Chronic inflammation of the prostate treatment. Chronic prostatitis and its consequences for men

Unfortunately, more and more often young men, and sometimes even teenagers, are diagnosed with chronic.

It is a consequence of frequent inflammation of the prostate gland and the transition to a chronic latent form.

The disease is characterized by a long development with an uncharacteristic, which is usually blurred or virtually absent. Although it is believed that chronic prostatitis inevitably occurs against the background of the acute stage, in practice this form of the disease is often detected by chance during routine examinations.

Symptoms of the disease depend on the nature inflammatory process, the duration of the disease, the degree of damage to neighboring organs, from . Also, an important role is played by what lifestyle (active or passive) a man leads.

Causes that provoke the occurrence of a chronic form of the disease:

infection of the genitourinary system and prostate gland (ureaplasmosis, chlamydia, candidiasis, mycoplasmosis, gonococcal and herpesvirus infection);
violation of blood flow in the pelvis, which leads to;
decreased immunity of various etiologies;
hypodynamia and inactive, sedentary work;
irregular intimate life, interruption of sexual intercourse without orgasm;
overwork, injury and damage;
abuse of alcohol and spicy foods;
retention of urination and violation of the stool ().

All these causes lead to congestion and inflammation. They contribute to the penetration of infections, and this can lead to complications, as well as impotence and complete infertility.

Chronic prostatitis divided into three main types:

bacterial, in which an infection is detected;
when there is no pathogenic microflora in the secret;
prostatodynia, when symptoms characteristic of the chronic form of prostatitis are present, but pathological changes in the secretion of the prostate are not detected (this is called chronic pelvic pain syndrome).

Symptoms of chronic prostatitis:

pain and cutting in the rectum during bowel movements;
and the inability to completely empty the bladder;
decrease and erections;
pulling sensations in the sacral and inguinal region;
dullness of sensations or their complete absence during orgasm.

There is also an asymptomatic form of the disease. Often, it does not manifest itself for a long time and is determined by the results, as well as in laboratory studies of the secretion of the prostate gland.

If at least one of the signs appears, a man should consult a doctor and undergo those examinations that he will prescribe.

How to cure chronic prostatitis?

Treatment of chronic prostatitis is one of the most difficult tasks facing modern medicine.

The disease proceeds in a latent form and is not always detected at the initial stage.

Men go to the doctor when symptoms of exacerbation with complications appear. Therefore, treatment depends on the phase of the disease, the degree of bacterial or viral damage and the nature of the pathological process.

To completely cure the patient, you need to spend a whole. This is the only way to achieve positive results.

Effective drugs and the scheme of their use

For the treatment of bacterial chronic prostatitis, they are used that can suppress pathogenic microflora.

So, antibacterial drugs of such groups as fluoroquinolones (, Moxifloxacin), macrolides (Erythromycin, Spiramycin), tetracyclines (, Oxytetracycline), cephalosporins () can be prescribed.

Tablets Tavanic

In the chronic form of the disease, antibacterial drugs are used for a long time to achieve a good therapeutic effect. The duration of admission depends on many factors, the required duration of therapy can vary from 2 to 6 weeks.

Also, for the treatment of the chronic form of the disease, drugs are needed that improve blood flow, relieve congestion, antispasmodic and painkillers.

Medicines used in the chronic form of the disease include:

, which has an antiandrogenic, vasoprotective effect. It is used in the treatment of non-bacterial chronic prostatitis and;
, which improves the condition of the prostate gland and microcirculation, reduces the degree of edema, prevents thrombosis and normalizes the secretory function of epithelial cells;
, which has a wound healing, anti-inflammatory and regenerating effect;
, which has a locally irritating and pronounced vasodilating effect.

Only a doctor can prescribe drug therapy; you cannot self-medicate with prostatitis.

Rectal prostate massage

An effective method to cure chronic prostatitis is. It can be done in and even.

Most effective method- This is a massage on the bougie. A special device is inserted into the urethra, after which light massaging movements are performed.

A similar procedure should be done by a specialist in stationary conditions. through the anus with a finger when the bladder is full. The prostate is in contact with the anterior wall of the rectum and is located 5 cm from the anus.

Most doctors believe that rectal massage should be done in a hospital to prevent complications and achieve the maximum therapeutic effect.

Therapeutic gymnastics and physiotherapy

Many men find rectal massage unacceptable for themselves, despite its effectiveness. For this category of patients, doctors have developed a special and physiotherapy.

Physiotherapy treatments include:

hydromassage;
acupuncture and stimulation of the sacrum and lower back;

Exercises and physiotherapy in each case are selected individually, as there are some contraindications, and only a specialist will help prescribe a safe and effective method.

Nutrition principles

Special attention in the chronic form of the disease deserves therapeutic diet therapy.

The principles and goals of the diet are as follows:

minimize irritating factors so as not to provoke additional inflammation;
ensure normal blood supply and prevent the occurrence of atherosclerosis;
if possible, reduce the frequency of urination;
normalize the work of the gastrointestinal tract;
boost immunity.

alcohol;
carbonated drinks;
smoked meats, butter, as well as fatty meats and rich broths;
spicy, sour and highly salty foods;
mushrooms, liver, kidneys and semi-finished products;
products that cause increased gas formation (legumes, cauliflower).

But it is useful to use:

all types of dairy products, especially homemade cottage cheese, yogurt;
fresh juices and compotes;
fish and lean meat;
cereals;
products containing (seafood, pumpkin seeds).

The diet should be varied and balanced in terms of nutrients, it is better to consult a nutritionist to select a diet.

How to get rid of the disease with the help of folk remedies?

Not bad proved themselves and chronic prostatitis. They are simple and safe, but still, any method has its own indications and contraindications, which is due to the individual characteristics of the body and the presence of concomitant diseases.

IN folk medicine widely used:

the use of fresh juices of carrots, beets, cucumbers, elderberries;
application with coniferous pine concentrate;
microclysters and suppositories with and other medicinal herbs;
honey therapy, use.

It is also useful to use pumpkin seeds, which have a stimulating effect on the prostate gland and contain in their composition all the necessary trace elements for its normal functioning.

There are many effective folk methods to get rid of the chronic form of prostatitis, but first you need to consult a doctor.

Surgical methods of therapy

In cases where drug therapy and other complex conservative methods of treatment do not give the desired result, and at the same time there is a negative dynamics of the pathological process, they resort to surgical intervention.

Types of operations for chronic prostatitis:

drainage used for purulent inflammation and;
resection involving the removal of part of the gland. With this option, surgical access is carried out through an incision or punctures on the abdomen, through the urethra;
when the gland is completely removed. It is used in extreme cases, mainly with malignant adenoma;
circumcisio- a rare and not always effective method of operation, involving the cutting off of the foreskin.

Surgical intervention for chronic prostatitis is an extreme measure, in order not to bring to such a state, it is necessary to consult a doctor at the first symptoms.

Approximate cost of a course of drug treatment

The treatment of chronic prostatitis is so individual and varied that pricing is influenced by many factors, the cost of therapy can vary in very wide ranges.

It all depends on the ongoing process, the duration of the necessary treatment, the medications and procedures used. Therefore, in each case, the price will be individual.

Possible consequences of re-inflammation

Under adverse conditions, the inflammatory process can recur. Frequent exacerbations of the disease lead to irreversible changes and serious complications.

There are not only pain and discomfort, the entire genitourinary and reproductive systems suffer, potency may decrease, or complete impotence may occur.

And in advanced forms, and, as a result, cancer (adenoma) develops. It must be remembered that any disease is easier to prevent than to treat, especially in a chronic form.

Strengthen immunity;

avoid, if necessary, take sedatives of natural origin (valerian, motherwort, peony).

- this is a protracted inflammation of the prostate gland, leading to a violation of the morphology and functioning of the prostate. Manifested by a prostatic triad: pain in the pelvis and genitals, urination disorders, sexual disorders. Diagnosis includes palpation of the gland, examination of prostate secretion, ultrasound, uroflowmetry, ureteroscopy, puncture biopsy of the prostate. Complex medical, physiotherapeutic treatment, massage of the prostate gland, instillations of the posterior urethra are shown. Surgical intervention is advisable in complicated forms of chronic prostatitis.

ICD-10

N41.1

General information

Chronic prostatitis is the most common male disease: about 50% of men suffer from some form of inflammation of the prostate. Chronic prostatitis often affects men aged 20 to 40, who are in the period of greatest sexual, reproductive and labor activity. In this regard, the identification and treatment of chronic prostatitis in modern andrology acquires not only a medical, but also a socially significant aspect.

Causes

However, for the development of chronic prostatitis, it is important not so much the presence and activity of microorganisms as the state of the pelvic organs and blood circulation in them, the presence of concomitant diseases, the level of protective mechanisms. Therefore, a number of factors can contribute to the occurrence of chronic prostatitis. First of all, these are urological diseases - pyelonephritis, cystitis, urethritis, urethral stricture, acute prostatitis that has not been completely cured, orchitis, epididymitis, etc.

A microbial etioagent can enter the prostate from distant foci of infection, for example, in the presence of sinusitis, tonsillitis, caries, chronic bronchitis, pneumonia, pyoderma, etc. Local and general hypothermia, overheating, exposure to a humid environment, fatigue, malnutrition predispose to chronic inflammation , infrequent urination, etc.

Non-bacterial chronic prostatitis is usually associated with congestive (congestive) phenomena in the prostate gland due to stasis of the venous circulation in the pelvic organs and impaired drainage of the prostate acini. Local congestion leads to overflow of prostate vessels with blood, edema, incomplete emptying of the secretion, violation of the barrier, secretory, motor, contractile function of the gland.

Stagnant changes are usually caused by behavioral factors: prolonged sexual deprivation, the practice of interrupted or prolonged sexual intercourse, excessive sexual activity, physical inactivity, chronic intoxication, occupational hazards (vibration). The pathology of the pelvic organs and nervous structures that innervate them (for example, spinal cord injury), prostate adenoma, hemorrhoids, constipation, androgen deficiency and other causes predispose to the development of non-bacterial inflammation.

Classification

According to the modern classification of prostatitis, developed in 1995, there are three categories of the disease:

II. Chronic prostatitis of bacterial origin.
III. Inflammation of non-bacterial origin / pelvic pain syndrome is a symptom complex that is not associated with obvious signs of infection and lasts from 3 or more months.
III A. Chronic process with the presence of an inflammatory component (detection of leukocytes and infectious agents in the prostate secretion);
III B. Chronic pathology with the absence of an inflammatory component (leukocytes and pathogens in the prostate secretion).
IV. Asymptomatic chronic prostatitis (no complaints when leukocytes are detected in the prostatic secretion).

In the presence of an infectious component, they speak of bacterial (infectious) chronic prostatitis; in the absence of microbial pathogens - about non-bacterial (non-infectious). It is believed that in 90-95% of all cases there is non-bacterial inflammation and only 10-5% - bacterial.

Symptoms of chronic prostatitis

The disease is manifested by local and general symptoms. Local manifestations include the prostatic triad, characterized by pain, dysuria, and sexual dysfunction. The pains are constant aching in nature, localized in the perineum, genitals, above the pubis, in the groin. The pain syndrome intensifies at the beginning and end of urination, while the pain radiates to the glans penis, scrotum, sacrum, and rectum.

Pain may increase after intercourse or due to prolonged abstinence; weaken or intensify after orgasm, become more intense immediately at the time of ejaculation. The intensity of the pain syndrome varies from sensations of discomfort to pronounced manifestations that disrupt sleep and performance. Pain with limited localization in the sacrum is often regarded as osteochondrosis or sciatica, and therefore the patient can be treated independently for a long time without resorting to the help of a doctor.

Urination is frequent and painful. In this case, there may be difficulty in starting micturition, weakening or intermittency of the urine stream, a feeling of incomplete emptying Bladder, frequent nocturnal urges, burning in the urethra. Floating filaments can be detected in the urine. After defecation or physical activity discharge (prostorrhea) appears from the urethra, due to a decrease in the tone of the prostate. There may be itching, a feeling of coldness or excessive sweating in the perineum, local changes in skin color associated with circulatory stasis.

Chronic prostatitis is accompanied by severe violations of sexual function. The phenomena of dyspotence can be expressed in deterioration, soreness of erection, prolonged and frequent nocturnal erections, difficulty or early ejaculation, loss of sexual desire (decreased libido), erased orgasms, hemospermia, infertility. Sexual disorders are always hard experienced by a man, they lead to psycho-emotional disorders, up to neurosis and depression, which worsen sexual function even more.

Exacerbations are accompanied by a slight increase in body temperature and a deterioration in well-being. The general condition is characterized by increased irritability, lethargy, anxiety, fatigue, loss of appetite, sleep disturbance, decreased ability to work, creative and physical activity. In almost a quarter of patients, symptoms of the disease are absent for a long time, which leads to a late visit to an andrologist.

Complications

Diagnostics

The information necessary for the diagnosis of chronic prostatitis is obtained using a comprehensive laboratory and instrumental examination. The primary examination includes clarification of the anamnesis and complaints, an external examination of the genitals for discharge, rashes, irritations, a digital rectal examination of the prostate in order to determine the contours, boundaries, consistency, and soreness of the gland.

To determine the structural and functional changes in the prostate gland, ultrasound of the prostate (TRUS) is indicated. Important methods in the diagnosis of chronic prostatitis are the study of prostate secretion, general urinalysis, bacteriological examination of a smear from the urethra and urine, a 3-glass urine test, PCR and RIF, a scraping study for pathogens of genital infections, and the determination of prostate-specific antigen (PSA). Clinically significant is the detection in the analysis of pathogens of chlamydia, mycoplasmosis, herpes, cytomegalovirus, trichomoniasis, gonorrhea, candidiasis, as well as nonspecific bacterial flora.

The sampling of prostate secretion for research is carried out after urination and massage of the prostate gland. Signs of the disease are an increase in the number of leukocytes in the field of view, a decrease in the number of lecithin grains, and the presence of pathogenic microflora. In the general analysis of urine, leukocyturia, pyuria, erythrocyturia can be detected. Bacteriological culture of urine allows you to identify the degree and nature of bacteriuria. In case of reproductive disorders, a study of the spermogram and the MAR test is indicated.

The degree and causes of urination disorders help to determine urodynamic studies (uroflowmetry, cystometry, profilometry, electromyography). With the help of these studies, chronic prostatitis can be differentiated from stress urinary incontinence, neurogenic bladder, etc. With hematuria, hemospermia, obstructive urination, endoscopic examination is indicated - ureteroscopy, cystoscopy. To exclude adenoma and prostate cancer, PSA determination is required, in some cases, a biopsy of the prostate gland with a morphological study of tissues is required.

Treatment of chronic prostatitis

The disease is not easy to cure, but it should be remembered that recovery is still possible and largely depends on the patient's mood, the timeliness of his visit to a specialist, and the strict observance of all the instructions of the urologist. The basis of the treatment of the bacterial inflammatory process is antimicrobial therapy in accordance with the antibiogram lasting at least 2 weeks. To reduce pain and inflammation, NSAIDs are prescribed (diclofenac, ibuprofen, naproxen, piroxicam); to relax the muscles of the prostate, restore urodynamics and outflow of prostatic secretion, the use of a-blockers (tamsulosin, alfuzosin) is indicated.

In order to improve drainage of the prostate gland, local microcirculation and muscle tone, a course of therapeutic prostate massage is carried out. A prostate massage session should end with the release of at least 4 drops of prostate secretion. Prostate massage is contraindicated in acute bacterial prostatitis, prostate abscess, hemorrhoids, prostate stones, rectal fissures, hyperplasia and prostate cancer.

To relieve pain, paraprostatic blockades, acupuncture can be recommended. An important role in the treatment is given to physiotherapy with the appointment of medicinal electrophoresis, ultrasound, ultraphonophoresis, magnetotherapy, laser magnetotherapy, inductometry, mud therapy, SMT, hot sitz baths with a temperature of 40 - 45 ° C, enemas with hydrogen sulfide and mineral waters, instillations into the urethra.

With the development of complications, surgical treatment is indicated: elimination of urethral strictures; TUR of the prostate or prostatectomy for prostate sclerosis; transurethral resection of the bladder with sclerosis of its neck, puncture and drainage of cysts and abscesses of the prostate; circumcision with phimosis caused by recurrent urinary tract infections, etc.

Forecast and prevention

The prognosis is determined by the timeliness and adequacy of treatment, the age of the patient, the presence of concomitant pathologies. Prevention of the disease requires adherence to sexual hygiene, timely treatment of urogenital and extragenital infections, normalization of the regularity of sexual life, sufficient physical activity, prevention of constipation, timely emptying of the bladder. To exclude relapses, dynamic examinations by an andrologist (urologist) are necessary; preventive courses of physiotherapy, multivitamins, immunomodulators; exclusion of hypothermia, overheating, stress, bad habits.

The prostate gland is the most vulnerable organ in the male body. Prostate disease occurs in every third man over the age of 20 years. At the same time, prostate hyperplasia and adenoma, leading to problems with erection, are most often the result of chronic prostatitis. That is why you should know characteristics chronic prostatitis and how to treat it.

Chronic prostatitis - what is it?

Chronic prostatitis is a long-term inflammatory process in the prostate gland. The term combines several forms of the disease, manifested by similar clinical symptoms.

Infectious - provoked by bacteria, fungus or virus;
Non-infectious (congestive) - otherwise called chronic pelvic pain syndrome, occurs with or without signs of inflammation;
Asymptomatic - in the complete absence of clinical manifestations, inflammation is detected only with a thorough examination of the prostate.

In 95% of cases, non-infectious chronic prostatitis is diagnosed. At the same time, stagnation in the prostate - its secretion or blood circulation in the veins - comes to the fore in the development of inflammation.

The risk of developing chronic prostatitis is increased in people who:

leading an irregular sexual life, regularly practicing interruption of sexual intercourse in order to avoid pregnancy of a partner;
office workers and drivers (sedentary work provokes stagnation of blood in the pelvis);
who prefer to wear tight underwear;
abusing alcohol and smoking.

Chronic prostatitis: signs of exacerbation

Chronic prostatitis develops gradually and may not cause concern for many years. Periodically, a man may note:

Unpleasant sensations in the perineal area;
Pain of minimal intensity with characteristic irradiation to the sacrum, rectum, genitals;
Some increase in urination with the occurrence of pain and slight pathological discharge from the urethral canal, a weak stream of urine;
Soreness of the glans penis after ejaculation (disappears within 30 minutes);
Burning in the urethra, the occurrence of pain during intercourse.

Stress, hypothermia, a previous infection leading to a weakened immune system, and the use of spicy food / alcohol can provoke an exacerbation of chronic prostatitis. At the same time, the intensity of painful manifestations increases and resembles acute inflammation.

With the development of the disease and the involvement of the nerves in the pathological process, erectile dysfunction is increasingly increasing, which significantly affects psychological state sick.

However, chronic prostatitis is fraught not only with a violation of potency - a weak erection, a decrease in sensations during orgasm or their complete absence, premature ejaculation.

Often, the disease leads to the development of cystitis, pyelonephritis and inflammation of the testicles, which aggravate the course of the underlying pathology. In addition, the risk of formation of stones in the prostate, adenoma, or the appearance of a malignant tumor increases significantly. With a long course of chronic prostatitis, infertility develops.

Symptoms of chronic prostatitis in forms and stages

Symptoms of chronic prostatitis depend on the form of the disease and the stage of the disease (exacerbation or remission).

Bacterial chronic prostatitis

Signs of chronic prostatitis caused by pathogenic microflora periodically occur with varying intensity. During an exacerbation, the symptoms of inflammation are most pronounced. Infectious, chronically flowing prostatitis manifests itself:

Common signs of inflammation in the body are fever, weakness, chills, muscle pain (occur during exacerbation);
syndrome of local inflammation - pain in the lower abdomen, aggravated by sexual intercourse, after defecation and urination, with a long absence of intimacy;
From the genitourinary system - intermittent urination, impaired erectile dysfunction;
Deviations in laboratory studies - detection of bacteria / fungi in the prostate secretion and urinalysis, signs of inflammation in the blood test (leukocytosis, elevated ESR) and urine (leukocyturia, protein).

Outside of the exacerbation of inflammation, the signs of chronic prostatitis are erased. The patient's complaints are more indicative of impaired urination, decreased sexual desire and other erectile disorders that cause severe nervousness.

Non-infectious chronic prostatitis: chronic pelvic pain syndrome

The name itself indicates the predominant symptom in this type of chronic prostatitis - pain. Due to the low intensity of pain, chronic non-infectious prostatitis often goes unnoticed.

Over time, the pain intensifies somewhat, and in the clinical picture, symptoms of sexual dysfunction appear due to the progression of congestion and a decrease in the muscle tone of the pelvic floor and urinary sphincter.

Often the disease is completely asymptomatic. The diagnosis of chronic prostatitis is made when signs of inflammation of the prostate and its hyperplasia are detected during diagnostic studies. Urinalysis may occasionally show leukocyturia.

Methods of treatment of chronic prostatitis

In each case, the treatment of chronic prostatitis requires an individual selection of a therapeutic regimen. This takes into account the cause of the disease (infection, stagnation of secretion or venous blood), the duration of the course and the presence of aggravating pathology.

Medical therapy:

Antibacterial drugs - antibiotic treatment (Ciprofloxacin, Amoxicillin, Azithromycin, Levofloxacin, Clarithromycin) is indicated only for severe inflammation, detection of a bacterial agent in the urine or prostate secretion. Antibiotic therapy continues for 2-8 weeks. At the end of the course, the symptoms of the disease often remain in full, although the infectious factor is completely eliminated.
Alpha-blockers (Terazonin, Tramsulosin, Alfuzosin) - are prescribed for increased intraurethral pressure, hypertonicity of the bladder muscles. Their use has no effect in violation of muscle innervation and pelvic floor myodystrophy.
Symptomatic treatment of chronic prostatitis - NSAIDs (Diclofenac, Ketorolac), often in tablets, are used to relieve pain, selective antidepressants (Imipramine, Fluoxetine) are recommended to eliminate anxiety.
Hormone therapy - treatment with antiandrogens and androgens is carried out in accordance with the deviations of the hormonal level.
Immunostimulants - are prescribed only with proven laboratory immunodeficiency.
Means that regulate the level of uric acid are only advisable when stones are found in the prostate. Most often, the doctor prescribes Allopurinol. However, the drug is effective only against urates.
Vitamin therapy - the means of choice in the treatment of chronic prostatitis are available vitamin-mineral complexes. Replacing them with advertised dietary supplements does not bring a therapeutic result, except for wasting money.

Surgical treatment of prostatitis

Depending on the pathological process that provoked chronic prostatitis, transurethral resection of the prostate is used (often replaces open operation), endoscopic drainage of a formed prostate cyst, surgical correction of seminal vesicles in case of impaired secretion outflow.

In advanced sclerosis, a prostatectomy is performed. With prostate hyperplasia, ablative methods are effective - microwave thermotherapy and laser ablation.

Other treatments for chronic prostatitis

Some doctors actively prescribe various methods of physical impact on the prostate to patients with chronic prostatitis. However, most of them have a number of contraindications and are prescribed only in certain cases:

Prostate massage (only a small part of the gland is available) with hyperplastic changes in the organ can provoke acute urinary retention and contribute to the spread of the inflammatory process (up to the development of sepsis). Also, massage can not be carried out with stones and cysts of the prostate, severe venous congestion. Release of the prostate from stagnant secretion the best way occurs during natural ejaculation.
Gymnastics for the bladder - special exercises to lengthen the intervals between urination up to 4-5 hours are effective in violation of the muscle tone of the bladder and its sphincter. However, their effectiveness is markedly reduced in myofascial syndrome caused by neurodystrophic changes.
Instillation - deep infusion medicines into the urethra is very painful and fraught with complications.
Electrical stimulation, transrectal ultrasound and phonophoresis, magnetotherapy and other methods of muscle stimulation are advisable to use only with a reduced tone of the pelvic floor muscles. Physiotherapy provides only temporary relief, and a lasting effect is achieved when the cause of the disease is eliminated.
Folk methods - home recipes (pumpkin seeds with honey, alcohol infusion of aspen bark and others) are used only with the approval of the treating andrologist and in no way replace drug therapy.

Prognosis: can chronic prostatitis be cured?

The prognosis for chronic prostatitis directly depends on the timeliness of the patient's request for qualified help. As you can see, the symptoms and treatment of chronic prostatitis in men are closely related - in the absence of hyperplastic changes in the gland and neurodystrophy, subject to complex treatment, a stable improvement in the condition can be achieved.

At the same time, it is important to radically reconsider your life: eliminate factors provoking stagnation, get rid of bad habits and eat well.

Chronic inflammation of the prostate gland occurs in men of any age. The catalyst in most cases is an infectious factor: trichomonas, staphylococci and gonococci. Bacteria that enter the body provoke inflammation of the urethral canal, the prostate gland itself.

Chronic prostatitis is often asymptomatic. The disease itself is determined only after the transition to an acute form. Late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.

Statistics show a constant "rejuvenation" of the disease. More and more patients are turning to urologists at the age of 30 years.

Chronic prostatitis - what is it

The prostate gland is located under the bladder. The main functions are to protect vesica urinaria from ingestion, seminal fluid, as well as the production of prostate secretion, a necessary component of the male seed. Inflammation of the tissues of the gland, provoked by infection, congestion and other factors, gradually becomes permanent.

Chronic prostatitis leads to degenerative changes. The tissue structure is gradually deformed. Often, against the background of inflammation, stones appear in the ducts. Some types of prostatitis cause cancer.

Was developed international system classification that facilitates differentiation between various diseases prostate.

Chronic prostatitis - causes

It is generally accepted that inflammation of the prostate gland is caused by two main factors: bacterial and abacterial.

The first is associated with the entry of pathogens and infections into the patient's body. Most often, sexually transmitted bacteria act as a catalyst.

The second cause of occurrence is not associated with an infectious agent. Inflammation can be catalyzed by:

Hypothermia of the body.
Hormonal disorders associated with aging, irregular sex life.
Bad habits.
Injury to the pelvic organs.
Congestion caused by metabolic disorders and a sedentary lifestyle.

After diagnosing prostatitis, the root cause of chronic prostatitis is necessarily determined. The course of therapy is prescribed based on what exactly caused the inflammation. Bacterial and non-infectious prostatitis are treated differently.

Urologists name several additional factors that aggravate the situation and affect the severe course of the disease:

Sexual abstinence.
Inferior ejaculation (selection of interrupted sexual intercourse as a method of contraception).
Stress.
Bad habits - alcohol abuse and smoking.
Wrong nutrition.
Past inflammatory diseases. Often they act as the cause of chronic prostatitis.

Inflammation is accompanied by destructive changes in the prostate gland, which makes it possible to classify the disease into several categories.

Classification of chronic inflammation of the prostate

Varieties of prostatitis have received their ICD-10 code - N41. To clarify the diagnosis and differentiation of the catalyst infection, a separate classification B95-B97 is used. The symptom rating scale divides the disease into several groups and subgroups:

I - acute inflammation, accompanied by a sharp rise in temperature, fever.
II - chronic prostatitis, provoked by an infectious factor.
III - the class includes a disease in which pelvic pain syndrome begins to manifest. It is customary to distinguish two subgroups:
1. IIIA - there are signs of an inflammatory process. Subfebrile temperature is maintained.
2. IIIB - no inflammation.
IV - prostatitis in which there are no symptomatic manifestations. Deviations from the norm are found only instrumental methods diagnostics.

According to the ICD code:

N41.1 Diagnose chronic prostatitis.
N41.8 Inflammatory diseases of the prostate.
N41.9 Definitive diagnosis not made.

How chronic prostatitis manifests itself - its symptoms

The first signs of chronic prostatitis in men appear at an advanced stage of the disease. Often, early development has no clinical manifestations. Symptoms, even if present, are temporary, short-term and of little intensity.

According to clinical manifestations, there are three stages of development of prostatitis:

Initial indirect signs of chronic prostatitis - as already noted, the onset of the disease is not expressed by clearly distinguishable symptoms. Signs are subtle or non-existent.
Signs that you should pay attention to: burning sensation during ejaculation, decreased potency, painful urination.
Secondary signs of chronic inflammation of the prostate - at this stage, pathological changes in the structure of tissues, the appearance of scar formations, and a decrease in genitourinary function occur.
The stage is characterized by a sharp deterioration in potency and urination, increased sweating, severe pain in the pelvic area, lumbar spine, scrotum.
Signs of advanced disease - the prostate ceases to function in a normal way. Healthy tissues begin to metamorphose. The gland increases in size. Interspersed with blood and pus appear in the urine, there is a constant feeling of incomplete emptying of the bladder, night trips to the toilet become more frequent. Erectile function is reduced so much that we can talk about complete impotence.

In addition to the symptoms characteristic of each stage of development, there are common signs that appear throughout the course of the disease.

Pain syndrome

Chronic prostatitis in the late stage of development has a pronounced symptomatology. Characteristic clinical manifestations are pains of strong intensity that do not go away on their own and require the use of analgesics and antispasmodics.

Pain syndrome accompanies the entire period of development of the disease. During primary signs prostatitis discomfort and burning in the urethral canal are of little intensity, so they are often ignored. Pain is often falsely attributed to sciatica, fatigue. After pain relief or taking an antispasmodic such as No-Shpa, the symptom usually goes away.

Over time, the clinical picture becomes more and more saturated. The pain syndrome manifests itself more intensely, remains after taking analgesics. Unpleasant sensations accompany every act of urination, defecation and ejaculation.

Pain radiates from the spine to the scrotum, sometimes to the limbs, accompanied by convulsions, numbness. Skin rashes, itching and burning of tissues in the prostate and genital organs are a normal reaction of the body to internal inflammation.

Temperature increase

Chronic inflammation of the prostate gland in an acute form is accompanied by fever and fever. There is a sharp increase in temperature, reaching up to 39-40 °. Indicators are stable. Body temperature does not decrease even after taking antipyretics.

Sluggish prostatitis is characterized by subfebrile course. Constant indicators of chronic inflammation, in the range of 37-37.2°.

Bring down the temperature and take it yourself medicines to reduce external manifestations is strictly prohibited!

Dysuria

The first signs of chronic prostatitis are manifested in various urinary disorders. Over time, the symptoms become more saturated, which helps to determine the disease. Manifestations of dysuria:

Frequent nighttime urge to go to the toilet.
Sensation of incomplete emptying of the bladder.
Hematuria (blood in urine), purulent discharge.
Pain during urination.

Clinical signs and the intensity of their manifestation directly affect the diagnosis, and require a mandatory additional study. Symptoms may indicate other inflammatory diseases of the genitourinary system, and.

Violations of the functions of the genital organs

Chronic prostatitis leads to the appearance of scar formations that impair blood supply. Nutritional deficiencies lead to:

Decreased potency - with chronic prostatitis, sexual disorders are observed. One of the characteristic symptoms is a normal erection, which decreases sharply during intercourse. In the advanced stage, a steady potency sets in.
Infertility - after the appearance of scars in the seminal ducts, the viability of spermatozoa decreases. Inflammation changes the structure and composition of the ejaculate. In the advanced stage, the sperm thickens, lumps appear.
Pain during intercourse - discharge from the urethral canal is observed. During sexual intercourse, discomfort and painful manifestations are felt, especially during ejaculation. Often psychosomatic causes lead to permanent impotence of the patient.

The main symptoms of chronic prostatitis: pain, fever, dysuria, dysfunction of the genital organs. When making a diagnosis, the intensity and duration of the period from the onset of the onset of clinical signs, as well as related symptoms, are taken into account.

How can chronic inflammation of the prostate be diagnosed?

Prostatitis has no symptoms to accurately differentiate the disease. Some disorders of the genitourinary system have similar symptoms. An accurate diagnosis can only be made after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.

Suspecting the presence of violations in the work of the pelvic organs, the urologist will prescribe a mandatory rectal examination. If tissue changes are detected during palpation, several laboratory tests are prescribed.

Laboratory research methods

Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the catalyst for the development of the disease. When making a diagnosis, you will need Additional Information obtained from the results of the following laboratory studies:

Cytological and bacteriological analysis of urine. The PSA level is set. Protein levels rise sharply with inflammation of the gland tissues.
Taking a swab from the urethra.
Microscopy of the secretion of the prostate - according to the results, failures in the work of the prostate gland are determined. Differentiate cancer from chronic tissue inflammation.
Sowing the secret of the prostate is prohibited during the acute period of the disease, accompanied by high body temperature, exacerbation of hemorrhoids, cracks in the anus.
Tests for STIs (sexually transmitted infections) - one of the common catalysts for prostate inflammation - pathogens.
Trichomonas, staphylococci, and gonococci can all cause disease. Prostatitis develops during the active phase of bacterial reproduction, and after the infection has already been cured.

Laboratory research is an obligatory component of the diagnosis of prostatitis and the subsequent choice of treatment method.

Instrumental detection of the disease

There are three main research methods for prostatitis. Each method of instrumental diagnostics provides information about changes in the structure of gland tissues, has its own indications and contraindications:

Tomography - MRI is often prescribed to diagnose chronic prostatitis. The study allows you to get a layered picture of the prostate. MRI signs accurately indicate chronic inflammation, and also show the beginning of tissue degeneration into a malignant formation.
The magnetic resonance technique is absolutely harmless, but has contraindications associated with the impossibility of examining patients with pacemakers, metal staples and shunts (left during surgical operations).
Transrectal TRUS are informative methods that indicate the presence of inflammation with great certainty. Echographic signs of structural changes in the prostate by the type of chronic prostatitis include: deviations from the norm in volume and size, structure, the presence of pathological formations.
Ultrasound technique is not prescribed for acute inflammation of the rectum, the presence of cracks in the anus, hemorrhoids.
Ultrasound - transabdominal technique has no contraindications. The method is less informative compared to TRUS and MRI. Sonographic signs make it difficult to determine the space abdominal cavity. Diagnostic results are often controversial and require clarification. The advantage of ultrasound is the simplicity and speed of the study.

The accuracy of the echographic picture largely depends on the experience of the doctor conducting the study.

Differential search for disease

After receiving the results of clinical and biochemical studies, an assessment of the symptoms of chronic inflammation of the prostate gland is carried out. Common standards for diagnosis have been developed and are valid throughout the world.

To facilitate the task of the urologist, the NIH-CPSI symptom index was invented, made in the form of a questionnaire or questionnaire. The doctor fills in the columns of the document, after which he makes a diagnosis.

Exist computer programs based on the NIH-CPSI index. The doctor is required to fill out a questionnaire, and the system will independently conduct a total assessment of symptoms in chronic prostatitis. The effectiveness of the technique has been proven worldwide.

After counting the results of the questionnaire, when making a diagnosis, the assessment of instrumental and clinical studies is additionally taken into account: the presence of echo signs of chronic prostatitis, an increased PSA level, and the detection of an infectious marker during secretion microscopy. The more data the urologist has, the more accurate the result will be.

What is dangerous chronic prostatitis - its consequences

The consequences of chronic prostatitis in men are disorders in the work of the genitourinary system. These include:

Impotence.
Acute urinary retention.
Infertility.

Fibrotic changes that accompany a neglected disease become the cause of the development of oncology. Normal tissues are transformed into malignant ones. Therefore, the prevention of functional changes in the prostate gland in order to prevent the development of cancer is an extremely important task facing the urologist.

When making a diagnosis, the presence of prostatic intraepithelial neoplasia, a precursor of oncology and fibrotic changes, is taken into account. A neglected disease often leads to the need for a surgical operation: prostatectomy.

Diagnosis of prostatitis and differentiation of the disease from related disorders of the pelvic organs is an important task for doctors and patients. The detection of the first symptoms depends entirely on the man himself. If you experience any discomfort during urination, decreased erection, constant subfebrile temperature - reasons to immediately seek professional advice. medical care. Delay is dangerous!