How is prostatitis treated? Based on the results of clinical and laboratory tests, the urologist-andrologist draws up a treatment program that should include a whole series of therapeutic measures. The comprehensive treatment program usually includes antibacterial and antiviral therapy, as well as therapy with drugs that improve vascular tone. Physiotherapeutic treatment methods are widespread (magnetic laser induction therapy, ultrasound, reflex zone massage, leech therapy) as well as tonics, a 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 produces a specific secret that nourishes and protects the 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 is located under the bladder and covers the upper part of the urethra, therefore, as it grows, various urinary tract diseases 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.
Function:The main function of the prostate is secretory. The secret (or juice) it produces consists of a liquid and dense fraction and includes proteins, carbohydrates, electrolytes, fats, and hormones. The gland not only transports the sperm, but also thins the sperm and thus ensures the mobility and vitality of the sperm. The prostate is an important organ that is involved in the regulation of testosterone production and also ensures the normal functioning of the erectile mechanism.
Classification of prostatitis
- acute;
- asymptomatic inflammation;
- chronic bacteria;
- chronic pelvic inflammatory pain syndrome.
Complaints with prostatitis
- Various urinary tract diseases associated with narrowing of the urethral lumen:
- Difficulty urinating
- intermittent urination;
- weak urine stream;
- urinate drop by drop;
- Feeling of incomplete emptying of the bladder;
- involuntary leakage of urine.
- Symptoms from irritation of the nerve endings:
- increased urination;
- increased urination at night;
- urgent need to urinate;
- urinate in small portions;
- Urinary incontinence with an urge to urinate.
- Pain in the lower abdomen, groin, inner thighs, or lower back, and a variety of sexual disorders can occur.
Remember that violations of urination and symptoms of pain can appear not only with prostatitis, but also with adenomas (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is also often diagnosed. For this reason, for the early detection of possible prostate pathology, all men over the age of 50 are recommended to donate blood for the prostate specific antigen (PSA).
Causes of Prostatitis
- sexually transmitted infections: chlamydia, ureaplasma, mycoplasma, herpesvirus, cytomegalovirus, trichomonas, gonococcus, candida fungus, escherichia coli can infect the urethra and be detected in prostate tissue;
- violation of blood supply to the pelvic organs (obstruction of the prostate leads to inflammation);
- sedentary lifestyle (drivers, office workers, civil servants);
- prolonged sexual abstinence, interrupted sexual intercourse or artificial prolongation 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, if left untreated, chronic prostatitis, such as inflammation of the vas deferens, can lead to an inhibition of libido, an inadequate erection, premature or accelerated ejaculation, pain during ejaculation and what is known as a deleted orgasm.
Prostatitis and male infertility.Among other things, the prostate also affects the viability of sperm and in some cases the inflammatory process leads to infertility.
In the industrialized countries, most men over the age of 45 have to undergo regular preventive examinations by a urologist-andrologist. Examination of the prostate has become commonplace in these countries. Our compatriots have a different position: They only go to the doctor if they "completely press it".
And here is the result: the treatment of prostatitis in our country requires 40 to 60% of men of childbearing age.
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 in time, a seemingly insignificant discomfort can turn into a real nightmare. Sometimes at the stage of exacerbation there is quite a high temperature (38-39 ° C), pain in the perineum makes the process of urination and defecation an achievement. An abscess can form, that is, a purulent fusion of the tissues of the prostate, with all the consequences that follow.
In its advanced form, prostatitis leads to the most serious complications that cause a lot of problems not only for the man himself, but also for his entire family. With prostatitis, not only does the libido decrease and erectile function is impaired. The sad thing is that around 40% of patients are at risk of some form of infertility because the prostate can no longer produce enough high-quality secretion to ensure the mobility of the sperm. That is why it is so important to treat prostatitis in the early stages of development. The success of the prostatitis treatment largely depends on it.
Urological examination
- General examination methods of urological patients: blood tests (clinical, biochemical, for HIV, RW and markers of hepatitis B and C) and urine tests.
- special examination methods of urological patients:
- Examination 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 Uroflowmetry (examination of urination if prostatitis is suspected);
- Blood test for PSA and prostate biopsy (if indicated) to rule out prostate cancer.
Treatment of prostatitis
After all the results are available, the urologist draws up a treatment program. This prostatitis treatment program should include a number of therapeutic measures. The development of prostatitis is always provoked by several factors, therefore it is necessary to act in several directions at the same time. The complex program for the treatment of prostatitis usually includes antibiotic therapy, therapy with drugs that improve vascular tone, physiotherapy procedures, as well as general tonics, prostate massage is prescribed.
Massage, despite the fact that it causes a number of unpleasant sensations, is a necessary procedure. Firstly, for diagnostics when you need to remove the secretion from the prostate for research purposes. In addition, in certain cases, massage is performed to relieve obstruction of the prostate. Usually this event is approached seriously and selectively.
Prostate adenoma or benign prostatic hyperplasia (BPH) A disease that affects 50% of men over the age of 50. The reasons for prostate tissue proliferation are still not clear enough. BPH is often linked to inflammation. If left untreated, prostatitis progresses, urine drainage 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 kidney failure.
Various examination methods make it possible to assess which disorders are prevalent and what degree they are. Depending on the results of the examination, the doctor decides together with the patient which of the treatment methods to choose. Possible surgical and medical treatment for 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.
In men without any manifestations of genital herpes on the skin and mucous membranes, for example, the virus can only be detected in laboratory diagnostics in semen or prostate secretion. The patient infects the sexual partner, he develops sperm pathology and, as a result, infertility. Often times, patients with a non-bacterial form of prostatitis receive a variety of massive antibiotic therapies without the expected positive effect, while viruses can actually be the cause of the disease, which requires 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 recurring character. In clinical practice, the diagnosis of chronic herpetic prostatitis is rarely made by urologists. The reason is apparently that virological diagnostic methods are not part of the standard examination for patients with chronic prostatitis. The reason is the doctor's stereotypical thinking and traditionally patients have been screened for genital infections of a non-viral nature.
In the clinical course of prostatitis, functional changes are noted - reproductive changes, pain (with irradiation of the external genitals, perineum, lower back) and dysuric syndromes. In patients with recurrent genital herpes, prostatitis is often subclinical: in these patients, the diagnosis of prostatitis is made due to the appearance of leukocytosis in the secretion of the prostate and a decrease in the number of lecithin grains.