How is prostatitis treated? Based on the results of clinical and laboratory examinations, the urologist-andrologist designs a treatment program, which should include a whole range of therapeutic measures. 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 therapy-laser-inductotherapy, ultrasound, reflexology, caterpillar therapy), as well as strengthening agents, prescribe a course of prostate massage. In each case, the choice and treatment tactics remain 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 secretion that nourishes and protects sperm. When the smooth muscle fibers of the prostate capsule and seminal vesicles contract, semen is thrown into the ureter - ejaculation (ejaculation).
Anatomia: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 vary with the age of the husband. The gland has a complex nervous apparatus and, even with small pathological changes, causes local and general disorders in it.
Function:The main function of the prostate is secretory. The secretion (or fluid) produced by it consists of a liquid and dense fraction and includes proteins, carbohydrates, electrolytes, fats and hormones. The gland not only transports sperm, but also thins the sperm, ensuring sperm motility 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 prostate
- Various urinary disorders associated with narrowing of the urethral lumen:
- Difficulty in starting urination
- intermittent urination;
- poor urine flow;
- point-by-point urination;
- feeling of incomplete emptying of the bladder;
- involuntary leakage of urine.
- Symptoms due to irritation of nerve endings:
- increased urination;
- increased urination at night;
- urgent urge to urinate;
- urination in small portions;
- urinary incontinence with desire to urinate.
- Pain may appear in the lower abdomen, groin area, inner thighs or lower back, and a range of sexual disorders.
Remember that urinary incontinence and pain symptoms can occur not only with prostate but also with prostate adenoma (benign hyperplasia). Unfortunately, prostate cancer is often diagnosed as well. This is why, to diagnose possible prostate pathology early, all men after the age of 50 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 infect the urethra and be found in prostate tissue;
- violation of blood circulation in the pelvic organs (blockage of the prostate leads to inflammation);
- sedentary lifestyle (drivers, office workers, officials);
- 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 does not lead to impotence. However, chronic untreated prostatitis, such as inflammation of the seminal tubercle, can lead to libido suppression, insufficient erection, premature or accelerated ejaculation, pain during ejaculation, and so-called erased 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 who have reached the age of 45 should undergo regular preventive examinations by a urologist-andrologist. Examination of the prostate gland in these places has become commonplace. Our compatriots have another position: they go to the doctor only when they "completely suppress 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 late and gradually becomes chronic. If you do not pay attention to it in time, then a seemingly insignificant bad condition can develop into a real nightmare. In the deterioration phase, sometimes giving a fairly high temperature (38-39 ° C), pain in the perineum turns the process of urination and defecation into an achievement. An abscess can form, i. e. purulent fusion of prostate gland tissue, 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 is libido reduced and erectile function impaired. The saddest thing is that about 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 movement. That is why it is so important to treat prostatitis in the early stages of development. The success of prostate treatment depends largely 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 prostate gland secretion;
- tests for sexually transmitted infections;
- digital rectal examination;
- Ultrasound of the kidneys, bladder and transrectal ultrasound of the prostate gland uroflowmetry (examination of urine with suspected prostate);
- blood test for PSA and prostate biopsy (if indicated) to rule out prostate cancer.
Treatment of prostatitis
Once all the results are obtained, the urologist will design a treatment program. This prostate treatment program should include a whole range of therapeutic measures. The development of prostatitis is always provoked by several factors, so 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 the tone of blood vessels, physiotherapeutic procedures, as well as general strengthening agents, prescribed a course of prostate massage.
Massage, despite the fact that it causes a number of unpleasant sensations, is a necessary procedure. First, for diagnosis, when should you get prostate gland secretion for research. In addition, in certain cases, massage is performed to relieve congestion in the prostate gland. Usually this event is treated 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 spread of prostate tissue are still not quite clear. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine output becomes more difficult, blood circulation 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 renal failure.
Different examination 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 surgical and medical treatment of BPH.
Viral prostates
Herpes viruses, cytomegalovirus, 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 appearance of genital herpes on the skin and mucous membranes, the virus can be detected only during laboratory diagnosis in sperm 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, whereas in fact, viruses can be the cause of the disease, which requires a completely different tactic 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 recurrent nature. In clinical practice, the diagnosis of chronic herpetic prostatitis is rarely made by urologists. Apparently, the reason is that virological diagnostic methods are not included in the standard of examination of patients with chronic prostate. The reason is the stereotype of doctor thinking and patients are traditionally examined 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 prostate secretion and a decrease in the number of lecine grains.