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 whole 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-inductotherapy, ultrasound, reflexotherapy, leech therapy), as well as fortifying agents, a course of prostate massage is prescribed. In each 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 produces a specific secret that nourishes and protects sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles contract, semen is ejected 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. Size, shape and density are individual and change with the age of the man. The gland has a complex nervous apparatus and, even with minor pathological changes, causes both local and general disorders in it.
Function:The main function of the prostate is secretory. The secret (or juice) produced by it consists of a liquid and 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 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 with prostatitis
- Various urinary disorders associated with narrowing of the lumen of the urethra:
- Difficulty starting urination
- intermittent urination;
- weak stream of urine;
- urination drop by drop;
- feeling of incomplete emptying of the bladder;
- involuntary urine leakage.
- Symptoms due to irritation of the nerve endings:
- increased urination;
- increased urination at night;
- urgent urge to urinate;
- urinating in small portions;
- incontinence of urine with the urge to urinate.
- Pain in the lower abdomen, groin areas, inner thighs or lower back, and a variety of sexual disorders can occur.
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. That is why, in order to early diagnosis of possible prostate pathology, all men after 50 years of age are recommended to 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 affect the urethra and be detected in the prostate tissue;
- violation of blood circulation in the pelvic organs (congestion in the prostate leads to inflammation);
- sedentary lifestyle (drivers, office workers, officials);
- prolonged sexual abstinence, interrupted sexual intercourse or artificial lengthening of sexual 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, like inflammation of the seminal tubercle, can lead to 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 commonplace. Our compatriots have a different position: they go to the doctor only when they "completely press it. "
And here is the result: treatment of prostatitis in our country requires 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 develop into a real nightmare. In the stage of exacerbation, it sometimes gives a rather high temperature (38-39 ° C), pain in the perineum turns the process of urination and defecation into a feat. An abscess may form, that is, 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 that create many problems not only for the man himself, but also for his entire family. With prostatitis, not only libido decreases and erectile function is impaired. The saddest thing is that about 40% of patients are threatened with some form of infertility, since the prostate gland can no longer produce enough high-quality secretions to ensure sperm motility. Therefore, 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 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 the secretion of the prostate gland;
- tests for sexually transmitted infections;
- digital rectal examination;
- 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
After all the results are received, the urologist will draw up a treatment program. This prostatitis treatment program should include a whole 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, therapy with drugs that improve vascular tone, physiotherapeutic procedures, as well as general strengthening agents, a course of prostate massage is prescribed.
Massage, despite the fact that it causes a number of unpleasant sensations, is a necessary procedure. First, for diagnostics, when you need to take the secretion of the prostate gland for research. In addition, in certain cases, 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 still not clear enough. BPH is often associated with inflammation. If untreated, prostatitis progresses, urine outflow becomes more 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 infection;
- acute urinary retention;
- bladder stones;
- chronic renal failure.
Various methods of examination make it possible to assess which disorders prevail 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 surgical and medical treatment of BPH.
Viral prostatitis
Viruses of herpes, 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 manifestations of genital herpes on the skin and mucous membranes, the virus can only be detected during laboratory diagnostics in semen or prostate secretions. The patient infects the sexual partner, he 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, which requires a completely different tactics in treatment (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. Usually, chronic prostatitis is characterized by a frequent and persistently 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 of patients with chronic prostatitis. The reason is the stereotype of the doctor's thinking, and patients are traditionally examined for genital infections of a non-viral nature.
In the clinical course of prostatitis, functional changes are noted - reproductive changes, pain (with irradiation 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.