We have selected 22 basic questions about prostatitis and its treatment. All answers are written by our leading male health specialist, the andrologist. We hope this article will help you and give you the necessary answers to your questions.
Symptoms of prostatitis: pain, burning, discharge, burning, incontinence
Symptoms of prostatitis are most often of 3 types:
- violation of urination: difficult, frequent, nocturnal urination.
- pain symptoms: pain in the perineum, lower abdomen, groin. Pain can radiate (give) to the scrotum or sacrum.
- mixed form, in which urinary disorders and pain are present.
What are the causes of prostatitis?
With bacterial prostatitis
Infection enters the prostate gland from nearby organs:
- through the blood and lymphatic vessels from a remote inflammatory focus (tonsillitis, sinusitis, caries).
The most common bacteria found in prostatitis are: Escherichia coli, Klebsiella, Proteus, Staphylococcus aureus, Enterococcus.
The role of sexually transmitted infections is discussed: chlamydia, mycoplasma, Trichomonas.
The activity and, consequently, the manifestation of the inflammatory process depend on the properties of the microorganism, the condition of the pelvic organs, their blood circulation, concomitant diseases and other predisposing factors.
With non-bacterial prostatitis
Stagnation plays an important role. Violation of blood flow causes edema, exudation of the 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 see ourselves as advocates of a direct connection between infections, the onset 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.
Beginning of prostatitis. How to determine? First signs
The first signs of prostatitis are changes in the nature of urination: difficult and frequent urination, frequent need to urinate, especially at night. Discomfort when urinating and pain of varying intensity in the groin area.
Age of prostatitis? Is it a disease of the young and / or the elderly?
Prostatitis is an inflammatory disease, so it can occur at any age. But adenoma or hyperplasia of the prostate is an age-related disease in men after the age of 50 and is associated with the development of benign prostate cancer.
Chronic prostatitis. Is it possible to cure?
The presence of a diagnosis of chronic prostatitis implies the presence of changes in the structure of the gland tissues, which remain throughout life. Like any chronic disease, prostatitis proceeds with alternating periods of exacerbation and remission, a period in which the patient is not worried at all. With proper treatment and lifestyle, periods of remission can be very long and complaints never bother the patient again.
Bacterial and other prostatitis
There are various classifications, the most commonly used was developed by the US Institutes of Health in 1995:
- Category I.Acute prostatitis.
- Category II.Chronic bacterial prostatitis.
- Category III.Non-bacterial prostatitis / chronic pelvic pain syndrome - with no obvious signs of infection and lasting 3 months or more.
- Sub-category III A.Chronic inflammatory pelvic pain syndrome (with leukocytes in the secretion of the prostate and excretion of the pathogen).
- Sub-category III B.Chronic non-inflammatory pelvic pain syndrome (absence of leukocytes in the secret of the prostate).
- Category IV.Asymptomatic prostatitis (with leukocytes in the secret of the prostate, but without complaints).
For ease of understanding, the classification can be presented in 3 types:
Acute prostatitis- proceeds 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 a patient with chronic prostatitis, they are referred to as exacerbation of chronic prostatitis.
Chronic bacterial prostatitis- Symptoms that periodically disturb the patient, as a rule, are less pronounced than in acute prostatitis. When diagnosing an increase in leukocytes in the secret of the prostate, it is possible to identify the causative agent of inflammation.
The most problematic for diagnosis isnon-bacterial prostatitis, or so calledchronic pelvic pain syndrome. . . This is due to the fact that the ailments are very similar to prostatitis, but associated with diseases of other organs and systems, in which it is not possible to detect signs of inflammation and pathogenic bacteria: spasm of the pelvic muscles, impaired interaction between the muscles of the bladder and its sphincter, anatomical disorders - stenosis (narrowing) of the urethra, leads to inflammation due to increased pressure inside the lobules of the prostate gland.
Who treats prostatitis - andrologist or urologist?
Prostatitis is treated by both a urologist and an andrologist.
An andrologist is a urologist who specializes in male reproductive and reproductive diseases.
Methods and treatment regimens for prostatitis
All treatment regimens for the prostate gland consist of drugs:
- biogenic stimulants
- drugs that improve the contraction of the prostate and bladder by relaxing the sphincter.
Good results are obtained from the simultaneous appointment of drugs and physiotherapy (prostate massage, complexes for the treatment of prostatitis).
What tests are given for prostatitis?
Fordiagnosis of prostatitisConsultation of a urologist (andrologist) is required to collect patient complaints, medical history, microscopy of prostatic secretions and ultrasound diagnostics.
For diagnostics, transrectal ultrasound of the prostate gland (TRUS) and prostate secretions obtained after prostate massage are used for microscopic examination.
In addition, the seeding of the secretion of the prostate gland on the bacterial flora with the determination of the sensitivity of the sown microflora to antibiotics can be used.
Surgery and operations for prostatitis
With prostatitis, operations 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 severe symptoms, it is better to be treated by a specialist, the time factor plays an important role in treatment, since the longer the inflammation lasts, the more irreversible changes in the organ are likely to occur.
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.
Medicines 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)they are prescribed only if there is a diagnosis - chronic bacterial prostatitis. The most commonly used fluoroquinolones, macrolides and doxycycline group of drugs.
Alpha blockers:they are prescribed to restore impaired urination by increasing bladder contraction and relaxing its detrusor.
Great groupbiogenic stimulants and herbal preparations: candles.
Effective treatment is possible only with the correct diagnosis, since there are no universal medicines for all types of prostatitis. Often, patients take drugs for the treatment of prostatitis, if they have a completely different disease, but with similar symptoms.
Nuts, roots, parsley, cucumber, honey, bees, leeches and other popular treatments for prostatitis
Traditional methods of treatment have a right to exist, but you need to understand that it is very difficult to choose a popular method that is suitable for you. Upon request, the search engine provides 70 million results for the treatment of prostatitis by folk methods.
No one has studied folk methods for effectiveness. The fact that she has helped a patient with such treatment (and if she has helped) does not mean that she will help you.
Exacerbation of prostatitis after treatment. Remission, relapse
All chronic inflammatory processes have periods of exacerbation and remission, when the patient is not worried about anything. The duration of remission can vary and depends on many factors, including whether the patient is undergoing prophylactic treatment. Patients who periodically carry out preventive treatment without waiting for a deterioration in well-being, as a rule, have more rare exacerbations.
Prostate massage at home. Is massage always necessary for prostatitis?
Prostate massage can also be done at home if you are married to a urology nurse. Any medical manipulation has its own subtleties and nuances. Only a doctor can determine the indications for this procedure, so for some diseases: prostate adenoma (in the presence of acute urinary retention), prostate massage is undesirable, and in case of tumors, it is contraindicated.
Alcohol and prostatitis
Alcohol, in itself, does not cause the development of prostatitis, but it is a factor that increases congestion and swelling of the prostate gland and, therefore, 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 in the prostate, stagnation occurs, which worsens metabolic processes and disrupts blood microcirculation, contributing to the development of inflammatory processes. Regularity is more important to prostate health than the intensity of sexual intercourse. Excessive sexual intercourse, especially with different and unprotected partners from infection, is the fastest way to prostatitis.
Does prostatitis affect women?
Of course, there is an effect on the health of a woman with prostatitis in a partner. The prostate, together with the seminal vesicles, produces a liquid component of the sperm which, during intercourse, enters the partner's genital tract. The main danger could be the presence of a sexually transmitted infection or bacterial prostatitis, which can cause inflammatory diseases in a woman.
Pregnancy and prostatitis
Because the prostate gland produces a liquid part of sperm that contains nutrients for the sperm, prostatitis often causes a decrease in sperm quality, which makes it difficult to get pregnant.
Prevention. What to do to avoid prostatitis?
Prevention is directly related to the climate and the patient's profession.
Prevention of prostatitis consists of avoiding and minimizing the factors that contribute to the development of prostatitis. It is necessary to avoid hypothermia, to alternate sedentary work with periods of physical activity. Regular sex life is important for prostatitis.