Chronic prostatitis

Chronic prostatitis is a prolonged inflammation caused by infection or accompanying pathology in the prostate.

Signs of chronic prostatitis

Chronic prostatitis is diagnosed in men of all ages.According to statistics, this disease is the most common reason why patients under 50 visit urologists.In the chronic form, bacteriological examination revealed pathogens in only 5-10% of patients.In most cases, other factors are considered to be the cause of the disease.It is well known that the presence of infection is not a prerequisite for the occurrence of this disease.Chronic inflammation of the prostate is a multisexual pathology, which is the result of the role of several causes and provocative factors.In 90-95% of patients, the effectiveness of antibacterial therapy is limited or not required at all.

Classification of chronic prostatitis

Etiology The classification of chronic prostatitis is distinguished in two main forms: chronic bacterial (infectious) prostatitis and chronic nonbacterial (sterile) prostatitis/chronic pelvic pain (KTS).

The etiology classification of chronic prostatitis includes:

  1. Chronic bacterial prostatitis.
  2. Chronic nonbacterial (sterile) prostatitis/CTB ("prostaglandin" or "painful prostate" is an outdated term used to determine pathology).
  3. Chronic nonbacterial (sterile) prostatitis/CTB with inflammatory components (the concentration of white blood cells is significantly increased in the prostate secret, sperm, the first part of urine).
  4. Chronic nonbacterial (sterile) prostatitis/CTB has no inflammatory components (the concentration of white blood cells in the secret of the prostate, sperm, the first part of the urine is not enough to undergo inflammation).
  5. Chimney chronic prostatitis (detected in laboratory studies and did not show clinically).

From the above statistics, it can be seen that chronic bacterial prostatitis is a rare pathology.Infection is the cause of chronic recurrent inflammation of the prostate in one of ten patients.Pathology is often associated with other infectious diseases of the urogenital organs.Most commonly, it is caused by a nonspecific infection, but in the presence of STSPP, chronic inflammation of the glands may be caused by chlamydia, urea disease, mucosa or other specific microorganisms.

Chronic nonbacterial (sterile) prostatitis or chronic pain syndrome is a long-term recurrent disease that occurs due to sterile inflammation of the prostate.This is a bit of a study of pathology.In the presence of symptoms of the disease, the test determined the secret of the gland, seed fluid, white blood cells in the initial part of the urine, but the bacteriological test was negative.In other cases, there are neither signs of infection nor obvious leukocytosis with bright symptoms.

There is also chronic prostatitis in the aggravation stage, and in the remission stage, there is also chronic prostatitis.The circulatory process is characterized by bacterial prostate and non-infectious inflammation.In both cases, the intensification of chronic prostatitis leads to increased symptoms.

The course of treatment (pathogen) classification of chronic prostatitis has limited interest to patients and clinicians.

Causes of chronic prostatitis

Causes of chronic bacterial inflammation in the prostate

Chronic infection of prostatitis occurs due to infection of prostate tissue.In most cases, the cause of inflammation is E. coli or e.E. coli.Enterococci have fewer engraving microorganisms, Claibsle, proteus, pseudomonas.

Like some other microorganisms, E. coli is able to form thin biofilms, consisting of bacterial accumulation and closely adjacent to the mucosa of the pipe.This explains why chronic prostatitis is not always curable.The infection is believed to be transmitted through the ascending method of the urethra.However, lymphatic development and hematogenous transmission are also possible.

The factors that cause chronic infectious prostatitis are as follows:

  • age of sexually active;
  • prostate adenoma or benign prostate hyperplasia;
  • narrowing of the urethra;
  • Unscrew the extreme flesh of the penis;
  • Bladder neck hypertrophy;
  • Medical procedures (cystoscopy, cystoscopy);
  • Genetic and anatomical characteristics are prone to disease.

Causes of chronic nonbacterial inflammation of the prostate

The causes of chronic non-bacterial prostatitis are unknown.Perhaps the disease is caused by viruses or bacteria that are not identified during the prostate bacterial secretion process.However, most scientists and doctors believe that chronic nonbacterial (sterile) prostatitis/CTB is a multisex disease caused by a combination of adverse factors: i.e.:

  • Riding a bicycle;
  • When urine enters the duct, tissue stimulation of prostate tissue;
  • The prostate stimulates the prostate due to the use of any product or beverage (especially food allergies or celiac disease);
  • Dysfunction of pelvic organ innervation;
  • atrophy of pelvic floor muscles;
  • stress, psychological and emotional load;
  • Pathology in the prostate, maintained after long-standing acute prostatitis;
  • Hormonal diseases;
  • bladder disease;
  • Cold climate.

Because the exact cause of the disease is little known, it is difficult to treat chronic prostatitis.

Symptoms of chronic prostatitis

Chronic bacterial (infectious) prostatitis is characterized by a circulating course.The aggravation phase is replaced by the relief phase.There are almost no symptoms between aggravation.There is a clear link between urinary surgery, urethritis, epiphytic angiitis, and other diseases of cystitis.Often, these pathologies are the pathogens that cause chronic prostatitis.Symptoms during aggravation are caused by instability (frequent urination, pain during rubber and urination), and pain, with various strengths in the vagina, scrot, s bone, s bone and penis.

General conditions are usually satisfactory.There was no sign of poisoning and no increase in body temperature.The prostate gland when examined by rectal examination (per rectal) may be normal or slightly swollen without the obvious painful features of acute prostatitis.

Chronic non-bacterial (sterile) prostatitis/KTB is characterized by the pelvis, perineum, sac bone, sac bone, and is the pain of the disease "visit card" (sterile chronic prostatitis).Signs of prostatitis were poorly expressed and were observed in 50% of cases.In other patients, they may not exist.

The existence of blood in the blood, painful ejaculation, defecation, and comfort are possible.The severity of symptoms may change.The rectum the feet give people pain, which makes it difficult to find a person sitting.Fatigue, unreasonable fatigue, joint and muscle pain are also possible.Some patients complain of decreased libido and erectile dysfunction (positive ot).

Asymptomatic chronic prostatitis does not have the symptomatic characteristics of this disease, hence its name.In laboratory studies on prostate secrets, it is possible to determine that leukocytosis, an increase in specific prostate antigen levels is possible.There are no other signs of illness.

Diagnosis of chronic prostatitis

The main methods for diagnosing chronic infection of prostatitis are laboratory tests and local tests that allow you to find out where the white blood cells in your urine and sperm are.

Three-wall-treated urine tests help identify inflammation.To this end, the patient had three containers of urine for analysis.Prostate massage between the second and third containers can cause irritation of the secretion of the glands.As a result, urine in the third container will contain emissions of the prostate (white blood cells, red blood cells, bacteria), which was determined during the analysis.No need to massage the prostate specifically and explore the pure secrets of the glands.

The urine in the third container can be sent to bacteriological examination via seed nutrient medium.The sensitivity of pathogens to antibiotics was tested in the presence of bacterial growth.This method helps to perform treatment more accurately and effectively.Since prostate secrets are an important part of sperm, microscopy and ejaculation bacteria also make the correct diagnosis possible.

Chronic bacterial (infectious) prostatitis is accompanied by a slight increase in PSA.After successful treatment, its level decreased.Ultrasound and other tool studies have no significant diagnostic value.

Diagnosis of chronic nonbacterial (sterile) prostatitis/CTB can be difficult.Typically, the diagnosis is performed by excluding other pathologies of urogenital tract and bacterial prostatitis.To this end, instruments and laboratory methods were used: urine microscope (three-wall tests were also used after prostate massage), sperm or prostate secrets, and then seeded nutrient medium.The study list includes analysis of PSA (differential diagnosis of cancer and prostatitis).

Microscopy reveals the presence of white blood cells in the urine, the secret of the prostate, the secret of seed fluid, and the negative results of bacterial treatment methods.Instrumental research methods (ultrasound, cystoscopy, MRI, CT) did not reveal signs of concomitant pathology.

Treatment of chronic prostatitis

In order to successfully treat chronic infectious prostatitis, there are reasons and targeted antibacterial treatments are necessary.The formulations selected are those that produce large concentrations of fluoroquinolones in gland tissue.The treatment process takes six to 12 weeks.The duration of this antibacterial treatment is necessary to completely eliminate infection and prevent recurrence.The second drug.

Bacterial chronic prostatitis can be cured with consistent and appropriate treatments.Patients who frequently relapse need to check for immune status.It may also be necessary to rule out HIV infection, which is usually the reason for the low effectiveness of antibacterial treatment.In such patients, antibiotics can be prescribed in doses sufficient to inhibit bacterial growth.

Treatment of chronic nonbacterial prostatitis/KTS is difficult because the infection is not the cause of chronic pelvic pain or abortion chronic prostatitis.It is necessary to seriously solve the problem and answer the question of how to treat the disease, and the reason is completely unknown.

The lack of a cause explains why attempts to treat this pathology often fail.

Treatment methods for chronic sterile prostatitis include:

  1. Antibacterial treatment with fluoroquinolones (for all patients).No infection was detected during bacteriological examination.
  2. alpha receptor blocker.They help improve blood circulation in prostate tissue.Very low effectiveness.
  3. NSAID and other anti-inflammatory drugs have severe efficacy, relieve pain and improve symptoms.However, treatment is disease-causing, and after cancellation, renewal of the disease is possible.
  4. Physical therapy and physical therapy exercise (yoga, exercise, active lifestyle), help improve blood circulation and eliminate venous stagnation, hypoxia, and strengthen muscles in the pelvic.This method can help patients with the appropriate disease.
  5. Antidepressants and anticonvulsants (no proven effectiveness).
  6. Surgical treatment: laser or thin gene ablation of the prostate gland (ineffective).

forecast

In most patients with chronic prostatitis infection, the prognosis is favorable.Consistent and appropriate antibacterial treatment allows you to succeed in more than 80% of cases.

Chronic nonbacterial (sterile) prostatitis/KTB is the worst predictor.Treatment can only help some patients.Others continue to suffer from chronic pain syndrome despite all available treatments.The disease has a significant impact on the psychological and emotional field and sexual relationships.