Chronic prostatitis – symptoms and treatment

The symptoms of chronic prostatitis are often mild and treatment is not given in the early stages. However, the problem can be solved if you take it seriously.

What is that

Many patients learn what chronic prostatitis is when they see a doctor for a completely different reason. Meanwhile, this disease is very dangerous and is a long-term inflammatory process that occurs in the prostate. If left untreated, serious complications can occur: impotence, infertility, vesiculitis, prostate cysts, adenomas and prostate cancer.

There are different forms of the disease:

  • acute bacterial prostatitis caused by the penetration of infectious pathogens into the prostate. Characterized by typical pain in the lower abdomen and when urinating;

  • chronic bacterial prostatitis, which, in addition to the clinical picture of the acute form of pathology, is accompanied by the presence of bacteria and an increased level of leukocytes in the urine and prostate secretion;

  • chronic prostatitis, which is a consequence of a previous bacterial form of the disease with ineffective or no treatment;

  • asymptomatic inflammatory prostatitis, which is characterized by the absence of any symptoms, but manifests itself using laboratory diagnostic methods.

More than 90% of cases are due to nonbacterial chronic prostatitis, which is asymptomatic and leads to delayed treatment.

Is a cure possible?

The diagnosis itself indicates that the disease has been progressing in the body for a long time. It is often difficult for men to see a doctor about such an urgent problem until the situation becomes critical. The sooner a man seeks medical help (at the first signs of illness), the more effective the treatment will be and the higher the likelihood that the disease will be completely eliminated. In its advanced form, chronic prostatitis is almost impossible to cure, but with correct and regular therapy the symptoms become less pronounced. That is why timely consultation with a doctor is so important.

causes

The disease occurs in men aged 20 to 50 and depends on a number of conditions:

  1. Infectious pathogens. They get into the prostate in several ways:

    • ascending (along the urethra);

    • descending (due to infected urine);

    • lymphogenic (through lymphatic channels);

    • hematogenous (through blood).

    Examples of pathogenic microflora that cause the bacterial form of prostatitis are staphylococci, E. coli, enterococci, Proteus, pathogens of a viral, fungal, parasitic nature, as well as chlamydia, gonococci, gardnerella and others.

  2. Disruption of normal blood circulation in the pelvic organs. This can be due to a sedentary lifestyle, sedentary work (drivers, office workers) and poor diet. As a result, congestion and swelling occur in the tissues of the prostate and incomplete expulsion of secretions from the organ cavity is observed. All this leads to partial or complete dysfunction of the gland.

  3. Prolonged sexual abstinence or practicing intermittent sexual intercourse. These effects also provoke inflammatory processes in the prostate.

  4. Concomitant diseases. This primarily concerns pathologies of a urological nature: cystitis, urethritis, pyelonephritis, untreated acute prostatitis. However, the cause of chronic prostatitis can also be other diseases: chronic bronchitis, pneumonia, sinusitis, etc.

  5. Frequent and prolonged stay in the cold, at high ambient temperature or high humidity, constant psycho-emotional stress.

Symptoms

The clinical picture of chronic prostatitis is mild in the initial stages. As a rule, a man does not feel any discomfort or does not pay attention to the appearance of signs of the disease if they do not interfere with leading a normal lifestyle. Over time, the general condition worsens and is accompanied by the following symptoms:

  1. The appearance of pain in the perineum, genitals and groin. The pain may be mild, aching, or very severe during urination, bowel movements, after sexual intercourse, and during ejaculation. Often the pain syndrome spreads to the sacrum, anus, scrotum and testicles.

  2. Disturbances in urination and bowel movements. In the first case, the process is characterized by frequent and painful urge and burning in the urethra. The presence of thread-like structures in the urine is observed. During bowel movements, discharge from the urethra is possible, which indicates insufficient tone of the prostate.

  3. Sexual function disorders. Men suffering from chronic prostatitis experience decreased libido, unstable or absent erection, pain during and after sexual intercourse, hematospermia, and infertility.

  4. Poor sleep, irritability, increased nervousness, fatigue, depression.

  5. Increased body temperature. It can be observed during an exacerbation of the disease and have minor deviations from the norm.

Symptoms may not appear all at once but may be constant.

diagnosis

Diagnostic studies make it possible to refute or confirm a suspected diagnosis, determine what kind of disease it is and how possible it is to cure it.

Ultrasound for chronic prostatitis – healthy prostate (left) and inflamed prostate (right)

The most important diagnostic procedures are:

  • general urinalysis;

  • Analysis of prostate secretion for the presence/absence of pathogenic microflora, as well as to determine deviations of physiological parameters from normal values (increased leukocyte count, etc. );

  • bacteriological urine culture and smear from the urethra;

  • a urine sample from three glasses to determine the location of the inflammation;

  • Analysis to identify pathogens of genital tract infections;

  • ultrasound of the prostate;

  • Examination of spermogram data, MAR test (for reproductive disorders);

  • urodynamic, endoscopic examinations;

  • Determination of prostate-specific antigen (PSA).

Treatment of chronic prostatitis

The answer to the question of how to treat chronic prostatitis depends on the severity of the pathology and its type. The disease requires an integrated approach to its elimination or stable relief of symptoms.

Medication

This involves taking medications from the following groups:

  1. Antibiotics, which are necessarily prescribed when diagnosing bacterial pathology. However, such therapy may also be indicated for non-bacterial chronic prostatitis if a persistent positive effect is observed. Drugs from the groups penicillins, cephalosporins, tetracyclines, aminoglycosides and fluoroquinolones are taken for at least two weeks according to the strict instructions of the doctor.

  2. Antispasmodics that help eliminate painful spasms in the perineum.

  3. Anti-inflammatory, pain-relieving.

  4. Alpha1 blockers are used to reduce prostate hypertonicity and normalize motility.

  5. Immunostimulating drugs.

The medication regimen is selected individually according to the specifics of the diagnosis and the intolerance of individual medications (if any).

Non-drug treatment

In this case, the positive effect of therapy is achieved through physical impact of a different kind on the diseased area. Patients can be prescribed:

  1. Prostate massage. It activates the full expulsion of secretions from the prostate, improves blood circulation and normalizes the tone of the organ. Massage combined with antibiotics is particularly effective in treating bacterial chronic prostatitis. However, there are contraindications to use if the patient is diagnosed with:

    • acute bacterial prostatitis;

    • Concomitant diseases of the gonads (vesiculitis, cooperitis);

    • the presence of stones in the prostate;

    • prostate cysts;

    • BPH;

    • Cancer of an organ or suspected cancer;

    • prostate abscess;

    • Hemorrhoids, rectal fissures and other diseases.

  2. Electrophoresis. The physiotherapeutic procedure involves the therapeutic effect on the pathological area with a small electric current (no more than 50 μA). In this way, recovery reactions are stimulated, pain is relieved and blood circulation in the glandular tissue is optimized. Electrophoresis promotes the deep penetration of antibiotics into the structures of the prostate, thereby increasing the effectiveness of their action.

  3. Ultrasonic. The method is often used in the treatment of chronic prostatitis, as it has a pronounced anti-inflammatory effect, restores sexual function and suppresses pain. Prostate tumors are successfully treated with ultrasound.

  4. Ultraphonophoresis is the use of ultrasound therapy together with medication. This method allows medications to penetrate into the deep layers of the affected organ and work most effectively there.

  5. Magnetic field therapy. The physiotherapeutic procedure has a comprehensive restorative effect on the genitourinary system, improves metabolic processes and neurogeneration.

  6. Laser magnetic field therapy. Laser irradiation also effectively treats the manifestations of the disease and eliminates the risk of possible complications.

  7. Inductometry involves the influence of a high-frequency alternating magnetic field.

  8. Instillations into the urethra, mud therapy, therapeutic enemas, hot baths.

Physiotherapy in combination with drug treatment makes it possible to achieve a lasting therapeutic effect and, in most cases, to completely defeat the disease in the initial stages.

Surgical intervention

Indicated in cases where it is impossible to help the patient using other methods.

  1. Prostatectomy is a partial or complete removal of the prostate while preserving erectile function.

  2. Transurethral resection (TUR) is a surgery to excise or remove overgrown glandular tissue. Prescribed for adenoma or prostate cancer.

  3. Laser treatment. During the operation, the affected organ tissue is removed using a laser beam. In this case, the blood vessels are "closed" and bleeding is prevented.

  4. Drainage of a prostate abscess. This operation allows you to remove pus from the gland cavity using a rubber drain inserted through the perineum or rectum by cutting the skin tissue.

  5. Transurethral section of the prostate. The operation involves making several incisions in the prostate to relieve pressure from the affected organ on the urethra and restore urine output.

After the surgical intervention, the patient needs rehabilitation, the time interval of which varies from 2-3 days to several months, depending on the type of operation.

home remedies

Herbal remedies are also effective drugs in the complex therapy of chronic prostatitis. For this purpose, tinctures, decoctions, food mixtures or ointments are used, including:

  • pumpkin seeds;

  • aspen bark;

  • hazelnut leaves and bark;

  • chestnut shells;

  • Parsley;

  • honey, propolis;

  • Kalanchoe etc.

Regular use of herbal medicines helps to eliminate unpleasant symptoms, restore impaired functions and have a long-term preventive effect.

Chronic prostatitis is a disease that you should pay attention to at the first signs in order to exclude dangerous complications and cure it in a timely manner.