There are several forms of prostatitis, which differ in symptoms and in the course of the inflammatory process. Despite the fact that, in general, this disease is quite well studied, there is a form about which little is known yet - this is bacterial prostatitis. This condition is also called chronic pelvic pain syndrome and, according to the latest information, it occurs in one in five men on the planet. Despite such a widespread event, the disease is still a mystery to doctors and is very difficult to treat.
Abacterial and non-infectious prostatitis: what's the difference?
Abacterial or non-bacterial prostatitis is often mistaken for non-infectious prostatitis. In reality, these are two different diseases with different manifestations and causes of development.
Chronic abacterial prostatitis is a disease with no clear symptoms of inflammation in the prostate gland. In addition, in the vast majority of cases, a detailed examination does not allow to establish 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 the trophism of the prostate gland, as a result of which the secretion of the prostate stagnates and the inflammatory process develops. Non-infectious prostatitis is most commonly diagnosed in older patients, while non-bacterial prostatitis can occur in men of all ages.
To avoid confusion, non-bacterial prostatitis is also called chronic pelvic pain syndrome, which perfectly characterizes the main symptoms of this complex disease.
Typical symptoms
With little need, painful discomfort is felt.
The signs of bacterial prostatitis are not similar to the symptoms of inflammation of the prostate gland, so many doctors assume the neurological nature of the development of this disease.
With abacterial prostatitis, the symptoms are as follows:
- constant aching pain in the pelvic region;
- increased pain syndrome when urinating;
- severe discomfort with ejaculation;
- general physical ailment;
- nervous tension.
As a rule, pelvic pain occurs for a long time, in the period from three months to six months. The pain syndrome is painful, monotonous, can pass on its own without the use of analgesics and then return spontaneously. The pain radiates to the testicles, perineum, anus. Sometimes there are short-term episodes of "nerve" pain in the lower back, lower abdomen, groin.
Patients complain of a worsening of the erection. During ejaculation, he feels intense tension, ejaculation is accompanied by sharp pain. Attacks of severe pain are also possible during urination.
Simultaneously with these symptoms, there is severe emotional depression. The man is tense, susceptible to stress, some patients have insomnia and neurosis-like states.
Causes of abacterial prostatitis
A fall, and as a result of a back injury, can cause illness.
Non-bacterial prostatitis is not well understood, so doctors give the probable causes of this disease.
The exact mechanism of development and pathogenesis of chronic abacterial prostatitis has not yet been established.
Presumably, the disease can have the following reasons for development:
- inflammation of the ligaments and tendons of the pelvic floor;
- autoimmune process;
- an increase in the pelvic floor ligaments;
- back injuries and chronic diseases of the spine;
- violation of blood microcirculation in the prostate gland;
- 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, located in the immediate vicinity. As a result, the infection spreads to the ligaments, they become inflamed and increase in size, squeezing and irritating nearby nerve endings. The pain a man feels at the same time can radiate down the nerves, giving way to the lower back, groin, lower abdomen, or anus.
Another suspected cause of chronic abacterial prostatitis or CABD is the autoimmune processes in the body. As a result of such a failure, the immune system begins to perceive the cells of the prostate gland as a foreign element and to attack them with immune cells, which leads to the appearance of the typical symptoms of bacterial prostatitis.
Another suspected cause is viral prostatitis, which the patient suffered in childhood. Since the prostate in boys is not yet sufficiently developed, viral inflammation of this organ may not have vivid 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 pathologies of the back, injuries or osteochondrosis, as a result of which compression of the spinal nerve roots occurs, which causes pain and rupture of the prostate gland.
Some doctors have suggested that this disease may be due to congenital circulatory failure of the prostate gland, as a result of which the organ cannot cope with its function. Over time, this leads to the onset of the chronic pain characteristic of abacterial prostatitis.
Additionally, there is a theory that CABD can be caused by neuropsychiatric disorders, such as severe stress, neurosis, and vascular dystonia. In this case, the pathology must be considered as a psychosomatic illness.
Another theory states that the disease can be associated with parasites or intracellular microorganisms, the size of which is so small that it does not allow the detection of the causative agent of the disease by standard methods.
Risk factors
Smoking can contribute to prostate problems.
Presumably, the risk factors for developing chronic pelvic pain syndrome in men are:
- previous diseases of the prostate gland;
- chronic stress;
- back injury;
- hypothermia of the pelvic organs;
- urogenital infections;
- chronic testicular disease;
- bad habits;
- circulatory disorders of the pelvic organs;
- hypodynamia;
- pelvic injury.
The risk of developing the disease increases if a man does not eat properly. Deficiency of essential vitamins and microelements can affect not only general well-being, but also the work of the prostate gland.
Differential diagnosis
To make a diagnosis of chronic pelvic pain syndrome, the following conditions are required:
- long-term pain, over a period of three months;
- the absence of pathogenic microorganisms in the prostatic 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 lead to irritation of the spinal nerve roots.
A general urological examination is imperative: palpation of the prostate, transrectal ultrasound of the organ, study of the composition of the prostatic secretion. You should also exclude inflammatory diseases of the testicles, bladder and kidney pathology, which can manifest themselves as pain syndrome of different localization.
It is imperative to be examined by a neurologist and therapist. 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 the 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 man.
Therapy includes the following methods:
- symptomatic treatment;
- prostatic massage;
- physiotherapy methods.
If necessary, the treatment can be supplemented with sedatives, homeopathy and herbal remedies.
Pharmacological therapy
Before using drug therapy, you need to consult with your doctor.
For the symptomatic treatment of abacterial prostatitis, drugs of the following groups are prescribed:
- antibiotics of a broad spectrum of antimicrobial action;
- non-steroidal anti-inflammatory drugs;
- antispasmodics and analgesics;
- alpha blockers;
- sedatives and antidepressants.
In the treatment of non-bacterial prostatitis, antibacterial agents are used, paradoxical as it may seem. The fact is that the theory of microorganisms that cannot be seen under the microscope remains open, so antibacterial agents are prescribed for prevention. Urologists claim that these drugs help to quickly eliminate the symptoms of the disease, so their use is fully justified.
Antispasmodics and analgesics are used to reduce pain. Non-steroidal anti-inflammatory drugs can also be used as symptomatic therapy.
To facilitate the urination process, the administration 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, take drugs of the listed groups without thinking, it is better to trust an experienced specialist.
Prostate massage and physiotherapy
In general, the treatment of abacterial prostatitis with drugs shows good results. Other methods are needed to consolidate the therapeutic effect.
Prostate massage improves organ function, prevents stagnation of prostatic secretions, normalizes blood circulation and metabolic processes. He is appointed in a course of 10 procedures.
As physical therapy, magnetic effects, ultrasound therapy, electrophoresis with vasodilators and other methods are prescribed. In addition, patients are shown a spa treatment, for example mud therapy.
Folk remedies
Motherwort herbal tinctures are good for treating ailments.
It is possible to treat non-bacterial prostatitis with folk remedies only after consulting a doctor, otherwise such treatment will not help, but will only aggravate the state of health.
For the treatment of non-bacterial prostatitis with folk remedies, you can use:
- decoctions of sedative herbs to improve general health - chamomile, lemon balm, motherwort, valerian;
- microenemas with anti-inflammatory decoctions of hypericum, calamus, yarrow;
- warm sitz baths with decoction of calamus, soda or nettle;
- suppositories with pumpkin seed oil;
- tampons with honey and propolis.
The use of any of the listed funds must be agreed with the doctor. The suppositories are prepared as follows: melt five parts of cocoa butter in a double boiler, then add one part of honey and one part of propolis (or two parts of pumpkin seed oil). Then the mass is cooled, suppositories 4 cm long and 1 cm in diameter are formed and cooled in the refrigerator. Such suppositories should be injected into the rectum after a cleansing enema overnight 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 right. It is important to maintain immunity, to prevent hypothermia of the pelvic organs. Men need a regular sex life with a constant partner to prevent the development of stagnant processes in the prostate gland. It is also necessary to regularly undergo preventive examinations with a urologist.