Chronic prostatitis

Chronic prostatitis is a long-term inflammation that occurs due to infection or simultaneous pathology in the prostate.

Chronic prostatitis is diagnosed in the men of all ages.According to statistics, this disease is the most common reason for visiting the urologist in patients under the age of 50.In chronic form, bacteriological overview reveals pathogen only in 5-10% of patients.In most cases, other factors are considered the cause of the disease.It is known that the presence of infection is not a prerequisite for the appearance of the disease.Chronic prostate inflammation is a polyethological pathology, which is the result of shares of several causes and provoking factors.In 90-95% of patients, antibacterial therapy has limited efficiency or not necessary at all.

Classification of chronic prostatitis

The classification of chronic prostatitis by etiological feature differs between the two main forms of the disease: chronic bacterial (contagious) prostatitis and chronic non-macacterial (aseptic) prostatitis / chronic pelvic pain (KTS).

Etiological classification of chronic prostatitis includes:

1. Chronic bacterial prostatitis.
2. Chronic non-pointing (aseptic) prostatitis / CTB ("Prostatinate" or "painful prostatural gland" is outdated to determine pathology).
3. Chronic non-pointing (aseptic) prostatitis / CTB from inflammatory components (Leukocyton concentration increases significantly in the secrecy of prostate, sperm, first part of urine).
4. Chronic non-pointing (aseptic) prostatitis / CTB without inflammatory components (concentration of white blood cells in the secret prostate, cum, the first part of urine is not enough for inflammation).
5. Ashmptomic chronic prostatitis (discovered in laboratory studies is not shown clinically).

Chronic bacterial prostatitis is a rare pathology, as can be seen from the above statistics.Infection is the cause of chronic recurring prostate inflammation in one of ten patients.Pathology is often associated with other infectious diseases of genitourin organ.Most often, its cause is an unassigned infection, however, in the presence of STSPP, chronic gland inflammation can cause chlamydia, ureaplasmosis, mycoplasmosis or other specific microorganisms.

Chronic non-pointing (aseptic) prostatitis or chronic pain syndrome, is a long-term repetitive disease that occurs as a result of a prostate inflammation.This is a little -pothered pathology.In the presence of symptoms of the disease, tests determine white blood cells in the secrecy of the gland, in the seed liquid, in the initial part of the urine, but the results of bacteriological examinations are negative.In other cases, there are no signs of infection, nor the levy symptoms have been imposed.

There are also chronic prostatitis in the stage of deterioration and chronic prostatitis in the remission phase.The cyclic course is characterized by bacterial and nonfective prostate inflammation.The deterioration of chronic prostatitis leads to increasing symptoms in both cases.

Pathanatomic (pathomorphological) Classification of chronic prostatitis is limited to the patients and doctors of the clinician.

Causes of chronic prostatitis

Causes of chronic bacterial inflammation prostate

Chronic contagious prostatitis occurs due to the prostate tissue infection.The most common is the cause of inflammation of E. coli or e.Coli.Less carbonated microbes are enterococcal, Klebsell, Proteus, Pseudomonas.

Like some other microbes, E. coli is capable of form biofilms, thin, which consist of bacterial accumulations and firmly adjacent with channel mucosa.This explains why it is not always possible to cure chronic prostatitis.The infection is believed to expand as an upward road through the urethra.However, lymphogenic and hematogen spreading infections are possible.

Predicting factors for the occurrence of chronic infectious prostatitis are as follows:

• sexually active age;
• adenum prostate or benign prostate hyperplasia;
• narrowing of the urethra;
• Unscrew the extreme penis meat;
• Urine door hypertrophy;
• Medical procedures (catheterization of bladder, cystoscopy);
• Genetic and anatomical characteristics predispose the disease.

Causes of chronic intact prostate inflammation

The causes of chronic non-control prostatitis are precisely unknown.Perhaps the disease is caused by viruses or bacteria, which are not identified during the bacterial excretion of the prostate gland.However, most scientists and doctors believe that chronic incompressise (aseptic) prostatitis / CTB polyethological disease occurs as a result of a combination of several harmful factors, namely:

• Cycling;
• An irritation of the prostate tissue watches when the urine enters its channels;
• Irritation of the prostate gland as a result of the use of any product or drink (especially with food allergies or Celiacia);
• Functional disorders of nervous innervation of pelvic authorities;
• Pelvic floor muscle atrophy;
• stress, psychoemotional loads;
• Pathology in prostate, remaining after long acute prostatitis;
• Hormone disorders;
• bladder diseases;
• Cold climate.

Since this exact causes of the disease know a little, the treatment of chronic prostatitis can be difficult.

Symptoms of chronic prostatitis

Chronic bacterial (contagious) prostatitis is characterized by a cyclic course.The worsening phase is replaced by the remission phase.Practically no symptoms between worsening.There is a clear link between other diseases of genitourinary bodies - urethritis, epidymmeters, cystitis.The cause of these pathology is usually the same pathogen that causes chronic prostatitis.Symptoms during deterioration represent dissidal phenomena (frequent urination, rubber and ignition of pain during urination) and the pain of different intensities in the perineum, scrotum, sacrum, with penis radiation.

The general condition is usually satisfactory.There are no signs of intoxication, no increase in body temperature.The prostatural gland during the examination through the rectum (per rectum) may be normal or slightly swollen, without sharp pain characteristics of acute prostatitis.

Chronic non-pointing (aseptic) prostatitis / KTB characterize various degrees weight (from stupid lungs to intense) in pelvis, perineum, Sacrum and are a "business card" disease (aseptic chronic prostatitis).The signs of prostate inflammation glands are poorly expressed and were observed in 50% of cases.In other patients, they can be absent.

It is possible to presence blood in sperm, painful ejaculation, defecation, disouric phenomena.The weight of the symptom can be changed.The pain is given to crotch, rectum, which makes it difficult to find a person in a seated position.Fatigue, unreasonable fatigue, articulated and muscle pain are also possible.Some patients complain about the reduced gender of the drive, erectile dysfunction (immorality).

Asymptomatic chronic prostatitis does not have symptoms characteristic of this disease, hence its name.During the laboratory study, the secret prostate is determined by leukocytosis, the increase in the level of specific prostatic antigen is possible.There are no other signs of the disease.

Diagnosis of chronic prostatitis

The main methods for diagnosing chronic infectious prostatitis are laboratory tests and current tests that allow you to find out the source of leukocytes in urine and sperm.

The urine test assists in identifying inflammation.In order to do this, the patient urinates three contents for analyzes.The prostate massage between the second and third containers leads to the stimulation of the gland excretion.As a result, urine in the third tank contains the discharge of the prostate (leukocytes, red blood cells, bacteria), which are determined during the analysis.It should not be especially massaging the prostate and explore a clean secret gland.

Urine from the third tank can be sent to bacteriological examination with sowing nutrient media.In the presence of bacterial growth, a test for the sensitivity of pathogens on antibiotics is carried out.The method helps to treat the procedure more precisely and more efficiently.Since the prostatic secret is a significant part of sperm, microscopy and ejaculate bacteria also allow the correct diagnosis.

Chronic bacterial (contagious) prostatitis follows a slight increase in the dog.Its level was reduced after successful treatment.Ultrasound and other instrumental studies do not have a significant diagnostic value.

The diagnosis of chronic non-hard (aseptic) prostatitis / CTB can be difficult.It is often diagnosed excluding other pathology of geniteal tract and bacterial prostatitis.This is used by instrumental and laboratory methods: urine microscopy (a three-hour test is used and after the prostate massage), sperm or secret prostate, followed by sowing in nutrients.The list of studies includes the analysis for the dog (differential diagnosis of cancer and inflammatory prostate diseases).

The microscopy reveals the presence of leukocytes in urine, in the secrecy of prostate, liquid seeds with the negative results of bacteriological treatment methods.Instrumental research methods (ultrasound, cystoscopy, MRI, CT) do not reveal signs of simultaneous pathology.

Treatment of chronic prostatitis

For the successful treatment of chronic contagious prostatitis, rational and targeted antibacterial therapy is needed.Preparation of choices are fluoroquinolons that create large concentrations of medicine in the tissues of the gland.The course of treatment lasts from six to 12 weeks.Such duration of antibacterial therapy is required for the complete eradication of infection and prevention of relapse.Another -row drugs.

Bacterial chronic prostatitis can be cured with consistent and adequate therapy.Patients with frequent relapse should check the immune status.It may be necessary and exclude HIV infection, which is often the cause of low efficiency of antibacterial therapy.In such patients, it is possible to prescribe antibiotics in a dose to control bacteria growth.

The treatment of chronic non-hard prostatitis / KTS is difficult because the infection is not the cause of chronic pain in the pelvis or a akacterial chronic prostatitis.It is necessary to take a serious approach to the problem and answer the question of how to treat the disease, which is the cause of which is accurately unknown.

The absence of a certain etiology explains why attempts to therapy these pathology are often unsuccessful.

Methods of treatment of chronic aseptic prostatis contains:

1. Antibacterial therapy with fluoroquinolons (which are implemented by all patients).It is possible to have an infection that has not been detected during bacteriological examination.
2. Alpha-blockers.Contribute to improving blood circulation in prostate tissues.Efficiency is low.
3. NSAIDS and other anti -infalmator medications have serious efficiency, relieve pain and improve symptoms.However, treatment is pathogenetic, after cancellation, the restoration of the disease is possible.
4. Physiotherapy and exercise of physiotherapy (yoga, sport, active lifestyle), helping to improve blood circulation and eliminate vezk stagnation, hypoxia, strengthening the muscles of the pelvis.The method helps patients with appropriate disorders.
5. Antidepressants and anticonvulses (efficiency are not proven).
6. Surgical treatment: Laser or thin -iginal prostate ablation (not effective).

Forecast

In chronic infectious prostatitis in most patients, the forecast is favorable.Consistent and adequate antibacterial therapy allows you to achieve success in more than 80% of cases.

Chronic nephacterial (aseptic) prostatitis / KTB has the worst forecast.Treatment helps only some patients.Others still suffer from chronic pain syndrome, despite the use of all available treatment methods.The disease has a pronounced effect on the psycho -emotional sphere and sexual intercourse.