We have selected 22 key questions related to 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, stinging, urinary incontinence
There are 3 main types of prostatitis symptoms:
- Urinary incontinence: difficult, frequent, nocturnal urination.
- Symptoms of pain: pain in the perineum, lower abdomen, groin. The pain can spread to the scrotum or sacrum.
- mixed form with 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 lymphatic vessels from a distant inflammatory focus (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 manifestation of the inflammatory process depends on the characteristics of the microorganism, the condition of the pelvic organs, their blood circulation, concomitant diseases and other predisposing factors.
With non-bacterial prostatitis
Stagnation plays an important role. Impaired blood flow causes edema, exudation of prostate tissue, and promotes the development of inflammatory processes that are not associated with a bacterial agent.
STDs and prostatitis
The involvement of sexually transmitted infections in the development of prostatitis is widely discussed in scientific medicine. There is no consensus on this issue.
We consider ourselves to be in favor of a direct link between infections, the onset 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.
Primary prostatitis. How to determine? The first signs
The first signs of prostatitis are changes in the nature of the urine: difficult, frequent urination, frequent urination, especially at night. Anxiety and pain of varying intensity in the groin area during urination.
Age of prostatitis? Is it a disease of young and / or old?
Prostatitis is an inflammatory disease, so it can occur at any age. However, prostate adenoma or hyperplasia is an age-related disease in men over the age of 50 and is associated with the development of benign prostate cancer.
Chronic prostatitis. Is it possible to treat?
The diagnosis of chronic prostatitis implies the presence of changes in the structure of the remaining glandular tissue. Like any chronic disease, prostatitis continues with alternating periods of exacerbation and remission - a period when the patient is not worried about anything. With proper treatment and lifestyle, periods of remission can be very long, and complaints no longer bother the patient.
Bacterial and other types of prostatitis
There are various classifications most commonly used by the US Institutes of Health in 1995:
- Category I.Acute prostatitis.
- Category II.Chronic bacterial prostatitis.
- Category III.Non-bacterial Prostatitis / Chronic Pelvic Pain Syndrome - without obvious signs of infection and lasting 3 months or more.
- III subcategory A.Chronic inflammatory pelvic pain syndrome (with leukocytes in prostate secretion and pathogen excretion).
- Subcategory III B.Chronic non-inflammatory pelvic pain syndrome (absence of leukocytes in the secretion of the prostate).
- Category IV.Asymptomatic prostatitis (with leukocytes in the secretion of the prostate, but without complaints).
For ease of understanding, the classification can be presented in 3 types:
Acute prostatitis- Continues with severe pain, fever, urinary incontinence. The secret of the prostate is a large number of leukocytes, which indicates a clear inflammatory process. This usually occurs for the first time in a particular patient. If these symptoms occur in a patient with chronic prostatitis, then they are called exacerbations of chronic prostatitis.
Chronic bacterial prostatitis- Symptoms that bother the patient from time to time are usually less pronounced than in acute prostatitis. When an increase in leukocytes in the secretion of the prostate is diagnosed, it is possible to determine the cause of inflammation.
It is the most problematic for diagnosisnon-bacterial prostatitis, or so calledchronic pelvic pain syndrome. . . This is due to the fact that the complaints are very similar to prostatitis, but are associated with signs of inflammation and diseases of other organs and systems in which pathogenic bacteria can not be detected: spasm of the pelvic muscles, impaired interaction between pelvic muscles. Muscles of the bladder and its sphincter, anatomical disorders - narrowing (narrowing) of the urethra, causing 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.
An andrologist is a urologist who specializes in male reproductive and reproductive diseases.
Methods and regimens of treatment of prostatitis
All treatment regimens for prostate cancer include medications:
- 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 administration 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 patient complaints, medical history, microscopy of prostate secretion, and ultrasound diagnosis.
Diagnosis is made by transrectal ultrasound examination of the prostate gland (TRUS) and microscopic examination of prostate secretion obtained after prostate massage.
In addition, spraying of prostate gland secretion into the bacterial flora can be used to determine the sensitivity of the seeded microflora to antibiotics.
Surgical interventions and operations for prostatitis
Surgery with prostatitis is practically not used. With the exception of prostate abscess - a process in which the formation of purulent foci.
Is it possible to treat prostatitis yourself?
When there are severe symptoms, it is better to be treated by a specialist, the time factor plays a big role in treatment, because the longer the inflammation lasts, the higher the probability of irreversible changes in the body.
But it is better to do the prevention yourself, no doctor will do it for you.
Avoid hypothermia, prolonged sitting, blockage, sexually transmitted infections, irregular sexual activity - all this is one way to effectively prevent prostatitis.
Drugs for prostatitis: finalgon, vitaprost, prostamol, ceftriaxone, doxycycline, omnix, etc.
Drugs for the treatment of prostatitis are divided into groups according to the mechanism of action:
Antibacterial agents (antibiotics)is prescribed only when diagnosed: chronic bacterial prostatitis. The most commonly used fluoroquinolones, macrolides and doxycycline drugs.
Alpha blockers:It is prescribed to restore impaired urinary excretion, increase the narrowing of the bladder and relax its detrusor.
Large groupbiogenic stimulants and herbal preparations: candles.
Effective treatment is possible only with a correct diagnosis, because there is no universal cure for all types of prostatitis. Often patients take medication to treat prostatitis if they have a completely different disease, but with similar symptoms.
Hazelnuts, carrots, parsley, cucumber, honey, beeswax, leech and other folk remedies for prostatitis
Traditional treatments have a right to exist, but you have to understand that it is very difficult to choose a folk remedy that suits you. Please, the search engine gives 70 million results for the treatment of prostatitis by folk methods.
No one has researched folk methods for effectiveness. Helping a patient with such a treatment (and whether it helps or not) does not mean that he 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 the patient's prophylactic treatment. As a rule, more rare exacerbations occur in patients who receive periodic prophylactic treatment without waiting for worsening of well-being.
Prostate massage at home. Is massage always necessary for prostatitis?
If you are married to a urologist, prostate massage can also be done at home. Any medical manipulation has its own subtleties and nuances. Indications for this procedure can be determined only by a doctor, so for some diseases: prostate adenoma (in case of acute urinary retention), prostate massage is undesirable, and in tumors it is contraindicated.
Alcohol and prostatitis
Alcohol itself does not cause the development of prostatitis, it is a factor that increases the blockage 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, stagnation occurs in the prostate gland, which worsens metabolic processes and contributes to the development of inflammatory processes by disrupting blood microcirculation. Regularity is more important for prostate health than the intensity of sexual intercourse. Excessive sexual intercourse, especially with unprotected partners and 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 one partner. The prostate, along with the seminal vesicles, produces a liquid component of sperm that enters the partner's genital system during sexual intercourse. The main danger may be a woman having a sexually transmitted infection or bacterial prostatitis that can cause inflammatory diseases.
Pregnancy and prostatitis
Because the prostate gland produces a liquid portion of sperm that contains nutrients for sperm, prostatitis often causes a decrease in sperm quality, which makes it difficult to conceive.
Prevention. What to do to prevent prostatitis?
Prevention is directly related to the patient's climate and occupation.
Prevention of prostatitis is to prevent and minimize the factors that contribute to the development of prostatitis. Hypothermia and alternating sedentary work with periods of physical activity should be avoided. Regular sex is important for prostatitis.