How is prostatitis treated? Based on the results of clinical and laboratory examinations, the urologist-andrologist draws up a treatment program, which should include a wide 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 are widely used (magnetic laser induction therapy, ultrasound, reflexology, leech therapy), as well as fortifying agents, a course of prostate massage is prescribed. In each case, the choice and treatment tactics are left to the urologist-andrologist.
The role of the prostate in a man's life.
Prostate- a part of the male reproductive system that produces a specific secret that nourishes and protects sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles contract, semen is expelled into the urethra - ejaculation (ejaculation).
Anatomy:The prostate gland is located under the bladder and covers the upper part of the urethra, therefore, with an increase in size, various urinary disorders develop. The size, shape and density are individual and change with the age of man. The gland has a complex nervous apparatus and, even with minor pathological changes, causes both local and general disorders.
Function:The main function of the prostate is secretory. The secret (or juice) it produces consists of a dense, liquid fraction and includes proteins, carbohydrates, electrolytes, fats, and hormones. The gland not only carries the sperm, but it also dilutes them, ensuring the motility and vitality of the sperm. The prostate is an important organ 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.
Prostatitis complaints
- Various urinary disorders associated with narrowing of the lumen of the urethra:
- Difficulty starting to urinate
- intermittent urination;
- weak urine stream;
- urination drop by drop;
- feeling of incomplete emptying of the bladder;
- involuntary loss of urine.
- Symptoms due to irritation of nerve endings:
- increased urination;
- increased urination at night;
- urgent need to urinate;
- urinate in small portions;
- urinary incontinence with the urge to urinate.
- Pain can occur in the lower abdomen, groin areas, inner thighs, or lower back, and a variety of sexual disorders.
Remember that violations of the act of urination and pain symptoms can occur not only with prostatitis, but also with adenoma (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is often diagnosed as well. Therefore, for the early diagnosis of a possible prostate disease, it is recommended that all men over 50 years of age donate 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 be detected in prostate tissue;
- violation of blood circulation in the pelvic organs (congestion in the prostate leads to inflammation);
- sedentary lifestyle (drivers, office workers, civil servants);
- prolonged sexual abstinence, interrupted sexual intercourse or artificial lengthening of intercourse;
- frequent hypothermia (fans of extreme recreation: diving, surfing, kayaking and skiing);
- stress: mental and physical overload.
Prostatitis and potency.Inflammation of the prostate itself does not lead to impotence. However, untreated chronic prostatitis, such as inflammation of the seminal tubercle, can produce inhibition of libido, insufficient erection, premature or accelerated ejaculation, pain during ejaculation and the so-called erased orgasm.
Prostatitis and male infertility.Among other factors, the prostate also affects the viability of sperm and, in some cases, the inflammatory process leads to infertility.
In developed countries, most men who have reached the age of 45 must undergo regular preventive examinations by a urologist-andrologist. Examination of the prostate gland in these countries has become common. Our compatriots have a different position: they go to the doctor only when they "push completely. "
And here is the result: the treatment of prostatitis in our country requires 40 to 60% of men of reproductive age.
Prostatitis diagnosis
Chronic prostatitis is an insidious disease. Most often, the disease develops latently and gradually becomes chronic. If you do not pay attention in time, then a seemingly insignificant discomfort can turn into a real nightmare. In the exacerbation stage, sometimes it 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 can form, that is, a purulent fusion of the tissues of the prostate gland, with all the consequent consequences.
In its advanced form, prostatitis leads to the most serious complications that create many problems not only for the man himself, but also for his entire family. With prostatitis, not only does libido decrease and erectile function is impaired. The saddest thing is that around 40% of patients are threatened with some form of infertility, as the prostate gland can no longer produce enough high-quality secretions to ensure sperm motility. Therefore, it is very important to treat prostatitis in the early stages of development. The success of prostatitis treatment depends largely on this.
Urological examination
- general methods of examination of urological patients: blood tests (clinical, biochemical, for HIV, RW, and hepatitis B and C markers) and urinalysis
- special methods of examination of urological patients:
- study of the secretion of the prostate;
- tests for sexually transmitted infections;
- digital rectal exam;
- Ultrasound of the kidneys, bladder and transrectal ultrasound of the prostate gland uroflowmetry (examination of urination with suspected prostatitis);
- blood test for PSA and prostate biopsy (if indicated) to rule out prostate cancer.
Treatment of prostatitis
Once all the results are received, the urologist will draw up a treatment program. This prostatitis treatment program should include a wide range of therapeutic measures. The development of prostatitis is always provoked by several factors, therefore it is necessary to act in several directions at once. The complex program for the treatment of prostatitis, as a rule, includes antibiotic therapy, drug therapy that improve vascular tone, physiotherapeutic procedures, as well as general strengthening agents, a course of prostate massage is prescribed.
Massage, despite causing a number of unpleasant sensations, is a necessary procedure. First, for diagnosis, when you need to take the secretion of the prostate gland for research. In addition, in certain cases, a massage is performed to relieve congestion in the prostate gland. Usually this event is approached seriously and selectively.
Prostate adenoma or benign prostatic hyperplasia (BPH) A disease that occurs in 50% of men over 50 years of age. The reasons for the proliferation of prostate tissue are not yet clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine flow becomes more difficult, blood circulation in the bladder wall deteriorates, and over time, the bladder wall stiffens. These changes are irreversible.
Complications of prostate adenoma
- urinary tract infection;
- acute urinary retention;
- stones in the bladder;
- chronic kidney failure.
Various screening methods make it possible to assess which disorders are prevalent and what their degree is. Depending on the results of the examination, the doctor together with the patient decide which of the treatment methods to choose. Possible medical and surgical treatment of BPH.
Viral prostatitis
Herpes viruses, cytomegaly, human papillomaviruses are often the cause of the development of urethritis, complicate the course of prostatitis and cause male infertility.
For example, in men without any manifestation of genital herpes on the skin and mucous membranes, the virus can only be detected 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 non-bacterial form of prostatitis receive a variety of massive antibiotic therapy without the expected positive effect, while, 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. In general, chronic prostatitis is characterized by a frequent and persistent recurrent nature. In clinical practice, the diagnosis of chronic herpetic prostatitis is rarely made by urologists. The reason, apparently, is that virological diagnostic methods are not included in the standard of examination for patients with chronic prostatitis. The reason is the stereotype of the doctor's thinking, and traditionally patients are screened for genital infections of a non-viral nature.
In the clinical course of prostatitis, functional changes are observed: reproductive changes, pain (with radiation to 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.