We have selected 22 main questions about prostatitis and its treatment. All answers are written by our leading male health specialist, andrologist. We hope that this article will help you and give you the necessary answers to your questions.
Symptoms of prostatitis: pain, burning, discharge, burning, incontinence
The most common symptoms of prostatitis are 3 types:
- urinary incontinence: difficulty, frequent, nocturnal urination.
- pain symptoms: pain in the perineum, lower abdomen, groin. The pain may radiate to the scrotum or sacrum.
- mixed form in which there are urinary disorders and pain.
What causes prostatitis?
With bacterial prostatitis
The infection enters the prostate gland from neighboring organs:
- urethra;
- Bladder
- through the blood and lymph vessels from a distant source of inflammation (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, 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. Impaired blood flow causes swelling, 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 participation of sexually transmitted infections in the development of prostatitis is widely discussed in scientific medical circles. There is no consensus on this issue.
We accept ourselves as supporters of the direct link between infections, the appearance 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 prostatitis. How to determine? First signs
The first signs of prostatitis are changes in the nature of urination: difficulty, frequent urination, frequent urge to urinate, especially at night. Discomfort during urination and pain of varying intensity in the groin.
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 prostate adenoma or hyperplasia is an age-related disease in men over the age of 50 and is associated with the development of a benign prostate tumor.
Chronic prostatitis. Is it possible to cure?
The diagnosis of chronic prostatitis suggests the presence of changes in the structure of glandular tissues that remain for life. Like any chronic disease, prostatitis occurs with alternating periods of exacerbation and remission - a period when the patient does not worry about anything. With proper treatment and lifestyle, periods of remission can be very long and complaints never bother the patient again.
Bacterial and other types of prostatitis
There are different classifications, the most commonly used being developed by the US Institute 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 3 months or more.
- Subcategory III A.Chronic inflammatory pelvic pain syndrome (with leukocytes in prostate secretion and pathogen excretion).
- Subcategory III B.Chronic non-inflammatory pelvic pain syndrome (without leukocytes in prostate secretion).
- Category IV.Asymptomatic prostatitis (with leukocytes in the secretion of the prostate, but no complaints).
For easier understanding, the classification can be presented in 3 types:
Acute prostatitis- runs with severe pain, fever, urinary incontinence. The secret of the prostate is a large number of leukocytes, which indicates a clear inflammatory process. It usually occurs for the first time in a patient. If these symptoms occur in a patient with chronic prostatitis, then they are called exacerbations of chronic prostatitis.
Chronic bacterial prostatitis- The symptoms that periodically bother the patient, as a rule, are less pronounced than in acute prostatitis. When diagnosing an increase in white blood cell count in the prostate secretion, it is possible to identify the cause of the inflammation.
The most problematic for diagnosis isnonbacterial prostatitis, or the so-calledchronic pelvic pain syndrome. . . This is due to the fact that the complaints are very similar to prostatitis, but are related to 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 muscles ofbladder and its sphincter, anatomical disorders - strictures (narrowing) of the urethra, leading 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.
The andrologist is a urologist specializing in male reproductive and reproductive diseases.
Methods and schemes of treatment of prostatitis
All treatment regimens for the prostate gland consist of drugs:
- anti-inflammatory
- antibacterial
- biogenic stimulants
- drugs that improve the contraction of the prostate and bladder while relaxing the sphincter.
Good results are obtained with the simultaneous appointment of drugs and physiotherapy (prostate massage, complexes for the treatment of prostatitis).
What tests are given for prostatitis?
Fordiagnosis of prostatitisconsultation with a urologist (andrologist) is required to collect the patient's complaints, medical history, microscopy of prostate secretion and ultrasound diagnosis.
Transrectal ultrasound of the prostate gland (TRUS) and prostate secretion obtained after prostate massage for microscopic examination are used for diagnosis.
In addition, seeding of prostate secretions on the bacterial flora can be used to determine the sensitivity of the planted microflora to antibiotics.
Surgical interventions and operations for prostatitis
In 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 yourself?
In the presence of severe symptoms it is better to be treated by a specialist, the time factor plays a major role in treatment, because the longer the inflammation lasts, the more likely irreversible changes in the body.
But it is better to do 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 doxycycline group drugs.
Alpha blockers:are prescribed to restore impaired urination, increase the contraction of the bladder and relax its detrusor.
Large groupbiogenic stimulants and herbal preparations: candles.
Effective treatment is possible only with a correct diagnosis, as there are no universal drugs for all types of prostatitis. Often patients take drugs to treat prostatitis if they have a completely different disease but with similar symptoms.
Nuts, roots, parsley, 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 request, the search engine gives 70 million results for the treatment of prostatitis with folk methods.
No one has studied folk methods of effectiveness. Just because it has helped a patient with such treatment (and whether it has helped) does not mean that it 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 undergo preventive treatment without waiting for deterioration in well-being usually have less frequent 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. Each medical procedure has its subtleties and nuances. Only a doctor can determine the indications for this procedure, so in some diseases: prostate adenoma (in the presence of acute urinary retention), prostate massage is not desirable, and in tumors is contraindicated.
Alcohol and prostatitis
Alcohol in itself does not cause the development of prostatitis, but is a factor that increases congestion and swelling of the prostate gland 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 in the prostate stagnation occurs, 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 intercourse. Excessive sexual contact, especially with different partners and unprotected from infections, is the fastest way to prostatitis.
Does prostatitis affect women?
Of course, it has an effect on the health of a woman with prostatitis in a partner. The prostate, along with the seminal vesicles, produces a liquid component of the sperm that 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 provoke inflammatory diseases in women.
Pregnancy and prostatitis
Because the prostate gland produces a fluid portion of semen that contains nutrients for sperm, prostatitis often causes a decrease in sperm quality, making it difficult to conceive.
Prevention. What to do to avoid prostatitis?
Prevention is directly related to the patient's climate and profession.
Prophylaxis of prostatitis consists in 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 is important for prostatitis.