Chronic prostatitis (MKB-10. N41.1 code) is called the inflammatory process, which is observed for more than three months in the tissues of the prostate gland.Its feature is that in almost 70% of all cases, it proceeds without any symptoms.And only 15% of patients complain of manifestations of the disease.All other men have symptoms that only partially indicate the development of prostatitis and can often contact other diseases.Therefore, it is so important when any signs occur to see a doctor who, after the examination, will tell you how to treat chronic prostatitis.
The peculiarity of the disease
Chronic prostatitis can diagnose not only in older people.People of young and middle -aged are also subject to the disease.At risk are those who lead a sedentary lifestyle, adheres to sexual abstinence or experience physical exertion in the perineum.That is, the probability of chronic prostatitis in drivers, athletes is much higher than everyone else.
Among all diseases of the reproductive system of men, chronic prostatitis occupies the first place in prevalence, followed by cancer and benign hyperplasia of the prostate gland of the DGPG (prostate adenoma).Approximately every third man faces an inflammation of the prostate, and every fifth of them suffers from a chronic form of the disease.
In most cases, the cause of chronic prostatitis is the transmitted diseases of the genitourinary system caused by infections.A little less often, it is caused by inflammatory processes associated with a change in the hormonal background of a man.
Classification
Similarly to other inflammatory diseases, chronic prostatitis can have acute and chronic stages.Its classification is based on the following features:
- The presence of leukocytes in the urine.
- The presence of pathogenic bacteria in the urine, ejaculate or the secret of the gland.
Based on the classification, the following types of illness exist:
- Asymptomatic inflammatory prostatitis is characterized by the lack of symptoms of chronic prostatitis.It is possible to identify it by chance when the patient addresses a doctor with any other disease.
- Acute bacterial prostatitis.The patient has acute inflammation of the prostate tissues, pathogens are present in the urine, which lead to an increase in temperature and the development of intoxication of the body.
- Chronic bacterial prostatitis.The doctor notes typical signs of chronic inflammation.And in the analysis of urine and the secret, the high content of leukocytes and bacteria is detected.
- Chronic pain syndrome in the pelvis.Such pain is considered the main symptom, since bacteria is not detected.To make a diagnosis of chronic prostatitis, the syndrome should be observed in a man for at least 3 months.
Causes of the disease
The main cause of chronic prostatitis is the penetration of pathogens (enterococci, intestinal or prayer sticks, etc.) into the prostate gland, etc.).Go to the prostate, bacteria can be in three ways:
- Through the urethra.
- Through blood.
- Through lymph.
According to statistics, 90% of cases of chronic prostatitis are a consequence of the development of acute prostatitis or a complication of urethritis.
In addition to getting into a prostate of bacteria, the causes of chronic prostatitis can be as follows:
- Sexual infections (STPP): herpes, trichomonas, gonococcus, chlamydia, etc.
- Stagnation processes in the pelvic area, which can provoke inflammation of the prostate.
- Reducing immunity.This may lead to: vitamin deficiency, violation of the balance of hormones, hypothermia, allergic reactions, significant physical and emotional stress, non -infected infections, etc.
- A sedentary lifestyle.
- Light weight.
- Irregular sex life or disorders in the intimate sphere.
- Crotch injuries.
- Wearing narrow linen.
- Irrational nutrition (predominance in the diet of spicy foods).
- Lining for urination.
- Violation of the chair.
All this can lead to circulatory disorders in the pelvic area, contribute to stagnant phenomena and the development of the inflammatory process.The consequences of the lack of therapy are infertility and impotence.
Symptoms of the disease
Signs of chronic prostatitis can be very different.Most often, the patient complains of:
- Reducing performance.
- Fast fatigue.
- Increased irritability.
- Anxiety.
- Sleep violation.
- Lethargy.
- Loss of appetite.
- Increased sweating.
Among local symptoms:
- Urination disorder.The patient feels frequent urges, pain at the beginning and end of urination.
- A aching pain that can give into the groin, sacrum, scrotum, sub -lane bone or rectum.
- Pain for sex.
- Discharge at the tension of the pelvic muscles.
Unlike the acute phase, in a chronic disease, a violation of sexual functions often occurs.This is associated with the fact that stagnant is also inflammatory processes, affect the nerve endings that provide the transmission of pulses to the brain.As a result, a violation of an erection is possible, which weakens or ejaculation (premature ejaculation), sensations during an orgasm (erased orgasm) are dull.Such symptoms of chronic prostatitis in men lead to fear of proximity, irritability, and as a result, sexual neurosis develops.
It is not easy to treat chronic prostatitis.How long will have to take medicines depends on the degree of pathology and the duration of the development of the disease.It is important to remember that if the symptoms of the disease have disappeared, this does not mean a final cure.The severe consequences of chronic prostatitis include scarring of the gland.This process can switch to the urethra.
Diagnosis of the disease
When going to the doctor, he will ask the patient with the available symptoms.Particular attention is paid to the frequency and nature of pain, impaired urination, sexual dysfunction.But due to the fact that chronic prostatitis can occur without any manifestations, certain studies are necessary:
- Clinical and bacterial urine analysis in which the amount of leukocytes and the presence of pathogenic microorganisms are determined.
- Analysis of the secret that may contain bacteria.
- A scraping from the mucosa in which the amount of leukocytes is determined, the presence of macrophages and amyloid bodies.
- Transuretral ultrasound makes it possible to identify an echobroblast of chronic prostatitis and determine the condition of the prostate.
High -quality diagnosis is a significant part of the correct treatment, as it makes it possible to distinguish chronic prostatitis from other pathologies with similar signs.
Treatment
This disease should have an integrated approach to therapy.In this case, the patient needs to tune in to long treatment.The treatment regimen of chronic prostatitis will be individual for each patient.Usually, the patient does not need hospitalization and he can be treated at home.A completely different matter is when the acute phase of the disease or its exacerbation against the background of chronic inflammation of the prostate is subject to treatment.In a hospital, antibacterial therapy is used and deintoxic is carried out.If necessary, an operation is needed.
Drug therapy
For a comprehensive treatment of chronic prostatitis, drugs are prescribed in men, the effect of which is aimed at eliminating infection, the normalization of blood circulation and the level of hormones.To do this, use:
- Antibiotics.
- Anti -inflammatory non -steroidal drugs.
- Anticholinergic agents.
- Immunomodulators.
- Angioprotectors.
- Vasodilative medicines.
Before making an appointment, the doctor will analyze the pathogen.If the disease is not a bacterial origin, then the course of antibiotic therapy will be short.In the case when it is not possible to determine the type of pathological microflora with laboratory methods, a histological analysis of the tissue of the prostate is used.
With relapse of the disease, antibacterial therapy is prescribed for the purpose of prevention.For this, a drug is used, which was already used during treatment, but in a lower dosage.
Knowing what chronic prostatitis is and what can cause its development, the specialist will pay attention to the pressure inside the prostate gland and its ability to reduce.If this function is reduced, then stagnant phenomena and inflammation of the prostate can occur in the pelvis.Alpha-blockers are prescribed to normalize intrauterine pressure.
You can avoid painful injections and taking pills using a candle.
For complaints about rapid and painful urination, non-steroidal anti-inflammatory drugs are used in conjunction with alpha-blockers.
In the case when taking antibiotics turned out to be ineffective and symptoms such as soreness and dysuria are preserved, treatment is adjusted so that it is directed at:
- Elimination of pain.To do this, use tricyclic antidepressants.
- Normalization of urination.Treatment is prescribed after urinodynamic analysis.With the hyperactivity of the sphincter, antihistamines, tricyclic antidepressants and rinsing of the bladder with antiseptic solutions are indicated.With the ineffectiveness of such treatment, neuromodulation and physiotherapy are used.
Non -drug methods
In order for the treatment with tablets to be more effective, the doctor may recommend physiotherapy (electrophoresis, phonophoresis, laser therapy, treatment with mud) and transrectal hyperthermia, which is carried out taking into account the existing changes in the tissue of the prostate and related diseases.When exposed to a temperature of 40 degrees, cellular immunity is activated.When exposed to a temperature of 45 degrees, inhibition of the nerve endings occurs, which helps to stop pain.The use of laser therapy has a biostimulating effect.
In the absence of contraindications, the patient is performed by the prostate gland.Often patients are prescribed a course of psychotherapy and special exercises that can strengthen the muscles of the perineum.
Treatment with folk remedies
Along with the use of medicines, manifestations of chronic prostatitis are treated with folk methods.Such treatment increases immunity and reduces pain.For this, in addition to herbal preparations, infusions and decoctions of herbs, baths, etc. are used.
The course of treatment with phytopreparations is at least 1 month and should be prescribed by a doctor, as some of them may have contraindications for use.Treatment with folk methods suggests:
- Abundant drink (teas with linden, rosehip, raspberries).
- Every day before meals, you need to drink 1 glass of freshly squeezed juice of carrots, pears, cucumber.
- If the patient is tormented by pain, coniferous baths are used, a temperature of 37 degrees.The duration of the procedure is 20 minutes.
- If the patient does not have an allergy to honey, he is recommended to eat up to 100 grams of product daily.
- At home, you can independently make suppositories based on propolis or honey.You need to put them within 1 month.To prepare candles with propolis, take a mixture of glycerol, gelatin and water in proportions of 5: 1: 2.Add propolis there and distribute the mixture on parchment.Place everything in the refrigerator, where the suppositories are completely frozen.
- Before going to bed, it is recommended to make an enema with wormwood.To do this, 1 teaspoon of dry plants is brewed in 1 liter of boiling water.
Treatment with pumpkin seeds, aloe juice, parsley, chestnut and celandine is also considered effective.Parsley has an anti -inflammatory effect and is able to restore sexual function.Fitotherapists recommend this treatment with this plant:
- Drink 1 tablespoon of parsley juice every day before meals.
- 4 teaspoons of plant seeds pour 250 ml of boiling water and insisted in the thermos for the night.The next day they drink an infusion of 1 tablespoon every hour.
- 100 g of the crushed root of the plant is poured with 1 liter of water, put on a slow fire and boiled for 10 minutes.A decoction is drunk during the day.
An effective tool is pumpkin seeds.About 30 such seeds contain a daily dose of zinc, which is necessary for male health.For treatment, you can make such a tool.500 g of pumpkin seeds are crushed in a meat grinder and mixed with 200 grams of natural honey.Balls are made from the resulting mass, the size of a walnut.Every day you need to eat 2 such balls.
Propolis helps to strengthen the body's defenses and relieve inflammation.You can buy its tincture in a pharmacy.For treatment, you need to drink a glass of milk daily with 1 teaspoon of such tincture.
In addition, decoctions of licorice, St. John's wort, echinacea are used for treatment, which are also used in cases where the disease occurs without obvious symptoms.
Surgery
Often, chronic prostatitis does not give symptoms, and patients seek medical help when serious changes in the prostate gland have occurred and chronic prostatitis are already powerless.In addition, such complications can pose a threat to the health of the patient.An example of complication can be called prostate sclerosis.
Due to the fact that such complications are often revealed in young men, doctors use minimally invasive surgery.The indication for its use is: phimosis, involuntary urine release, or, conversely, its delay, prostate abscess, significant increase in the gland in size, urethral blockade or bleeding.There are types of surgical intervention that are indicated for chronic inflammation:
- Circumcia - is used when the patient has phimosis.During the operation, the foreskin is dissected.
- Prostatectomy is a radical operation during which the prostate is completely removed.It is carried out in case of suspicion of the presence of a malignant tumor.
- Prostate resection is a partial removal of the gland, in the case of its sclerotic change.
- Elimination of adhesions.
- Drainage of a cyst or abscess.It is produced by endoscopy.For drainage, a special tube with a camera at the end is used.Such a device is introduced into the lumen of the urethra and makes it possible to control the course of the operation.
- In the case of complaints of various sexual disorders (violation of orgasm, painful ejaculation, etc.), the patient is carried out by an incision of the erystarmal ducts.
The result of surgical intervention will depend on the timeliness of diagnosis.In cases where there is a prostate adenoma, then manifestations of chronic prostatitis can be lubricated.This is observed in 70% of cases.25% of men learn about the development of chronic prostatitis during an adenoma examination.And only 5 % of patients - during a preventive examination.
The condition for the operation is the lack of an effect with the conservative treatment of the disease.Therefore, the operation is needed to prevent complications and improve the quality of life.
However, it must be borne in mind that even after surgery it is possible to return prostatitis.This happens in almost half of the operated ones.Contraindication to any operation is:
- Diabetes.
- Pathology of the liver.
- Respiratory system diseases.
- Mental disorders.
- Heart disease.
The prognosis of the disease
Everyone who is faced with such a diagnosis is interested in whether chronic prostatitis can be cured?The disease is considered cured if the symptoms do not appear a significant period of time, the level of leukocytes in the urine is within normal, in the secret of prostate there are no pathogenic bacteria, urination and sexual function are restored.
Most often, the prognosis is favorable in cases where the disease did not lead to irreversible processes, and the patient observes the treatment prescribed to him.
Prevention of the disease
Each middle -aged man should prevent the prevention of diseases of the genitourinary system, which will also help reduce the likelihood of chronic prostatitis.Enough for this:
- Adhere to the foundations of a healthy lifestyle, play sports.
- Eat right.It is important to consume a lot of protein foods (low fat meat and fish, dairy products, eggs) and limit the amount of animal fats.At the same time, canned food, sharp, salty dishes, alcohol should be excluded from the menu.
- Regular sex life.It is important to avoid unprotected sex.
In order to prevent prostate disease, every man, especially after 35 years, must monitor health and lead an active life.No need to ignore a medical examination, which always helps to identify prostatitis in time and begin its treatment.It is important to remember that it is cured if it is detected at the initial stage, and the patient observes all the doctor’s prescriptions.