Prostatitis chronic long – term decline caused by breach morphology and functioning of the prostate inflammation of the prostate gland. Manifested chronic prostatitis prostatic trio – of the genital organs and pelvic pain disorders, sexual disorders. Diagnosis gland chronic prostatitis containing palpation, research of hidden prostate ULTRASOUND, uroflowmetry, a puncture biopsy, prostate cancer. Shown chronic prostatitis comprehensive medicine, physiotherapy, massage, prostate, protect the rear urethra. At the appropriate time for surgical treatment of chronic prostatitis in complex ways.
Chronic prostatitis
Chronic prostatitis most often a man's disease: 50% male, pain, inflammation of the prostate or in another form. Chronic prostatitis more often in men ages 20 years to 40 years old from the period of peak sexual, reproductive, and business activities. In this context, the diagnosis and treatment of chronic prostatitis urology buy not only medical, but from a social perspective is an important aspect.
Classification of chronic prostatitis
Developed by the contemporary classification of prostatitis, in 1995, features 3 categories of diseases:
- I. acute prostatitis.
- II. Originated in chronic bacterial prostatitis.
- III. Genesis nonbacterial chronic prostatitis/chronic pelvic pain syndrome – symptom complex, not related to ongoing infection and obvious symptoms of 3 months or more.
- III – chronic prostatitis with the presence of an inflammatory component (detection, pathogen infection, and the cells of the prostate hidden);
- III B – chronic prostatitis the lack of inflammatory component (hidden prostate white blood cells and pathogens).
- IV. Asymptomatic chronic prostatitis (prostatic leukocyte no complaints in determining hidden).
If you have an infectious component to talk about bacterial (infection) prostatitis, chronic; about nonbacterial pathogens in the absence of microbial (non-contagion) prostatitis. Accepted, %90-95 all events has a place in non-bacterial chronic prostatitis, and only 10-5% - bacterial.
Causes chronic prostatitis
Etiology and pathogenesis of chronic bacterial prostatitis infections associated with hitting men in the following ways: rising (in the urethra), descending (infected urinary bladder using casting), osteomyelitis hematogenas (inserted in the blood) or lymphonodus (lymph collectors). Motion is the most common uropathogen Escherichia coli, Klebsiella, proteus, Staphylococcus, Shooting, CORINNE, fungal, parasitic and viral pathogens. In conjunction with non-specific chronic prostatitis pathogens in plant growth, join specific urethritis (chlamydia, Mycoplasma, gonokok, Trichomonas, Gardnerella).
However, the presence of chronic prostatitis development and microbial activity, so it is important how the situation pelvic organs and blood circulation, to them, the presence of comorbid illness, level, and defense mechanisms.
Therefore, there are several factors that can contribute to the emergence of chronic prostatitis. First of all, this urologic diseases –pyelonephritis, cystitis, urethritis, urethral adhesions, until the end of Minecraft, acute prostatitis, orchitis, epididymitis, etc. Remote infection foci prostate microbial etiologies may fall, for example, if you have sinusitis, tonsillitis, dental caries, chronic bronchitis, pneumonia, pyoderma, etc. Of local and general susceptibility to chronic inflammation, hypothermia, overheating, works in a moist environment, fatigue, malnutrition, urination, etc.
Non-bacterial chronic prostatitis is usually associated with the lack of enter the parameters in (cold) events in the prostate, prostate drainage of pelvic pain and impaired venous circulation in your internship and why. Local vascular obstruction causing overflow, prostate, blood, edema, incomplete emptying hidden from him, breach the barrier, secretory, motor, gland contractility.
Stagnant changes, usually due to behavioral factors – prolonged sexual abstinence, the application is cancelled or long-term sexual acts excessive sexual activity, physical inactivity, long seat, chronic intoxication (alcohol, nicotine, drugs), professional hazard (vibration). Chronic nonbacterial prostatitis pathology to the pelvic organs and nervous structures development, exercise their nerves (e.g., spinal cord injury), adenoma, prostate, hemorrhoids, constipation, androgenodeficiency etc. causes.
Symptoms of chronic prostatitis
Chronic prostatitis manifested a local and general symptoms. Local refers to the prostatic triad manifestations characterized by pain, urinary and sexual dysfunction. Worn constantly nagging chronic prostatitis pain localized to the perineum, the genitals, pubis, pubic. The beginning and end of developed pain syndrome, radiating pain during urination , glans penis, scrotum, buttocks, rectum. The pain may increase after sexual intercourse long abstinence or linked; it will strengthen or weaken, and then to have an orgasm intense ejaculation instantly.
Prostatitis chronic pain syndrome violence and operability of a dream that expresses a feeling of discomfort varies symptoms. Low back pain low back pain or sacrum pain localization is often considered to be limited due to the patient long-term treatment, a doctor without their help.
Urination, chronic prostatitis and painful learning. In this case, there may be difficulty starting, marbles, or in the absence of the weakening jet of urine, feeling of bladder emptying demolition urine, frequent nighttime urine, a burning sensation in the urethra. Chronic prostatitis may be to detect filaments floating in the urine. Visible due to the decline of physical load or discharge a bowel movement then the subject of the urethra, prostate. The emergence of chronic prostatitis may celebration, itching, feeling cold or excessive sweating groin, the color of the skin changes related to local stagnation of blood circulation.
Sexual function chronic prostatitis accompanied by disorders of speech. The deterioration phenomenon can be expressed gipotenzia, pain, erection, prolonged erection and frequent night, difficulty or premature ejaculation, loss of sex drive (libido), erased orgasm, hematosperm infertility. Always difficult sexual disorders to an experienced man, a leader, psycho-emotional disorders, neuroses and depression, worsening sexual function.
Acute, chronic prostatitis accompanied by a slight increase in body temperature, and degradation. The general condition of chronic prostatitis is characterized by increased irritability, drowsiness, anxiety, fatigue, loss of appetite, sleep disturbance, low work capacity, creative and physical activity.
Almost a quarter of patients with chronic prostatitis symptoms missing for a long time why late treatment urologist. Long-term impotence may be complicated chronic prostatitis, vesiculitis, epididimoorsit, male infertility, urinary incontinence, stone formation and cysts, prostate cancer, multiple sclerosis, prostate adenoma and prostate cancer development.
Chronic prostatitis diagnosis
The diagnosis is chronic prostatitis necessary information using a comprehensive laboratory and instrumental surveys. Suspected chronic prostatitis includes illuminating stories and complaints during the first examination, holding examination in the subject of external genital secretions, rash, irritation, digital rectal examination, prostate to determine, stroke, nerve, consistency, pain gland.
Ultrasound shows the prostate to determine structural and functional changes of the prostate (TRUS). The important methods in the diagnosis of chronic prostatitis the secretions of Service, prostate, general analysis of urine urethral smear and bacteriological study of urine, urine sample, 3 cups water, scraping the diagnosis of genital infections pathogens PCR and reef research on Prostate-Specific Antigen (PSA).
Chronic prostatitis in service, clinically pathogen detection tests chlamydia, mycoplasmosis, herpes, cytomegalovirus, trichomoniasis, gonorrhea, candidiasis, as well as non-specific bacterial flora. Hidden urinating and retention of the fence after they do research for the prostate, massage, prostate. Chronic prostatitis symptoms service number, increase in white blood cells and lecithin seeds a reduction in the visual field by the presence of pathogenic microflora.
General analysis of urine chronic prostatitis detect pyuria, pyuria, erythrocytaire. Bacteriological urine culture reveals the degree to which the upper of the air. A shown in a study of reproductive disorders in sperm donation and mar-the test.
Help identify the degree and causes of disorders of the urinary tract, requested investigations (uroflowmetry, cytometry, profilometry, electromyography). Manages research data for chronic prostatitis to distinguish urinary stress incontinence, neurogenic bladder, etc. when hematuria, Hematosperm, shown blocking urinary endoscopic examination urethroscopy, cystoscopy. Exceptions for the definition of PSA for prostate cancer and adenoma required, in some cases – holding fabrics with prostate biopsy morphological research.
Treatment of chronic prostatitis
Chronic prostatitis-defying treatment is difficult, however, it should be noted that recovery is still possible, and the attitude depends to a large extent, the timely treatment of patients in a specialist, clarity, harmony of all prescription urologist. Basic treatment of chronic bacterial prostatitis with appropriate antibiotics, the duration of antibacterial treatment for at least 2 weeks. Assigned to reduce pain and inflammation NSAIDs ; relaxation, Nov, prostate, secretions of the prostate the intake and output recovery is shown in the poster a-adrenoblokator.
With the goal to develop prostate drainage, circulation and Tonus organized local Nov course, therapeutic massage, prostate. Prostate massage the prostate secretory the end of the allocation of at least 4 drops. Prostate massage is contraindicated in acute bacterial prostatitis, prostate abscess, hemorrhoids, stones, prostate, cracks, rectum, hyperplasia and prostate cancer.
Chronic prostatitis to relieve the pain syndrome may be recommended for periprostatic blockade, acupuncture. Chronic prostatitis medical treatment is given to a physical therapy appointment electrophoresis, ultrasound, phonophoresis, magnetic field therapy, laser magnetica national, inductometal, mud, SMT, hot sitz baths, the temperature 40 to 45°c, enemas, and mineral water, inoculation of the urethra.
Development-related chronic prostatitis with complications, The Illustrated surgical therapy: urethral stricture is the problem; TYPE of multiple sclerosis or prostate during prostatectomy, transurethral resection of the bladder and prostate sclerosis her mouth, puncture and drainage of prostate abscess and cyst; phimosis a circumcision, current, recurrent infections, urinary tract infections, etc.
Prevention of chronic prostatitis
Warning chronic prostatitis requires commitment, sexual hygiene, timely treatment of genital and extragenital infections, normalization of a regular sex life, adequate physical activity, prevent constipation, empty the bladder at the time.
Recurrence chronic prostatitis Andrology dynamic controls required for special cases (urologist); preventive physiotherapy courses, multivitamins, immunomodulators; exception a dry, warming, stress, bad habits.