How is prostatitis treated? Based on the results of clinical and laboratory tests, the urologist-andrologist prepares a treatment program, which should include a range of therapeutic measures. The comprehensive treatment program, as a rule, includes antibacterial and antiviral therapy, therapy with drugs that improve vascular tone. Physiotherapeutic methods of treatment (magnetic laser induction therapy, ultrasound, reflexology, leech therapy) are widely used, as well as tonics, 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
The prostate- part of the male reproductive system, which produces a specific secretion that nourishes and protects sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles contract, the sperm is expelled into the urethra - ejaculation (ejaculation).
Anatomy:The prostate gland is located below the bladder and covers the upper part of the urethra, due to which with increasing size develop various disorders of urination. The 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 both local and general disorders in it.
Function:The main function of the prostate is secretory. The secretion (or juice) produced by it consists of a liquid and a dense fraction and includes proteins, carbohydrates, electrolytes, fats and hormones. The gland not only transports the sperm, but also dilutes the sperm, ensuring the motility and vitality of the sperm. The prostate is an important organ involved in regulating testosterone production and also ensures the normal functioning of the erection mechanism.
Classification of prostatitis
- sharp;
- asymptomatic inflammation;
- chronic bacterial;
- chronic pelvic pain inflammatory syndrome.
Complaints of prostatitis
- Various urinary disorders associated with narrowing of the urethral lumen:
- Difficulty starting to urinate
- periodic urination;
- weak urine stream;
- urination drop by drop;
- feeling of incomplete emptying of the bladder;
- involuntary leakage of urine.
- Symptoms due to irritation of the nerve endings:
- increased urination;
- increased urination at night;
- urges to urinate;
- urination in small portions;
- urinary incontinence with a desire to urinate.
- Pain in the lower abdomen, groin, inner thighs or lower back and various sexual disorders may occur.
Remember that disorders of the act of urination and symptoms of pain can occur not only in prostatitis, but also in adenoma (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is also often diagnosed. Therefore, for early diagnosis of possible prostate pathology, all men over the age of 50 are advised to donate blood for prostate-specific antigen (PSA).
Causes of prostatitis
- sexually transmitted infections: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, fungus Candida, Escherichia coli can infect the urethra and be found in prostate tissue;
- disturbance of blood circulation in the pelvic organs (congestion in the prostate leads to inflammation);
- sedentary lifestyle (drivers, office workers, employees);
- 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 lead to impotence. However, untreated chronic prostatitis, like inflammation of the seminal tubercle, can lead to libido inhibition, insufficient erection, premature or accelerated ejaculation, pain during ejaculation and the 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 should undergo regular preventive examinations by a urologist-andrologist. Examination of the prostate gland in these countries has become commonplace. Our compatriots have a different position: they go to the doctor only when they "push him completely".
And here is the result: the treatment of prostatitis in our country requires from 40 to 60% of men of reproductive age.
Diagnosis of prostatitis
Chronic prostatitis is an insidious disease. Very often the disease develops latently and gradually becomes chronic. If you do not pay attention in time, then a seemingly insignificant malaise can turn into a real nightmare. In the exacerbation stage sometimes gives a fairly high temperature (38-39 ° C), pain in the perineum turns the process of urination and defecation into a feat. An abscess may form, ie a purulent fusion of the tissues of the prostate gland with all the ensuing consequences.
In its advanced form, prostatitis leads to the most serious complications, which create many problems not only for the man himself, but also for his whole family. With prostatitis, not only does libido decrease and erectile function is impaired. The saddest thing is that about 40% of patients are at risk of some form of infertility, as the prostate gland can no longer produce enough high-quality secretion to ensure sperm motility. That is why it is so important to treat prostatitis in the early stages of development. The success of prostatitis treatment largely depends on this.
Urological examination
- general methods for examination of urological patients: blood tests (clinical, biochemical, for HIV, RW and markers of hepatitis B and C) and urine tests.
- special methods for examination of urological patients:
- examination of the secretion of the prostate gland;
- tests for sexually transmitted infections;
- digital rectal examination;
- Ultrasound of the kidneys, bladder and transrectal ultrasound of uroflowmetry of the prostate gland (examination of urine 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 prepare a treatment program. This program for the treatment of prostatitis should include a whole range of therapeutic measures. The development of prostatitis is always provoked by several factors, which is why it is necessary to act in several directions at once. The complex program for the treatment of prostatitis, as a rule, includes antibiotic therapy, therapy with drugs that improve vascular tone, physiotherapy procedures, as well as tonics, a course of prostate massage is prescribed.
Massage, although it causes a number of unpleasant sensations, is a necessary procedure. First, for diagnosis, when you need to take the secretion of the prostate gland for examination. In addition, in certain cases, a massage is performed to relieve congestion in the prostate gland. 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 spread of prostate tissue are still not clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine flow becomes more difficult, blood flow to the bladder wall deteriorates, and over time, the bladder wall hardens. These changes are irreversible.
Complications of prostate adenoma
- urinary tract infection;
- acute urinary retention;
- bladder stones;
- chronic renal failure.
Different research methods allow to assess which disorders prevail and what is their degree. Depending on the results of the examination, the doctor together with the patient decide which of the treatment methods to choose. Possible surgical and medical treatment of BPH.
Viral prostatitis
Herpes viruses, cytomegalovirus, human papillomaviruses often cause 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, he develops sperm pathology and as a result of this infertility. Often patients with non-bacterial prostatitis receive a variety of massive antibiotic therapy without the expected positive effect, when in fact viruses can cause the disease, which requires completely different treatment tactics (antiviral treatment, immunotherapy, etc. ).
Herpetic:According to various authors, prostatitis is caused or maintained 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, the diagnosis of chronic herpes prostatitis is rarely made by urologists. The reason is obviously that virological diagnostic methods are not included in the standard for examination of patients with chronic prostatitis. The reason is in the stereotype of the doctor's thinking and patients are traditionally tested for genital infections of a non-viral nature.
In the clinical course of prostatitis there are functional changes - reproductive changes, pain (with irradiation of the external genitalia, perineum, lower back) and dysuric syndromes. Often in patients with recurrent genital herpes prostatitis is subclinical: in these patients the diagnosis of prostatitis is made on the basis of the appearance of leukocytosis in the secretion of the prostate and a decrease in the number of lecithin grains.