There are several forms of prostatitis, which differ in symptoms and course of the inflammatory process. Despite the fact that in general this disease is quite well studied, 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 occurs in every fifth man on the planet. Despite such a widespread disease, 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 nonbacterial prostatitis is often confused with non-infectious 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 inflammation in the prostate gland. In addition, in most cases, a detailed examination does not allow to detect the presence of an inflammatory process in the body. 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, nonbacterial prostatitis is also called chronic pelvic pain syndrome, which perfectly characterizes the main symptoms of this complex disease.
Typical symptoms
With a small need, painful discomfort is felt.
The signs of abacterial prostatitis are not similar to the symptoms of inflammation of the prostate gland, so many doctors suggest the neurological nature of the development of this disease.
In abacterial prostatitis the symptoms are as follows:
- constant painful pain in the pelvic area;
- increased pain syndrome during urination;
- severe discomfort during ejaculation;
- general physical illness;
- 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 go away 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 shooting "nervous" pain in the lower back, lower abdomen, groin.
Patients complain of worsening erections. During ejaculation he feels strong tension, ejaculation is accompanied by sharp pain. Attacks of severe pain are also possible during urination.
Simultaneously with these symptoms there is a strong emotional depression. The man is tense, prone to stress, some patients have insomnia and neurosis-like conditions.
Causes of abacterial prostatitis
Falling and resulting in a back injury can cause illness.
Nonbacterial 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.
It is suggested that the disease may have the following causes:
- inflammation of the ligaments and tendons of the pelvic floor;
- autoimmune process;
- increase pelvic floor ligaments;
- back injuries and chronic diseases of the spine;
- disturbance of blood microcirculation in the prostate gland;
- neuropsychiatric causes;
- 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 genitourinary system located in the immediate vicinity. As a result, the infection spreads to the ligaments, they become inflamed and increase in size, compressing and irritating nearby nerve endings. The pain that a man experiences at the same time can radiate to the nerves, giving in the lower back, groin, lower abdomen or anus.
Another suspected 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 the cells of the prostate gland as a foreign element and attack them with immune cells, leading to the appearance of typical symptoms of abacterial prostatitis.
Another suspected cause is viral prostatitis experienced by the pediatric patient. As the prostate in boys is not yet sufficiently developed, the viral inflammation of this organ may not have bright 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, which results in compression of the roots of the spinal nerve, which causes pain and damage to the prostate gland.
Some doctors suggest that this disease may be due to congenital circulatory failure of the prostate gland, due to which the body can not cope with its function. Over time, this leads to the onset of chronic pain characteristic of abacterial prostatitis.
There is also a theory that CABD can be caused by neuropsychiatric disorders, such as severe stress, neurosis and vascular dystonia. In this case, the pathology should be considered as a psychosomatic illness.
Another theory states that the disease may be associated with intracellular parasites or microorganisms whose size is so small that they do not allow detection of the cause of the disease by standard methods.
Risk factors
Smoking can contribute to prostate problems.
It is assumed that the risk factors for the development of 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;
- pelvic circulatory disorders;
- hypodynamia;
- pelvic injury.
The risk of developing the disease increases if the man does not eat properly. Deficiency of vitamins and essential trace elements can affect not only the general well-being, but also the work of the prostate gland.
Differential diagnosis
The following conditions are required to diagnose chronic pelvic pain syndrome:
- prolonged pain for a period of three months;
- the absence of pathogenic microorganisms in the prostate secretion;
- lack of chronic foci of infection in the body;
- ejaculation discomfort.
To make a diagnosis, a differential diagnosis is made with prostate cancer, neurological syndromes, pathologies of the spine, leading to irritation of the spinal nerve roots.
A general urological examination is obligatory - palpation of the prostate, transrectal ultrasound of the organ, examination of the composition of the prostate secretion. Inflammatory diseases of the testicles, pathology of the bladder and kidneys, which may manifest as a pain syndrome with different localization, should also be ruled out.
An examination by a neurologist and a therapist is mandatory. You should also consult a proctologist to rule out rectal pathology.
Methods of treatment
An integrated approach is used in the treatment of abacterial prostatitis. The 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 man.
The therapy includes the following methods:
- symptomatic treatment;
- prostate massage;
- physiotherapeutic methods.
If necessary, treatment can be supplemented with sedatives, homeopathy and herbal medicines.
Drug therapy
You should consult your doctor before using drug therapy.
For the symptomatic treatment of abacterial prostatitis, drugs from the following groups are prescribed:
- broad-spectrum antibiotics;
- non-steroidal 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 under a microscope remains open, which is why 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. Non-steroidal anti-inflammatory drugs can also be used as symptomatic therapy.
The use of alpha-blockers has been shown to facilitate the process of urination.
It should be noted that the optimal treatment regimen is chosen individually for each man. You should not self-medicate, it is pointless to take the drugs from the listed groups, it is better to trust an experienced specialist.
Prostate massage and physiotherapy
In general, treatment of abacterial prostatitis with drugs shows good results. Other methods are needed to consolidate the therapeutic effect.
Prostate massage improves the functionality of the organ, prevents stagnation of prostate secretion, normalizes blood circulation and metabolic processes. He is appointed in a course of 10 procedures.
Magnetic effects, ultrasound therapy, electrophoresis with vasodilators and other methods are prescribed as physiotherapy. Patients are also shown balneotherapy, such as mud therapy.
Folk remedies
Tinctures of motherwort herbs are good for treating diseases.
It is possible to treat nonbacterial prostatitis 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 with folk remedies you can use:
- decoctions of sedative herbs to improve overall health - chamomile, balm, motherwort, valerian;
- microenemas with anti-inflammatory decoctions of St. John's wort, calendula, 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 should be agreed with your doctor. The suppositories are prepared as follows: five parts of cocoa butter are melted in a water bath, then one part of honey and one part of propolis (or two parts of pumpkin seed oil) are added. The mass is then cooled, suppositories 4 cm long and 1 cm in diameter are formed and cooled in a refrigerator. Such suppositories should be injected into the rectum after a cleansing enema 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, to prevent hypothermia of the pelvic organs. Men need regular sex with a regular partner to prevent the development of stagnant processes in the prostate gland. It is also necessary to regularly undergo preventive examinations with a urologist.