There are several forms of prostatitis, which differ in symptoms and the course of the inflammatory process. In general, although the disease is well studied, there is still a little-known form - it is bacterial prostatitis. This condition is also called chronic pelvic pain syndrome, and according to the latest data, it occurs in one in five men on the planet. Despite this widespread phenomenon, the disease still remains a mystery to doctors and is very difficult to treat.
Bacterial and non-infectious prostatitis: what is the difference?
Bacterial or non-bacterial prostatitis is often mistaken for non-infectious prostatitis. In fact, these are two different diseases with different manifestations and causes of development.
Chronic abacterial prostatitis is a disease in which there are no obvious symptoms of inflammation in the prostate gland. Moreover, in most cases, a detailed examination does not allow to determine the presence of an inflammatory process in the body. At the same time, non-infectious prostatitis is an inflammatory disease with well-defined and well-studied causes. Non-infectious prostatitis is caused by a violation of the trophism of the prostate gland, resulting in stagnation of prostate secretion and the development of inflammatory processes. Non-infectious prostatitis is more commonly diagnosed in older patients, while non-bacterial prostatitis can occur in men of all ages.
To prevent confusion, non-bacterial prostatitis is also called chronic pelvic pain syndrome, which perfectly characterizes the main symptoms of this complex disease.
Typical symptoms
Painful discomfort is felt with little need.
The symptoms of abacterial prostatitis are not similar to the symptoms of inflammation of the prostate gland, so many doctors accept the neurological nature of the development of this disease.
Symptoms of bacterial prostatitis include:
- constant aching pain in the pelvic region;
- increased pain syndrome during urination;
- severe discomfort with ejaculation;
- general physical illness;
- nervous tension.
As a rule, pelvic pain occurs for a long time, from three to six months. The pain syndrome is painful, monotonous, can go away on its own without the use of analgesics, and then returns spontaneously. The pain spreads to the testicles, perineum, anus. Sometimes there are short-term episodes of "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. Severe attacks of pain during urination are also possible.
Simultaneously with these symptoms there is a strong emotional depression. Men are tense, prone to stress, and some patients experience insomnia and neurosis.
Causes of bacterial prostatitis
It can cause illness as a result of falls and back injuries.
Non-bacterial prostatitis is not well understood, so doctors give the probable causes of this disease.
The exact mechanism and pathogenesis of chronic abacterial prostatitis have not yet been determined.
Probably the following reasons for the development of the disease:
- inflammation of the ligaments and tendons of the pelvic floor;
- autoimmune process;
- increase in pelvic floor ligaments;
- back injuries and chronic diseases of the spine;
- disorders 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 nearby organs of the genitourinary system. As a result, the infection spreads to the ligaments, where they become inflamed and increase in size, squeezing and irritating nearby nerve endings. Pain experienced by a man at the same time can spread along the nerves in the lower back, groin, lower abdomen or anus.
Another suspected cause of chronic bacterial prostatitis or CABD is autoimmune processes in the body. As a result of such a failure, the immune system begins to accept prostate cells as foreign elements and attack them with immune cells, which leads to the typical symptoms of bacterial prostatitis.
Another suspicious cause is viral prostatitis in childhood. Because the prostate in boys is not yet sufficiently developed, viral inflammation of this organ may not have bright symptoms and may become a chronic form of pelvic pain syndrome in an adult man.
The disease can also be associated with various spinal pathologies, injuries or osteochondrosis, resulting in compression of the spinal nerve roots, which leads to pain and disruption of the prostate gland.
Some doctors have suggested that the disease may be due to a congenital circulatory failure of the prostate gland, which is why the body is unable to cope with its function. Over time, this leads to chronic pain, which is characteristic of abacterial prostatitis.
In addition, there is a theory that CABD can cause neuropsychiatric disorders, such as severe stress, neuroses, and vascular dystonia. This condition should be considered a pathological psychosomatic illness.
Another theory claims that the disease may be related to intracellular parasites or microorganisms, the size of which is so small that it does not allow the detection of the pathogen by standard methods.
Risk factors
Smoking can help with prostate problems.
The risk factors for the development of chronic pelvic pain syndrome in men are likely to be:
- previous diseases of the prostate gland;
- chronic stress;
- back injury;
- hypothermia of the pelvic organs;
- urogenital infections;
- chronic testicular disease;
- bad habits;
- circulatory disorders of the pelvic organs;
- hypodynamics;
- pelvic injury.
If a man does not eat properly, the risk of developing the disease increases. Deficiency of vitamins and essential micronutrients can affect not only the general well-being, but also the function of the prostate gland.
Differential diagnosis
The following conditions are required for the diagnosis of chronic pelvic pain syndrome:
- long-term pain, for three months;
- absence of pathogenic microorganisms in prostate secretion;
- absence of chronic foci of infection in the body;
- anxiety about ejaculation.
Differential diagnosis is made with prostate cancer, neurological syndromes, pathologies of the spine, causing irritation of the roots of the spinal nerves.
General urological examination is mandatory - palpation of the prostate, transrectal ultrasound of the body, study of the composition of prostate secretion. You should also rule out inflammatory diseases of the testicles, bladder and kidney pathology, which can manifest themselves as pain syndromes of various localizations.
It is necessary to be examined by a neurologist and therapist. You should also consult a proctologist to rule out rectal pathologies.
Methods of treatment
A complex approach is used in the treatment of bacterial prostatitis. Therapy is selected by the urologist, taking into account the characteristics of the patient's course of the disease. It takes into account a person's general health and psycho-emotional state.
Therapy includes the following methods:
- symptomatic treatment;
- prostate massage;
- physiotherapy methods.
If necessary, treatment can be supplemented with sedatives, homeopathy and herbal remedies.
Drug therapy
You should consult your doctor before using drug therapy.
The following groups of drugs are prescribed for the symptomatic treatment of abacterial prostatitis:
- broad-spectrum antimicrobial antibiotics;
- non-steroidal anti-inflammatory drugs;
- antispasmodics and analgesics;
- alpha blockers;
- sedatives and antidepressants.
In the treatment of non-bacterial prostatitis, as paradoxical as it may sound, antibacterial agents are used. The fact is that the theory of microorganisms invisible under a microscope remains open, so antibacterial agents are prescribed for prevention. Urologists say that these drugs help to quickly eliminate the symptoms of the disease, so their use is fully justified.
Antispasmodics and analgesics are used to reduce pain. Nonsteroidal anti-inflammatory drugs can also be used as symptomatic therapy.
Alpha-blockers are indicated to facilitate the process of urination.
It should be noted that the optimal treatment regimen is selected individually for each man. You should not self-medicate by taking the drugs of these groups foolishly, it is better to trust an experienced specialist.
Prostate massage and physiotherapy
In general, drug treatment of abacterial prostatitis gives good results. Other methods are needed to enhance the therapeutic effect.
Prostate massage improves the function of the body, prevents stagnation of prostate secretion, normalizes blood circulation and metabolic processes. It is prescribed with a course of 10 procedures.
As physical therapy, magnetic effects, ultrasound therapy, electrophoresis with vasodilators and other methods are prescribed. Patients are also given spa treatments, such as mud therapy.
Folk remedies
Motherwort herb tinctures are good for treating diseases.
Treatment of non-bacterial prostatitis with folk remedies is possible only after consulting a doctor, otherwise such treatment will not help, but will only aggravate the health condition.
For the treatment of non-bacterial prostatitis with folk remedies you can use:
- decoctions of soothing herbs to improve overall health - chamomile, lemon balm, motherwort, valerian;
- Microclysters with St. John's wort, calamus, yarrow anti-inflammatory decoctions;
- warm sitting baths with calamus, soda or nettle decoction;
- suppository with pumpkin seed oil;
- tampons with honey and propolis.
The use of any of these products should be agreed with your doctor. Candles 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 prepared and cooled in the refrigerator. Such suppositories should be injected into the rectum within two weeks after a night cleansing enema.
Possible complications and prevention
Bacterial 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 and prevent hypothermia of the pelvic organs. To prevent the development of stagnant processes in the prostate gland, men need regular sex with a regular partner. It is also necessary to undergo regular preventive examinations with a urologist.