Chronic (bacterial) prostatitis is characterized by constant or recurring symptoms with confirmed bacterial infection in the prostate.
The prostatitis of this category is rare in about 10% of cases from all cases of prostatitis.The question - whether atypical pathogens such as ureaplasma Uealiticum), the prostate - is discussed.They can be present in the body of a man and without signs of inflammation and symptoms.
The causes of chronic prostatitis
The causes of chronic prostatitis mainly resemble the causes of the development of acute bacterial prostatitis.In most cases, microorganisms penetrate into the prostate through the urethra - as a result of the casting of urins into the channel of the prostate.
Chronic bacterial prostatitis develops due to inadequate treatment or brief treatment of acute bacterial prostatitis.
Symptoms
- Complaints or pain - in the crotch, in the lower abdomen, in the groin, in the scrotum, in the penis, during ejaculation
- Changes in urination - level of difficulty, quick urination in small parts, a feeling of incomplete emptying of the bladder.
The patient can complain separately about a number of symptoms and symptoms.An increase in body temperature is not characteristic (or light).
Important:
Many men associate erectile dysfunction with prostatitis.This is often made easier by unprofessional publications in the media and the advertising of dubious drugs.The fact that an erection can even remain with a complete removal of a prostate (due to the presence of a malignant organ tumor) suggests that it itself plays no role in maintaining an erection.
According to many relevant urologists, erectile dysfunction in patients with chronic prostatitis is due to psychogenic and neurotic problems.
Diagnosis
A questionnaire is used for the primary evaluation - an index for symptoms of chronic prostatitis.You can objectify the patient's symptoms.
The standard method for diagnosis of prostatitis is the performance of the sample.This is a microscopic and bacteriological examination of urine samples, which were obtained from different parts of the genitarian tracts and the secretion of the prostate gland.However, the test method is quite tedious, and at the moment samples are used more often.A possible alternative is the delivery of ejaculate (sperm) for a microscopic and bacteriological examination, since the ejaculate partly (at least 1/3) consists of a secretion of the prostate.This method is more convenient for patients, especially if you categorically reject a rectal examination or carry out a diagnostic prostate massage in order to obtain prostate secret.However, the handover of the ejaculate has lower information and reliability compared to breakdown.
The submission of ejaculate for a bacteriological examination is included in the diagnostic algorithm for infections of the male genital organs and when examining a man on infertility.
The results of laboratory tests (general urine analysis, a general blood test, a biochemical blood test, a spermogram and other general clinical tests) are not informative in chronic prostatitis.These tests most likely show the "norm".
During a rectal examination of changes that indicate the inflammatory process in the prostate in patients with chronic prostatitis, far away.This means that it is impossible to rely on the result of a rectal study on the diagnosis of chronic prostatitis.
The same applies to UZ diagnostics: to make a diagnosis of chronic prostatitis that only focuses on ultrasound data is wrong.The European and American Association of urologists are not recommended to carry out ultrasound for the diagnosis of prostatitis.The type of execution in this case is not important due to the front abdominal wall - the lower abdomen or trust - due to the rectum.In order to write "Chronic prostatitis" in the conclusion of the ultrasound study, "Ultrasound signs of chronic prostatitis" are wrong, "signs of prostatitis".The privilege of installing this diagnosis has only one urologist who determines it based on complaints, anamnesis, laboratory tests and only after ultrasound.
The most common ultrasound sign that the diagnosis of chronic prostatitis is determined - the so -called diffuse changes in the prostate gland, which are associated with the transmitted inflammatory process or other changes in the parenchyma of the prostate.This is a kind of fiber process that replaces the normal parenchyma of the prostate with a scar.However, there are no correlations about the number of fibrous changes in the prostate with complaints.With age, the chances of the appearance of such "scars" in the organ, but a man can live all his life without feeling uncomfortable in the crotch or pubic area.As soon as these changes are found on an ultrasound, some “specialists” are diagnosed with prostatitis.And some men will feel that they are really difficult to listen to themselves and to feel all the symptoms described on the Internet.
For many men over 30 years, ultrasound diffuse changes in the prostate gland can show.However, the fibrous process does not indicate the presence of prostatitis.
The diagnosis of chronic prostatitis is determined on the basis of the exclusion of other diseases of the genitator system -especially urethritis, prostate hyperplasia, urethra stricture, neurogenic disorders of urine, prostate cancer and bladder cancer.
There is no specific image for chronic prostatitis based on the results of a routine examination.
Treatment of chronic prostatitis
Antibiotics of the phthikinolone group are optimal antimicrobial drugs for the treatment of chronic bacterial prostatitis.The recommended course of antibacterial therapy is between 4 and 6 weeks.Such a long course is justified by scientific data, which is due to a decrease in the probability of illness.
If sexually transmitted infections (STIS) and chlamydia are prescribed an antibiotic group of macrolide groups.
There is data on a decrease in the relaxation of the neck of the bladder in patients with chronic prostatitis, which leads to a refluxurine in the channels in the urethra and causes inflammation of the tissue of the prostate and pain.Such patients are recommended by the appointment of alpha blockers.
When treating chronic prostatitis, it is advisable for patients to avoid the temptation of sentences for the use of herbal medicine.A characteristic of nutritional supplements and plants is the instability of plant components in part of the matter, they can differ in the medicine of the same manufacturer themselves.In addition, from the perspective of evidence -based medicine, the advantages of herbal medicine did not criticize.
The prostate massage, which was used today thanks to new scientific approaches and classifications thanks to new scientific approaches and classifications as the basis for the diagnosis of prostatitis, but not treatment as a therapy massage.You do not have to use the prostate massage as a therapeutic procedure (the effect has not been proven).There are assumptions that frequent ejaculation in its properties is similar to the sessions of the therapeutic massage of the prostate.
To other methods, the effectiveness of which has only been proven or investigated as a result of one or more studies: related to:
- Pilling Bottom Muscle Training - Some data show the effectiveness of special exercises to reduce the symptoms of chronic prostatitis and chronic pelvic pain syndrome.
- Acupuncture - A small amount of studies shows the advantage of acupuncture compared to placebo in patients with chronic prostatitis;
- Extracor poral shock wave therapy on the effects of acoustic impulses with significant amplitude on binding and bone tissue is often used in the treatment of diseases of the musculoskeletal diseases recently used in urology.Its effectiveness is examined.
- Behavioral therapy and psychological support - since chronic prostatitis is associated with a low quality of life and the development of depression, these methods can improve the patient's psychological condition and help to reduce some symptoms of the disease.
It is worth mentioningAsymptomatic (asymptomatic) chronic prostatitis.The diagnosis is most frequently determined according to the results of the histological conclusion - according to the biopsy of the prostate gland or a surgical treatment of the prostate.The frequency of detection of inflammation in the tissue of the prostate varies from 44% (with prostate tabiopsia) and 98-100% (after surgical treatment of the prostate).Scientists have proposed that inflammatory changes in this way are nothing more than an age -related physiological characteristic.Nobody is busy with a specially diagnostic diagnostics of this category of prostatitis, this is a kind of random find.It does not require treatment, it does not require any further measures by the doctor and the patient.