How is prostatitis treated? Based on the results of clinical and laboratory examinations, the urologist-andrologist compiles a treatment program that should include a range of therapeutic measures. A comprehensive treatment program, as a rule, includes antibacterial and antiviral therapy, therapy with drugs that improve vascular tone. Physiotherapeutic methods of treatment (magnetic-laser inductotherapy, ultrasound, reflexology, leech therapy) are widely used, as well as strengthening agents, and a course of prostate massage is prescribed. In any case, the choice and tactics of treatment remains with the urologist-andrologist.
The role of the prostate in a man's life
Prostate- a part of the male reproductive system that creates a certain secret that nourishes and protects sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicle are tightened, the semen is expelled into the urethra - ejaculation (ejaculation).
Anatomy:The prostate gland is located below the bladder and covers the upper part of the urethra, so with increasing size, various urination disorders develop. Size, shape and density are individual and change with the age of the man. The gland has a complex nervous system and, even with minor pathological changes, causes local and general disorders in it.
Function:The main function of the prostate is secretory. The secretion (or juice) that is produced consists of a liquid and thick fraction and includes proteins, carbohydrates, electrolytes, fats and hormones. The gland not only transports sperm, but also dilutes sperm, ensuring sperm motility and vitality. The prostate is an important organ that is involved in the regulation of testosterone production, and also ensures the normal functioning of the erection mechanism.
Classification of prostatitis
- acute;
- asymptomatic inflammation;
- chronic bacterial;
- chronic pelvic pain inflammatory syndrome.
Complaints of prostatitis
- Various urination disorders associated with narrowing of the urethral lumen:
- Difficulty starting to urinate
- occasional urination;
- weak urine flow;
- drip urination;
- feeling of incomplete bladder emptying;
- involuntary leakage of urine.
- Symptoms due to irritation of nerve endings:
- increased urination;
- increased urination at night;
- urgent need to urinate;
- urination in small meals;
- urinary incontinence with the urge to urinate.
- Pain in the lower abdomen, groin, inner thighs or lower back and various sexual disorders can occur.
Keep in mind that urinary incontinence and pain symptoms can occur not only in prostatitis, but also in adenomas (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is also often diagnosed. Therefore, in order to diagnose possible prostate pathology early, all men after the age of 50 are recommended to give blood for prostate-specific antigen (PSA).
Causes of prostatitis
- sexually transmitted infections: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungus, Escherichia coli can infect the urethra and detect them in prostate tissue;
- violation of blood circulation in the pelvic organs (prostate congestion leads to inflammation);
- inactive lifestyle (drivers, clerks, clerks);
- prolonged sexual abstinence, interrupted sexual intercourse or artificial prolongation of sexual intercourse;
- frequent hypothermia (lovers of extreme recreation: diving, surfing, kayaking and skiing);
- stress: mental and physical overload.
Prostatitis and potency. Inflammation of the prostate does not in itself lead to impotence. However, untreated chronic prostatitis, such as inflammation of the seminal tuberculosis, can lead to libido inhibition, insufficient erection, premature or accelerated ejaculation, pain during ejaculation, and so-called deleted orgasm.
Prostatitis and male infertility.Among other factors, the prostate also affects sperm viability, and in some cases the inflammatory process leads to infertility.
In developed countries, most men over the age of 45 must undergo regular preventive examinations by a urologist-andrologist. Prostate examination has become common in these countries. Our compatriots have a different attitude: they go to the doctor only when they "press him completely".
And here are the results: 40 to 60% of men of reproductive age are needed to treat prostatitis in our country.
Diagnosis of prostatitis
Chronic prostatitis is an insidious disease. Very often the disease develops latently and gradually becomes chronic. If you don’t pay attention to the weather, then seemingly insignificant malaise can develop into a real nightmare. In the phase of worsening, it sometimes gives a rather high temperature (38-39 ° C), the pain in the perineum turns the process of urination and defecation into a feat. An abscess, or purulent fusion of prostate tissue, can occur, with all the consequences.
In its advanced form, prostatitis leads to the most serious complications that create numerous problems not only for the man himself, but also for his entire family. With prostatitis, not only is libido reduced, but erectile function is also impaired. The saddest thing is that about 40% of patients are threatened by some form of infertility, because the prostate can no longer produce enough high-quality secretions to ensure sperm motility. This is why it is so important to treat prostatitis in the early stages of development. The success of prostatitis treatment largely depends on it.
Urological examination
- general methods of examination of urological patients: blood tests (clinical, biochemical, for HIV, RW and markers of hepatitis B and C) and urine tests.
- special methods of examination of urological patients:
- study of prostate secretion;
- tests for sexually transmitted infections;
- digital rectal examination;
- Ultrasound of the kidneys, bladder and transrectal ultrasound of uroflowmetry of the prostate (examination of urination with suspected prostatitis);
- blood test for PSA and prostate biopsy (if indicated) to rule out prostate cancer.
Treatment of prostatitis
After receiving all the results, the urologist will compile a treatment program. This prostatitis treatment program should include a range of therapeutic measures. The development of prostatitis is always caused by several factors, so it is necessary to act in several directions at once. A complex program for the treatment of prostatitis, as a rule, includes antibiotic therapy, therapy with drugs that improve vascular tone, physiotherapeutic procedures, as well as generally strengthening agents, and a course of prostate massage is prescribed.
Despite the fact that it causes numerous unpleasant sensations, massage is a necessary procedure. First, for diagnosis, when you need to take prostate secretion for research. In addition, in certain cases, massage is performed to relieve congestion in the prostate. This event is usually approached seriously and selectively.
Prostate adenoma or benign prostatic hyperplasia (BPH) A disease that occurs in 50% of men over the age of 50. The reasons for the proliferation of prostate tissue are still not clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine outflow becomes difficult, blood circulation in the bladder wall deteriorates, and over time the bladder wall becomes hardened. These changes are irreversible.
Complications of prostate adenoma
- urinary tract infections;
- acute urinary retention;
- bladder stones;
- chronic renal failure.
Various testing methods make it possible to assess which disorders are prevalent and to what extent they are. Depending on the results of the examination, the doctor together with the patient decides which of the treatment methods to choose. Possible surgical and medical treatment of BPH.
Viral prostatitis
Herpes viruses, cytomegalovirus, human papilloma viruses are often the cause of the development of urethritis, complicate the course of prostatitis and cause male infertility.
For example, in men without any manifestations of genital herpes on the skin and mucous membranes, the virus can be detected only during laboratory diagnosis in semen or prostate secretions. The patient infects the sexual partner, develops sperm pathology and, as a result, infertility. Often patients with a nonbacterial form of prostatitis receive a variety of massive antibiotic therapy without the expected positive effect, when in fact viruses can be the cause of the disease, requiring completely different treatment tactics (antiviral treatment, immunotherapy, etc. ).
Herpetic:According to various authors, prostatitis is caused or supported by the herpes simplex virus in 2, 9 - 21, 8% of cases. Chronic prostatitis is usually characterized by a frequent and recurrent nature. In clinical practice, urologists rarely diagnose chronic herpetic prostatitis. The reason is, obviously, that virological diagnostic methods are not included in the standard of examination of patients with chronic prostatitis. The reason is the stereotype of doctors' thinking, and patients are traditionally examined for genital infections of a non-viral nature.
In the clinical course of prostatitis, functional changes have been reported - reproductive changes, pain (with irradiation to the external genitalia, perineum, lower back) and dysuric syndromes. Prostatitis is often subclinical in patients with recurrent genital herpes: in these patients, the diagnosis of prostatitis is made on the basis of the appearance of leukocytosis in the prostate secretion and a decrease in the number of lecithin grains.