Most of the male population explains many problems with prostatitis: erectile dysfunction and decreased libido, infertility and violations of intimate relationships. There are cases when a prolonged increase in temperature at the level of 37. 5 ° C is also explained by chronic prostatitis. And such a temperature may indicate very dangerous pathological processes in the body, including oncological nature.
People are so intimidated by this diagnosis that they become neurotic, the disease is psychosomatic in nature and requires appropriate treatment. In order for the treatment to be successful, it is necessary to accurately understand the cause of the appearance of the pathology and develop the correct treatment regimen.
Symptoms of chronic prostatitis
Most often, the disease does not have pronounced clinical signs, only a deterioration in the standard of living is noted. According to the NIH international classification, the disease belongs to the II category. Pathology is caused by bacteria, which means that it is impossible to get rid of the disease without special medical treatment. No folk methods - teas, tinctures and drinks - will cure the disease, they only take time from patients. Chronic bacterial prostatitis occurs when the pathology lasts more than three months and makes up no more than 10% of the total number of all inflammatory diseases. This is the most common type of persistent male urinary tract infection.
Important.Patients with diabetes must be treated in a timely manner, to maintain an adequate level of glycemia. Due to such therapeutic manipulations, the risks of the appearance of pathology are reduced.
Pathogenesis and etiology
Chronic bacterial prostatitis is mainly caused by Escherichia coli, but there are also isolated cases when chlamydia and various mycoplasmas are pathogenic organisms. Microbes enter the prostate in a descending or ascending way through the urethra, but medical science also describes options for hematogenous or lymphogenous infection. If you do not engage in treatment for a long time, then sclerosis of the gland tissues is possible - a very dangerous complication that has negative consequences and is difficult to treat.
A correct diagnosis plays a decisive role in the treatment process, minimizes the likelihood of complications and allows you to completely recover from the pathology. Diagnosis takes place in several stages, each of them should be treated very carefully. The symptomatology consists of the patient's complaints about health problems and dysuric phenomena. The complexity of clinical examinations is that the symptoms are inconsistent, quite often their features and combinations change individually.
- Anamnesis.The patient should tell in as much detail as possible about all his discomfort. It may be pain in the lower abdomen, urethra. There may be discomfort in the rectum, difficulty micturition, false urge to urinate. It is very important that the patient does not hide from the doctor casual sex, hypothermia. The doctor clarifies the presence of diabetes. In some medical institutions, patients are asked to fill out a questionnaire. It lists the clinical signs of the disease, there is a score for the intensity and frequency of their occurrence. A special scale enables physicians to have an objective idea of the pathology clinic.
- Palpation.During palpation, the doctor approximately determines the degree of enlargement of the prostate gland, checks for soreness, asymmetry and heterogeneity of tissues.
- Laboratory diagnostics.Gives the most valuable and accurate information for the correct diagnosis of chronic bacterial prostatitis. For analysis, urine samples are collected before and after prostate massage. Samples are two-glass, they determine the number of leukocytes and bacteria before and after the massage. There is an alternative method of laboratory tests, during which the seminal fluid is examined for the content of leukocytes. In addition, all patients undergo a smear examination from the urethra.
- Instrumental diagnostics.It is not always used due to the fact that there are no typical changes in chronic prostatitis. But it allows doctors to visually see the heterogeneity of the gland tissue.
- Differential diagnosis.Allows you to distinguish chronic prostatitis from chronic urethritis. Diagnosis is performed on the basis of a four-glass sample.
If there are difficulties with the final diagnosis, patients can be sent for consultations to other doctors:
- the otorhinolaryngologist must make sure that the patient does not suffer from chronic tonsillitis;
- a dermatologist must confirm that chronic prostatitis has a staphylococcal etiology, in which pustular lesions of the skin are possible;
- when ascertaining an odontogenic causative agent of chronic inflammation of the prostate gland, the dentist is recommended to examine the oral cavity.
During the examination, pathologies with a similar clinic should be completely excluded. These can be sexually transmitted diseases, inflammation of the anorectal zone, infection of the genitourinary organs. The most difficult case is oncological neoplasms. Based on the data obtained from a comprehensive examination of the patient, adequate treatment of the pathology is prescribed.
Causes contributing to the appearance of chronic prostatitis
In most cases, chronic prostatitis occurs due to improper treatment of the acute form. Many patients do not tolerate the full course of medication and stop treatment with little improvement in health. In addition, the likelihood of pathology increases due to the following factors.
- Chaotic sex life.This refers not only to changes in sexual partners, but also to prolonged abstinence.
- Frequent and prolonged exposure to perineal trauma.Professional cycling or horseback riding, sedentary work, etc. contribute to permanent injury to nearby soft tissues and blood vessels. As a result, the functionality of the prostate gland is impaired, inflammatory processes may occur due to infection.
- Malfunctions of the immune system.The weakening of the body's defenses occurs due to improper lifestyle, frequent hypothermia, neurogenic and hormonal disorders.
Ways to treat chronic prostatitis
The ultimate goal of treatment is complete eradication of the pathogen. Procedures can be performed on an outpatient basis, but periodic consultations with a doctor are required. The result depends not only on the optimally selected medications, but also on the desire of the patient himself. He must lead a correct and active lifestyle, avoid hypothermia and insolation. Regular sexual intercourse has a positive effect. After the diagnosis is made, it is mandatory to check the sexual partner, in case of detection of pathogens, the treatment is mutual.
Antibiotics are used to treat chronic prostatitis, various active substances have their own advantages and disadvantages. The drugs of choice are fluoroquinolones, they are better tolerated by patients. The duration of treatment is at least four weeks, in some cases it can reach three months. More often, drugs are used orally, injections are used extremely rarely and only against the background of specific reactions of the body.
After the symptoms of chronic prostatitis disappear, treatment should continue for at least 14 days.
Complete cure is confirmed by repeated laboratory tests. A month after the completion of the course, samples must be taken, in which all indicators should be normal.
Used antibacterial drugs
Depending on the actual condition of the patient, the doctor prescribes certain antibacterial drugs.
Advantages and disadvantages
Pharmacokinetics is convenient for use, has similarities in all forms for both oral and parenteral use. It accumulates well and is retained by the tissues of the gland for a long time, it is characterized by high bioavailability. The drugs are effective against atypical and typical microorganisms, and are also indicated for the suppression of Pseudomonas aeruginosa. The disadvantages include a poor combination with other medicines. In addition, fluoroquinolones have a negative effect on the patient's nervous system and can provoke photosensitivity.
In tissues, glands accumulate well and are retained for a long period of time. There are forms for oral and parenteral administration. At a cost affordable to all patients, high activity against a wide range of typical pathogenic bacteria was noted. The disadvantage is that clinical trials have not confirmed the effectiveness of the drug against Pseudomonas aeruginosa and enterococcus. Some types of bacteria Enterobacteriaceae do not react to sulfonamides. Before the appointment, it is desirable to re-clarify the diagnosis, otherwise the therapeutic measures will not bring the planned result.
They have various forms of application, at a cost available to all patients. They are highly effective against chlamydia, ureaplasma and mycoplasma. No obvious side effects were noted. Disadvantages - not active against Pseudomonas aeruginosa. Another problem is that coagulase-negative staphylococci, bacteria of the Enterobacteriaceae family and enterococci react little to the drug. Side effects include a high likelihood of skin lesions. Do not take if the patient has renal or hepatic insufficiency.
Advantages - very active against various types of gram-positive bacteria, proven to be effective against chlamydia. The tissues of the gland are filled with the drug evenly and hold it for a long time. Macrolides have minimal toxicity to the body, which makes it possible to prescribe them to patients with kidney or liver problems. The disadvantage is the minimal effectiveness against gram-negative bacteria and atypical microbes.
As an addition to the main ones, it is recommended to use herbal preparations made from the extract of dwarf palm, pollen of various plants and other plants that have anti-inflammatory and antiandrogenic effects. But this can only be as an addition to complex treatment.
If specific indications are found, some patients are prescribed αone- adrenoblockers. They reduce the dynamic obstruction of the posterior urethra and minimize dysuria.
Common methods of influencing the prostate gland
Modern medicine allows the use of additional methods of influencing the soft tissues of the gland. Such manipulations are done simultaneously or after the end of the treatment of chronic prostatitis.
It is strictly forbidden to independently perform any manipulations with the gland. Unqualified and unprofessional influences can have serious consequences.
If chronic prostatitis is not treated, there are risks of new, more complex pathologies. For their localization, the following influences can be assigned.
- thermal. Most often, transurethral microwave therapy is used, due to exposure to high temperatures, the size of prostate tissues decreases.
- Ultrasonic.A very effective method of influencing the prostate, there is no pain during the procedures.
- Cryodestruction.Low temperatures remove the affected prostate tissue.
In all cases, patients should know that the sooner treatment of chronic prostatitis begins, the easier and faster the pathological process is eliminated, the less likely it is to have severe consequences, the higher the chances of a complete cure. After recovery, patients return to a normal lifestyle.
Answers to the most frequently asked questions
Prostatitis, including chronic, scares the male population with its negative consequences. The vast majority of unfounded fears are explained by extremely low medical knowledge, a large number of rumors, and faith in various healers. How does medical science answer the most common questions?
Can permanent sedentary work cause chronic prostatitis?
Previously, medical professionals used the so-called congestive chronic prostatitis when making a diagnosis. Modern diagnostic devices have shown that prostatitis is of an infectious and inflammatory nature, all other physiological factors can only affect the overall health of the body and provoke it. Most often, the cause of the disease is casual sexual intercourse, during which pathogens are transmitted. Uncomfortable underwear, non-recurrent sexual intercourse or prolonged abstinence provoke erection problems. Due to stagnant or traumatic consequences, soft tissue pathologies begin to appear in the prostate gland. But according to modern medical classification, this is not prostatitis, but prostatopathy.
Is there a link between chronic prostatitis and cycling?
Yes there is. Rumors about the positive impact on the course of chronic prostatitis of professional horse riding or cycling are based on the fact that the saddle constantly massages the perineum. Due to this, the blood supply to the prostate improves, the negative consequences of chronic prostatitis are eliminated. In fact, everything is exactly the opposite. The saddle severely injures the arteries, the functional blood supply to the cavernous bodies is disturbed. They are located in the penis. As a result, there may be problems with erectile function. You need to know that all the recommended gentle massages of oriental traditional medicine do not cure. They are erotic in nature, not therapeutic. They can be used as an additional psychological tool, and not as the main treatment for chronic prostatitis.
The second question naturally arises - why do some urologists strongly recommend rectal massage? Everything is a little more complicated here. This massage is used during the delivery of tests. Previously, it was prescribed as an additional procedure to increase blood supply to the prostate. Modern diagnostic methods have proven the ineffectiveness of such massage in chronic prostatitis. But there are significant risks of damage to the mucous membranes of the rectum. As practice has shown, the most effective gland massage is natural ejaculation during intercourse.
Do problems with intimate life, pain in the lower abdomen, frequent urge to urinate always indicate chronic prostatitis?
No, not always, such symptoms may indicate other problems not related to the functioning of the prostate. On the contrary, often chronic prostatitis proceeds without noticeable symptoms at all and is detected by chance. It must be borne in mind that prostate adenoma, bladder dysfunction, problems of the sigmoid colon, and neurological disorders have quite a lot of common symptoms.
Is it possible to cure chronic prostatitis only by physiotherapy?
It's impossible. How not to hope that the disease will eventually disappear on its own. Magnetotherapy, laser therapy and other procedures are prescribed as additional methods during the complex protocol treatment of chronic prostatitis. The protocol describes all medical measures, it is not recommended to cancel them.
Is it always necessary to treat chronic prostatitis?
Some patients suffer from the disease for many years, during which time nothing terrible, in their opinion, happens. Naturally, patients have such a question. Lethal cases from chronic prostatitis have not been recorded in medical practice. But there is a sharp decline in the quality of life, in some cases prostate sclerosis may occur. In addition, the constant presence of pathological microorganisms in the body depresses the immune system, which can cause any disease. It does not have to be related to the functioning of the prostate.
Adequate medical measures and unquestioning compliance by patients with the recommendations of doctors give a 100% guarantee of curing chronic prostatitis. A prerequisite is the correct diagnosis and the optimal selection of medications, the use of complex treatment.