We selected 22 basic questions about prostatitis and its treatment. All the answers are written by our leading men's health specialist, an andrologist. We hope this article will help you and provide the necessary answers to your questions.
Symptoms of prostatitis: pain, burning, discharge, burning, incontinence
Symptoms of prostatitis are usually 3 types:
- violation of urination: difficult, frequent, nocturnal urination.
- pain symptoms: pain in the perineum, lower abdomen, groin. The pain may radiate (give) to the scrotum or sacrum.
- mixed form, in which urination disorders and pain occur.
What causes prostatitis?
With bacterial prostatitis
The infection enters the prostate from neighboring organs:
- urethra;
- Bladder
- through blood and lymph vessels from a distant focus of inflammation (tonsillitis, sinusitis, caries).
The most commonly detected bacteria in prostatitis are: Escherichia coli, Klebsiella, Proteus, Staphylococcus aureus, Enterococcus.
The role of sexually transmitted infections is discussed: chlamydia, mycoplasma, trichomoniasis.
The activity and, accordingly, the manifestation of the inflammatory process depends on the properties of the microorganism, the condition of the pelvic organs, their blood circulation, concomitant diseases and other predisposing factors.
With nonbacterial prostatitis
Stagnation plays an important role. Disorder of blood flow causes edema, exudation of prostate tissue and creates conditions for the development of an inflammatory process that is not associated with a bacterial agent.
Sexually transmitted diseases and prostatitis
The question of the involvement of sexually transmitted infections in the development of prostatitis is widely discussed in scientific medical circles. There is no consensus on this issue.
We consider ourselves proponents of a direct link between infections, the occurrence and course of prostatitis.
Why is prostatitis dangerous?
Prostatitis does not pose a threat to the patient's life, the process is chronic and worsens the quality of life.
Initial prostatitis. How to determine? The first signs
The first signs of prostatitis are changes in the nature of urination: difficult, frequent urination, frequent urge to urinate, especially at night. Discomfort during urination and pain of varying intensity in the groin area.
Age of prostatitis? Is this a disease of the young and / or old?
Prostatitis is an inflammatory disease, so it can occur at any age. But adenoma or prostate hyperplasia is a disease associated with aging in men after the age of 50 and is associated with the development of a benign prostate tumor.
Chronic prostatitis. Is it possible to cure?
The presence of a diagnosis of chronic prostatitis implies the presence of changes in the structure of glandular tissue, which remain for life. Like any chronic disease, prostatitis runs with alternating periods of exacerbation and remission - a period when the patient worries nothing. With proper treatment and lifestyle, periods of remission can be very long, and the difficulties never bother the patient again.
Bacterial and other types of prostatitis
There are different classifications, the most commonly used developed by the American Institutes of Health in 1995:
- category I.Acute prostatitis.
- Category II.Chronic bacterial prostatitis.
- Category III.Nonbacterial prostatitis / Chronic pelvic pain syndrome - no obvious signs of infection and lasts for 3 months or more.
- Subcategory III A.Chronic inflammatory pelvic pain syndrome (with leukocytes in prostate secretion and pathogen secretion).
- Subcategory III B.Chronic non-inflammatory pelvic pain syndrome (no leukocytes in the secretion of the prostate).
- Category IV.Asymptomatic prostatitis (with leukocytes in the prostate secretion, but without discomfort).
For ease of understanding, the classification can be presented in 3 types:
Acute prostatitis- flows with severe pain, fever, urinary disorders. The secret of the prostate is a large number of leukocytes, which indicates a clear inflammatory process. It occurs, as a rule, for the first time in a given patient. If these symptoms occur in patients with chronic prostatitis, then they are called exacerbations of chronic prostatitis.
Chronic bacterial prostatitis- Symptoms that periodically disturb the patient, as a rule, are less pronounced than in acute prostatitis. When an increase in leukocytes in the prostate secretion is diagnosed, it is possible to identify the cause of the inflammation.
It is the most problematic for diagnosisnonbacterial prostatitis, or so-calledchronic pelvic pain syndrome. . . This is due to the fact that the symptoms are very similar to prostatitis, but are associated with diseases of other organs and systems, in which it is not possible to detect signs of inflammation and pathogenic bacteria: pelvic muscle spasm, impaired interaction between the bladder muscle and its sphincternarrowing) of the urethra, leads to inflammation due to increased pressure inside the lobules of the prostate.
Who treats prostatitis - an andrologist or a urologist?
Prostatitis is treated by both a urologist and an andrologist.
An andrologist is a urologist specializing in male reproductive and reproductive diseases.
Methods and regimens for the treatment of prostatitis
All prostate treatment regimens consist of medications:
- anti-inflammatory
- antibacterial
- biogenic stimulants
- drugs that improve the contraction of the prostate and bladder while relaxing the sphincter.
Good results are achieved by the simultaneous appointment of drugs and physiotherapy (prostate massage, complexes for the treatment of prostatitis).
What tests are given for prostatitis?
Fordiagnosis of prostatitisIt is necessary to consult a urologist (andrologist) in order to collect patient complaints, anamnesis, microscopy of prostate secretions and ultrasound diagnostics.
Transrectal ultrasound of the prostate (TRUS) and prostate secretion obtained after prostate massage for microscopic examination are used for diagnosis.
In addition, screening of prostate secretions for bacterial flora can be used to determine the sensitivity of the seeded microflora to antibiotics.
Surgical interventions and prostatitis operations
In prostatitis, surgeries are practically not used. With the exception of prostate abscess - a process in which foci with purulent contents are formed.
Is it possible to cure prostatitis on your own?
In the presence of pronounced symptoms, it is better to be treated by a specialist, the time factor plays a big role in the treatment, because the longer the inflammation lasts, the more likely it is that there are irreversible changes in the organ.
But it is better to do the prevention yourself, no doctor will do it for you.
Avoid hypothermia, congestion during prolonged sitting, sexually transmitted infections, irregular sexual activity - all this is the way to effective prevention of prostatitis.
Drugs for prostatitis: finalgon, vitaprost, prostamol, ceftriaxone, doxycycline, omnix and others
Drugs for the treatment of prostatitis are divided into groups according to the mechanism of action:
Antibacterial agents (antibiotics)are prescribed only if there is a diagnosis: chronic bacterial prostatitis. The most commonly used fluoroquinolones, macrolides and the doxycycline group of drugs.
Alpha blockers:they are prescribed to restore disturbed urination, increasing the contraction of the bladder and relaxing its detrusor.
Large groupbiogenic stimulants and herbal preparations: candles.
Effective treatment is possible only with a correct diagnosis, because there are no universal cures for all types of prostatitis. Often patients take medication to treat prostatitis, if they have a completely different disease, but with similar symptoms.
Nuts, roots, primrose, cucumber, honey, bees, leeches and other folk remedies for prostatitis
Traditional methods of treatment have a right to exist, but you must understand that it is very difficult to choose a folk method that suits you. On demand, the search engine gives 70 million results for the treatment of prostatitis by folk methods.
No one has researched folk methods for efficiency. Just because it helped one patient with such treatment (and whether it helped) does not mean that it will help you.
Worsening of prostatitis after treatment. Remission, relapse
All chronic inflammatory processes have periods of exacerbation and remission, when the patient has nothing to worry about. The duration of remission can vary and depends on many factors, including whether the patient has undergone prophylactic treatment. Patients who periodically undergo preventive treatment without waiting for deterioration in well-being generally have less frequent exacerbations.
Prostate massage at home. Is massage always necessary for prostatitis?
You can also do prostate massage at home if you are married to a urology nurse. Every medical manipulation has its subtleties and nuances. Indications for this procedure can be determined only by a doctor, so for some diseases: prostate adenoma (in the presence of acute urinary retention), prostate massage is not desirable, and it is contraindicated in tumors.
Alcohol and prostatitis
Alcohol in itself does not cause prostatitis, but it is a factor that increases congestion and swelling of the prostate and thus contributes to its development.
Sex life and prostatitis
There is a direct link between the intensity of sexual activity and prostate disease. With prolonged abstinence, stagnation occurs in the prostate, which worsens metabolic processes and disrupts blood microcirculation, which contributes to the development of inflammatory processes. Regularity is more important for prostate health than the intensity of sexual intercourse. Excessive sexual intercourse, especially with different partners and unprotected from infections, is the fastest way to prostatitis.
Does prostatitis affect women?
Of course, there is an impact on the health of a woman with prostatitis in a partner. The prostate, together with the seminal vesicles, produces a liquid component of sperm, which enters the partner's genital tract during intercourse. The main danger may be the presence of a sexually transmitted infection or bacterial prostatitis, which can cause inflammatory diseases in women.
Pregnancy and prostatitis
Because the prostate gland produces a liquid portion of sperm that contains sperm nutrients, prostatitis often causes a decrease in sperm quality, making pregnancy more difficult.
Prevention. What to do to avoid prostatitis?
Prevention is directly related to the patient's climate and profession.
Prevention of prostatitis is to avoid and minimize the factors that contribute to the development of prostatitis. Hypothermia should be avoided, alternating sedentary work with periods of physical activity. Regular sex life is important for prostatitis.