Chronic prostatitis: signs, symptoms and treatment, causes
Prostatitis is a masculine disease of the prostate gland mainly inflammatory.
Is the most common disease among all pathologies of the male genital area, accompanied by inflammation. At least once in a lifetime with the symptoms of prostatitis, 8 men out of 10 came across.
The peak incidence falls on the age range from 20 to 40 years. Chronic prostatitis occurs in every tenth man. Under the clinical picture of chronic prostatitis, a variety of diseases not only of the genitourinary system but also of other organs are masked.
Chronic prostatitis differs from acute by the presence and alternation of periods of exacerbation and remission( attenuation of symptoms).
Chronic prostatitis is a polyethylene disease. Its most important cause is an infection that is transmitted mainly during unprotected intercourse, as well as hematogenous( through the blood), lymphogenous( through the lymph) way.
In the last two cases, the infection is most often transmitted from a number of located organs, for example, the colon or urethra( urethra), etc. Along with the infection in the pathogenesis of the disease, hemodynamic, neurovegetative disorders are of no small importance.
The disease-promoting factors:
2) Pathological changes accompanied by impaired blood supply to the pelvic organs, the reasons for which are a sedentary lifestyle( for example, office workers).Hypodinamy leads to a disruption in the functioning, primarily of the cardiovascular and other systems, as well as the circulation of blood in all tissues and organs. The result of this process is the insufficient supply of oxygen to the tissue;
3) Reducing the body's defenses, promoted by chronic fatigue, malnutrition, abuse of bad habits( alcohol, smoking, etc.).Reduced immunity makes the body vulnerable to many pathogenic and opportunistic microorganisms.
During prostatitis in men, there are several stages of development, each of which is characterized by its clinical signs.
The most convenient classification is the one developed by the National Institute of Health in the United States.
According to it, the following types of disease exist:
See also, signs of prostatitis in men.
The classic triad of symptoms, which are revealed in the process of questioning the patient, indicates a chronic prostatitis. In addition, the physician should perform palpation examination of the rectum( digital rectal examination), during which the doctor gropes the posterior surface of the prostate and determines its size, shape, consistency, soreness, etc.
In chronic prostatitis, the prostate gland is characterized by an inelastic, soft consistency, pain, an increase in size. The mucous membrane of the rectum over the inflamed prostate is still.
Treatment of prostatitis in men should begin with a change in the patient's lifestyle, which will help stop further progress of the disease.
It is important to eradicate bad habits: alcohol use, hypodynamia, chronic hypothermia, etc. It is recommended to normalize sexual life, monitor the balance of nutrition.
Drug treatment for chronic prostatitis consists in prescribing drugs of different groups that affect all parts of the pathological process. Antibacterial drugs are prescribed( ciprofloxacin, pefloxacin, norfloxacin, etc.), immunomodulators, nonsteroidal anti-inflammatory drugs, vasodilators. Antibiotics are also shown to prevent an exacerbation of the disease.
When abacterial prostatitis is prescribed drugs from the group of a-adrenoblockers( tamsulosin, terazosin, etc.).Under their influence, intraurethral pressure decreases, the bladder neck and smooth muscles of the prostate are relaxed, etc.
Complications of chronic prostatitis are constrictions of the urethra and, as a consequence, impaired urinary excretion. In this case, surgical treatment is recommended, the main goal of which is restoration of the normal urethral patency. Surgery is also indicated for chronic prostatitis, which was caused by a benign tumor - adenoma.
For physiotherapeutic methods, prostate massage, microwave hyperthermia, electrophoresis, mud therapy, etc. are effective.
Proper, timely treatment of chronic prostatitis leads to prolonged remission or much less often recovery.
Evidence of a cure for prostatitis is the onset of a prolonged remission, during which, in addition to the absence of symptoms( pain, dysuria), the changes in laboratory tests are improving. In the secretion of the prostate there is no clinically significant concentration of pathogenic bacteria, etc.
Is the most common disease among all pathologies of the male genital area, accompanied by inflammation. At least once in a lifetime with the symptoms of prostatitis, 8 men out of 10 came across.
The peak incidence falls on the age range from 20 to 40 years. Chronic prostatitis occurs in every tenth man. Under the clinical picture of chronic prostatitis, a variety of diseases not only of the genitourinary system but also of other organs are masked.
Chronic prostatitis differs from acute by the presence and alternation of periods of exacerbation and remission( attenuation of symptoms).
Causes of
Chronic prostatitis is a polyethylene disease. Its most important cause is an infection that is transmitted mainly during unprotected intercourse, as well as hematogenous( through the blood), lymphogenous( through the lymph) way.
In the last two cases, the infection is most often transmitted from a number of located organs, for example, the colon or urethra( urethra), etc. Along with the infection in the pathogenesis of the disease, hemodynamic, neurovegetative disorders are of no small importance.
The disease-promoting factors:
- supercooling;
- inadequate physical activity;
- concomitant diseases;
- promiscuous sexual intercourse;
- microtraumas of the prostate, resulting from shaking, vibration( for example, drivers);
- presence of a permanent catheter in the urethra;
2) Pathological changes accompanied by impaired blood supply to the pelvic organs, the reasons for which are a sedentary lifestyle( for example, office workers).Hypodinamy leads to a disruption in the functioning, primarily of the cardiovascular and other systems, as well as the circulation of blood in all tissues and organs. The result of this process is the insufficient supply of oxygen to the tissue;
3) Reducing the body's defenses, promoted by chronic fatigue, malnutrition, abuse of bad habits( alcohol, smoking, etc.).Reduced immunity makes the body vulnerable to many pathogenic and opportunistic microorganisms.
Symptoms of chronic prostatitis in men
- Typically, the clinical symptoms of chronic prostatitis manifested as follows:
- 1) The occurrence of discomfort, as well as aching pain, cutting in the lower abdomen for 3 months or more. Pain can be given in the lower back, leg, scrotum, groin, anal opening and felt more clearly during ejaculation, especially after a long absence of sexual relations;
- 2) Sexual dysfunction is manifested by a decrease in libido, a weak erection. At first, premature ejaculation is observed, and a little later, after months of the disease, ejaculation becomes slow;
- 3) Violation of the act of urination, accompanied by chronic pain in the pelvic region;
- 4) Decreased quality of life of the patient.
Stages of the inflammatory process
During prostatitis in men, there are several stages of development, each of which is characterized by its clinical signs.
- 1) The exudative stage is characterized by acute pain in the scrotum, groin, pubic area, accelerated ejaculation, etc.;
- 2) The alterative stage is accompanied by unpleasant sensations in the same areas as in the stage of exudation. There is frequent urination, accelerated ejaculation;
- 3) In the stage of proliferation, there is a pollakiuria( frequent urination), a weakening of the intensity of the urine stream, slowing of ejaculation;
- 4) The stage of cicatricial changes is accompanied by sclerotic transformations of prostate tissue. The patient is concerned about the severity of the sacrum, pubic, as well as a sluggish stream of urine, frequent urination, weakening of the erection, slow ejaculation, "blurred" orgasm.
Classification of
The most convenient classification is the one developed by the National Institute of Health in the United States.
According to it, the following types of disease exist:
- of bacterial nature with acute course;
- of a bacterial nature with a chronic course;
- with a chronic course that is not accompanied by signs of inflammation;
- with asymptomatic course( histological prostatitis), which is detected by chance during examination for other pathologies.
See also, signs of prostatitis in men.
Diagnosis of chronic prostatitis
The classic triad of symptoms, which are revealed in the process of questioning the patient, indicates a chronic prostatitis. In addition, the physician should perform palpation examination of the rectum( digital rectal examination), during which the doctor gropes the posterior surface of the prostate and determines its size, shape, consistency, soreness, etc.
In chronic prostatitis, the prostate gland is characterized by an inelastic, soft consistency, pain, an increase in size. The mucous membrane of the rectum over the inflamed prostate is still.
If the disease has an asymptomatic course, as well as to determine the pathogen, the stage of the pathological process - the doctor appoints additional methods of investigation.
- 1) Laboratory diagnosis consists in examining the prostate secretion, urine analysis for infection. In addition, the study takes the scraping of the mucous membrane of the urethra and the PCR method determines the presence of bacteria that are the cause of the disease. The results of the laboratory study indicate the nature of the disease. In the event that microorganisms are not found, then it is an abacterial prostatitis. The study of the immune status helps to determine the effectiveness of treatment and the stage of the pathological process.
- 2)
- 3) Ultrasonic examination method, which measures the size, volume of the prostate gland, the presence of cysts, sclerotic changes, prostate enlargement, etc.
- 4) Uroflowmetry is a method that allows to determine the prostatitis by the indices of the process of urination. With normal urethral patency, the rate of urinary outflow is 15 ml per second. The consequence of poor patency of the urinary tract is a urine rate of less than 10 ml per second;
- 5) Computed tomography is performed for the purpose of differential diagnosis with a disease such as prostate cancer, as well as if there is a suspicion of prostatitis of non-inflammatory nature.
Treatment of chronic prostatitis
Treatment of prostatitis in men should begin with a change in the patient's lifestyle, which will help stop further progress of the disease.
It is important to eradicate bad habits: alcohol use, hypodynamia, chronic hypothermia, etc. It is recommended to normalize sexual life, monitor the balance of nutrition.
Drug treatment for chronic prostatitis consists in prescribing drugs of different groups that affect all parts of the pathological process. Antibacterial drugs are prescribed( ciprofloxacin, pefloxacin, norfloxacin, etc.), immunomodulators, nonsteroidal anti-inflammatory drugs, vasodilators. Antibiotics are also shown to prevent an exacerbation of the disease.
When abacterial prostatitis is prescribed drugs from the group of a-adrenoblockers( tamsulosin, terazosin, etc.).Under their influence, intraurethral pressure decreases, the bladder neck and smooth muscles of the prostate are relaxed, etc.
Complications of chronic prostatitis are constrictions of the urethra and, as a consequence, impaired urinary excretion. In this case, surgical treatment is recommended, the main goal of which is restoration of the normal urethral patency. Surgery is also indicated for chronic prostatitis, which was caused by a benign tumor - adenoma.
For physiotherapeutic methods, prostate massage, microwave hyperthermia, electrophoresis, mud therapy, etc. are effective.
Prognosis for chronic prostatitis
Proper, timely treatment of chronic prostatitis leads to prolonged remission or much less often recovery.
Evidence of a cure for prostatitis is the onset of a prolonged remission, during which, in addition to the absence of symptoms( pain, dysuria), the changes in laboratory tests are improving. In the secretion of the prostate there is no clinically significant concentration of pathogenic bacteria, etc.