The diagnosis of "chronic Prostatitis" (CP) is in the presence of sluggish inflammation of the tissue of the prostate, which lasts for 3 months and longer. Under the influence of triggering factors of Remission, periodic exacerbations soaked always. The disease occurs in one out of every fifth man. 30% of patients with this diagnosis at the age of 20 to 50 years. Completely heal the chronic Form of Prostatitis is almost impossible, but in most cases it succeeds in a stable Remission under the condition of compliance with the recommendations of the doctor (which doctor deals with the treatment of the Prostatitis).
Types of chronic Prostatitis
Universal is regarded as a classification, according to which there are a few types of chronic Prostatitis:
- Acute bacterial (in the case of recidivism).
- Chronic bacterial.
- Chronic aseptic (abakterialniy) Prostatitis, which is divided into 2 sub-types: chronic pelvic pain, inflammatory or non-inflammatory character (prostatodynia).
- Asymptomatic course of the end of (latent) chronic Prostatitis.
The symptoms of chronic Prostatitis in men appear not always in the strict order. The severity of which 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 is usually due to nonspecific infections (Escherichia coli, Staphylococcus Aureus, hemolytic Streptococcus), into the prostate penetration of other bodies or the environment. Inflammation, caused by this type of bacteria that develops slowly with the deleted symptoms, so a chronic infectious Prostatitis is escalating often, as a running. Sometimes, inflammation manifested slight itching, burning, and even pain in the urethra, trouble urinating. The active development of the infection pain point in the abdomen, and fever. These are the first signs that the defeat of the other organs of the small pelvis began. The formation of abscesses.
Causes
Non-specific infection in the rule, to penetrate into the prostate in the case of damage to the mucous membranes of the genital organs as a result of inflammation, damage, foreign body, instrumental urological manipulations. On the surface of the skin of the perineum, a certain amount of intestinal bacteria is constantly, that is why it is so important body hygiene before Sex. When in the vicinity of the Anus, the groin, the scrotum excessive fluid intake, and irritable, and then start active pathogens penetrate into the depth of the Epidermis. Non-specific pathogens of chronic Prostatitis fall into the tissue of the prostate of the ureter in the case of oral intercourse, as in the neck often streptococci found, some Gram-negative bacteria. The infection is often done through the hands of the men. Most of the men suffer from chronic bacterial Prostatitis, belong to the age group of 20 to 40 years, because this period is the Peak of sexual activity. Ignore means of contraception barrier leads to frequent infection of the specific pathogen, the inflammation of the prostate gland. The most dangerous of them are the following:
- Mycoplasma;
- Ureaplasma;
- Trichomonas;
- Chlamydia.
Erectile dysfunction on the background of chronic bacterial Prostatitis is often sexual neuroses, whereby the man becomes irritable, aggressive.
Treatment
The modern methods of treatment of bacterial Prostatitis to suspect the use of antibiotics, against active, as determined at the time of diagnosis of the pathogen. As an aid prescribed antispasmodics, for the pain of a class of NSAIDs, diuretics. Antibacterial drugs the first row are: antibiotics of the second row of the macrolides. The scheme also included sulfonamides can be. Quickly heal chronic Prostatitis is not possible. Depending on the type of inflammation, the therapy will take between 2 to 12 weeks. If within 2 weeks, the positive dynamics is absent, the drug is changed. The unsatisfactory result of anti-bacterial therapy for the chronic Prostatitis is due to the following reasons:
- Short course;
- The low concentration of the active substance;
- Education and training in the strip of light channels, acini of the prostate (acinar bags, form the glandular tissue of the prostate) colonies of resistant bacteria.
Antibiotics are not only oral, but also intra-prostatic ally and saccus through (injections imposed, or lymph nodes).
Fungal Prostatitis
Fungal infections (mycoses) Prostatitis is a separate subspecies of the chronic Form of the disease. Pathogens penetrate as through unprotected sexual contact, as well as with limfatica from other institutions. Symptoms of tissue of the prostate often blurred, so that the inflammation becomes chronic. In the case of normal immunity fungal colonies no longer breed safe standard. The risk of development of Candida Prostatitis increased in diabetics, men with a positive HIV Status, as well as systemic disease in the affected.
Abakterialniy Prostatitis
Chronic pelvic pain experience, exciting the coccyx and Perineum, is a sign of abacterial Prostatitis (prevalence as high as 80-90%, including prostatodynia 20-30%). Other manifestations can't be. In the diagnosis of pathogenic microorganisms is not detectable, neither in the juice of the prostate gland, neither in the urine nor in the ejaculate. The inflammatory nature of the pelvic pain in the above-mentioned body fluids is increasing the number of leukocytes. Apart from the pain, in chronic abacterial Prostatitis regularly symptoms such as blood in the ejaculate, discomfort during ejaculation, and bowel movements, difficulty urinating. In some men Libido, reduced erectile function deteriorates, a General weakness and muscle pain.
Causes and treatment
Possible causes of chronic non-bacterial Prostatitis:
- Systemic Diseases.
- Pathology of the blood vessels of the blood circulation.
- Auto-Immune Diseases.
- Stagnant Processes.
The exact cause for the emergence of chronic non-infectious (non-specific) and Prostatitis are not always recognized, so that drug therapy is often not successful. For the derivation of purulent inflammation of the prostate catheterisation of the urinary is bladder. In the case of ineffectiveness of drug treatment, surgical in the Form of a transurethral fine-needle or Laser Ablation of the prostate (minimally invasive methods of destruction of the proliferating tissue).
Prostatitis chronic calculous
Chronic calculösen the Form of the Prostatitis also abacterial is. Stones (practicality) in the prostate, due to the Stagnation of the secret. They consist of products of inflammatory reactions, salts, necrotic masses. The pathology usually develops on the background of stagnating (congestive) of chronic Prostatitis, Urolithiasis (stones migrate from the kidneys and bladder), the disturbed metabolism of the adenoma.
Signs of chronic Prostatitis with calcification:
- Violation of urination.
- Pain in the groin area, coccyx.
- Blood in the seminal fluid.
- A deterioration of the erection.
For dissolution of stones in the prostate specific medication to be administered and produce rectal Massage. If conservative methods do not work, then resorting to surgery. Launched in the Form of chronic calculous Prostatitis of the abscess, atrophy of the gland or organ can lead to.
Asymptomatic Prostatitis
In the case of latent chronic Prostatitis any characters are missing. The only thing in the diagnosis is undetectable, is leukocytosis the secret of the prostate and the probable increase of the PSA. Undetectable asymptomatic Prostatitis will happen is: in the case of a proposed investigation or to contact any other occasion.
The consequences of chronic Prostatitis
Itself chronic Prostatitis for the life of the men is not dangerous. Threatening, its consequences can be, if not timely medical assistance. Complications most often develop in young patients. In the case of chronic Prostatitis protective function of the gland is disrupted, decrease the amount of zinc, lysozyme, for the normal operation. As a result of the organ to be a source of infection is permanent. Disease Hiking causative agent is often in the testicles, the rectum, causing Epididymitis, paraproctitis. When you move the infection to the rising ways, the development of Pyelonephritis, renal failure. Since the prostate plays an active role in the formation of the ejaculate, then there is the constant inflammation can lead to infertility. Often the woman can't be pregnant, not due to the inferior sperm of the partner, but due to poor semen. Try a child in a natural way ends in failure for a long time (more on the impact of Prostatitis on a pregnancy, a Baby). Serious complication is scarring of the wall of the urinary bladder, the prostate, of the urethra. Protracted inflammatory tissue, you fold, deform non-functional. Also the chances of development of prostate adenoma (BPH), can process a catalyst for the cancer.
Diagnosis of chronic Prostatitis
On the consultation of the doctor, and the medical history of the patient is defined in detail, to describe particularly important in the no disturbances in the sexual. The spectrum of complaints in men with chronic Prostatitis can be very extended: from sexual dysfunction, to neuroses. ¼ Of All patients do not notice any symptoms, pathology detected by chance. Important the history is. The characteristic precursor of the various types of chronic Prostatitis: infectious it is bacterial or gonorrheal Urethritis, non-infectious − hemorrhoids, varicocele, varicose veins, venous disease of the legs. Of the utmost importance in the diagnosis of prostate cancer, chronic Palpation of the prostate, the analysis of your mystery (for more on the seed of the secret of the prostate gland). During the exacerbation of the size of the prostate increased slightly, and in periods of Remission back to normal, is only a small swelling. The secret is by rectal Massage of the prostate. If the inflammatory process has a local character, the consistency of the organ is uneven: areas of change Zapadni, VitaScene, razmagcheniu. In such cases, prostate juice, you will receive separately from each lobe. Changes in the secretion of the gland, as indicators of chronic Prostatitis:
- A shift in the direction of acid and Alkali;
- The increased activity of lysozyme;
- The decrease of acid Phosphatase.
Very informative cytological examination of the prostate juice, as well as Test its crystallization is of a different fluorescent. In healthy male juice fern crystallized in the Form of a sheet. Violation of the geometry of the drawing testifies to endocrine pathologies, due to which there is a noticeable lack of androgens. In some cases, in the diagnosis of infectious chronic Prostatitis nutritional uses provocation – the Patient intentionally used spicy food or alcohol, whereby the active causative agent of gonorrhea, and trichomoniasis. Sluggish inflammation occur in the administration of prednisone or pyrogenal. Among the laboratory investigations, the statement applies as a Test, called trehstakannoy punch. The Patient urinates first into one glass, then a second, then the Massage of the prostate is. The remaining urine in the urinary bladder is in the third Cup. It is exposed to the semen bacteriological research. In the number of analyses required, a swab from the urethra assumes the presence of venereal diseases. Not all conditional pathogens, the be automatically replicated as a causative agent of chronic Prostatitis. In the intestinal flora is a variant of the Norm is the presence. Important Titer Growth (Concentration). If a number greater than 10 in 4 steps, he is considered to be diagnostically meaningful. Otherwise, the Patient shows dynamic observation and treatment. Informative method of diagnosis of a TRUS or transabdominal ultrasound examination is. After sonographic reasons, the duration and severity of the inflammation can. The most important exeprince in chronic Prostatitis:
- The volume of the gland takes up to 20 cm3, and more;
- Sclerotic and fibrotic Transformation of tissues;
- Stones;
- Puffiness.
The rate of urine flow and the availability of obstructive changes in the urinary tract uroflowmetry can keep track of. For the differentiation of chronic Prostatitis from cancer, and hyperplasia, if necessary, a biopsy of the prostate is performed. PSA levels in chronic Prostatitis in Remission is normal or slightly increased. Against the background of an active inflammatory process can take up to 8-10 ng/ml, the diagnosis will not rise-bacterial chronic Prostatitis is a little more complicated. Necessary for the implementation of a series of Tests to exclude bacterial forms of inflammation, pathologies of other organs of the small pelvis. Microscopy of urine and ejaculate indicates an exceedance of the level of white of white cells in the blood, but ultrasound, cystoscopy, CT, and comorbidities did not identify.
General methods of therapy of chronic Prostatitis
In addition to specific methods of treatment of various kinds of chronic of prostate cancer, there are General, applicable to all kinds of inflammation. An effective way of healing is a Massage effect on the prostate. It has a direct effect on the tissue of the prostate, improves blood circulation and lymph flow, bringing products of inflammatory reactions. During exacerbation of prostate Massage is not carried out.