The diagnosis of "chronic prostatitis" (CP), is taken from the English smoldering inflammation of the prostate tissue, which lasts longer than 3 months or. Under the influence of precipitating factors, remission, periodic exacerbations replaced. The disease occurs in one out of five are men. 30% of patients with this diagnosis in age from 20-50 years. To completely cure chronic prostatitis is almost impossible, in most cases, but it is possible to achieve stable remission, subject to the recommendations of the doctor (what doctor deals with treatment of prostatitis).
The type of chronic prostatitis
Universal is the classification, according to which there are several types of chronic prostatitis:
- Acute bacterial (at relapse).
- Chronic bacterial.
- Chronic aseptic (abakteerista) prostatitis, which is divided into 2 subtypes: chronic pelvic pain syndrome, inflammatory or noninflammatory nature (prostatodynia).
- Flowing asymptomatic (latent) chronic prostatitis.
The symptoms of chronic prostatitis in men don't always appear in a strict sequence. Waste their severity depends on the characteristics of the organism.
Chronic bacterial prostatitis
Bacteria, causing inflammation of the prostate 6-10% of cases. Bacterial form of chronic prostatitis is usually caused by nonspecific infection (Escherichia coli, Staphylococcus aureus, hemolytic Streptococcus), penetrates the prostate to other organs in the external environment or. Inflammation caused by a type of bacteria that is removed develops slowly symptoms, so a chronic infectious prostatitis is an acute use of the camera, when he was running. Sometimes the inflammation occurs in mild itching, burning and even pain, urethritis, disorder of urination. About active infection as evidenced by pain in the abdomen for the development and fever. This is the first signs that the beginning loss of other pelvic organs. The formation of abscesses.
Reasons
Nonspecific infections can usually penetrate the prostate to harm the mucous membranes of the genital organs, due to inflammation, damage, and foreign objects, instrumental urological procedures. The skin surface of the perineum is always a certain amount of intestinal bacteria, and therefore what is important is hygiene before sexual intercourse. If the area of the anus, groin, scrotum are too much and moisture irritation, pathogens begin to penetrate the epidermis thickness. Non-specific pathogens of chronic prostatitis decline in the prostate tissue of the urethra by oral sex, because often the throat is Streptococcus, some gram-negative bacteria. Often the infection paid through the hands of men. Most men with chronic bacterial prostatitis, belong to the age group of 20-40 years, as this period is the peak of sexual activity. Ignoring the mechanical contraception leads to recurrent infections with special pathogens inflammation of the prostate. The most dangerous among them are the following:
- Mycoplasma;
- Ureaplasma;
- Trichomonas;
- Chlamydia.
Erectile dysfunction on the background of chronic bacterial prostatitis often leads to sexual neurosis, in consequence of which man becomes irritable, aggressive.
Treatment
Modern methods of treatment of bacterial prostatitis is associated with the antibiotics detected in the diagnosis of the pathogen. Subsidiary means a prescribed antispasmodics, analgesics class nsaids, diuretics. Anti-bacterial first-line drugs are second-line antibiotics – macrolides. The system can also be associated with sulfonamides. Quickly cure chronic prostatitis impossible. Depending on the nature of the inflammation of therapy is from 2 to 12 weeks. If after 2 weeks the positive dynamics is absent, then the drug changes. Unsatisfactory results of antibiotic treatment of chronic prostatitis due to the following reasons:
- Short courses;
- Low concentration of the active substance;
- Education, Lumina station and the spices of the prostate (protruding pouches that form the glandular tissue of the prostate gland) colonies of resistant bacteria.
Antibiotics use is not oral in vain, but also intrapro statically and endolymphatic (injections use or lymph node).
Fungal prostatitis
Mushroom (mushroom) prostatitis is a separate subtype of chronic forms of the disease. Comes as Fungus unprotected sexual contact and other bodies limfatica. Symptoms of prostate tissues the use of the camera's oiled, so the infection enters the chronic form. Under normal immune system, the fungus colonies do not reproduce more than the safe limits. Table of developing candidal prostatitis elevated in diabetics, men with a positive HIV status, as well as those suffering from systemic diseases.
Abacterial prostatitis
Chronic pelvic pain, exciting and the coccyx the perineum, is a sign of abacterial prostatitis (incidence of 80-90%, including prostatodynia 20-30%). Other manifestations may be not at all. Diagnosis of pathogenic micro-organisms in the juice could not be found or or prostate in the urine in the ejaculate. The inflammatory in nature pelvic pain mentioned in biological fluids increases the amount of white blood cells. In addition to pain, chronic abacterial prostatitis visible symptoms, such as blood, semen, discomfort during ejaculation, bowel movements, difficulty urinating. Men are Some clearly decreased libido, erectile deterioration, the weakness is the most Common and muscle pain.
Causes and treatment
The most likely causes of chronic non-bacterial prostatitis:
- Systemic diseases.
- Vascular pathology, circulation.
- Auto-immune diseases.
- Stalled processes.
The exact cause of chronic non-communicable (non-specific) prostatitis is not always possible to identify, therefore, treatment is often unsuccessful. Drainage of the purulent abscess is bladder catheterization. With the ineffectiveness of the network tasks, surgical in the form of either a fine-needle transurethral laser ablation of the prostate (minimally invasive destruction of overgrown tissue).
Chronic calculous prostatitis
Chronic calculous form of prostatitis is also abakteerista. Stones (practicality) of the prostate is formed due to stagnation of the secretions. They consist of products of inflammatory reactions, salts, necrotic masses. The pathology usually develops on the background of congestive (congestive) chronic prostatitis, urinary stone disease (transferred to stones in the kidneys and bladder), disturbed metabolism, adenoma.
Signs of chronic prostatitis with calcification:
- Violation of urination.
- Groin pain, tailbone.
- Blood in the semen.
- The deterioration of an erection.
Dissolution of stones in the prostate are given a special drug and produces rectal massage. If conservative methods do not work, then resort to surgery. The activated form of chronic calculous prostatitis can lead to gland abscess or atrophy of the organ.
Asymptomatic prostatitis
When latent chronic prostatitis is missing characters. Only asia, which is observed when the diagnosis is leukocytosis of prostate secretion of growth-and likely PSA level. Asymptomatic prostatitis detected by chance on routine examination during the treatment period or in another context.
The effects of chronic prostatitis
Its chronic prostatitis in men's life is not dangerous. Threatening can be the consequence, if the applicant a doctor of the time does not help. Complications often develop in younger patients. Chronic prostatitis, the protective function of glands is disturbed, reducing the amount of zinc, lysozyme required for normal operation. As a result, the organ becomes a permanent source of infection. Pathogens use the camera to move to the testicles, the rectum, cause epididymis inflammation, abscess. When moving to the infection of the ascending paths can develop pyelonephritis, renal failure. Because the prostate gland is actively involved in the formation of the ejaculate, that constant inflammation can lead to infertility. Often a woman can not get pregnant not poor quality because his partner's sperm, and defective semen. Trying to get pregnant naturally for a long time been rejected (read more about the effects of prostate inflammation is the conception of the child). A serious complication is scarring of the bladder wall, prostate, urethra. Long-term inflammatory corrupting the fabric, he frown, become non-functional. Also, the likelihood of development of prostate benign hyperplasia (BPH), which can catalyze the cancer process.
The diagnosis of chronic prostatitis
Consultation, the doctor will explain in detail the historian of the patient, it is particularly important to describe any interference in the intimate life. Variety of complaints in men with chronic prostatitis can be very extended: sexual dysfunction anxiety. ¼ Of All Patients do not all notes of the symptoms, the abnormality is detected incidentally. The importance of history. Typical precursors of various chronic prostatitis: an infectious bacterial or gonorrheal urethritis contagious its diseases − hemorrhoids, varicocele, varicose veins lose veins in the legs. Paramount to the diagnosis of chronic prostatitis is palpation of the thyroid gland the secret and analysis (read more sowing prostate secretion). Acute prostate During the whole grow up a little and periods of remission, will come back to normal, to no avail mild swelling. The secret is obtained by rectal massage of the prostate. If the inflammatory process is focal in nature, that consistency is uneven alternating sections of Zapadni, vito my razmagcheniu. In such cases, prostate juice is obtained separately for each part. Changes to glands secretion, which is indicators of chronic prostatitis:
- Exchange acidity towards alkalinity;
- Increased lysozyme activity;
- Calculate the acid phosphatase.
Eri High informativity fluorescent Cytology of the prostate juice, as well as to test its crystallization. Healthy men juice kristallizuetsya in the form of fern leaves. A violation of the geometry the figure shows, endocrine abnormalities, which is why there is a lack of androgens. In some cases, the diagnosis of infectious chronic prostatitis use alimentary provocation – the patient intentionally consume spicy food or alcohol, when aktiviziruyutsya the causative agents of gonorrhea and Trichomonas. Slow the inflammatory processes are manifested in the introduction of pyrogen electrical or prednisolone. Among the laboratory studies are considered the most informative here, a sample called trehstakannoy. Patients urine from the first one, then another, then massage the prostate. Residual bladder urine collected in the third Cup. He, done in conjunction with exclaim bacteriological examination. The number of required tests also take a swab of the urethra in English sexually transmitted diseases. Conditional pathogens Not all, who grew up in the culture you are automatically considered agents of chronic prostatitis. In microbiocenosis their English is a normal variant. Important to the growth of the titre (concentration). If greater than the ratio of 10 to 4°, it is considered to be diagnostically significant. Otherwise, the patient shows dynamic observation and treatment. Informative method of diagnosis is TRUS or transabdominal ultrasound examination. Is sonographic signs, you can determine the duration and the severity of inflammation. The main exeprince chronic prostatitis:
- The volume of the breast has increased more or 20 cm3;
- Sclerotic fibres and change in the tissues;
- Stones;
- Swelling.
Urine flow and changes in English obstructive ureter allows you to monitor uroflowmetry. Differentiation of chronic prostatitis hyperplasia and cancer, if necessary, perform a biopsy of the prostate. PSA levels in chronic prostatitis in remission have normal or slightly elevated. The background of the active inflammatory process may lead to 8-10 ng/ml. The diagnosis of non-bacterial chronic prostatitis is more complicated. Perform a number of tests Need to close the poi bacterial forms of inflammation, abnormalities of other pelvic organs. Microscopy of the urine in the ejaculate and shows the excess blood of the son, but the ultra sound, cystoscopy, CT scan of the underlying disease is not revealed.
The most common methods of treatment of chronic prostatitis
In addition to the specific treatments for different chronic prostatitis is the most common used in all kinds of inflammation. Effective method of healing effect on the prostate massage. It's effect on the prostate tissue, the nun, and improves blood circulation lymph flow, remove products of inflammatory reactions. Worsening prostate massage During is not carried out.