Chronic prostatitis is characterized by permanent or repetitive symptoms with a confirmed bacterial infection in the prostate.
The prostatitis of these categories is rare, in approximately 10% of cases from all cases of prostatitis.Question - whether atypical pathogens can, such as ureaplasm, is a breakthrough), a prostate inflammation is discussed.They can be present in the body of man and without any signs of inflammation and complaints.
Causes of chronic prostatitis
The causes of chronic prostatitis are mainly similar to the causes of the development of acute bacterial prostatitis.In most cases, the entry of microorganisms in the prostate occurs through the urine - as a result of urine casting in the prostate channel.
Chronic bacterial prostatitis is developed due to inadequate treatment or a shorter course of treatment of acute bacterial prostatitis.
Symptoms
- Discomfort or pain - in crotch, lower abdomen, in groin, scrotum, penis, during ejaculation
- Changes in urination - Difficulties in urinating, rapid urination in small parts, feeling incomplete bladder discharge.
The patient may appeal to numerous symptoms and any symptom separately.Increasing body temperature is tightly (or small).
IMPORTANT:
Many men cooperate erectile dysfunction with prostatitis.It is often facilitated by unprofessional publications in the media and advertising suspicious drugs.The fact that the erection can remain even complete by removing the prostate (due to the presence of a malignant bodies of the organ), suggests that alone is not playing a role in maintaining erection.
According to many authoritative urologists, erectile dysfunction in patients with chronic prostatitis due to psychogenic and neurotic problems.
Diagnostics
The primary assessment is used by the questionnaire - the symptom index of chronic prostatitis.You can object to the patient's complaints on it.
Standard method for diagnosing prostatitis is the performance of the sample.This is a microscopic and bacteriological survey of urine samples obtained from different parts of the genitourin tract and excretion prostate glands.However, the test method is quite tiring, and at this point the samples are more often used.The possible alternative is the delivery of ejaculation (sperm) for a microscopic and bacteriological examination, as ejaculated partially (at least 1/3) consists of excretion prostate.This method is more comfortable for patients, especially if categorically refused a rective examination or perform a diagnostic prostate massage to obtain the secret prostate.However, teaching ejaculate has lower information and reliability in relation to the failure.
Delivery of bacteriological examination ejaculate is included in the diagnostic algorithm for male genital organs and when testing man on infertility.
Results of laboratory tests (general urine analysis, general blood test, biochemical blood test, spermogram and other general clinical tests) in the case of chronic prostatitis uninformatively.Most likely these tests will show "norm".
During the re-examination, changes in the inflammatory process in the prostate, in patients with chronic prostatitis, away from always observed.That is, it is impossible to rely on the result of a rectal study for the diagnosis of chronic prostatitis.
The same goes for UZ-Diagnostics: to diagnose chronic prostatitis, focusing only on ultrasonic data, it is incorrect.The European and American Association of Urologists is not recommended to the ultrasound for the diagnosis of prostatitis.The type of execution in this case is not important through the front abdominal wall - the lower abdomen or trust - through the rectum.In order to write in the conclusion of ultrasonic study "Chronic prostatitis", "ultrasound signs of chronic prostatitis", "signs of prostatis" are wrong.Pretogenic installations of this diagnosis has only a urologist who determines it on the basis of complaints, history, laboratory tests and - only after - ultrasound.
The most common ultrasonic sign, according to which chronic prostatitis is diagnosed - thus-are calculated in the expensive gland connected to the transmitted inflammatory process or other changes in the prostate parenchym.This is a kind of fibrous processes, replacing the normal parenchyma prostate with a fist.However, there are no correlations of the number of fibrous changes in the prostate with the presence of complaints.The chances of such "scars" in the organ increase in the age of such "scars, but a man can live throughout his life without feeling any discomfort in the crotch or stybian area.However, as soon as these changes are in ultrasound, some "experts" diagnose prostatitis.And some men will have a feeling that they are really seriously ill, start listening to yourself, feel all the symptoms described on the Internet.
For many men older than 30 years, ultrasound can show diffuse changes in the prostate.However, the fibrous process does not indicate the presence of prostatitis.
The diagnosis of chronic prostatitis was established based on the exclusion of other diseases of the genitine system - primarily urethritis, prostate hyperplasia, neurogenic urination, prostate cancer and bubble cancer.
There is no specific image for chronic prostatitis based on the results of routine examination.
Treatment of chronic prostatitis
Antibiotics of phthikinolon groups are optimal antimicrobial remedies for the treatment of chronic bacterial prostatitis.The recommended flow of antibacterial therapy is from 4 to 6 weeks.Such a long exchange rate is justified by scientific data that indicate a decrease in the probability of relapse diseases.
If sexually transmitted infections (STI-I) are sexually transmitted, such as chlamydia, the prescribed antibiotic group of macrolide groups.
There are data on reducing the relaxation of the bladder doors in patients with chronic prostatitis, which leads to reflux urine in urethra channels and causes prostate and pain tissue inflammation.Such patients are recommended by appointing alpha-blockers.
In the treatment of chronic prostatitis, patients are recommended to refrain from tempting sentences for herbal medicine.The feature of dietary supplements and plant additives is the instability of plant components in the part of matter, may differ even in the drugs of the same manufacturer.In addition, from the point of view of evidence - the drug transferred, the benefits of plant medicine do not bear criticism.
Prostate massage, which is in the middle of 20. century used as the basis of therapy, thanks to new scientific approaches and classification, remains an important tool for diagnosing prostatitis, but not its treatment.You don't need to use prostate massage as a therapeutic procedure (effect is not proven).There are assumptions that frequent ejaculation in their estates are similar to the sessions of the prostate therapeutic massage.
On other methods whose efficiency is proven as a result of only one or more studies or is still studied: referred to:
- Lower muscle training shower - Some data indicate the efficiency of special exercises to reduce symptoms of chronic prostatitis and chronic pelvic pain syndrome;
- Acupuncture - a small amount of studies indicates the advantage of acupuncture in relation to placebo in patients with chronic prostatitis;
- Extracorporal impact therapies based on the effects of sound pulses significant amplitude on the connective and bone tissue, is widely used in the treatment of muscle-bone system, recently used in urology, its effectiveness is in the study;
- Behavior and psychological support - Since chronic prostatitis is associated with low quality of life and the development of depression, these methods can improve the patient's psychological state and help reduce some symptoms of the disease.
Separately, worth mentioningAsymptomatic (asymptomatic) chronic prostatitis.The diagnosis is most often established according to the results of histological conclusion - after the prostate biopsy or after the surgical treatment of the prostate.The frequency of inflammation detection in the prostate tissues varies from 44% (with prostate biopsy) to 98-100% (after the surgical treatment of prostate).Scientists suggested that inflammatory changes were discovered in this way, there is nothing other than physiological personality - deleted.No one deals with special diagnostics of this category of prostatitis, this is a kind of random inventory.It does not need treatment, it does not require any further actions of a doctor and patient.