The diagnosis of "chronic prostatitis" (XN) is placed in the presence of a slow inflammation of the tissue of the prostate gland, which lasts 3 months and longer. Under the influence of provoking factors remission replaced by periodic aggravations. The disease occurs in one out of every five men. 30% of patients with this diagnosis − at the age from 20 to 50 years. To completely cure chronic prostatitis is almost impossible, but in most cases manages to achieve a stable remission under the premise of compliance with the recommendations of the physician (which the physician deals with the treatment of prostatitis).
Kinds of chronic prostatitis
It is considered a universal classification, according to which excels in several types of chronic prostatitis:
- Acute bacterial (at relapse).
- Chronic bacterial.
- Chronic aseptic (abacterial) prostatitis, which is divided into 2 subspecies: the syndrome of chronic pelvic pain inflammatory either non-inflammatory nature (prostatodynia).
- Asymptomatic flows (latent) chronic prostatitis.
Data symptoms of chronic prostatitis in men is not always appear in the right. The degree of their severity depends on the characteristics of the organism.
Chronic bacterial prostatitis
Bacteria are the cause of the inflammation of the prostate gland in 6-10% of cases. The bacterial form of chronic prostatitis usually causes non-specific infection (escherichia coli, staphylococcus aureus, hemolytic strep), penetrates in the prostate from other organs helena the external environment. Inflammation caused by this type of bacteria develops slowly erased the symptoms, so chronic infectious prostatitis often develops, has been launched. Sometimes the inflammation manifests itself weak itching, burning and even pain in the urethra, disorder of urination. On the active development of infection indicates pain in the lower abdomen and fever. This is the first signs that started the defeat of the other organs of the small pelvis. Maybe education of abscesses.
Reasons
Nonspecific infections usually penetrate in the prostate in damage to the mucous membranes of the genital organs due to inflammation, damage to the foreign entities, instrumental urological manipulation. On the surface of the skin of the crotch constantly a certain amount of intestinal bacteria, that's why it is so important to hygiene before sexual intercourse. If around the anus, groin, scrotum are present excess hydration and irritation, then the pathogens are beginning to actively rolled out at the thickness of the epidermis. Non-specific activators of chronic prostatitis they get into the tissue of the glands of the ureter during oral sexual intercourse, because the throat often detected streptococci, some gram-negative bacteria have. Often infection occurs through the hands of the man himself. Most men, who suffer from chronic bacterial prostatitis, belong to the age group from 20 to 40 years, because in this period is the peak for sexual activity. Ignoring the funds of barrier contraceptives leads to frequent infections of the specific representatives of the inflammation of the prostate. The most dangerous of them are the following:
- Mycoplasmas;
- Ureaplasma;
- Trichomonas;
- Chlamydia trachomatis.
Erectile dysfunction on the background of chronic bacterial prostatitis often leads to sexual neurosis, the result is that the person becomes irritable, aggressive.
Treatment
Modern methods of treatment of bacterial prostatitis suggest the intake of antibiotics, active against the findings in the diagnosis of pathogens. As the utilities are written antispasmodics, pain medication class NSAIDS, diuretics. Antibacterial drugs of the first row, are: antibiotics of the second row – macrolides. The system may also be included sulfonamides. Quickly cure a chronic prostatitis it is impossible. Depending on the nature of the inflammation of therapy lasts from 2 to 12 weeks. If during the 2 weeks of the positive dynamics is absent, medicine is changing. A bad outcome of antibacterial therapy in chronic prostatitis is caused due to the following reasons:
- Short course;
- The low concentration of the relevant substance;
- Education in the lumina of the tubules, acini of the prostate (botryoidal vesicles, which form the glandular tissue of the prostate gland) a colony of resistant bacteria.
Antibiotics are administered not only orally, but also intraprostatically and endolymphatic way (injected in the stored helena lymph nodes).
Fungal prostatitis
Fungal (mycotic) prostatitis is a separate subspecies of the chronic form of the disease. The pathogens penetrate as during unprotected sexual intercourse, and with limfatica from other organs. The symptoms of lesion of the tissue of the prostate often lubricated, so that the inflammation becomes chronic. In normal immunity to the fungal colony is not propagated by a more secure standards. The risk of developing Candida prostatitis prevalent in diabetics, men with a positive HIV status, and also in patients with systemic diseases.
Abacterial prostatitis
Chronic pelvic pain, exciting the coccyx and the crotch is a sign of abacterial prostatitis (prevalence amounts to 80-90%, including prostatodynia 20-30%). Other manifestations may not be at all. In the diagnosis of pathogenic microorganisms is not detected even in juice prostate or in the urine or in the ejaculate. When the inflammatory character of pelvic pain in the above mentioned biological fluids increases the number of leukocytes. In addition to the head, in chronic abacterial prostatitis regularly observed symptoms such as blood in the ejaculate, discomfort during ejaculation and stool, difficulty in urination. For some men, significantly decreases libido, impairs erectile function, occurs general weakness and muscle pain.
Causes and treatment
Likely causes of chronic non-bacterial prostatitis:
- A systemic disease.
- Pathology of blood vessels, blood circulation.
- An autoimmune disorders.
- Stagnant processes.
The exact cause of development of chronic non-communicable (non-specific) prostatitis is not always possible to detect, so the treatment is often prove to be unsuccessful. For desktop purulent removable of the prostate is carried out bladder catheterization. Upon failure of pharmacological treatment used surgical in the form of a transurethral fine-needle helena laser ablation of the prostate (minimally invasive methods of destruction, to put an end to the rampant tissue).
Chronic calculous prostatitis
Chronic calculous form of the prostatitis also is abacterial. Stones (practicality) in the prostate arise due to stagnation of secretion. It consists of products of inflammatory reactions, salts, necrotic masses. The pathology usually develops on the background of a stagnant (congestive) chronic prostatitis, bladder diseases (stones can migrate from the kidneys and bladder), disturbed metabolism, adenoma.
Symptoms of chronic prostatitis with calcification:
- Violation of urination.
- Pain in the groin, the tailbone.
- Blood in the semen.
- Deterioration of erection.
For dissolution of stones in the prostate are introducing special products and produce of the rectum and massage. If conservative methods don't work, then resort to surgery. Stty form of chronic calculous prostatitis can lead to an abscess of the gland helena atrophy of the organ.
Asymptomatic prostatitis
Long-term exposure to latent prostatitis no signs of missing. The only thing that is detected when the diagnosis is leukocytosis of prostate secretion and the likely increase in PSA levels. Detectable asymptomatic prostatitis by chance: during a planned examination of helena when handling at other opportunities.
The consequences of chronic prostatitis
Itself chronic prostatitis for the life of men are not dangerous. It is alarming, the consequences could be, if time does not seek medical help. Complications most often develops in young patients. Long-term exposure to prostatitis protective function of the gland is impaired, reducing the amount of zinc, lysozyme, necessary for its normal work. As a result the body becomes a source of permanent infection. Pathogens frequently migrate into the testes, the colon, which causes epididymitis, abscess. When transferring the infection on the rising way, perhaps, that the development of pyelonephritis, renal failure. Because the prostate is actively involved in the formation of the ejaculate, his constant inflammation can lead to infertility. Often a woman can not get pregnant is not due to poor sperm quality of the partner, and due to defective seminal fluid. Attempts to conceive a child the natural way long ends in failure (read more about the impact of prostatitis on the conception of the child). A severe complication is scarring of the bladder wall, the prostate, urethra. Long-lasting inflammatory deformation of the tissue, to become non-functional. It is also a great likelihood of developing adenoma of the prostate (BPH), which can be a catalyst for cancer of the process.
Diagnosis of chronic prostatitis
On consulting the doctor in detail to find the medical history of the patient, and especially important to describe any irregularities in the intimate life. A number of complaints in men with chronic prostatitis can be very extended: from sexual dysfunction up to a neurosis. ¼ Of All patients at all, no notes, no symptoms, pathology detected randomly. Of crucial importance is the medical history. The characteristic antecedents of different types of chronic prostatitis: infectious bacterial helena gonorrheal urethritis, for non-transferable − hemorrhoids, varicocele, varicose the defeat of the veins of the legs. Decisive in the diagnosis of chronic prostatitis have a palpation of the gland, the analysis of its secretion (more on sowing prostate secretion). During an exacerbation the size of the prostate gland slightly increases, while in periods of remission he comes in peace, is maybe just a little swelling. The secret is obtained by rectal massage of the gland. If the inflammatory process is focal in nature, then the consistency of the authority's non-uniform: alternate sections of the Western, VitaScene, razmagcheniu. In such cases, prostate juice is extracted separately from each share. Changes the secretion of glands, which are the indicators of chronic prostatitis:
- The shift of the ph toward the alkaline;
- Increased activity of lysozyme;
- Reducing the amount of acid phosphatase.
High informative different fluorescent-cytological study of prostate juice, as well as a test of its crystallization. In healthy men the juice crystallizes in the shape of the leaves of ferns. Violation of the geometry of the artwork is indicative of endocrine pathologies, as a result of which arises the lack of androgens. In a number of cases in the diagnosis of infectious chronic prostatitis apply alimentary provocation – the patient deliberately uses the spicy food helena alcohol, because of the operating activators gonorrhea and Trichomonas. Slow inflammatory processes manifested in the introduction of pirogenala helena prednisolone. Among the laboratory tests is most informative is considered a test, the so-called trehstakannoy breakdown. The patient in the urine first on one glass, then the second, then performs prostate massage. Remaining in the bladder urine is going to the third glass. This, together with the ejaculate exposed to bacteriological study. Including mandatory inspections is also taken a swab from the urethra for the presence of sexually transmitted DISEASES. Not all conditional pathogens, who grew up in cultures, automatically considered to be representatives of a chronic prostatitis. In the microbiocenosis of their presence is a variant of the norm. Important is the headline growth (concentration). If the score exceeds 10 in, 4 degrees, then it is considered diagnostically significant. In the opposite case the patient is referred to the dynamic observation rather than treatment. Informative method of diagnosis is the DROPPINGS helena transabdominal ULTRASOUND-study. The sonographic reasons can be determine the duration and severity of inflammation. Basic exeprince long-term exposure to prostatitis:
- Breast volume increases up to 20 cm3, and more;
- Sclerotic and fibrotic transformation of tissues;
- Stones;
- Swelling.
The rate of urine flow and the availability of the obstructive changes in the ureter allows you to monitor the uroflowmetry. For the differentiation of chronic prostatitis from cancer and hyperplasia, if necessary, is done by biopsy of the breast. The PSA level long-term exposure to prostatitis in the period of remission is in the standard helena only slightly increased. On the background of the active inflammatory process can climb up to 8-10 ng/ml. the Diagnosis of non-chronic bacterial prostatitis is somewhat more complicated. Must perform a number of tests to exclude bacterial forms of inflammation, diseases of other organs of small pelvis. Microscopy of the urine and the ejaculate indicates excessive levels of leukocytes, but an ULTRASOUND examination, cystoscopy, CT associated diseases do not reveal.
General methods and therapy of chronic prostatitis
In addition to the specific methods to treat different kinds of chronic prostatitis, there are general, used in all types of inflammations. An effective way of healing effects on the prostate massage. This has a direct impact on the tissue of the gland, improves blood circulation and lymph flow, removes products of the inflammatory response. When sharpening prostate massage is not carried out.