There are several forms of prostatitis, which differ in symptoms and the course of the inflammatory process. Despite the fact that in general this disease has been studied quite well, there is one form about which little is still known - it is abacterial prostatitis. This condition is also called chronic pelvic pain syndrome and according to the latest information, it occurs in every fifth man on the planet. Despite such widespread occurrence, the disease is still a mystery to doctors and is very difficult to treat.
Abacterial and non-infectious prostatitis: what is the difference?
Abacterial or nonbacterial prostatitis is often mistaken for noninfectious prostatitis. In fact, these are two different diseases with different manifestations and causes of development.
Chronic abacterial prostatitis is a disease without clear symptoms of prostatitis. Moreover, in the vast majority of cases, a detailed examination does not allow to determine the presence of an inflammatory process in the organ. At the same time, non-infectious prostatitis is an inflammatory disease that has well-defined and well-studied causes. Non-infectious prostatitis is caused by a violation of prostate trophism, due to which the prostate secretion stagnates and an inflammatory process develops. Noninfectious prostatitis is most commonly diagnosed in elderly patients, while nonbacterial prostatitis can occur in men of all ages.
To avoid confusion, nonbacterial prostatitis is also called chronic pelvic pain syndrome, which perfectly characterizes the main symptoms of this complex disease.
Typical symptoms
With little need, one feels painful discomfort.
The signs of abacterial prostatitis are not similar to the symptoms of prostate inflammation, so many doctors assume the neurological nature of the development of this disease.
In abacterial prostatitis, the symptoms are as follows:
- constant pelvic pain;
- increased pain syndrome during urination;
- severe discomfort with ejaculation;
- general physical illness;
- nervous tension.
Pelvic pain usually occurs for a long time, in the period from three months to six months. The pain syndrome is painful, monotonous, it can pass on its own without the use of analgesics, and then return spontaneously. The pain spreads to the testicles, perineum, anus. Sometimes there are short-term episodes of shooting "nervous" pain in the lower back, lower abdomen, groin.
Patients complain of worsening erections. During ejaculation, he feels intense tension, ejaculation is accompanied by sharp pain. Attacks of severe pain are possible when urinating.
Simultaneously with these symptoms, there is a strong emotional depression. The person is tense, prone to stress, some patients have insomnia and neurosis-like conditions.
Causes of abacterial prostatitis
A fall and as a result of a back injury can cause illness.
Nonbacterial prostatitis is not well understood, so doctors list the probable causes of this disease.
The exact mechanism of development and pathogenesis of chronic abacterial prostatitis has not yet been determined.
It is assumed that the disease may have the following reasons for development:
- inflammation of the pelvic floor ligaments and tendons;
- autoimmune process;
- enlargement of the pelvic floor ligaments;
- back injuries and chronic spinal diseases;
- violation of blood microcirculation in the prostate;
- neuropsychiatric reasons;
- intracellular parasites and pathogens in the prostate.
Inflammation of the ligaments and tendons of the pelvic floor can develop due to infectious diseases of the organs of the genitourinary system that are located in the immediate vicinity. As a result, the infection spreads to the ligaments, they become inflamed and increase in size, tightening and irritating nearby nerve endings. The pain that a man feels at the same time can spread along the nerves, giving way to the lower back, groin, lower abdomen or anus.
Another possible cause of chronic abacterial prostatitis or CABD are autoimmune processes in the body. As a result of such a failure, the immune system begins to perceive prostate cells as a foreign element and attacks them with immune cells, leading to the appearance of typical symptoms of abacterial prostatitis.
Another suspicious cause is viral prostatitis from which the patient suffered in childhood. Because the prostate in boys is not yet sufficiently developed, viral inflammation of this organ may not have pronounced symptoms and turn into a chronic form, which in an adult man is manifested by pelvic pain syndrome.
The disease can also be associated with various back pathologies, injuries or osteochondrosis, resulting in compression of the spinal nerve root, causing pain and prostate disorder.
Some doctors suggest that this disease may be due to congenital circulatory failure of the prostate, which is why the organ cannot cope with its function. Over time, this leads to the onset of chronic pain characteristic of abacterial prostatitis.
In addition, there is a theory that CABD can be caused by neuropsychiatric disorders, for example, severe stress, neuroses, and vascular dystonia. In this case, the pathology must be considered a psychosomatic disease.
Another theory claims that the disease may be associated with intracellular parasites or microorganisms, the size of which is so small that they do not allow the detection of the cause of the disease by standard methods.
Risk factors
Smoking can contribute to prostate problems.
Risk factors for the development of chronic pelvic pain syndrome in men are thought to be:
- previous prostate disease;
- chronic stress;
- back injury;
- pelvic organ hypothermia;
- urogenital infections;
- chronic testicular disease;
- bad habits;
- pelvic circulatory disorders;
- hypodynamics;
- pelvic injury.
The risk of developing the disease increases if a man does not eat properly. Lack of vitamins and essential microelements can affect not only the general condition, but also the work of the prostate.
Differential diagnosis
In order to diagnose chronic pelvic pain syndrome, the following conditions are necessary:
- prolonged pain, lasting three months;
- absence of pathogenic microorganisms in prostate secretion;
- absence of chronic foci of infection in the body;
- discomfort with ejaculation.
To make a diagnosis, a differential diagnosis is made with prostate cancer, neurological syndromes, pathologies of the spine, which leads to irritation of the spinal nerve roots.
General urological examination is imperative - palpation of the prostate, transrectal ultrasound of the organs, study of the composition of prostate secretions. Inflammatory diseases of the testicles, bladder and kidney pathology, which can manifest as pain syndrome of different localization, should also be excluded.
An examination by a neurologist and therapist is necessary. You should also consult a proctologist to rule out rectal pathologies.
Methods of treatment
An integrated approach is used in the treatment of abacterial prostatitis. Therapy is selected by a urologist, taking into account the characteristics of the course of the disease in the patient. This takes into account the general health and psycho-emotional state of the person.
Therapy includes the following methods:
- symptomatic treatment;
- prostate massage;
- physiotherapy methods.
If necessary, treatment can be supplemented with sedatives, homeopathy and herbal remedies.
Drug therapy
It is necessary to consult your doctor before applying drug therapy.
Drugs of the following groups are prescribed for the symptomatic treatment of abacterial prostatitis:
- broad-spectrum antibiotics with antimicrobial activity;
- nonsteroidal anti-inflammatory drugs;
- antispasmodics and analgesics;
- alpha blockers;
- sedatives and antidepressants.
In the treatment of nonbacterial prostatitis, antibacterial agents are used, as paradoxical as it may sound. The fact is that the theory of microorganisms that cannot be seen through a microscope remains open, so antibacterial agents are prescribed for prevention. Urologists say that these drugs help to quickly eliminate the symptoms of the disease, so their use is completely justified.
Antispasmodics and analgesics are used to reduce pain. Nonsteroidal anti-inflammatory drugs can also be used as symptomatic therapy.
To facilitate the urination process, the use of alpha-blockers is indicated.
It should be noted that the optimal treatment regimen is selected individually for each man. You should not self-medicate, mindlessly taking drugs from these groups, it is better to trust an experienced specialist.
Prostate massage and physiotherapy
In general, drug treatment of abacterial prostatitis shows good results. Other methods are needed to consolidate the therapeutic effect.
Prostate massage improves the functionality of organs, prevents stagnation of prostate secretions, normalizes blood circulation and metabolic processes. It is appointed during 10 procedures.
As physical therapy, magnetic effects, ultrasound therapy, electrophoresis with vasodilators and other methods are prescribed. Also, patients are shown spa treatments, for example, mud therapy.
Folk remedies
Tinctures of lemon balm are good for treating diseases.
Non-bacterial prostatitis can be treated with folk remedies only after consulting a doctor, otherwise such treatment will not help, but will only worsen the health condition.
For the treatment of nonbacterial prostatitis folk remedies you can use:
- decoctions of sedative herbs to improve overall health - chamomile, lemon balm, lemon balm, valerian;
- microenemas with anti-inflammatory decoctions of St. John's wort, calamus, yarrow;
- warm sitting baths with a decoction of calamus, soda or nettle;
- suppositories with pumpkin seed oil;
- tampons with honey and propolis.
The use of any of these products must be agreed with your doctor. Suppositories are prepared as follows: five parts of cocoa butter is dissolved in a water bath, then one part of honey and one part of propolis (or two parts of pumpkin oil) are added. Then the mass is cooled, plugs 4 cm long and 1 cm in diameter are formed and cooled in the refrigerator. Such suppositories should be injected into the rectum after enema for cleansing at night for two weeks.
Possible complications and prevention
Abacterial prostatitis requires timely diagnosis and treatment. Otherwise, pelvic pain syndrome can lead to infertility, impotence, vesiculitis and other problems of the male genitourinary system.
To prevent the development of the disease, it is necessary to lead an active lifestyle and eat properly. It is important to maintain immunity, prevent hypothermia of the pelvic organs. Men need a regular sex life with a regular partner to prevent the development of stagnant processes in the prostate. It is also necessary to regularly go to the urologist for preventive examinations.