Diagnosis of chronic prostatitis" (hp) arises if you have a slow inflammation of the tissues of the prostate, which has a duration of 3 months and more. Under the influence of the factors that cause the remission changes periodic the acute episodes. The disease occurs one of every five men. The 30% of patients with this diagnosis − age from 20 to 50 years. To fully cure the chronic form of the prostate is almost impossible, but in most cases it is possible to achieve stable remission, as long as the implementation of the recommendations of a doctor (the doctor has been involved in the treatment of prostatitis).
Types of chronic prostatitis
Universal is considered the classification, according to which it highlights several types of chronic prostatitis:
- Acute bacterial (in case of relapse).
- Chronic bacterial.
- Chronic aseptic (nonbacterial) prostatitis, which is divided into 2 subtypes: the syndrome of chronic pelvic pain, inflammatory or non-inflammatory nature (prostatodynia).
- Asymptomatic flows (latent) chronic prostatitis.
The symptoms of chronic prostatitis in men do not always appear in strict order. The degree of training depends on the specific characteristics of the body.
Chronic a bacterial prostatitis
The bacteria are the cause of the inflammation of the prostate in 6-10% of cases. Bacterial form of chronic prostatitis usually cause specific infections (escherichia coli, staphylococcus aureus, beta hemolytic streptococcus), penetrating into the prostate to other organs or the external environment. The inflammation caused by this type of bacteria, it develops slowly, with deleted from the sintomatologa, so that chronic infection prostatitis is often aggravating, as being executed. Sometimes, the inflammation manifests itself weak of itching, burning and even pain in the urethra, a disorder of the urination. On the active development of the infection indicate abdominal pain and fever. Are the first signs of the plague has begun to other organs of the pelvis. It is possible the formation of abscesses.
The causes of the
Nonspecific infection tend to penetrate into the prostate when they are damaged the mucous membranes of the genitals because of inflammations, injuries, foreign bodies, instruments, manipulations, urological. On the surface of the skin of the crotch is constantly a certain amount of intestinal bacteria, hence the importance of body hygiene prior to the sexual act. If in the area of the anus, the groin, the scrotum there is excess moisture and irritation, the pathogens begin to penetrate the thickness of the epidermis. Nonspecific of the causative agents of chronic prostatitis enter in the breast tissue of the ureter when the lingual sexual contact, as the pharynx is often detected, streptococci, some gram-negative bacteria. Often, the infection occurs via the hands of the man himself. The majority of men suffering from bacterial prostatitis, belong to the age group of 20 to 40 years of age, since this period is the maximum of sexual activity. The contempt of the means of contraception barrier and often results in infestations specific to the inflammation of the prostate. The most dangerous of them, the following:
- Mikoplazmi;
- Ureaplazmi;
- Trichomonas;
- Chlamydia.
Disorders of the erection on the background of chronic bacterial prostatitis often lead to sexual neurosis, in consequence of which the man becomes irritable, aggressive.
The treatment of the
The current methods of treatment of bacterial prostatitis involve the taking of antibiotics active against detected in the diagnostic of the excitation. As auxiliary means sets the antispasmodics, analgesics from the class of nsaids, diuretics. Antibacterial properties of first-line drugs are: second-line antibiotics – the macrolides. In the schema may also include the sulfonamides. Quickly cure the chronic prostatitis is not possible. Depending on the nature of the inflammation of the therapy occupies from 2 to 12 weeks. If within 2 weeks dynamic Russian language does not exist, then the medicine is changing. Unsatisfactory the result of the antibiotic therapy in prostatitis is conditioned by the following reasons:
- Short course;
- The low concentration of the active substance;
- Education in clearings of ditches, the acini of the prostate (botryoidal bags that are glandular tissue of the prostate) colonies of resistant bacteria.
The antibiotics are introduced not only oral, but also intraprostatically and endolymphatic using injections in tax or lymph nodes).
Fungal prostatitis
Fungal (mycotic) prostatitis is a subtype of a chronic form of the disease. Pathogens penetrate as when a sexual contact, and with limfatica of other organs. The symptoms of the defeat of the tissues of the prostate often spotted, therefore, the inflammation passes to a chronic form. In normal conditions of the immunity of the colonies of fungi do not multiply more sure of the standard. The risk of development of Candida prostatitis up-to-date diabetic men with hiv-the Russian language of the state, as well as in patients with systemic diseases.
Nonbacterial Prostatitis
The chronic pelvic pain, exciting the tail bone and crotch, it is a symptom of nonbacterial prostatitis (prevalence of approximately 80-90%, including prostatodynia 20-30%). Other manifestations may not be at all. In the diagnosis of pathogenic microorganisms is not detected, neither in the juice of the prostate, nor in the urine or in the ejaculate. When inflammatory nature of pelvic pain in the biological fluids, increases the number of white blood cells. In addition to the pain, to the nonbacterial prostatitis will periodically observe symptoms such as blood in the ejaculate, discomfort with ejaculation and bowel movements, difficulty urination. Some of the men of markedly reduced libido, impairs erectile function, occurs general weakness, and muscle aches.
Causes and treatment
Probable causes of chronic non-bacterial prostatitis:
- Systemic diseases.
- Pathology is the blood vessels, the circulation of the blood.
- Autoimmune of the infringement.
- Stalled processes.
The exact cause of developing chronic non-contagious (non-specific) of the prostatitis cannot always be identified, therefore, the medical therapy is often futile. For the evacuation of the purulent nasal of the prostate is performed the catheterization of the bladder. The ineffectiveness of the medications, surgical treatment is applied in the form of transurethral fine-needle or laser ablation of the prostate (minimally invasive methods of destruction grown of the fabric).
Chronic calculous prostatitis
Chronic calculous form of the prostatitis also is abacterial. The stones (practicality) in the prostate are formed due to the stagnation of the secret. Are composed of products of inflammatory reactions, salts, necrosis of the masses. Pathology is usually develops on the background of the stagnant (congestive) of the chronic prostatitis, in the kidneys (stones can migrate from the kidneys and the bladder), violation of exchange of substances, adenomas.
Symptoms of chronic prostatitis with calcification:
- The violation of urination.
- Pain in the groin, the tailbone.
- Blood in the semen.
- The deterioration of erection.
For dissolution of stones in the prostate is injected with special drugs and produce rectal massage. If conservative methods do not work, then resort to surgery. Is running chronic calculous prostatitis can cause abscess in the breast or the atrophy of the authority.
Asymptomatic prostatitis
The latent chronic prostatitis one of the signs that are missing. The only thing that is detected when the diagnosis is leukocytosis of the secretion of the prostate and the likely increase in the PSA level. Detected asymptomatic prostatitis by chance: when a scheduled survey or when you put on another occasion.
The consequences of the chronic prostatitis
By itself, chronic prostatitis of the life of a man is not dangerous. Threaten can be its consequences, if no time to consult a doctor. The complications most often develop in younger patients. In prostatitis, the protective function of the gland is broken, it reduces the amount of zinc, lysozyme, necessary for its operation. In consequence, the authority becomes a permanent source of infection. Pathogens often migrate in the testicles, the rectum, causing epididymitis, abscess. When you move the infection of the upstream pathways, it is possible the development of pyelonephritis, renal failure. As the prostate is actively involved in the formation of the ejaculation, is a persistent inflammation can lead to infertility. Often the woman can't get pregnant, not because of the poor quality of the sperm of the couple, but for the poor of the semen. The attempt to conceive a child naturally for a long time ends up in failure (more information on the impact of prostatitis in the conception of the child). A serious complication is scarring of the bladder wall, prostate, urethra. Long inflammatory deform the fabric, that is wrinkle, become functional. It is also a great likelihood of development of benign prostatic hyperplasia (bph), which can serve as a catalyst of a process oncology.
The diagnosis of chronic prostatitis
In the consultation the doctor detail inquire about the medical history of the patient, especially important to describe perturbations in the intimate life. The spectrum of complaints of men with chronic prostatitis can be extremely high: of the sexual dysfunction to the neurosis. ¼ Of all patients in general do not observe any symptom, the pathology is diagnosed by coincidence. The importance of the story. Characteristic of the ancestors of the different types of chronic prostatitis: infection is bacterial or blenorrgico urethritis, not contagious − hemorrhoids, varicocele, the defeat of the veins in the legs. Of paramount importance in the diagnosis of chronic of the prostate have by palpation of the gland, the analysis of its secret (for more information on the planting of the secretion of the prostate). During the exacerbation of the size of the prostate increases slightly, while that in the periods of remission becomes the norm, it is only possible to a small swelling. The secret is extracted by rectal massage of the breast. If the inflammatory process focus is the nature, is the consistency of the authority's uneven: there are alternating sections of Zapadni, VitaScene, razmagcheniu. In such cases, the prostatic juice receive separately of each part. The changes of the secretion of the gland, which are indicators of chronic prostatitis:
- Change the acidity in the side of the alkalization;
- The increase of lysozyme activity;
- The reduction in the volume of the acid phosphatase.
High informative different fluorescent-cytologic screening prostate juice, as well as the proof of its crystallization. The men's healthy juice crystallized in the form of a fern leaf. The violation of the geometry of the drawing of the evidence from pathologies of the endocrine, due to the lack of androgens. In some cases in which the diagnosis of the infection of the chronic prostatitis apply digestive provocation – patient intentionally used the spicy food or alcohol, so that is activated the causative agents of gonorrhea and trichomonas. Slow inflammatory processes are manifested in the introduction of pirogenala, or prednisone. Among the laboratory studies are more informative it is considered a proof, called trehstakannoy a break. The patient's urine, first in a glass, and then in the second, after which it performs the massage of the prostate. It is in the bladder the urine is collected in the third vessel. She, along with the ejaculate-bacteriological, are subjected to study. As required analysis also takes a sample from the urethra in the presence of sexually transmitted diseases. Not all conditional pathogens, which have grown the cultures, it is considered a cause of chronic prostatitis. In the microbiocenosis their presence is a variant of the norm. It is important to the title of growth (concentration). If the percentage exceeds the 10 in 4 degrees, it is considered that it is the diagnosis important. Otherwise, the patient is shown the dynamics of the observation, and not the treatment. Informative diagnostic method is the TRUS or transabdominal ultrasonography-study. By ultrasonographic grounds may determine the duration and the intensity of the inflammation. The main exeprince when chronic prostatitis:
- The volume of the breast is increased by up to 20 cm3, and more;
- Sclerotic and fibrous transformation of the tissues;
- The stones;
- The swelling.
The speed of urine flow and the presence of obstructive changes in the ureter allows you to perform a follow-up uroflowmetry. For the differentiation of chronic prostatitis from cancer, and the benign if necessary, a biopsy is performed of the breast. PSA levels in prostatitis in the period of remission is normal or slightly elevated. At the bottom of the active inflammatory process can go up to 8 to 10 ng/ml Diagnosis non-bacterial chronic prostatitis a little more difficult. Necessary to carry out a series of analysis to the exclusion of the bacteria in the form of inflammation, diseases of other organs of the pelvis. Microscopy of the urine and the ejaculation shows the levels of excess white blood, but ultrasound, tsistoskopiya, the tc of the co-morbidities not identified.
The common methods of therapy of chronic prostatitis
In addition to the specific methods of the treatment of several types of chronic of the prostate, are general, applicable to all types of inflammation. An effective way to of the healing impact is a prostate massage. It has a direct influence on the tissue of the breast, improves blood circulation and lymph flow, shows the products of the inflammatory reaction. To intensify the massage of the prostate is not carried out.