Prostatitis occurs in two forms: acute and chronic. If acute inflammation is quickly treated with antibiotics, chronic prostatitis becomes a serious problem in older men, with negative effects on quality of life. Chronic prostatitis can be caused by both infection and congestion in the pelvic organs. The disease requires complex and long-term treatment.
Disease classification
Chronic prostatitis in men is divided into two types: congestive (bacterial, congestive) and infectious.
Chronic congestive prostatitis is a consequence of compromised trophism of the prostate. The disease develops with heart failure or lack of regular sex life.
Chronic bacterial prostatitis is characterized by moderate symptoms and the absence of acute pain syndrome. When analyzed, no infectious agents are detected in the secretion of the prostate, so the disease is called bacterial.
Chronic infectious prostatitis is a consequence of an untreated bacterial inflammation. The disease begins with an acute form due to the infection of the prostate gland. The disease becomes chronic due to the lack of adequate and timely therapy. Chronic infectious prostatitis is characterized by periodic exacerbations.
Causes of chronic non-infectious prostatitis
Speaking of chronic prostatitis, most often we mean a non-infectious disease triggered by congestion of the pelvic organs. This is due to a violation of the trophism of the prostate: blood circulation, lymphatic flow, outflow of prostatic secretions.
This form of illness is directly related to lifestyle and is considered an employee illness. The main reason for the development of congestive prostatitis is physical inactivity.
Among the factors that predispose to the development of congestive prostatitis are:
- sedentary work;
- lack of regular sports;
- unbalanced diet;
- obesity;
- bad habits;
- varicose veins;
- hemorrhoids;
- irregular sex life.
The disease develops against the background of any conditions, accompanied by circulatory disorders of the lower extremities. Quite often, prostatitis appears with obesity, when, due to increased stress on the lumbar region and lower extremities, metabolic processes in this area are disrupted.
If for the peculiarities of the profession you have to sit all day, you have to move at least in the evening.
Bad habits can trigger the development of prostatitis. Smoking destroys blood vessels and disrupts normal blood flow. Due to the physiological characteristics of a person, this primarily affects the blood circulation of the lower limbs and pelvic region.
Sex plays an important role in the functioning of the prostate gland. The optimal number of intercourse per week for a man over the age of 40 is 3-4. A smaller amount leads to a violation of the outflow of prostatic secretion, a larger amount - to depletion of organs.
Another cause of congestive prostatitis is heart failure. This disease is characterized by impaired blood circulation, including in the pelvic organs.
The reasons for the development of chronic infectious prostatitis
Chronic bacterial prostatitis is a consequence of acute untreated inflammation of the prostate gland. This form of the disease is characterized by severe symptoms and the presence of pathogens present in the secretion of the prostate.
The most common causative agents of infectious prostatitis:
- E. coli and Pseudomonas aeruginosa;
- staphylococcus and streptococcus;
- chlamydia;
- ureaplasma;
- Trichomonas;
- fungal flora.
Infection enters the prostate gland in three ways: through the bloodstream, through the lymph or through the urethra. The last path of penetration of pathogens is valid in cases of infection with chlamydia, ureplasma or Trichomonas.
Reasons for the development of the disease:
- decreased immunity;
- severe hypothermia;
- stress;
- long-term antibiotic therapy.
Conditionally pathogenic bacteria are always present in the body, and only strong immunity does not allow them to be activated.
Chronic bacterial prostatitis develops from an acute form in the following cases:
- presence of a chronic focus of infection;
- antibiotic therapy selected incorrectly;
- late termination of treatment;
- weakened immunity.
In most cases, the chronic form of the disease develops precisely due to improper treatment. This happens when the antibiotic therapy scheme is not drawn up correctly or self-medication. Stopping antibiotics when you feel better means that the pathogen will not be completely destroyed. Any decrease in immunity or hypothermia in this case leads to the re-development of the disease.
The most difficult to treat is fungal prostatitis caused by yeast-like fungi. This pathogen rapidly develops resistance to antifungal drugs, which makes treatment difficult and increases the risk of developing a chronic form of the disease.
Symptoms of the disease
In chronic prostatitis, the symptoms are mild, however, with a decrease in immunity or after suffering from stress, the disease worsens.
The most common symptoms of chronic prostatitis in men are:
- urination disorder;
- heaviness in the prostate;
- weakening of potency;
- nighttime urge to use the toilet.
With an exacerbation of chronic prostatitis, pain in the bladder and perineum is noted. The frequency of stress in the bathroom can reach 10 per hour. At the same time, the urine stream is weak, it is necessary to strain the muscles to urinate, but the process itself does not bring relief, and after a few minutes, repeated impulses appear.
Symptoms and treatment of chronic prostatitis largely depend on the form of inflammation. With congestive prostatitis, erection problems are common. This is due to impaired blood circulation. Ejaculation may occur rapidly or completely absent due to the thickening of the prostatic secretion.
In the case of infectious inflammation of the prostate or chronic bacterial prostatitis, pain when urinating and burning in the urethra after ejaculation may occur. Such symptoms are accompanied by irritation of the urethral mucosa by pathogens contained in the secretion of the prostate.
Prostatitis and erectile dysfunction
Inflammation of the prostate is not visible to the eye, the symptoms of chronic prostatitis have no visible manifestations, but refer to internal disorders. One of the characteristic symptoms of the disease is a weakening of the erection.
Erectile dysfunction in congestive prostatitis develops in several stages. The disease itself can proceed for a long time without pronounced symptoms, and signs of prostatitis will appear only with a sharp weakening of the immune system.
Bacterial inflammation of the prostate can be suspected from changes in the erection. At the very beginning of the development of the disease, an increase in potency is noted. The man gets aroused quickly, but ejaculation also comes quickly. This is due to a change in the viscosity of the secretion of the prostate gland. Discomfort may be felt during ejaculation, but pain is characteristic of infectious but not congestive prostatitis.
This causes a number of psychological problems which aggravate the course of the disease. Erectile dysfunction due to problems with blood flow is aggravated by fear of a sexual partner, which can lead to the development of impotence against the background of prostatitis.
Urinary disorder
Problems with urodynamics have been observed in all forms of prostatitis.
Chronic bacterial inflammation is characterized by the nocturnal urge to urinate. It is caused by swelling of the prostate gland, which gets worse during the night. There is a weakening of the urine pressure and the need to contract the pelvic floor muscles to urinate. At the same time, he feels heaviness and fullness in the bladder, and occasional spasms may appear. Due to the frequent urge to use the toilet at night, sleep problems and insomnia appear. All this affects the psychological state of man and further aggravates the course of the disease, since against the background of stress there is a decrease in immunity and a slowing down of metabolic processes.
Men often complain of cramps in the lower abdomen, which is explained by the increased tone of the bladder muscles. Usually, severe symptoms of prostatitis with a decrease in immunity are noted. Without exacerbation of the disease, the pain syndrome can be completely absent.
Congestive prostatitis is characterized by severe prostate edema. The contours of the organ become indistinct, the prostate itself swells and increases in size. In this case, there may be a feeling of fullness in the rectum and increased discomfort during bowel movements. Problems with urination are due to compression of the urethra by the swollen prostate gland.
Why is prostatitis dangerous?
The consequences of chronic prostatitis depend on several factors:
- age of the patient;
- severity of symptoms;
- current duration;
- the efficacy of drug therapy.
The longer a man lives with chronic prostatitis, the more severe the consequences of the disease. In most cases, the urinary system is affected. With bacterial prostatitis, a kidney infection can occur when urine flows back. This is due to the entry of pathogens into the urethra during ejaculation.
Constant irritation of the bladder and urethra can cause inflammation. Against the background of prostatitis, cystitis and urethritis of various kinds are often diagnosed.
In chronic prostatitis, the consequences affect the psycho-emotional state of the man. Violation of potency, frequent need to go to the toilet, discomfort in the bladder - all this leads to the development of stress. Prostatitis can be an indirect cause of neurosis and depression.
Disruption of the nervous system against the background of constant discomfort in the genitourinary organs leads to a decrease in immunity and deterioration of all metabolic processes in the body. Thus, prostatitis causes nervous disorders, which in turn aggravate the course of the disease and the circle is closed.
Constant discomfort, reduced power, inability to sleep - all this greatly affects the quality of life.
Diagnosis of the disease
If inflammation of the prostate is suspected, consult a urologist or andrologist. The following diagnostic methods are used to make a diagnosis:
- rectal palpation of the prostate;
- Ultrasound and TRUS of an organ;
- renal ultrasound;
- analysis of prostatic secretion;
- PSA blood test.
The need for further examinations is determined after palpation of the rectal organ. This procedure is also known as prostate massage. The doctor inserts two fingers into the rectal opening and feels the prostate. Inflammation is evidenced by a change in the structure of the organ, the heterogeneity of the tissues and the contours of the prostate. During the massage, the organ is stimulated and the secretion of the prostate is secreted from the urethra. It is collected for further analysis. Analysis of prostatic secretion shows:
- quantity of lecithin grains;
- white blood cell and red blood cell count;
- presence of pathogenic microorganisms;
- presence of fungal microflora.
This allows not only to determine the nature of the inflammatory process, but also to identify the causative agent in infectious prostatitis.
Ultrasound and TRUS are performed rather to rule out stones in the prostate than to diagnose prostatitis, since the method is not very informative, contrary to the analysis of secretions.
PSA blood test is prescribed to rule out oncopathology in the prostate gland. It also detects inflammation or prostate adenomas. How to treat chronic prostatitis depends on the test results and the type of inflammation.
Treatment characteristics
The treatment regimen of chronic prostatitis is a combination of drugs, physiotherapy and folk methods. The treatment is complemented by a change in lifestyle: adjusting the menu, giving up bad habits, regular sports and sex life.
It is important to understand that for chronic prostatitis treatment will take at least six months. In addition to drugs to relieve inflammation, men are prescribed long-term rehabilitation therapy, which is necessary to normalize the function of the prostate gland.
Medication
How to cure chronic prostatitis depends on the form of the disease. Medicines for chronic prostatitis include:
- antibiotics or anti-inflammatory drugs;
- rectal suppositories to normalize trophism;
- immunostimulants and agents that improve general health.
For the treatment of chronic prostatitis in men, antibiotics are used, but only if it is an infectious inflammation of the prostate. How to treat infectious prostatitis in men depends on the pathogen and the success of the previous therapeutic course. In acute bacterial inflammation, macrolide antibiotics are prescribed in most cases. They effectively suppress the activity of pathogens and have a wide spectrum of action. In case of non-compliance with the treatment regimen or improper selection of drugs, the microorganisms that caused inflammation quickly develop resistance to macrolides, which largely determines the transition of the disease to a chronic form.
Fluoroquinolones are effective antibacterial agents for prostatitis caused by microorganisms. They have a marked anti-inflammatory activity against a wide range of pathogenic microorganisms.
Despite the fact that fluoroquinolones do not have natural analogues, which is the reason for the lack of resistance of pathogenic microorganisms to the action of the drug, it is necessary to carefully follow the treatment regimen selected by the doctor. Otherwise, the drug will be ineffective and antibiotic therapy will have to be repeated.
Antibacterial drugs and tablets are not used to treat chronic non-infectious prostatitis. With congestive prostatitis, inflammation is caused not by microbes, but by a violation of trophism, so it is not appropriate to use antibiotics for treatment. Instead they use anti-inflammatory drugs. They are applied in short courses to reduce inflammation and swelling. Drugs are prescribed in suppositories or injections. Treatment lasts an average of one week, the drug is administered rectally at night or intramuscularly once a day. In case of severe inflammation, you can use the drug twice during the day.
Anti-inflammatory drugs are not antibiotics. Tablets are successfully used to relieve the inflammatory process with non-infectious or congestive prostatitis. On average, doctors prescribe two tablets a day for 5 days, then transfer the patient to phytopreparations that improve prostate trophism.
In case of severe urination disorders, treatment is supplemented with drugs of the alpha-blocker group. These drugs relax the bladder, reducing muscle tone, thus allowing urine to flow normally. Medicines in this group are taken one tablet a day in short courses, treatment with alpha-blockers rarely exceeds a week.
After the inflammation subsides, congestive (cognitive) and infectious prostatitis is treated with drugs that normalize the trophism of the prostate gland. Medicines contribute to:
- reduces inflammation;
- pain relief;
- normalization of urination;
- increased power.
For chronic prostatitis, these drugs are used for at least two weeks. They come in the form of rectal suppositories. The recommended dosage is one candle per day during the night.
Propolis suppositories are recommended to restore local immunity. Relieves inflammation, improves blood circulation and the outflow of prostatic secretions, and also significantly increases immunity, preventing an exacerbation of prostatitis. Medicines come in the form of small suppositories that are injected into the rectum at night.
Also, the doctor may recommend suppositories with ichthyol. Relieves inflammation and reduces swelling of the prostate gland.
Preparations based on echinacea extract are recommended as a general tonic for prostatitis. They strengthen the immune system and prevent the development of exacerbations of prostatitis. With the appearance of neurosis and insomnia against the background of prostatitis, the doctor may recommend sedatives.
Physiotherapy for chronic prostatitis
The causes of chronic prostatitis lie in poor circulation in the pelvic organs. To accelerate the recovery and restoration of prostate trophism, physiotherapy methods are widely used:
- magnetic therapy;
- electrophoresis;
- shock wave therapy;
- acupuncture.
Acupuncture (acupuncture) and leech therapy (hirudotherapy) are distinguished from non-traditional methods.
There are many methods of home physiotherapy. The most popular are special devices. They create alternating magnetic fields that have a positive effect on metabolic processes, eliminating congestion in the pelvic organs.
Darsonvaluation can also be used at home. This is a microcurrent effect that improves metabolic processes. You can purchase home treatment devices at any medical equipment store, but it is recommended that you consult your doctor first.
Prostate massage is used to treat congestive prostatitis. It is performed by a specialist in a medical facility. Stimulation of the organ allows you to get rid of swelling and discomfort, and also relieves stagnation of prostatic secretions. The course of treatment consists of 10-15 procedures.
Folk remedies
Treatment of chronic prostatitis depends on the range of therapeutic measures taken. Traditional medicine will help complement drug treatment.
Homemade suppositories are used to relieve inflammation of the prostate. To prepare candles, you will need 200 g of any fat base, 40 ml of propolis extract. The base is melted in a water bath, propolis is poured slowly, stirring constantly. When the product acquires a uniform color, it is poured onto cling film and packaged in the shape of a sausage. The mass should be refrigerated for an hour to cool. When the product has cooled, it is divided with a knife into equal torpedo-shaped pieces, approximately 5 cm long and 2 cm in diameter. These candles should be stored individually wrapped in the refrigerator. The recommended dosage is a suppository in the rectal opening before bedtime. The duration of treatment is 2-3 weeks.
You can also make candles with pumpkin seed oil and honey. The proportions are 200 g of base, 50 ml of oil and 3 tablespoons of honey. As a basis, you can take beeswax, lanolin, cocoa butter. Such suppositories relieve inflammation, improve the function of the prostate and increase immunity.
To cure chronic prostatitis at home, you can use various infusions and decoctions. One of the most effective remedies is parsley juice. 3 large spoons per day should be taken.
Traditional medicine recommends consuming 30 g of pumpkin seeds per day. They contain many nutrients necessary for the normal functioning of the prostate gland.
Another effective treatment is a blend of pumpkin seeds, nuts and honey. To prepare the medicine it is advisable to take 100 peeled seeds and the same number of walnut kernels, put them in a convenient container and pour 500 ml of honey. The product is stored in the refrigerator for 4 days for infusion, then 4 large spoons are taken per day.
Surgical treatment
Whether chronic prostatitis can be cured permanently depends on the severity of the disease and the age of the patient. With frequent exacerbations, you have to constantly take drugs.
Surgical treatment of prostatitis in most cases is not performed. Perhaps the use of radical measures: complete removal of the prostate gland. Such an operation is performed only if the prostate does not perform its functions due to chronic inflammation, and drug treatment is ineffective. Also, removal of the prostate is done at the risk of developing oncology.
Interestingly, the effects of prostatitis are usually seen in old age, in men over 65. In this case, a number of difficulties arise in treatment:
- diseases of the cardiovascular system;
- contraindications for taking medications;
- many side effects.
Many men, who have been suffering from prostatitis for more than 10 years, insist on surgery. This is usually associated with poor drug tolerance and a large number of side effects. Doctors say surgery is a last resort, and with the right approach, prostatitis can be treated conservatively.
Prevention and prognosis
Having understood what chronic prostatitis in men is and how dangerous it is, the question immediately arises whether the disease can be completely cured.
Patient testimonials indicate that chronic prostatitis can be cured, but it will take a long time. The course of treatment lasts an average of six months or more. Urologists agree that adequate therapy, lifestyle changes and a balanced diet will help get rid of inflammation.
Very often, men who do not follow the recommendations of the doctor, but are treated according to the advice of friends, encounter exacerbations and repeated episodes of inflammation after a prolonged remission. It is important to understand that successful treatment of therapy depends on the correct selection of drug therapy. Lead to exacerbation or manifestation of signs of chronic prostatitis can:
- unsystematic drug intake;
- failure to comply with the doctor's recommendations;
- stop treatment after the first improvements;
- bad habits;
- lack of physical activity.
Self-selection of drugs often leads to a deterioration in well-being. This is especially true in cases of infectious inflammation, when the patient independently selects antibiotics without testing.
A common mistake men make is to stop treatment when the first improvements appear. In this case, the inflammation does not go away, but only subsides for a while. With a decrease in immunity or hypothermia, the disease will again make itself felt.
In addition to medications, prostatitis requires lifestyle changes. It is important to give up bad habits, normalize nutrition and start playing sports. With prostatitis, it is recommended to do yoga, physical therapy, swimming. Any workout that involves the pelvis will benefit. Men with this condition, especially sedentary work, should do 10-minute exercises every day and do a full workout several times a week. Also, during the treatment of chronic prostatitis, it is necessary to have sex, as regular ejaculation helps to reduce prostate edema.
Successful treatment of prostatitis depends on timely diagnosis, so if you notice problems with urination, you should consult a urologist as soon as possible.