How is prostatitis treated? Based on the results of clinical and laboratory examinations, the urologist-andrologist develops a treatment program that covers a number of therapeutic measures. A comprehensive treatment program, as a rule, includes treatment with antibacterial and antiviral therapy, drugs that improve vascular tone. Physiotherapeutic treatment methods are widely used (magnetic-laser-inductotherapy, ultrasound, reflexology, leech therapy), as well as tonics, a course of prostate massage is prescribed. In both cases, the choice of treatment and tactics remain with the urologist-andrologist.
The role of the prostate in a person's life
Prostate- part of the male reproductive system that produces a specific secretion that nourishes and protects sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles constrict, the seed is thrown into the urethra - ejaculation (ejaculation).
Anatomy:The prostate gland is located below the bladder and covers the upper part of the urethra, so as the size increases, various urinary disorders develop. Size, shape and density vary according to the individual and the age of the man. The gland has a complex nervous system and causes both local and general discomfort, even with small pathological changes.
Activity:The main function of the prostate is secretion. The secretion (or juice) it produces consists of a liquid and a dense part and contains proteins, carbohydrates, electrolytes, fats and hormones. The gland not only transports sperm, but also dilutes the sperm to ensure sperm motility and vitality. The prostate is an important organ involved in the regulation of testosterone production and at the same time 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 diseases associated with narrowing of the lumen of the urethra:
- Difficulty urinating
- intermediate urination;
- poor urine flow;
- urine secretion drop by drop;
- feeling of incomplete emptying of the bladder;
- involuntary urination.
- Symptoms that irritate the nerve endings:
- increased urination;
- increased urination at night;
- emergency urination;
- urine in small portions;
- urinary retention with urinary excretion.
- Pain in the lower abdomen, groin, inner thighs or lower back and various sexual disorders can occur.
Keep in mind that urinary incontinence and pain symptoms can occur not only with prostatitis, but also with prostate adenoma (benign hyperplasia). Unfortunately, prostate cancer is also often diagnosed. Therefore, for early diagnosis of possible prostate pathology, it is recommended that all men over the age of 50 be given blood for prostate-specific antigen (PSA).
Causes of prostatitis
- sexually transmitted infections: chlamydia, ureaplasma, mycoplasma, herpes virus, cytomegalovirus, trichomonas, gonococcus, Candida fungus, esherichia coli can be transmitted to the urinary tract and found in prostate tissue;
- disruption of blood circulation in the pelvic organs (obstruction of the prostate causes inflammation);
- sedentary lifestyle (drivers, office workers, officials);
- long-term sexual abstinence, interrupted sexual intercourse, or artificial prolongation of sexual intercourse;
- frequent hypothermia (extreme recreation lovers: diving, surfing, skiing and skiing);
- stress: mental and physical overload.
Prostatitis and strength.Inflammation of the prostate does not cause impotence. However, chronic prostatitis, which is not treated as inflammation of the seminal tubercle, can lead to inhibition of libido, adequate erection, premature or accelerated ejaculation, pain during ejaculation, and 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 need regular check-ups by a urologist-andrologist. In these countries, examination of the prostate gland has become commonplace. Our compatriots are in a different position: they go to the doctor only when "completely pressed".
Here is the result: the treatment of prostatitis in our country requires 40-60% of men of reproductive age.
Diagnosis of prostatitis
Chronic prostatitis is an insidious disease. Often, the disease develops in secret and gradually becomes chronic. If you do not pay attention in time, then a seemingly insignificant concern can turn into a real nightmare. During the exacerbation phase, it sometimes gives a very high temperature (38-39 ° C), pain in the perineum, making the process of urination and defecation a success. All of this can result in an abscess, a purulent mass of prostate tissue.
In its advanced form, prostatitis leads to the most serious complications, causing many problems not only for the man himself, but for the whole family. Prostatitis not only reduces libido and erectile function. The most unfortunate thing is that about 40% of patients are threatened with some kind of infertility because the prostate gland can no longer secrete high enough quality to ensure sperm motility. For this reason, it is very important to treat prostatitis in the early stages of development. The success of the treatment of prostatitis largely depends on it.
Urological examination
- General examination methods of urological patients: blood tests (clinical, biochemical for HIV, RW and hepatitis B and C markers) and urine tests.
- Special examination methods of urological patients:
- study of prostate gland secretion;
- tests for sexually transmitted infections;
- digital rectal examination;
- Ultrasound of the kidneys, bladder and transrectal ultrasound uroflowmetry of the prostate gland (examination of urine secretion on suspicion of prostatitis);
- blood test for PSA and prostate biopsy to rule out prostate cancer (if indicated).
Treatment of prostatitis
After receiving all the results, the urologist will prepare a treatment program. This prostatitis treatment program should cover all therapeutic measures. The development of prostatitis is always triggered by several factors, so it is necessary to act in several directions at once. A comprehensive program for the treatment of prostatitis, as a rule, prescribes antibiotic therapy, treatment with drugs that improve vascular tone, physiotherapy procedures and general tonics, a course of prostate massage.
Massage is a necessary procedure, although it causes a number of unpleasant sensations. First, when you need to get a prostate gland secretion for diagnosis, research. In addition, in some cases, massage is performed to remove the blockage in the prostate gland. In general, this event is taken seriously and selectively.
Prostate adenoma or benign prostatic hyperplasia (BPH) is a disease that occurs in 50% of men over the age of 50. The reasons for the proliferation of prostate tissue are still unclear. BPH is often associated with inflammation. When left untreated, prostatitis develops, 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;
- sac stones;
- chronic renal failure.
Different examination methods allow you to assess which disorders are predominant and what their degrees are. Depending on the results of the examination, the doctor together with the patient decides which of the treatment methods to choose. Possible surgical and medical treatment of BPH.
Viral prostatitis
Herpes viruses, cytomegalovirus, human papillomaviruses generally cause the development of urethritis, complicate the course of prostatitis and cause male infertility.
For example, in men who do not have genital herpes on the skin or mucous membranes, the virus can only be detected during laboratory diagnosis of semen or prostate secretions. The patient becomes infected with a sexual partner, develops sperm pathology and, as a result, infertility. Often patients with non-bacterial forms of prostatitis receive various mass antibiotic therapy without the expected positive effect, in fact, viruses can be the cause of the disease, which requires completely different tactics in treatment (antiviral therapy, immunotherapy), etc. ).
Herpetic:According to various authors, prostatitis is caused or supported by 2. 9 -% 21. 8% of the herpes simplex virus. 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 seems to be that virological diagnostic methods are not included in the standard of examination of patients with chronic prostatitis. The reason is a stereotype of physician thinking, and patients are traditionally screened for genital infections of a non-viral nature.
Functional changes in the clinical course of prostatitis - reproductive changes, pain (with such radiation to the external genitalia, perineum, down) and dysuric syndromes are noted. Often, prostatitis is subclinical in patients with recurrent genital herpes: in these patients, the diagnosis of prostatitis is based on the appearance of leukocytosis in the prostate secretion and a decrease in the number of lecithin granules.