How is prostatitis treated? Based on the results of clinical and laboratory tests, the urologist-andrologist prepares a treatment program, which must include a whole range of therapeutic measures. The comprehensive treatment program typically includes antibacterial and antiviral therapy, drug therapy that improves vascular tone. Physiotherapeutic methods of treatment are widely used (magnetic laser inductotherapy, ultrasound, reflexology, leech therapy), as well as fortifying agents, a course of prostate massage is prescribed. In each case, the choice and tactic of treatment 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 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 under the bladder and covers the upper part of the urethra, so as the size increases, 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 small pathological changes, it causes local and general disturbances.
Occupation:The main function of the prostate is secretion. The secret (or juice) 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 dilutes it, ensuring sperm motility and vitality. The prostate is an important organ involved in the regulation of testosterone production, in addition to ensuring the normal functioning of the erection mechanism.
classification of prostatitis
- acute;
- asymptomatic inflammation;
- chronic bacterial;
- Chronic pelvic pain inflammatory syndrome.
Prostatitis complaints
- Difficulty starting to urinate
- intermittent urination;
- weak stream of urine;
- dropwise urination;
- feeling of incomplete emptying of the bladder;
- involuntary leakage of urine.
- increased urination;
- increased urination at night;
- urgent need to urinate;
- urinate in small portions;
- urine incontinence with urge to urinate.
Remember that violations of urination and pain symptoms can occur not only with prostatitis, but also with adenoma (benign hyperplasia) of the prostate. Unfortunately, prostate cancer is also frequently diagnosed. Therefore, for the early diagnosis of a possible prostate pathology, all men over 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 detected in prostate tissue;
- violation of blood circulation in Organs pelvic organs (congestion of the prostate leads to inflammation);
- sedentary lifestyle (drivers, office workers, employees);
- prolonged sexual abstinence, interrupted intercourse or artificial prolongation of intercourse;
- frequent hypothermia (extreme recreation fans: diving, surfing, kayaking and skiing);
- stress: mental and physical overload.
Prostatitis and potency.Prostate inflammation 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 the 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 must undergo regular preventive examinations by an urologist-andrologist. Prostate examination in these countries has become commonplace. Our compatriots have a different position: they go to the doctor only when they "completely press".
And here is the result: the treatment of prostatitis in our country requires 40 to 60% of men of reproductive age.
diagnosis of prostatitis
Chronic prostatitis is an insidious disease. The disease often develops latently and gradually becomes chronic. If you don't pay attention in time, a seemingly insignificant discomfort can turn into a real nightmare. In the exacerbation stage, sometimes gives a very high temperature (38-39 ° C), the pain in the perineum turns the process of urinating and defecating into a feat. An abscess can form, that is, a purulent fusion of the prostate tissues, with all the 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 the entire family. In prostatitis, not only does libido decrease and erectile function is impaired. The saddest thing is that about 40% of patients are threatened with some form of infertility, since the prostate is no longer able to produce high-quality secretions in sufficient quantity to guarantee sperm mobility. Therefore, it is very important to treat prostatitis in the early stages of development. The success of prostatitis treatment depends a lot on it.
urological exam
- study of prostate secretion;
- testing for sexually transmitted infections;
- digital rectal exam;
- Kidney, bladder and transrectal ultrasound of the prostate uroflowmetry (voiding test with suspected prostatitis);
- blood test for PSA and prostate biopsy (if indicated) to rule out prostate cancer.
Prostatitis treatment
Upon receipt of all results, the urologist will design a treatment program. This prostatitis treatment program should include a wide range of therapeutic measures. The development of prostatitis is always caused by several factors, so it is necessary to act in several directions at the same time. The complex treatment program for prostatitis usually includes antibiotic therapy, therapy with drugs that improve vascular tone, physiotherapeutic procedures, in addition to general strengthening agents, and a course of prostate massage is prescribed.
Massage, despite causing a lot of unpleasant sensations, is a necessary procedure. First, for diagnosis, when you need to take the secretion from the prostate for research. Also, in certain cases, massage is performed to relieve prostate congestion. Typically, this event is approached 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 proliferation of prostate tissue are still not clear enough. BPH is often associated with inflammation. If left untreated, prostatitis progresses, urine flow becomes more difficult, blood circulation in the bladder wall deteriorates, and over time the bladder wall becomes hardened. These changes are irreversible.
Complications of Prostate Adenoma
- urinary tract infection;
- acute urinary retention;
- bladder stones;
- chronic renal failure.
Various examination methods allow you to assess which disorders are prevalent and to what degree. Depending on the test results, the doctor and the patient decide which treatment method to choose. Possible surgical and medical treatment from BPH.
viral prostatitis
Herpes viruses, cytomegaly and 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 manifestations of genital herpes on the skin and mucous membranes, the virus can only be detected during laboratory diagnosis in semen or prostate secretions. The patient infects the sexual partner, develops sperm pathology and, consequently, infertility. Often, patients with a non-bacterial form of prostatitis are given a variety of massive antibiotics without the expected positive effect, whereas viruses may actually be the cause of the disease, which requires an entirely different tactic of treatment (antiviral treatment, immunotherapy, etc. . ).
Herpetic:According to several authors, prostatitis is caused or supported by herpes simplex virus in 2, 9 - 21, 8% of cases. Chronic prostatitis is typically characterized by a frequent and persistently recurrent nature. In clinical practice, the diagnosis of chronic herpetic prostatitis is rarely made by urologists. The reason, apparently, is that virologic diagnostic methods are not included in the standard of examination of patients with chronic prostatitis. The reason is the stereotype of physician thinking, and patients are traditionally screened for non-viral genital infections.
In the clinical course of prostatitis, functional changes are noted - 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 based on the appearance of leukocytosis in the prostate secretion and a decrease in the number of lecithin grains.