Men’s health is always a burning problem at any age, and the most acute problem is with prostatitis. If manifestations of inflammation and sharp pain still cause a man to go to a doctor immediately and be treated, then the presence of a chronic and scarce symptoms process is often considered insignificant. It is not treated and is launched to such a stage when tissue changes are already irreversible, potency and urination suffer, and prostate adenoma is formed. According to the researchers, the role of infection is large in the formation of chronic prostatitis, due to which sluggish inflammation of the prostate is maintained. It requires antibiotic treatment in conjunction with additional measures.
Chronic prostatitis: types of pathology
By their origin today, chronic prostatitis is divided into infectious, caused by a bacterial infection and abacterial (non-infectious). If the cause is the penetration of microbes into the gland tissue, a sluggish, chronic inflammation is formed, supported by colonies of microbes that are almost always present in the tissues. The diagnosis is made on the basis of prostate secretion cultures with the identification of microbial colonies. Chronic prostatitis of a non-microbial nature usually proceeds as an autoimmune inflammation, in the study of the juice of the prostate no bacteria are sown, while all the symptoms of the inflammatory process, leading to functional problems of the gland, are present.
Often, chronic prostatitis forms an asymptomatic course: although, according to research results, the inflammatory process in prostate tissues is present, but the man does not feel any external signs and discomfort. A separate option is the course of chronic prostatitis in the form of permanent pelvic pain. Against the background of the existing inflammatory changes, chronically occurring pains in the area of the perineum, small pelvis and genitals are typical.
Manifestations of prostatitis: is pain typical for a chronic course?
If we talk about the process of inflammation in the development of chronic lesions of the prostate, it is not as pronounced as during an acute illness. Therefore, the whole manifestation is not very pronounced, and often the man may not attach importance to them. So, pain or burning along the urethra is periodically felt, increasing during the period of intimate intimacy or when a man urinates. Also felt heaviness or slight pain in the projection of the perineum, extending into the rectum. Periods can be felt discomfort and aching pain in the sacrum or lower abdomen, groin, urge to urinate sharply increased. In addition, intimate disorders are typical for prostatitis – weakening of erection with tendencies to premature ejaculation, weakening of craving and lack of orgasm. It is important to note the fact that prostatitis in a quarter of men has no clinically pronounced manifestations, and therefore patients do not rush to the doctor for treatment.
How the diagnosis is set: detection of inflammation
To begin with, it is important for the doctor to find out the main complaints of the patient, which are typical for prostatitis in chronic form, and details of the development of pathology. It is important not to conceal all the manifestations from the doctor, even if they are of a very delicate nature – this is the lack of pleasure during sexual intercourse, weakening of erection, problems with arousal. They may indicate the presence of inflammation in the prostate, along with pain and discomfort. No less important will be a full examination with palpation of the gland (probing it through the rectum), as well as obtaining prostate secretion and subsequent seeding. This allows you to determine the inflammation and its nature (microbial or aseptic), as well as changes in the prostate (induration, tenderness and swelling). Due to this study, it is possible in parallel to conduct a differential diagnosis of prostatitis with hemorrhoids, adenoma, and cancerous lesions of the anogenital zone. Complement the cycle of ultrasound examinations of the prostate with obtaining data on the nature of inflammation, the degree of its spread and changes in the body. At the expense of seeding, the type of microbial flora responsible for inflammation, as well as the sensitivity of microbes to antibiotics, is detected. It is also important to conduct an analysis of PSA (prostate-specific antigen), which will help in the diagnosis of adenoma and oncological degeneration in the prostate.
Methods of treatment: antibiotics and not only
The process of treating chronic prostatitis, when compared with the treatment of acute inflammation, is not an easy task, it is important to carefully and meticulously follow all the doctor’s instructions. The scheme includes not only antibiotics to suppress the infection, but also a course of physiotherapy and some non-drug methods. Only an integrated approach can suppress inflammation and eliminate the infection completely.
First of all, the doctor will prescribe antibiotics that are necessary to suppress the activity of the microbial flora supporting the inflammatory process in the tissues of the gland. Most often today apply such antibiotic groups as macrolides and tetracyclines, although the use of other groups is acceptable (monomitsin, kanamycin), sometimes a doctor may prescribe nitroxoline or trimetaprim. The type of drug, its dose and duration of administration depend on the severity of the lesion, the presence of symptoms and the general condition. Antibiotics usually take up to 2 weeks. At the end of the course of treatment, a control seeding of prostate secretion is given in order to evaluate the effectiveness of therapy.
What else is applicable in the treatment of prostatitis?
In addition to antibacterial therapy, treatment requires the implementation of prostate massage, which helps in restoring blood circulation to the organ and full outflow of fluid. This eliminates congestion and reduces the activity of inflammation. This procedure is indicated only for chronic prostatitis, on the background of an acute course or in the presence of anus fractures, hemorrhoids, it is prohibited. The combination of antibiotic therapy and prostate massage is most effective in the treatment.
As additional drugs in the treatment can be used adrenergic blockers, which remove smooth muscle spasm and improve the flow of urine and prostate secretion. Also shown are the methods of physiotherapy, selected individually.