be performed.

In some cases, chronic prostatitis may not give symptoms, so doctors do not have a common opinion about antibiotic therapy in such cases. The same doctors who prescribe such therapy for suspected chronic prostatitis do not extend it for more than two to four weeks, and only when positive dynamics are achieved - for another two weeks. In the absence of the effect of antibiotics, they are canceled.

In this case, doctors stop at a group of fluoroquinolones, which have a high degree of penetration into the tissues of the gland. In this case, the concentration of some drugs in the prostate secretion may be even greater than in the blood serum. Another plus of such drugs is their high activity against gram-negative microorganisms, ureaplasma and chlamydia. At the same time, all drugs in this group have sufficient effectiveness, so you do not need to choose any particular drug. Fluoroquinolones include drugs such as norfloxacin, ciprofloxacin and pefloxacin.

If fluoroquinolones do not bring the desired improvements, then combined therapy is prescribed, namely, they strengthen these drugs with a number of antibiotics - amoxicillin, clindamycin, and in case of chlamydial infection, it would be rational to add a tetracycline series to the prescriptions. But with ureaplasma, the drug clarithromycin best of all penetrates into the tissues of the prostate and kills pathogens.

If the patient suffers from recurrence of prostatitis, then the appointment of antibiotics is necessary for prophylactic purposes.

Usually, during relapses, antibiotics do not change and drugs already familiar to the patient are prescribed, but lowering the daily dose. If therapy is ineffective, do not change the drug, but pay attention to its dosage.

In the treatment of prostatitis, the contractility of the prostate, the pressure inside it is also taken into account. With reduced pressure, stagnation can occur, which will cause inflammation of the prostate. Alpha-blockers are responsible for stimulating intraurethral pressure, which normalize pressure, relax the bladder sphincter and prostate muscles. The statistics on the use of alpha-blockers is quite encouraging - a positive result can be achieved in almost eighty percent of cases. Among alpha-blockers, doctors use drugs such as tamsuzolin, alfuzosin and terazosin.

If patients feel pain, frequent urination, nighttime urge, urination in small portions, then non-steroidal anti-inflammatory drugs are prescribed, to which alpha-blockers are added.

If antibiotic therapy has not helped and symptoms such as dysuria, pain still occur, then treatment should solve the following problems:

relief of pain;
establishment of normal urination.

To relieve pain, tricyclic antidepressants are prescribed, which block histamine receptors. Among the popular drugs we will name amitriptyline, imipramine. To solve the problem of dysuria, a urodynamic study is performed, after which the doctor determines the treatment of the disease. If the sphincter of the bladder is hyperactive, then prescribe amitriptyline, antihistamines, washing the bladder with an antiseptic solution. If drug therapy is ineffective, then resort to other methods of treatment - physiotherapy, neuromodulation.

Non-drug treatment

Non-drug therapy for chronic prostatitis is aimed at increasing the concentration of drugs in the prostate without exceeding their daily allowable dose. This contributes to the rapid impact of drugs on the cause of the disease, which is especially important for antibiotic therapy.

The most effective methods used for prostatitis are transrectal hyperthermia and physiotherapy. Physiotherapeutic methods include laser therapy, electrophoresis, mud therapy, phonophoresis.

Microwave hyperthermia is performed in patients taking into account changes in the prostate tissues under the influence of the inflammatory process, concomitant diseases of the reproductive system. The greatest efficiency of the method is achieved at a temperature of forty degrees, when a bacteriostatic effect is observed and the process of activation of immunity at the cellular level starts. At a temperature of forty-five degrees, an analgesic effect is achieved due to the inhibition of nerve endings.

Laser therapy has an effect similar to forty-degree hyperthermia. In addition, the laser also has a biostimulating effect. If the patient has no contraindications, then a good effect is achieved by prostate massage. Patients with chronic prostatitis are treated in specialized sanatoriums and resorts, undergo the necessary psychotherapy.

Surgical treatment

Chronic prostatitis itself is not life threatening and patients with mild symptoms may not need to go to the hospital. At this time, chronic prostatitis will give rise to serious complications, which are very difficult to get rid of. In addition, these complications are a serious threat to the health of the patient. The most serious of these are sclerosis of the prostate and sclerosis of the bladder neck.

Most often, complications occur in young patients. In view of this, doctors initially put minimally invasive surgery at the head of the method of surgical intervention, which, with minimal penetration, will give a good result. The indications for the operation are as follows - prostate abscess, phimosis, an increase in the volume of the gland to eighty cubic centimeters or more, acute urinary retention, involuntary excretion of urine, bleeding, blockade of the urethra. There are several types of surgery that are performed for chronic prostatitis:

Circumcisio - this surgery is performed when the course of prostatitis is complicated by phimosis, inflammation of the glans penis and the spread of infection through the genitourinary tract. During the operation, the foreskin is dissected and appropriate drug treatment is carried out;
Resection of the gland - is carried out if there is a need to remove only part of the gland, for example, when sclerotic changes appear. The procedure is performed under the control of the endoscope and transurethral access;
Prostatectomy is a radical surgical intervention that involves the removal of the entire prostate gland. Such an operation is prescribed quite rarely, mainly doctors with suspicion of malignant changes in the prostate. It is best to carry out such an intervention with a laser;
Elimination of adhesions is a symptomatic intervention that improves the patient's quality of life;
Drainage of an abscess or cyst - this operation is performed endoscopically. Drainage is performed using a tube inserted into the urethra. At the end of the tube is a camera that allows you to control the process on the monitor in the operating room.
Another complication in which surgery is recommended is sclerosis of the seminal tubercle. Most often, patients come to the doctor with complaints of sexual problems - a weak orgasm, pain during ejaculation, a small amount of sperm. However, the reason lies not so much in sexual dysfunction as in violation of the patency of the prostate tract, which makes it difficult for the prostatic secretion to come out. As a result of this, cellular protection decreases, local immunity decreases. To resolve the situation, a resection of the seminal tubercle is made, an incision of the vas deferens, seminal vesicles.

The outcome of surgery to a certain extent depends on the timely diagnosis of chronic prostatitis. It is quite difficult to make a diagnosis if the disease is complicated by prostate adenoma, which in seventy percent erases the symptoms of chronic prostatitis. And only about thirty to forty percent of patients learn about their diagnosis during an outpatient examination for adenoma, and another fifteen percent during a preventive examination. Other patients are forced to operate at the stage of exacerbation of the disease, when inflammatory changes occur in the parenchyma of the organ.

With transurethral electroresection, serous or purulent prostate contents may be released in patients. In this case, they speak of an exacerbation of the inflammatory process and remove the entire prostate or part of it, if such an operation was performed earlier. The prostate gland is removed by electroresection, bleeding vessels are cauterized pointwise with a ball electrode. To protect the prostatic ducts from the ingress of infected urine, a trocar cystostomy is installed.

Note that surgery for chronic prostatitis is performed only when conservative methods fail to cure the disease. The purpose of surgery is to improve the quality of life of the patient, eliminate the complications of prostatitis and normalize the urinary function. However, the operation does not guarantee that the prostatitis will not return again. Typically, the effect of such operations is about fifty percent. In addition, not all patients can be operated on. Contraindications to surgical intervention are mental disorders, diabetes mellitus, disorders in the respiratory system, heart disease, liver pathology.

Forecast

It is possible to talk about the cure of the disease when it is possible to achieve a long period of remission, during which the symptoms of prostatitis do not appear. Also indicative will be a decrease in the level of leukocytes, the absence of bacteria in the secretion of the prostate, the elimination of infection, the restoration of normal urination and sexual function.

In most cases, the prognosis is favorable, however, much depends on the time of contacting the clinic, the type of infection found in the patient, and his compliance with all doctor's prescriptions.

However, a favorable outcome in the treatment of the underlying disease - chronic prostatitis, does not guarantee the absence of complications that may occur with this disease. So, chronic prostatitis is fraught with vesiculitis (inflammation of the seminal vesicles), colliculitis (inflammation of the replaceable tubercle), urethritis (inflammation of the urethra), prostate abscess (formation of a purulent cavity on the surface of the prostate), prostate sclerosis, formation of stones and cysts.

Prevention

In the life of every man, prevention of diseases of the genitourinary system is important. It is on how a man feels that his sexual activity, self-esteem, relationships with others and, especially, with the opposite sex, depend. In order to protect yourself from chronic inflammation of the prostate, you must follow a few simple rules that greatly reduce the possibility of prostatitis. Among these rules we list:

sufficient physical activity - walking, morning exercises, perineal muscle training;
rational nutrition - the use of foods rich in zinc and B vitamins.
regular sexual life - observance of the rhythm of sexual intercourse, full ejaculation (without interrupted sexual intercourse), the exclusion of casual sexual intercourse, unprotected sex.

Separately, I would like to dwell on the rationalization of the nutrition of patients with prostatitis. Usually, men are not used to limiting their diet, so nutritional recommendations are not followed by everyone. However, proper nutrition is a guarantee that the disease will not return.

With prostatitis, you need to consume a sufficient amount of protein per day. It is best to eat lean meats, chicken, lean beef, unsalted cheese with a reduced percentage of fat. Lean pork, seafood, nuts, pumpkin seeds, oily fish, quail eggs are allowed. These foods are sources of zinc, essential for men's health. Be sure to include dairy products - kefir, milk, fermented baked milk, low-fat cottage cheese. These products do not lead to squeezing the intestines and do not provoke congestion. Among fats, it is necessary to limit the use of animal fats, which lead to the deposition of cholesterol plaques on the walls of blood vessels. Small amounts of animal fat are allowed in lean meat, fish, and dairy products.

Prostatitis is one of the most common problems of the genitourinary system that occurs in men. At the same time, the disease “gets younger” every year, the chronic form, which is difficult to treat, is increasingly common.

The chronic form is about 90-95% of all cases of prostatitis. Usually it proceeds almost imperceptibly, manifesting itself only during periods of exacerbations. However, this disease is dangerous because it can lead to infertility, prostate adenoma, and inflammatory diseases of the bladder.

Therefore, when chronic prostatitis is detected, treatment should be started as soon as possible.

Causes of chronic prostatitis

The mechanism of the disease is still not fully understood, but there are several obvious reasons that can cause it:

hypothermia;
infections;
passive lifestyle;
bad habits;
other advanced diseases of the genitourinary system.

Symptoms of chronic prostatitis

The chronic form of this disease proceeds rather modestly, reminding of itself during periods of exacerbation with such symptoms:

discomfort when urinating;
pain in the perineum, lower abdomen, may be constant or periodic;
decreased sexual activity.

Over time, all symptoms intensify, the process of urination becomes even more painful, the patient completely ceases to be sexually active.

Important! If these symptoms appear, you should consult a urologist.

Treatment at home

It is worth starting treatment with the appearance of the first symptoms, even if they seem insignificant, since the disease will progress, bringing physical and moral discomfort.

Treatment of chronic prostatitis begins with a visit to the urologist. He, having assessed the patient's condition, the severity of the disease, its nature, prescribes a set of drugs and procedures. It usually includes a set of medicines, physiotherapy and herbal medicine. In the future, the selected scheme can be adjusted.

For a clear diagnosis and the exclusion of contraindications, additional studies may be prescribed: a blood test for hormones, ultrasound of the pelvic organs and the entire genitourinary system, and others.

Important! If suddenly there is a remission, you should go to the doctor immediately with the onset of the next exacerbation.

Prostatitis is well treated at home, if you correctly follow all the doctor's recommendations and attend consultations in a timely manner, monitor the course of the disease. The main task is to achieve long-term remission, preferably lifelong. There is a list of recommendations for this.

Do not tolerate, regularly visit the toilet. A constantly overfull bladder can trigger a return of the disease.
Avoid hypothermia. You should not sit on cold surfaces, clothes should be warm enough in the cold season, you should not freeze.
During sedentary work, you need to constantly take breaks. Light warm-up for 5-10 minutes every 1-2 hours of hard work.
Regular physical activity. To prevent new manifestations of prostatitis, a high level of activity in general is needed. At least - charging every morning, better - a few full-fledged sports per week.
In this case, sports that can cause injury to the perineum should be excluded. These include cycling and horseback riding.
During exacerbations of prostatitis, it is necessary to completely abandon alcohol, during remissions - to reduce its consumption as much as possible. You should also avoid cheap alcohol, especially wines and beer drinks.
It is recommended to have a full sexual life, to avoid congestion in this area.
For observations, you need to visit a urologist twice a year, it is important to know if the disease is progressing even during remission.

Combining these rules with official medical treatment will help to cope with the acute stage of the disease and in prevention, when the exacerbation passes.

Important! In the treatment of chronic prostatitis, you must strictly adhere to all the doctor's recommendations.

Medical treatment

In the treatment of this disease, the use of medicines in various forms is mandatory. The main goals of taking them: remove pain, relieve inflammation, destroy the infection

In some cases, antibiotics are used if it is proven that the infection that caused the disease is of bacterial origin. These drugs are effective only with a full course, with constant monitoring of changes.

With prostatitis, suppositories (suppositories) are often used. They are used during exacerbations to suppress unpleasant symptoms and during remission for prevention. The main active ingredients of most candles are propolis, honey, vegetable oils and extracts from the prostate glands of livestock. The most affordable suppositories:

ichthyol candles;
Prostopin;
candles based on diclofenac;
Vitaprost;
Voltaren.

Biseptol (analogues: Bactrim, Abatsin, Septocid);
Prostamol Uno (analogues: Prostanorm, Prostalamine);
Nolicin, Tsiprolet or Tavanic;
Amoxicillin or Amoxiclav.

Tablets are usually taken in combination with several drugs for different purposes. Some of them are available not only in the form of tablets, but in injection form.

Important! It is impossible to select drugs on your own, this can only be done by a doctor after the necessary examinations.

Treatment of chronic prostatitis with folk remedies

Folk remedies will not replace complex treatment, including the mandatory intake of medications, but they can supplement it and speed up the healing process. Some doctors even include herbal medicine in their official treatment program.

Firstly, traditional medicine knows many recipes for making candles at home, even pharmacy ones consist of natural and quite affordable ingredients.

Candles

One of the simplest recipes is this. You can take 50 grams of propolis, the same amount of wax and 200 grams of lamb fat, heat it all up in a water bath and mix thoroughly. After cooling, cut into pieces and form candles. Store this homemade product in the refrigerator.

Juices

With prostatitis, to maintain immunity and improve the body as a whole, it is recommended to drink more fresh juices. Traditional medicine advises juices from carrots, beets, cucumbers, black elderberries.

Herbs

In a chronic disease, you can do enemas based on herbal decoctions. The most commonly used are sage, chamomile, calendula. These herbs have strong anti-inflammatory and healing effects.

For an infusion suitable for enemas, take two tablespoons of dried herbs per one hundred milliliters of boiling water, leave for an hour.
Night microclysters of 50 milliliters are recommended.

Decoctions from the same herbs can be drunk to normalize digestion and the overall therapeutic effect.

Other means

With prostatitis, it is advised to include pumpkin in the diet, especially its seeds, rich in zinc. A small handful a day is enough.
Celery is believed to increase potency. You can eat it fresh, add dried root to food as a seasoning, or drink an infusion.
It is useful to drink teas and infusions based on rose hips, which contain a huge amount of vitamins and nutrients that help fight many diseases. Chronic prostatitis is one of them.

Important! All recipes based on herbs, juices and honey can cause individual intolerance, they should be used carefully, in case of allergies, stop such treatment.

In general, herbal medicine and folk methods will help the body cope with such an unpleasant problem as prostatitis. However, some folk remedies and exclusively home treatment will not be enough. An integrated approach and mandatory specialist consultations are required.

Chronic prostatitis in men- This is a recurrent form of the disease that develops with inflammation of the prostate gland or lower urinary tract. The disease is characterized by periods of exacerbation and remission. Statistics say that chronic prostatitis is diagnosed in 8 to 35% of men of mature age, and in two-thirds it is complicated by some disease (epididymitis, vesiculitis), as a result of which urination disorders, infertility, and erectile dysfunction develop. In elderly men, chronic prostatitis often occurs together with prostate adenoma.

What constitutes chronic prostatitis can be seen in the photos and videos selected for the article.

urological diseases;
untreated prostatitis;
exacerbation of respiratory diseases;
general hypothermia;
malnutrition;
stress;
pathology of the pelvic organs;
chronic prostate adenoma;
haemorrhoids;
lack of sexual life or its excessively saturated rhythm;
rare urination and others.

Medicine distinguishes 3 stages of development of chronic prostatitis:

Signs of chronic prostatitis

Urologists call the usual trio of symptoms of chronic prostatitis:

urination disorder;
aching pain in the pelvic area;
reproductive dysfunction (reduction or complete absence of erection, libido, ejaculation).

This does not mean at all that this is how this urological disease manifests itself in all men. In most patients, the disease proceeds almost imperceptibly, that is, asymptomatically. This is a hidden form of the disease. There are cases when other signs hron are found. prostatitis. Among them happens:

fever (sometimes up to 40 °);
chills;
pain in the perineum;
general malaise.

Having noticed the first signs of the disease, you need to visit a urologist and, if necessary, undergo an ultrasound. The sooner the correct treatment is started, the more likely it is to completely defeat the insidious male disease.

Diagnosis of chronic prostatitis: ultrasound and tests

There are a large number of diagnostic techniques that will allow the urologist to correctly diagnose. During the initial conversation with the patient, the doctor listens to the patient's complaints, makes an external and rectal examination and, on the basis of them, establishes a preliminary diagnosis, determines further laboratory and instrumental methods for diagnosing chronic prostatitis.

If inflammation of the prostate is suspected, patients are prescribed laboratory tests:

urinalysis (first and second portion);
prostate secretion analysis.

Elena Malysheva: "Prostatitis is defeated by European doctors. Their discovery in the field of men's health is ideal. This is a breakthrough and it is called ..."

Additionally, a man may be assigned a PCR test to detect the DNA of microorganisms that can cause sexually transmitted diseases.

Of the methods of instrumental diagnostics, patients are often prescribed transrectal ultrasound to detect violations of the urodynamic process. This method differs from conventional ultrasound in more accurate results.

In some cases, with a severe course of the disease, patients may be prescribed ultrasound of the abdominal organs, cystoscopy, and in case of violation of the reproductive function, a spermogram. In order to exclude the presence of oncology, patients are invited to perform a biopsy.

Treatment of chronic prostatitis

Having received the results of the diagnosis, the urologist determines the methods of effective treatment of chronic prostatitis. Since the disease is usually not detected in the early stages of its development, it is not easy to choose the right course of therapy and completely overcome the malaise that has appeared. Maybe that's why so many men come to the urologist's office with the question whether chronic prostatitis can be cured and how, whether this disease is curable and how to get rid of it forever.

Usually, complex therapy represents several interrelated activities that are offered to the patient. The treatment regimen includes the use of antibiotics, taking drugs that increase the efficiency of blood vessels, strengthen the immune system, increase the outflow of secretions (a-blockers), and reduce pain (Diclofenac, Naproxen).

Many patients are recommended physiotherapy. Today, clinics offer reflexology, ultrasonic phonophoresis, magnetotherapy, hot baths, mud therapy, urethral instillations, drug electrophoresis and other procedures. These procedures speed up the healing process, as they increase the trophism of the gland tissues.

In extremely severe cases, in the presence of complications, not medical, but surgical treatment is prescribed. The operation is inevitable to eliminate strictures of the urethra, in the presence of cysts and abscesses, with sclerosis of the bladder neck, with narrowing of the urethra.

Medicines for the treatment of chronic prostatitis: antibiotics, tablets, suppositories and other means

For the medical treatment of chronic prostatitis in men, there are many drugs that will help cope with the symptoms of the disease and alleviate the patient's condition. Antibiotics are considered the main medicine for helping patients. The minimum course of treatment with tablets is determined by the doctor. Usually it is at least 14 days. In severe exacerbations of the disease, it is not always possible to achieve the desired result with the help of tablets, so antibiotics can be administered intramuscularly. In such cases, the course of treatment is increased to 4 weeks. To exclude the body's addiction to the drug used, it is recommended to replace it after 2 weeks of use. The most common antibiotics for treatment are:

Ofloxacin;
Norfloxacin;

To stop inflammation of the prostate, anti-inflammatory drugs are prescribed:

Celecoxib;
Ibuprofen.

Facilitate the course of the disease alpha-blockers:

Tamsulosin;
Terazosin;
Doxazosin.

For the treatment of chronic prostatitis, some urologists consider suppositories (rectal suppositories), which contain NSAIDs, to be the best medicine. Among these drugs can be noted Voltaren and Diclofenac. Also, candles with antibiotics, with beta-sitosterol, with antispasmodics, with herbal extracts, with propolis (Prostaflow, Laktonorm, Vitaprost Plus, Papaverine, Hemo-PRO and others) are used for treatment.

Traditional medicine and its remedies for the treatment of chronic prostatitis

Do not give up effective folk remedies and methods of treating chronic prostatitis. For many, they help get rid of the disease, for others they alleviate the condition. It is best to use them as an addition to the therapy prescribed by the doctor. We suggest trying some of the most accessible recipes that you may find useful.

To defeat the disease, eat mature pumpkin seeds daily in the morning (before breakfast). They contain a lot of zinc, which is required for the health of the male body.
Bulgarians are treated with lime ash. To get it, they burn a linden branch. The ashes are collected and tea is brewed from it. It is necessary to take such a drink for a week.
2 tbsp. l tablespoons of parsley seeds finely chopped in a coffee grinder. They must be poured with a glass of water and boiled for about 15 minutes. Then leave to infuse under a closed lid. Drink a medicinal decoction of 1 tbsp. spoon up to 6 times a day.
Herbs have a strong effect, which can also be used to treat chronic prostatitis. Healers consider birch buds, licorice, plantain, fireweed, knotweed, lungwort, wintergreen, burdock and parsnip roots to be the most common in the fight against this ailment. Herbal preparations for patients can be prepared independently or bought at a pharmacy.

Consequences and complications of chronic prostatitis

A whole bunch of unpleasant complications and consequences can have chronic prostatitis if the disease is neglected, treated incorrectly or left to chance. The insidiousness of the disease is manifested in the fact that it never affects only the prostate. Most often, the disease goes through the genitourinary system, affecting the pelvic organs (seminal tubercle, bulbourethral glands, urethra). More serious complications include the formation of stones or the development of a cyst in the prostate gland.

Among the consequences of chronic prostatitis are noted:

Infertility is a problem that affects almost 30% of men with the condition. Problems with conception occur due to the fact that the prostate gland produces a small amount of secretion, so sperm activity is low and pregnancy cannot occur.
Problems with potency also often accompany this disease. They are manifested by impaired ejaculation or lack of erection. Impotence can be avoided if you go through a full course of treatment and avoid psychological trauma that subconsciously affects potency.
Vesiculitis observed with inflammation of the testicles, seminal vesicles or appendages. If left untreated, the disease also affects other tissues and nearby organs.
Sclerosis of the prostate develops with the growth of connective tissue and its replacement of the parenchyma. Gradually, iron ceases to cope with its functions.
prostate cancer- the most dangerous consequence of chronic prostatitis, which develops due to the large number of free radicals that can damage healthy DNA, turning them into cancer cells.

Physical exercises for the prevention of chronic prostatitis

Remarkable prevention, and sometimes treatment for chronic prostatitis are exercise. Their goal is to improve blood circulation in the prostate gland, increase secretion production, which will solve problems with lymph and blood stagnation. When choosing exercises, you need to consult a urologist. The main emphasis of the choice is on those special exercises that help strengthen the muscles of the anterior abdominal wall, perineum, and small pelvis. Regular exercise will help normalize urination, improve metabolism. No physical activity should be during the period of exacerbation of the disease. You will have to stop exercise therapy in the presence of pain, the appearance of blood in the urine.

An approximate list of the simplest exercises for men with chronic prostatitis:

Lying on your back, bring in place and spread to the sides of the toes. In this case, the heels cannot be torn off the floor.
Contraction of the muscles of the anus. First you need to try to squeeze the muscles when urinating, delaying the stream of urine. Try contracting your muscles while standing, sitting, or walking.
Abdominal breathing is performed several times a day, 10 to 20 times. When inhaling, the stomach inflates, filling with air, while exhaling, the muscles contract. Inhalation is done through the nose, it is better to exhale the air through the mouth.

How more complex exercises are performed, you can watch a video that demonstrates classes with a rehabilitation doctor.