What are the signs of chronic prostatitis. Distinctive signs and methods of treatment of prostatitis at different stages. Can chronic prostatitis be cured without antibiotics?

18.09.2020

It is a serious problem even for modern urology, since many questions regarding this disease still remain unclear. There is an opinion that chronic prostatitis is a pathology that implies that a person has a whole range of health problems, including tissue damage, functional disorders of the work of not only the prostate gland and urinary tract, but also other systems of male organs.

Since there is no single characteristic of the concept of "chronic prostatitis", this negatively affects the diagnosis and treatment of the disease as a whole.

In order to make this diagnosis, a man must have pain in the perineum, in the pelvic area and in the organs of the genitourinary system for at least 3 months (USA, National Institutes of Health). Signs such as urination disorder and detection of bacteria in secret are not prerequisites for making a diagnosis.

In this case, the process of inflammation in the tissues of the prostate gland must be confirmed by the data of histological studies of prostate tissues, or by microbiological analysis of the secret. Ultrasound examination allows you to clarify the nature of changes in the organ.

Epidemiology of chronic prostatitis

Statistics indicate that the disease is extremely common and is in first place among all diseases of the male reproductive system of an inflammatory nature. In addition, this pathology holds a leading position among all diseases that affect young men in general. It's about about the representatives of the stronger sex up to 50 years. Average age patients - 43 years, while 30% of men until they reach 80 years of age will definitely suffer this pathology.

Up to 35% of all visits to the urologist in Russian Federation due to chronic prostatitis. Often the disease occurs with complications - it can be vesiculitis, dysuria, erectile dysfunction, inability to conceive a child, epididymitis. These and other complications occur according to various data in 7-36% of cases.

The causes of chronic prostatitis are varied. The disease occurs under the influence of infectious agents, while patients have neurovegetative, hemodynamic, immunological, hormonal disorders. Urine reflux into the prostate lobes, biochemical factors (violation metabolic processes, and in particular salt metabolism), as well as disturbances in the functioning of growth factors responsible for the proliferation of living cells.

Experts identify the following provocateur factors that influence the formation of the disease:

Infections of the genitourinary system (non-compliance with the rules of personal hygiene, lack of a permanent sexual partner, failure to protect, the presence of an infection in a partner);

Surgical interventions on the prostate without prior preparation with antibacterial agents;

Dysrhythmia of sexual life;

Regular hypothermia;

catheterization Bladder on an ongoing basis;

Physical inactivity.

The role of immunological disorders in the development of the disease should not be rejected. If there is an imbalance of immunocompetent factors, namely cytokines, then this directly affects the work of immunity.

Intraprostatic reflux of urine contributes to the development of chronic non-bacterial prostatitis.

Chronic abacterial prostatitis is associated with neurogenic disorders of the pelvic floor muscles, as well as those elements that are responsible for the functioning of the bladder wall, prostate and urethra.

Pelvic pain syndrome may be due to the fact that a man forms myofascial trigger points, which are located next to the prostate gland and the organs of the genitourinary system. Points that are the result of injuries, surgical interventions and some diseases that can lead to pain in the perineum, pubis and nearby areas.

Symptoms of chronic prostatitis

The symptoms of chronic prostatitis are diverse, but the pain and discomfort that occurs in the pelvic area and lasts at least 3 months come to the fore.

In addition, men suffer from erectile dysfunction and urination disorders:

As for pain, they occur mainly in close proximity to the prostate gland, that is, in the perineum, but can radiate to the anus, to the inner surface of the thigh, scrotum, lower back, sacrum and inguinal zone. When pain occurs on one side and radiates to the testicle, most likely this is not a symptom of chronic prostatitis.

Libido suffers, erection does not occur at the moment when there are adequate conditions for this, but although certain sexual disorders are present, complete impotence is not observed.

Another symptom of chronic prostatitis is premature ejaculation. This is typical for the initial stages of the development of the disease. As the pathology progresses, ejaculation becomes, on the contrary, slow. Orgasm is often dim, devoid of richness and emotional color. The ejaculate loses its qualitative and quantitative characteristics.

The disease is characterized by irritative symptoms (increased urination at night, urgency, pain and burning sensation during bladder emptying, urinary incontinence). Ifravesical obstruction with bladder occlusion is less common.

The disease has an undulating course, the symptoms either weaken or become stronger, but they clearly indicate the presence of inflammation.

The following stages of development of chronic prostatitis can be distinguished:

exudative stage. A man experiences pain in the scrotum, in the groin, in the pubis. Urination becomes more frequent, there may be a feeling of discomfort at the end of intercourse. Erections can hurt.

alternative stage. The pains intensify, are localized mainly in the pubic region, in the groin and are given to the sacrum. Emptying the bladder most often goes without any difficulty, although it may occur more often than usual. Erection does not suffer.

proliferative stage. The stream of urine loses its strength, during an exacerbation of the disease, urination becomes more frequent. The erection is intense, but some slowing down of the reaction is possible.

Scar stage. Prostate tissue sclerosis occurs. In the pubic area, in the sacrum there is a feeling of heaviness. Urination becomes more frequent, the urge disturbs the man not only during the day, but also at night. Ejaculation may be completely absent, erection becomes weak.

One should not expect that the symptoms characteristic of a particular stage will be present in a strictly defined order and will occur in in full. They may vary depending on the characteristics of the individual course of the disease. But pain, increased urination and functional erectile dysfunction will gradually increase.

At the same time, many men underestimate the severity of the disease until they encounter it. Meanwhile, studies show that the quality of life of people with this problem suffers no less than if they had suffered, Crohn's disease, or.

The classification of prostatitis was proposed in 1995 in the United States, developed by scientists from the National Institutes of Health:

Acute bacterial prostatitis - type 1 (5% of all diagnosed inflammation of the prostate gland).

Chronic bacterial prostatitis - type 2.

Abacterial prostatitis of chronic course - type 3. This prostatitis is also called chronic pelvic pain syndrome.

Inflammatory form (with a leukocyte jump in the discharge from the prostate) of chronic prostatitis - type 3A. Diagnosed among total weight chronic prostatitis in 60% of cases.

Non-inflammatory form (without leukocyte surge) of chronic prostatitis - type 3B. Diagnosed among the total mass of chronic prostatitis in 30% of cases.

Asymptomatic prostatitis - type 4.

Diagnosis of chronic prostatitis

Diagnosis of chronic prostatitis is not particularly difficult when there is a complex of symptoms (pain, urination disorders, sexual disorders). However, it happens that the pathology is asymptomatic, which requires additional methods research, other than the standard survey and examination of the patient. These are physical, laboratory, and instrumental methods. Be sure to study the immunological status of the patient, a neurological examination.

In addition, questionnaires and questionnaires have been developed that allow you to clarify the subjective feelings of the patient, give more full information about the state of his health, about the strength of pain, about disorders of urination, erection, ejaculation, about the patient's psycho-emotional moods.

Often practicing urologists use the prostatitis symptom scale questionnaire developed by the American National Institutes of Health - this is the NIH-CPS questionnaire.

Laboratory diagnosis of chronic prostatitis

Laboratory diagnosis of chronic prostatitis allows you to distinguish between abacterial and bacterial forms of the disease, determine the type of pathogen and make the most accurate diagnosis. When the fourth urine sample, or prostate secretion, contains more than 10 leukocytes in the PZ, or bacterial associations, in this case, it is confirmed chronic inflammation prostate. If the number of leukocytes is increased, but the bacteria are not sown, the material should be examined for the detection of chlamydia and other STD pathogens in it.

Discharge from the urethra is sent to the laboratory to detect leukocytes, bacterial, fungal or viral flora, as well as mucus in it.

A scraping taken from the urethra is studied by PCR, which makes it possible to identify pathological sexually transmitted agents.

The secret of the prostate is sent for microscopic examination to count the number of leukocytes, macrophages, amyloid and Trousseau-Lallemand bodies. They also conduct its bacteriological study and immunological study, determine the level of nonspecific antibodies.

10 days after the digital rectal examination, blood is taken to determine the concentration of PSA in it. If the indicator exceeds 4.0 ng / ml, then the patient is recommended to undergo a prostate biopsy to exclude cancer.

Based on the results of the performed studies, a diagnosis is made.

Instrumental diagnosis of chronic prostatitis

transrectal ultrasound procedure gland makes it possible to clarify the form of the disease, its stage. With the help of ultrasound, it is possible to weed out other diagnoses, track the effectiveness of the therapy, visualize the size of the prostate, its echostructure (exclude the presence of cysts, stones, sclerotic changes, abscess), the density and uniformity of the seminal vesicles.

Urodynamic studies and myography of the pelvic floor muscles reveal neurogenic disorders and infravesical obstruction, which often accompanies chronic prostatitis.

Tomography, both computed and magnetic resonance, is used to make a differential diagnosis, in particular, with prostate cancer. In addition, these methods make it possible to identify existing disorders in the spinal column, in the pelvic organs.

Differential diagnosis of chronic prostatitis

Differential diagnosis of chronic prostatitis is of no small importance, since there is a risk that a man has a more serious disease.

So, the differential diagnosis is established with diseases such as:

Bladder dysfunction of neurogenic origin, complex regional pain syndrome, functional disorder of the detrusor-sphincter system, pseudodyssynergia;

Prostate adenoma, hypertrophic changes in the neck of the bladder, bladder stricture;

Everyone has heard of the prostate. This disease is often found in men. This disease affects reproductive system. It is known that men at a young age can get sick with prostatitis. Adults of the stronger sex are also affected by this disease. Chronic prostatitis present in 80% of males whose age limit is approaching 80 years.

What is the essence of the disease? Causes

The essence of prostatitis is that such an organ becomes inflamed. One of the most common causes of the disease is neglected infectious diseases of the reproductive system. In addition, there are a number of factors that can trigger the onset of the disease.

Now we will consider them. This is:

There are statistics: most often prostatitis occurs in men from 20 to 40 years old. This age is the most active in life. can affect the subsequent sexual activity of a man. There are certain difficulties in diagnosing this disease. They are due to the fact that its symptoms are similar to other ailments. The opposite option is also possible, namely, a man may think that he has prostatitis, but in fact a completely different ailment develops in his body.

Types

There are two main forms of the disease:

Acute form of prostatitis, or bacterial disease. Acute prostatitis is much less common than chronic. Namely, in 5 cases out of 100.
Chronic form of prostatitis most often present in male body. It does not develop as a consequence of acute prostatitis. An ailment appears on its own, that is, chronic prostatitis occurs immediately.

If a man in the body has such an ailment as chronic bacterial prostatitis, then laboratory research methods will reveal the presence of red blood cells in the secretion of the prostate gland. In addition, elements such as enterobacteria, E. coli and Klebsiella are found in the ejaculate.

In the case when chronic non-bacterial prostatitis develops in the body, laboratory studies reveal the presence of leukocytes both in the urine and in the secretion of the prostate gland.

How to treat?

Do not think that this disease is not treatable. Chronic prostatitis can be cured through conservative methods. It should be borne in mind that the treatment regimen consists not only of taking certain medications. The patient will be assigned a comprehensive approach to improving the body.

How to treat chronic prostatitis? The patient should be aware that in addition to medical remedies that will provide pain relief and improve the functioning of the urinary system, he will need to change his lifestyle. It is necessary for a person to understand that his current way of life has led him to the occurrence of such a disease. The consequences of chronic prostatitis can be very sad. Therefore, it is not worth starting the disease. The appearance of this disease is influenced by factors such as malnutrition, lack of physical activity and sexual intercourse of a promiscuous nature.

Preparations

You can treat chronic prostatitis in men with medications. The action of drugs is aimed at reducing or eliminating the pain of the patient. Next, you need to ensure that the inflammatory process is gone.

In addition, the patient is prescribed drugs that activate the regenerative properties of the body. Depending on the condition of the patient and the neglect of the disease, antibiotics may be prescribed to him. Most of the time they are prescribed. If one course of antibiotics does not lead to the desired result, then the patient is prescribed a second and even a third. Taking these drugs has a bad effect on the patient's stomach, its microflora deteriorates, so the patient is prescribed probiotics.

Massage

You can treat chronic prostatitis in men through prostate massage.

It should be said that this procedure is not very pleasant. Therefore, not all men are ready for it. Prostate massage is done through the anus. But such treatment positive effect. Massage also speeds up the recovery process.

Physiotherapy

You can treat chronic prostatitis through physiotherapy. Such methods also have a beneficial effect on the human body. Due to the fact that microcirculation and heating occur, tissues better absorb medications. It uses such methods of treatment as warming up with ultrasound and irrigation with enemas, which are filled with a special solution with antibacterial properties.

Balneotherapy

What methods are used for chronic prostatitis in men? For example, balneotherapy. This is a special complex for the treatment of prostatitis with the help of mineral waters. In this way, patients are treated in special sanatoriums that deal with this area of medicine. Water is used, which is slightly mineralized. It is prescribed to the patient for oral administration. It is also used externally. There are several well-known sanatoriums that specialize in this area. They are located in the south of our country.

Nutrition

If a man begins to show certain symptoms that indicate that there is prostatitis in the body, then it is worth starting to follow the diet. The dietary guidelines are pretty simple, but you should stick to them.

First of all, it is necessary to exclude the use of alcoholic beverages. Then you need to give up foods high in fat. The fact is that fat provokes the appearance of cholesterol, which is deposited on the vessels. Also, avoid salty foods. And remove from the diet of coffee, tea, drinks with gases.

Conclusion

Now you know how chronic prostatitis manifests itself. Symptoms and treatment are two important topics that we have covered in detail in the article. We hope that this information will be useful to you.

Chronic prostatitis (ICD code 10 - N 41.1) is the most common disease of the male genital area. Pathology is an inflammatory process in the prostate gland, which occurs against the background of stagnant processes or infection of the organ by various microorganisms.

Chronic prostatitis can be primary and secondary, often it is a complication of acute prostatitis, which was treated incorrectly or out of time. The disease most often occurs in men of mature age, older than 50-60 years. But in severe cases, pathology is also diagnosed in patients of fertile age: from 30 to 50 years.

Causes of chronic prostatitis

There is a huge list of causes and factors that can trigger chronic prostatitis. First of all, this infectious diseases prostate and age-related changes, stagnant processes in the prostate.

Acute prostatitis very often causes the development of a chronic form of the disease. The fact is that men in most cases do not dare to turn to an andrologist for pain in the small pelvis. As a result, the inflammatory process can take place on its own, if the immune system copes, or provoke suppuration. In any case, a complication arises in the form of chronicization of the process.

In older patients, chronic prostatitis is associated with circulatory disorders in the pelvis, lack of sexual life. The prostate secretes a special secret that enters the ejaculate during ejaculation. If a man does not have sex and does not masturbate, the fluid stagnates, thickens, the prostate gland degrades. The same thing happens with insufficient blood circulation, the prostate lacks nutrients.

Stagnant processes in the prostate can also be provoked by interrupted sexual intercourse, unrealized excitement. If a man has an erection, the synthesis of prostate juice increases, but at the same time ejaculation does not occur - excess fluid stagnates.

Doctors identify a number of factors that contribute to the development of chronic prostatitis in men:

A passive lifestyle is a direct path to the formation of stagnant processes in the small pelvis, circulatory disorders, and the appearance of adhesions.
Poor nutrition, an abundance of fatty and unhealthy food, obesity.
Improper sexual conduct.
Hypothermia of the genitals.
Chronic inflammatory processes in the body, including the upper respiratory tract, caries, history of urogenital infections, etc.
Chronic.
Endocrine disorders, hormonal disruptions.
Genital trauma.
Weakened immunity, beriberi.
Chronic overwork, depression.

Increases the risk of chronic prostatitis and regular drinking and smoking. The fact is that these substances provoke a spasm vascular system by disrupting circulation. If this happens constantly, the vessels cease to function normally, and internal organs food is not received.

Signs of chronic prostatitis in men

Symptoms of chronic prostatitis manifest themselves in varying degrees. During the period of remission, the signs can be very mild, so patients are in no hurry to see a doctor. Exacerbation of chronic prostatitis is accompanied by the following symptoms:

in the perineum and lower abdomen, which give into the penis and rectum.
Pain during ejaculation.
Various forms of urination disorders: frequent urge, urinary retention, pain and burning, sluggish urine stream.
The accession of infection is accompanied by an increase, a general deterioration in well-being.
Infertility during the year can be a sign of chronic prostatitis, as the disease disrupts the process of sperm production.
The advanced form of the disease is accompanied by various forms of erectile dysfunction: rapid ejaculation, weakening of erection during intercourse, impotence.

During remission, patients complain of dull pain, especially after active physical exertion, a hard day's work. As the pathology progresses, the symptoms become more pronounced.

If at the first stage the violations of the excretory system are almost imperceptible, only frequent urination is observed, the man begins to get up to go to the toilet at night. Then at stages 2-3 of the disease, patients begin to actively push so that urine output begins. The last stage of the disease is accompanied by acute urinary retention.

The same thing happens with erectile function. At the initial stage of the disease, only small deviations are visible: the duration of sexual intercourse decreases, the erection is sometimes insufficient if the man is tired. At the last stage of chronic prostatitis, patients complain of complete impotence, even wet dreams do not occur.

Treatment of chronic prostatitis with drugs

Many men are sure that chronic prostatitis is forever, so it is not necessary to treat it, it is just a waste of money and time. This is a complete fallacy. Treating chronic prostatitis is a must, and it is better to start doing it as early as possible.

Of course, no one can guarantee that after a course of pills, prostatitis will go away and will never bother you again. Any chronic process requires constant monitoring, adequate treatment. But it is safe to say that the right approach to therapy will help restore normal urination, return a man to healthy erectile function.

Treatment of chronic prostatitis is a long and rather laborious process. The patient is prescribed medication, visits to physiotherapy, diet, spa vacation, regular sex life. It is necessary to reconsider your lifestyle, start eating right, do exercises, pay attention to your psychological health.

First of all, the patient is prescribed medication. If a bacterial infection is detected, then with chronic prostatitis, the following is prescribed:

and etc.

For pain and spasm, antispasmodics are prescribed:

No-shpa;
Papaverine and others.

For the normal excretion of prostatic fluid are shown:

Urorek;
Silodosin and others.

It is strongly not recommended to use these groups of drugs for self-medication. It is very important to choose the right remedy and choose the dosage, otherwise the therapy can be not only ineffective, but also significantly harm the body. It must be remembered that all medications have side effects, and even uncontrolled intake of ascorbic acid can cause serious.

In the complex treatment of chronic prostatitis, vitamins and immunomodulators are required. This is necessary to make up for the lack of nutrients. If there are problems with blood circulation, venotonic drugs, blood-thinning agents are indicated. The decision to prescribe such drugs is made by the doctor based on the results of the tests.

Massage for chronic prostatitis

The most important stage in the treatment of chronic prostatitis is and. It should be noted right away that such methods are used exclusively during the period of remission. During an exacerbation of chronic prostatitis, with infectious inflammation, in the presence of cysts, tumors, massage cannot be done. Stimulation of the prostate in such cases can lead to increased pain, swelling of the gland, and damage to it.

You can also perform prostate massage at home, but you should not try to do it yourself, it is better to ask your wife, or contact medical institution. For many men, this procedure is rather unpleasant, because the massage is carried out through the anus.

A man undresses to the waist, lies on his side, pulling his knees to his stomach, or takes a knee-elbow position. The masseur puts on a glove, applies medical vaseline to the index finger.

The finger is gently inserted into the rectum, while the patient is better off relaxing as much as possible. If the anus is tense, the massage will seem very painful. Within a couple of minutes, the massage therapist gently strokes the prostate area.

If a man is categorically against this method of treatment, you can massage the prostate through the perineum, but this method is less effective. You can also improve the outflow of fluid and blood circulation in the pelvis with the help of exercises on the pubococcygeal muscle, through active cycling and long walks.

Physiotherapy treatment helps to improve blood circulation, activate local immunity, it contributes to the destruction of adhesive processes. In chronic prostatitis, the following methods of therapy are used:

Magnet;
Laser;
ultrasound therapy;
electrical stimulation, etc.

The attending physician chooses the method of therapy, while he pays attention to the stage of the disease, the cause of its occurrence.

Alternative treatment of chronic prostatitis

Recipes are actively used in the complex treatment of chronic prostatitis traditional medicine. But they cannot be used for exacerbation of prostatitis, tumors, infectious diseases, and personal intolerance to the components of the remedy is also a contraindication.

Recipes for chronic prostatitis:

since ancient times used to treat prostatitis and impotence. To speed up recovery, you need to eat 30 grams of peeled seeds daily. They can be added to a salad or used as a healthy snack.
In chronic prostatitis, pear compote is very useful. But before using such a compote, you need to make sure that it is prepared without sugar.
Recommended 3 times a week with decoctions of herbs and sea salt. To prepare a decoction, you can use sage, chamomile, calendula, needles. The herb is brewed in boiling water, filtered, and then poured into a bath with warm water. The duration of the procedure is 15 minutes. It is very important to remember that the water should not be hot, overheating of the genitals should not be allowed.
Parsley seeds and juice are very useful, and the herb can also be added fresh to various dishes. contains a lot beneficial vitamins and also has a positive effect on the reproductive system.
A well-known remedy is rectal suppositories with. You need to mix propolis with cocoa butter, form candles and store them in refrigerators. A month must be injected into the anus, 1 suppository at bedtime.

It is not a panacea for all diseases. In chronic prostatitis, they can only be used in complex therapy after consultation with an andrologist.

Prevention of chronic prostatitis

The prevalence of chronic prostatitis makes one think about the need for it. To prevent such a pathology, you must follow the following recommendations:

At the first signs of prostatitis, you should immediately consult a doctor. The sooner treatment begins, the less likely the process is to become chronic.
Lead a healthy and active lifestyle.
Avoid alcohol, drugs and tobacco.
Have sex regularly, and when arousal occurs, try to satisfy your needs.
Avoid questionable sex, use condoms.
Timely treat all infectious diseases.
Strengthen immunity.
Dress for the weather.

Conclusion

Chronic prostatitis is not a sentence. Many men live with such a pathology for many years, and I don’t know any problems, all thanks to timely treatment, a responsible attitude to their health. To maintain potency for as long as possible, you need to be regularly examined by an andrologist, as well as a responsible approach to the treatment of detected diseases.

Chronic prostatitis in men treatment is one of the most popular questions among those interested in the stronger sex. The disease is a sluggish inflammatory process that develops in the prostate region. According to various sources, the disease occurs in 35% of men of reproductive age.

It is rarely possible to completely cure the chronic form of prostatitis, but with properly selected complex therapy, it is possible to forget about this disease for a long period.

Category 10 includes bacterial and non-bacterial prostatitis. The disease, the causative agent of which is not bacteria, is in turn divided into chronic pelvic pain syndromes of an inflammatory and non-inflammatory nature.

In the first case, signs of an acute infection cannot be detected, but the causative agents of the disease can be seen in the sowing of the secretion of the prostate gland and in the urine, and the number of leukocytes also increases. In the second case, they are absent.

Causes of the disease

Causes of chronic prostatitis:

Autoimmune diseases.
Reflux of urine.
Circulatory disorders.
Infection with pathogenic microorganisms.

Factors contributing to the appearance of prostatitis

The following factors contribute to the development of non-bacterial and bacterial prostatitis:

Frequent change of sexual partners.
No protection.
The presence of a sexual partner of chronic diseases of the pelvic organs.
Violation of the rules of personal hygiene.
Hypothermia.
Lack of physical activity.
Sedentary work.
Irregular sex.
Operations on the prostate.
Injuries in the genital area.
Vascular diseases.
Frequent insertion of a catheter into the bladder.
Weak immunity.

The development of non-bacterial prostatitis is affected by neurogenic disorders of the pelvic floor muscles or other elements responsible for the functioning of the bladder.

Symptoms of the disease

Symptoms of inflammation of the prostate periodically increase, and then weaken. Signs of chronic prostatitis in men can be observed for a long time.

These include:

Pain sensations. The pain may be dull, aching, stabbing. It arises in the perineum and gives to the anus, lower back, abdomen, scrotum or inner thighs. Pain can be observed constantly or appear during urination or defecation. Also during this period they can intensify.
Sexual disorders. In most men, this symptom appears at the initial stage of the disease. The first wake-up call is erectile dysfunction, while complete impotence is not observed. A man with chronic prostatitis often has premature ejaculation, the period during which sexual intercourse lasts is significantly reduced, and the orgasm becomes inexpressive. Sometimes with chronic bacterial prostatitis, an erection can be accompanied by pain.
Violation of urination. Patients complain that at night the number of urges to urinate increases, and after the release of urine, there is a feeling that the bladder is not completely empty. There is a burning sensation during the act of urination during exacerbations.

Stages of disease development

As the disease progresses, the symptoms of inflammation of the prostate increase.

There are four stages of the disease:

Exudative. This causes pain, small breaks between urination at night and discomfort after intercourse.
Alternative. The pain intensifies and can radiate to the sacrum or pubis, the number of urination increases while the urine stream remains strong enough.
Proliferative. Urination is frequent, while the stream of urine weakens. The husband has problems with erection, it can remain strong enough, but appear with a delay.
Cicatricial. There is a feeling of constant heaviness in the inguinal region. Frequent urination, weak urine stream. An erection may be completely absent.

Diagnostics

What is chronic prostatitis in men and how to identify it? Such a diagnosis can be established after the patient has symptoms for three months that indicate the presence of the disease. In order to identify the disease and begin its treatment, you need to contact a urologist. The doctor takes a history and conducts an examination. Then the patient is prescribed an ultrasound examination to detect exacerbations of chronic prostatitis.

Methods for diagnosing chronic prostatitis include:

Microscopy. Material taken from the urethra is sent to a laboratory to detect bacteria, fungi or viruses and to determine the number of white blood cells.
PCR (polymerase chain reaction). In smears, the presence of DNA of pathogenic microorganisms that cause the disease is determined.
Analysis for prostate specific antigen. With an increase in this indicator, the patient is biopsied in order to exclude the presence of malignant neoplasms.

Treatment of the disease

How to treat chronic prostatitis, which one? These questions are of interest to many men who do not really like to visit a doctor. In order to cure the prostate gland, a combination of drugs from different groups is used.

If the disease is caused by bacteria, then antibiotics are prescribed for its treatment. With the right therapy, success is achieved in 90% of cases. Preparations of this group are also prescribed when bacteria are not detected in the smear. Treatment is effective in 40% of cases. This indicates that the infection is latent.

Corticosteroids may be used to treat abacterial prostatitis. These are hormonal drugs that allow you to stop the inflammatory process.

In order to strengthen the immune system and enable the body to actively fight the disease, vitamins and immunostimulants are prescribed. Particular attention should be paid to their composition. They must contain vitamin E, which has a positive effect on the reproductive function of men. As an addition to the treatment of chronic prostatitis, biologically active supplements based on pumpkin seeds are used.

In some cases, get rid of the symptoms of chronic prostatitis will help folk remedies such as decoctions and infusions medicinal herbs. But they need to be used regularly for a long period, because after the early termination of treatment, the symptoms of the disease can resume with renewed vigor.

Prostate massage

In chronic prostatitis, special attention is paid to prostate massage. During this procedure, the secret of the prostate gland is obtained. Together with this biological fluid, pathogenic microorganisms that cause inflammation are excreted. Massage also eliminates sexual dysfunction, lengthens sexual intercourse and enhances orgasm. The procedure can only be performed by a urologist.

In chronic prostatitis, prostate massage is prescribed in a course of eight or twelve procedures. The duration of one session is about a minute. The procedure is carried out with a full bladder, because after the massage is completed, and the secret is released, the urine will wash the urethra.
The urologist inserts a finger into the patient's anus and massages first the right and then the left lobe of the prostate gland.

Antibiotics

Preparations from the group of antibiotics are used to treat bacterial infections that cause the development of an inflammatory process in the prostate gland.

The most commonly used drugs are from the following groups:

Penicillins.
Macrolides.
Tetracyclines.
Cephalosporins.

Often therapy is carried out with drugs such as Doxycycline (Unidox) and Azithromycin (Summamed). Depending on the causative agent of the disease and the intensity of the inflammatory process, the dosage of the drug is selected individually. With exacerbations of the inflammatory process, the course of treatment with drugs is from 3 to 6 days.

Antifungal drugs

When choosing, one should not forget about antifungal agents. They are prescribed in combination with antibiotics in order to prevent the development of fungal microflora, and also if during the analysis it was detected in the patient. Most often, Fluconazole is used in complex treatments, less often Nistatit.

Non-steroidal anti-inflammatory drugs

If chronic prostatitis of non-bacterial origin is observed, taking drugs from this group gives a good effect. They make it possible to eliminate the inflammatory process, and also relieve pain.

Chronic prostatitis can be treated with pills or rectal suppositories. The basis for these drugs is diclofenac, meloxicam, piroxicam or nimesulide.

Alpha-adrenergic blockers

Among other drugs, a special place is occupied by drugs of this particular group. Most often they are prescribed if the patient has a violation of urination. A good effect from the use of such drugs is observed in the proliferative and cicatricial stages of the disease. They not only reduce the tone of the muscles of the bladder, but also reduce the inflammatory process.

To such effective drugs include Omnik, Omix, Flosin, Dalfaz. Apply them 1 or 2 tablets per day. The effect of treatment becomes noticeable already in the second week after the start of therapy.

Means for restoring erection

Which help restore potency. One such remedy is Cialis. It is used at 2.5 mg once a day. The drug not only restores erection, but also helps to get rid of prostate adenoma. The duration of treatment should be determined by the doctor.

Drugs for the treatment of adenoma

Drug therapy of chronic prostatitis cannot be imagined without drugs used to treat prostate hypertrophy. One of the most famous products from this series is Prostamol Uno. It is taken once a day for 2 months. The drug allows you to get rid of urination disorders, relieves the inflammatory process and restores the function of the prostate gland.

Prevention

Prevention of prostatitis should be carried out constantly.

For this, the following rules must be observed:

Keep the genitals clean.
During sexual intercourse with unreliable partners and during anal sex, use condoms.
Don't change sexual partners too often.
Have a regular sex life.
Get rid of bad habits.
Strengthen immunity.
Healthy food.
Give the body adequate physical activity.
Get rid of all sexual infections in time.
If you have to long time sit, every hour you need to take a break and walk around in order to restore blood circulation in the pelvic organs.

To say that chronic prostatitis still managed to get rid of only when the symptoms of the disease do not appear for a certain time, in the secret of the prostate there is a normal level of leukocytes, and the absence of pathogenic microorganisms. No urologist can guarantee that the disease will not recur soon and that the symptoms will not worsen.

Chronic prostatitis- one of the most common diseases among men of mature age. Inflammation of the prostate significantly reduces the quality of life, causing psychosomatic and sexual disorders. The lack of sufficient information about the nature of this disease makes the treatment of chronic prostatitis a difficult task that requires a lot of patience from both the patient and his doctor.

Prostatitis is an inflammatory and degenerative lesion of the prostate gland.

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The American National Institutes of Health (NIH USA) has developed and proposed the following classification chronic prostatitis:

chronic bacterial prostatitis;
chronic non-bacterial prostatitis (with and without signs of inflammation);
chronic asymptomatic prostatitis.

Modern andrologists adhere to this classification in the diagnosis and treatment of inflammatory diseases of the prostate. Separately allocated acute prostatitis. Knowing which category the identified pathology belongs to, the doctor will be able to select optimal scheme therapy and achieve significant progress in the treatment of the disease.

Causes and risk factors

The division into bacterial and non-bacterial chronic prostatitis is not accidental. Various causes of the disease determine the tactics of treatment and largely affect the outcome of the disease.

Chronic bacterial prostatitis

Chronic bacterial prostatitis occurs in 10-15% of patients. The direct cause of the development of the disease is the penetration into the prostate of pathogenic and opportunistic flora. By definition, the prostate gland is free of bacteria. Infection of the prostate is possible through the urethra, as well as hematogenous and lymphogenous routes. During the examination, the following microorganisms are most often detected:

coli (up to 95%);
Proteus;
klebsiella;
pseudomonas.

Representatives of gram-positive flora (staphylococci, streptococci) are quite rare. In some cases, the growth of two or more microorganisms (mixed infection) is noted. Possible infection with pathogenic flora (chlamydia, gonococci, etc.).

Most of the microorganisms detected during the examination are representatives of the normal microflora. Under normal conditions, they do not harm the body and exist peacefully on the mucous membranes of the urinary system and digestive tract. Under certain conditions, the growth and reproduction of conditionally pathogenic flora occurs, which leads to inflammation of the prostate tissues and the appearance of all symptoms of the disease.

Risk factors development of chronic bacterial prostatitis:

non-compliance with personal hygiene;
hypothermia;
genital trauma;
inflammatory diseases of the urinary system;

All this leads to a decrease in local and general immunity and the natural reproduction of conditionally pathogenic flora in the prostate. Infection through the urethra cannot be ruled out inflammatory diseases genital tract. The likelihood of developing prostatitis increases with the existing,.

Chronic non-bacterial prostatitis

There are several theories of the occurrence of this form of the disease:

Theory of chemical inflammation. The reflux of urine into the prostate during urination leads to the deposition of urate and the development of inflammation. Urethro-prostatic reflux is promoted by narrowing of the urethra () and other developmental anomalies.
immune theory. The version is based on autoimmune damage to prostate tissue as a result of exposure to bacterial antigens. The hereditary predisposition to this form of pathology is considered.
neurogenic theory. Violation of innervation in the pelvic area provokes and leads to the development of prostatitis.

In the development of non-bacterial prostatitis, the following also deserve special attention: risk factors:

long sedentary work;
sedentary lifestyle;
bad habits;
stress and emotional overload;
prolonged sexual abstinence(cm. ).

These risk factors provoke the development of congestion in the prostate, lead to impaired microcirculation in the pelvic organs. The microbial factor plays a role only in early stages disease development. In the future, its value decreases, and autoimmune processes and trophic disorders in the tissues of the prostate gland come to the fore.

According to statistics, 85-90% of men have non-bacterial chronic prostatitis (not directly associated with infection with pathogenic or opportunistic bacteria).

Symptoms

Chronic prostatitis occurs mainly in men aged 25-40 years. With age, the likelihood of developing the disease increases. In old age, inflammation of the prostate gland is often combined with adenoma - a benign tumor of the prostate.

signs chronic prostatitis:

dull aching pain in the lower abdomen;
irradiation of pain in the groin, scrotum, perineum, lower back, sacrum;
gain discomfort during intercourse and during bowel movements.

Very common urination disorders:

frequent urination;
excretion of urine in small portions;
the appearance or intensification of pain during urination;
sluggish and intermittent urine stream.

The last symptom is characteristic of prostate adenoma, which often occurs against the background of chronic prostatitis.

With a long course of the disease, disorders in the sexual sphere are noted:

decreased libido;
deterioration of erection;
reduction in the duration of sexual intercourse;
pulling pains in the lower abdomen after ejaculation;
lack of spontaneous morning erection.

Chronic prostatitis is one of the leading causes of erectile dysfunction, in which a man cannot achieve and maintain an erection sufficient for a full sexual intercourse. Such a condition significantly disrupts the course of life, can cause depression and other psycho-emotional disorders.

Chronic asymptomatic prostatitis occurs without any clinical manifestations. The disease is discovered by chance during examination by a urologist. Although there are no symptoms, inflammation of the prostate gland can lead to serious complications, erectile dysfunction and other health problems.

Complications

Running prostatitis provokes the development of such conditions:

prostate abscess;
cystitis and pyelonephritis (inflammation of the bladder and kidneys);
vesiculitis (inflammation of seminal vesicles);
erectile disfunction;
infertility.

The sooner the disease is detected and treatment is started, the greater the chance of a favorable outcome of the disease.

Diagnostics

The following methods are used to detect chronic prostatitis:

Urologist examination

At a personal appointment, the doctor focuses on the patient's complaints. Be sure to examine the external genitalia, and carried out. On palpation, the doctor evaluates the size and shape of the gland. In the case of chronic prostatitis, the organ will be somewhat enlarged in size. The procedure is combined with taking for microbiological research.

Four glass sample

The main method to identify the inflammatory process in the prostate and distinguish it from other diseases. The collection of material takes place in several stages. In the morning, after 5-6 hours of abstinence from the toilet, a man urinates in two jars - for the first (initial) and for the second (middle) portion of urine. In the first portion, the contents of the urethra are washed off, in the second - the bladder. The third portion of urine is collected after prostate massage and allows you to assess the condition of the prostate gland. Separately, the secret of the prostate gland is collected for bacteriological culture.

In the analysis of urine, two parameters are evaluated: the number of leukocytes and erythrocytes. In diseases of the prostate, the level of leukocytes rises in the third portion of urine. Normally, their number does not exceed 10 in the field of view.

Microbiological research

When conducting a three-cup sample, not only the number of leukocytes is estimated, but material is also taken for bacteriological seeding. If chronic prostatitis is suspected, the doctor is especially interested in the third portion of urine. According to the results of the examination, the doctor can identify the causative agent of the disease and select the optimal antibiotic therapy.

The detection of opportunistic bacteria in a titer of more than 10 3 CFU/ml or the detection of unambiguously pathogenic microorganisms in any quantity is of diagnostic value.

Bacteriological culture of prostate secretion

Bacteriological culture of prostate fluid makes it possible to assess the nature of the process (infectious or not) and determine the type of pathogen

Before taking the third portion of urine during prostate massage, the doctor takes the allocated secret for bacteriological examination. The result obtained also allows you to determine the diagnosis and treatment tactics.

Diagnostic criteria for chronic bacterial prostatitis:

Detection in the third portion of urine or prostate secretion of opportunistic microorganisms in a titer above 10 3 CFU / ml.
Detection in the third portion of urine or prostate secretion of opportunistic bacteria, the number of which is significantly (10 times) higher than in the second portion of urine.
Detection in the third portion of urine or prostate secretion of pathogenic microorganisms.

ultrasound

Ultrasound examination allows you to assess the size of the organ and identify concomitant pathology. Often, chronic prostatitis is combined with.

Principles of treatment

The goal of therapy for chronic prostatitis is to eliminate the inflammatory process, activate blood flow and improve the nutrition of the organ. If pathogenic or opportunistic microorganisms are detected in high titer, they are eliminated. Particular attention is paid to the correction of lifestyle and stimulation of the body's defenses.

Medical treatment

For the treatment of chronic prostatitis, the following are used: medicines:

selected according to the identified pathogen.
Anti-inflammatory drugs to reduce inflammation and relieve pain.
Means that facilitate urination (relaxing the muscles of the urethra and stimulating the outflow of urine.).
Drugs that increase blood flow in the pelvic organs.

The choice of antibiotic will depend on the identified pathogen. When choosing a drug, one should take into account its ability to penetrate the hematoprostatic barrier and accumulate in the tissues of the prostate gland. These conditions correspond to funds from the group of fluoroquinolones. Macrolides and tetracyclines are also used to treat chronic prostatitis.

Upon receipt of the results of bacteriological examination and confirmation of the bacterial nature of the disease, treatment continues up to 4-6 weeks. This approach allows not only to get rid of the causative agent of the disease, but also to prevent the recurrence of prostatitis.

Unfortunately, not always antibiotic therapy happens to be effective. Many microorganisms safely exist in the prostate secretion for a long time and become resistant to antibiotics. Bacteria form special biofilms and form colonies of microorganisms covered with a complex polysaccharide structure. Most antibacterial drugs are not able to penetrate this biological barrier, which significantly reduces the effectiveness of the therapy. This problem can be avoided by the use of modern antibiotics, which can not only penetrate the prostate tissue and heat up in it, but also pass through biofilms and infect bacteria that are under such serious protection.

Non-drug therapy

Among non-drug methods of treatment, special attention is paid to. The procedure stimulates the blood supply to the prostate gland, eliminates congestion and facilitates the excretion of secretions. The combination of massage and long-term use of antibacterial drugs is the main way to save a man from the unpleasant symptoms of chronic prostatitis.

How does chronic prostatitis affect potency?

Chronic inflammation of the prostate threatens the development of erectile dysfunction. With this pathology, there is a decrease in sexual desire, the frequency and strength of erections decrease, orgasms become painful. In advanced cases sex life becomes impossible.

Can chronic prostatitis be cured without antibiotics?

Antibacterial therapy is considered one of the key treatments for chronic prostatitis. In most cases, it is impossible to cope with the disease without antibiotics.

Is it possible to cure chronic prostatitis with folk remedies?

Get rid of chronic prostatitis by traditional medicine methods alone will not work. To achieve the optimal effect, complex treatment is carried out using antibiotics, herbal preparations, anti-inflammatory drugs and physiotherapy methods.

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