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. As a rule, the comprehensive treatment program includes antibacterial and antiviral therapy, therapy with drugs that improve vascular tone. Physiotherapeutic treatment methods are widely used (magnetic laser inductotherapy, ultrasound, reflexology, leech therapy), as well as fortifying agents, prostate massage is prescribed. In each case, the choice and tactics of treatment belong to 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 is located below 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 man. The gland has a complex nervous apparatus, and even with minor pathological changes it causes local and general disorders.
A function:The main function of the prostate is secretory. The secret (or juice) it produces consists of a liquid, dense fraction and includes proteins, carbohydrates, electrolytes, fats, and hormones. The gland not only transports 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 a narrowing of the lumen of the urethra:
- Difficulty starting to urinate
- intermittent urination;
- weak stream of urine;
- drip urination;
- 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;
- urinate in small portions;
- urinary incontinence with the urge to urinate.
- Pain in the lower abdomen, groin, inner thighs or lower back and various sexual disorders can occur.
Remember that violations of the act of urinating and symptoms of pain can occur not only with prostatitis, but also with adenoma (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is also often diagnosed. That is why, in order to diagnose any possible pathology of the prostate at an early stage, 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, fungus Candida, Escherichia coli can infect the urethra and be detected in prostate tissue;
- violation of blood circulation in the pelvic organs (congestion of the prostate leads to inflammation);
- sedentary lifestyle (drivers, office workers, civil servants);
- prolonged sexual abstinence, interrupted intercourse or artificial lengthening of intercourse;
- frequent hypothermia (lovers 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, such as inflammation of the seminal tubercle, can lead to inhibition of libido, insufficient erection, premature or accelerated ejaculation, pain during ejaculation and what is 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 require regular preventive examinations by a urologist-andrologist. Prostate examinations in these countries have become commonplace. Our compatriots have a different position: they only go to the doctor when they "fully support him".
And here is the result: the treatment of prostatitis in our country requires 40-60% 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 are not careful in time, seemingly insignificant discomfort can turn into a real nightmare. At the stage of exacerbation, sometimes it gives a rather high temperature (38-39 ° C), pain in the perineum turns the process of urination and defecation into a feat. An abscess can form, that is, a purulent fusion of the tissues of the prostate, 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 whole family. With prostatitis, not only does the libido decrease and erectile function is impaired. The sad part is that about 40% of patients are at risk of some form of infertility because the prostate 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 the treatment of prostatitis largely depends on it.
Urological examination
- general methods of examining urological patients: blood tests (clinical, biochemical, for HIV, RW and hepatitis B and C markers) and urine tests.
- special methods of examination of urological patients:
- study of prostate secretion;
- tests for sexually transmitted infections;
- Rectal touch;
- Ultrasound of the kidneys, bladder and transrectal ultrasound of the flowmetry of the prostate (examination of urination with suspicion of prostatitis);
- blood test for PSA and prostate biopsy (if indicated) to rule out prostate cancer.
Treatment of prostatitis
Once all the results are received, the urologist will establish a treatment plan. 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. As a rule, the complex program for the treatment of prostatitis 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 diagnosis, when you need to take the secretion from the prostate for research. In addition, in some cases, massage is performed to decongest the prostate. Usually this event is approached seriously and selectively.
Prostate adenoma or benign prostatic hyperplasia (BPH) A disease that occurs in 50% of men over the age of 50. The reasons for the proliferation of prostate tissue are not yet clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, it becomes more difficult to pass urine, blood flow 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.
Various examination methods are used to assess which disorders are prevalent and to what degree. Based on the results of the examination, the doctor and the patient decide which methods of treatment to choose. Possible surgical and medical treatment of 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.
For example, in men without any manifestation of genital herpes on the skin and mucous membranes, the virus can only be detected during laboratory diagnostics in semen or prostatic secretions. The patient infects the sexual partner, he develops pathology of the sperm and, as a result, infertility. Often, patients with a non-bacterial form of prostatitis are given a variety of massive antibiotics without the expected positive effect, when in fact viruses can be the cause of the disease, which requires tactics. completely different treatment (antiviral treatment, immunotherapy, etc. ).
Herpetic:According to various authors, prostatitis is caused or promoted by the herpes simplex virus in 2, 9 to 21, 8% of cases. Usually, chronic prostatitis is characterized by a frequent and recurring character. 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 for this is the stereotypical thinking of the doctor, and patients are traditionally examined for genital infections of a non-viral nature.
During the clinical course of prostatitis, functional changes are noted - changes in reproduction, pain (with irradiation of 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 thenumber of grains of lecithin.