How is prostatitis treated? Based on the results of clinical and laboratory tests, the urologist-andrologist prepares a treatment program that should include a full range of therapeutic measures. The comprehensive treatment program usually includes antibacterial and antiviral therapy, therapy with drugs that improve vascular tone. Physiotherapy methods of treatment are widely used (magnetic-laser induction therapy, ultrasound, reflexology, leech therapy), as well as strengthening agents and prostate massage. The choice and tactics of treatment is always the responsibility of the urologist-andrologist.
The role of the prostate in human life
Prostate- a part of the male reproductive system that produces a special secret that nourishes and protects sperm. When the smooth muscle fibers of the prostate capsule and the bladders contract, the sperm is expelled into the urethra - ejaculation (ejaculation).
Anatomy:The prostate gland is located under the bladder and covers the upper part of the urethra, so as it increases in size, various urinary tract disorders develop. Size, shape, and density are unique and vary with a man’s age. The gland has a complex nervous system and causes local and general disorders in it with minor pathological changes.
Function:The main function of the prostate is secretion. The secret (or juice) it produces consists of a liquid and dense fraction and contains proteins, carbohydrates, electrolytes, fats and hormones. The gland not only transports the sperm but also dilutes the sperm, ensuring sperm motility and vitality. The prostate is an important organ that is involved in regulating testosterone production and also ensuring the normal functioning of the erectile mechanism.
Classification of prostatitis
- acute;
- asymptomatic inflammation;
- chronic bacterial;
- chronic pelvic pain inflammatory syndrome.
Complaints related to prostatitis
- Various urinary disorders associated with narrowing of the lumen of the urethra:
- Difficulties in starting to urinate
- intermittent urination;
- poor urine flow;
- urination drop by drop;
- 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 doses;
- urinary incontinence and urinary stimuli.
- Pain may occur in the lower abdomen, lumbar region, inner thigh, or lower back, and various sexual disorders may occur.
Keep in mind that violation of the symptoms of urination and pain can occur not only in prostatitis but also in prostate adenoma (benign hyperplasia). Unfortunately, prostate cancer is also often diagnosed. Therefore, in order to diagnose possible prostate pathology early, 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, herpesvirus, cytomegalovirus, Trichomonas, gonococcus, Candida fungus, Escherichia coli can infect the urethra and can be detected in prostate tissue;
- violation of the blood circulation in the pelvic organs (congestion 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 (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 otitis media, can lead to inhibition of libido, insufficient 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 45-year-old men have to undergo regular preventive examinations by a urologist-andrologist. Examination of the prostate gland has become common in these countries. The position of our compatriots is different: they only go to the doctor if they are "completely pressed".
And here is the result: in Hungary, 40-60% of men of reproductive age are needed to treat prostatitis.
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 malaise can become a real nightmare. At the stage of exacerbation, it sometimes gives a rather high temperature (38-39 ° C), and pain in the perineum turns the process of urination and defecation into feats. An abscess can form, i. e. a purulent fusion of the tissues of the prostate gland, with all its consequences.
In its advanced form, prostatitis leads to the most serious complications that cause many problems not only for the man but for the whole family. With prostatitis, not only does libido decrease and erectile function deteriorates. The saddest thing is that about 40% of patients are at risk of some form of infertility because the prostate is no longer able to produce enough good quality secretions to ensure sperm motility. This is why treating prostatitis is so important in the early stages of development. The success of the treatment of prostatitis depends largely on this.
Urological examination
- general testing methods for urological patients: blood tests (clinical, biochemical, HIV, RW and hepatitis B and C markers) and urine tests.
- special examination methods for urological patients:
- examination of prostate secretions;
- tests for sexually transmitted infections;
- digital rectal examination;
- Transrectal ultrasound of the kidneys, bladder, and prostate gland uroflowmetry (examination of urination with suspected prostatitis);
- blood test for PSA and prostate biopsy (if needed) to rule out prostate cancer.
Treatment of prostatitis
After all the results are received, the urologist prepares a treatment program. This prostatitis treatment program should include a number of therapeutic measures. The development of prostatitis is always provoked by several factors, so it is necessary to act in several directions at the same time. A complex program for the treatment of prostatitis usually includes antibiotic therapy, therapy with drugs that improve vascular tone, physiotherapy procedures, and general strengthening agents, a course of prostate massage.
Massage, despite causing many discomforts, is a necessary procedure. First, for diagnosis, when you need to bring in the secretions of the prostate gland for research. In addition, in some cases, massage is performed to relieve congestion of the prostate gland. 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 years. The reasons for the proliferation of prostate tissue are still not clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine output becomes more 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 infections;
- acute urinary retention;
- bladder stones;
- chronic renal failure.
Different test methods make it possible to assess which abnormalities predominate and to what extent. Depending on the outcome of the test, the doctor will decide with the patient which treatment to choose. Possible surgical and medical treatment of BPH.
Viral prostatitis
Herpes viruses, cytomegaly, and human papillomaviruses are often the causes of urethritis, complicate the course of prostatitis, and cause infertility in men.
For example, in men who do not have genital herpes on the skin and mucous membranes, the virus can only be detected in sperm or prostate secretions during laboratory diagnosis. The patient infects the sexual partner, sperm pathology, and as a result develops infertility. Often, patients with non-bacterial forms of prostatitis receive various massive antibiotic therapies without the expected positive effects, while in fact viruses can cause the disease, which requires completely different tactics during treatment (antiviral therapy, immunotherapy), and so on. ).
Herpetic:According to various authors, prostatitis is caused or supported by the herpes simplex virus in 2, 9 to 21, 8% of cases. In general, chronic prostatitis is characterized by frequent and persistent recurrence. In clinical practice, the diagnosis of chronic herpes prostatitis is rarely made by urologists. This is obviously due to the fact that virological diagnostic methods are not included in the test standard for patients with chronic prostatitis. This is due to the stereotype of the physician’s mindset, and patients are traditionally examined for non-viral genital infections.
During the clinical course of prostatitis, functional changes are observed - reproductive changes, pain (with irradiation of the external genitalia, perineum, lower back) and dysuric syndromes. 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 secretion of the prostate and a decrease in the number of lecithin particles.