How is prostatitis treated? Based on the results of clinical and laboratory examinations, the urologist-andrologist determines the treatment program, which should include the full range of therapeutic measures. A comprehensive treatment program typically includes antibacterial and antiviral therapy, therapy with medications that improve vascular tone. Physiotherapeutic methods of treatment are widely used (magnetic-laser-induction therapy, ultrasound, reflexology, plankotherapy), as well as firming agents, a course of prostate massage is prescribed. In each case, the choice of treatment and tactics remains with the urologist-andrologist.
The role of the prostate in men’s lives
Prostate- The part of the male reproductive system that produces specific secretions that nourish and protect sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles contract, the 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 increasing size, various urinary disorders develop. Size, shape and density are individual and vary with the age of the man. The gland has a complex nervous system and even during small pathological changes it causes both local and general disorders.
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 sperm but also dilutes the sperm, ensuring sperm movement and vitality. The prostate is an important organ involved in regulating 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 urethral lumen:
- Difficulty in initiating urination
- Intermittent urination;
- Weak urine flow;
- Urination drop-by-drop;
- Feeling of incomplete emptying of the bladder;
- Involuntary leakage of urine.
- Symptoms due to irritation of the nerve endings:
- Frequent urination;
- Increased urination at night;
- Urge to urinate urgently;
- Urination in small portions;
- Urinary incontinence with urge to urinate.
- Pain in the lower abdomen, groin area, inner thigh or lumbar region and various sexual disorders can occur.
Remember that urinary incontinence and pain symptoms can occur not only in prostatitis but also in prostate adenoma (benign hyperplasia). Unfortunately, prostate cancer is also often diagnosed. That is why, for early diagnosis of possible prostate pathology, it is recommended that all men after the age of 50 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 be infected through the urethra and found in prostate tissue;
- Disorders of blood circulation in the pelvic organs (swelling of the prostate causes inflammation);
- Sedentary lifestyle (drivers, office workers, officials);
- Prolonged sexual abstinence, interrupted sexual intercourse or artificial prolongation of sexual intercourse;
- Frequent hypothermia (fans of extreme rest: diving, surfing, kayaking and skiing);
- Stress: mental and physical overload.
Prostatitis and potential.Inflammation of the prostate itself does not cause impotence. However, untreated chronic prostatitis, like inflammation of the testicles, can lead to libido inhibition, insufficient erection, premature or accelerated ejaculation, pain during ejaculation, and so on. წ. Deleted orgasm.
Prostatitis and male infertility.Among other factors, the prostate also affects sperm viability and in some cases, the inflammatory process causes infertility.
In developed countries, most men over the age of 45 should undergo regular prophylactic examinations by a urologist-andrologist. Prostate examination has become commonplace in these countries. Our compatriots have a different position: they only go to the doctor when they "completely stop 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 disease can become a real nightmare. In the exacerbation stage it sometimes gives a rather high temperature (38-39 ° C), pain in the perineum turns into a process of urination and defecation. An abscess may form, or a purulent fusion of prostate tissue, with all consequences.
In its advanced form, prostatitis leads to the most serious complications, which cause many problems not only for the man himself, but for the whole family. In prostatitis not only libido is reduced and erectile function is impaired. The most unfortunate thing is that about 40% of patients are at risk for some form of infertility, since the prostate gland can no longer produce a secretion high enough to ensure sperm movement. That is why it is so important to treat prostatitis at an early stage of development. The success of treatment for prostatitis largely depends on it.
Urological examination
- General methods of examining urological patients: blood tests (clinical, biochemical, HIV, markers of hepatitis RW and B and C) and urine tests.
- Special methods of examination of urological patients:
- Study of prostate gland secretion;
- Tests for sexually transmitted infections;
- Digital examination of the rectum;
- Ultrasound ultrasound of the kidneys, bladder and prostate uroflowmetry (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 makes a treatment program. The prostatitis treatment program should include the full range of therapeutic measures. The development of prostatitis is always caused by several factors, so it is necessary to act simultaneously in several directions. Typically, a complex program for the treatment of prostatitis includes antibiotic therapy, therapy with drugs that improve vascular tone, physiotherapy procedures, as well as general enhancers, a course of prostate massage is prescribed.
Massage, although it causes a lot of unpleasant sensations, is a necessary procedure. First, for diagnosis when it is necessary to obtain prostate gland secretion for research. In addition, in some cases massage is done to remove the swelling in the prostate gland. As a rule, this event is taken seriously and selectively.
Prostate adenoma or benign prostatic hyperplasia (BPH) disease, which occurs in 50% of men over 50 years of age. The reasons for the proliferation of prostate tissue are still not sufficiently understood. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine flow becomes difficult, blood circulation in 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 methods of examination can assess which disorders are prevalent and which are their degree. Based on the results of the examination, the doctor decides with the patient which method of treatment to choose. Possible surgical and medical treatment of BPH.
Viral prostatitis
Herpes, cytomegalovirus, human papillomavirus viruses often cause urethritis, complicate the course of prostatitis and cause male infertility.
For example, in men without the manifestation of genital herpes on the skin and mucous membranes, the virus can be detected only in the laboratory diagnosis of sperm or prostate secretion. The patient infects a sexual partner, he develops sperm pathology and, as a result, infertility. Often, patients with non-bacterial forms of prostatitis receive a variety of antibiotic therapy without the expected positive effect, when in fact viruses can cause the disease, which requires completely different tactics for treatment (antiviral treatment, immunotherapy, etc. ).
Herpetic:According to various authors, prostatitis is caused by or supported by the herpes simplex virus 2. 9 - 21. 8% of cases. Chronic prostatitis is usually characterized by a frequent and recurrent nature. In clinical practice, the diagnosis of chronic herpetic prostatitis is rarely made by urologists. Presumably, the reason is that viral diagnostic methods are not included in the standard examination standard for patients with chronic prostatitis. The reason for this is the stereotype of the doctor's thinking and patients have traditionally been examined for non-viral genital infections.
The clinical course of prostatitis is marked by functional changes - reproductive changes, pain (irradiation of the external genitalia, perineum, lumbar region) and dysuric syndromes. Often, in patients with recurrent genital herpes, prostatitis is subclinical: in these patients prostatitis is diagnosed based on the appearance of leukocytosis in the prostate secretion and a decrease in the number of lecithin granules.