Learn more about the symptoms and treatment of chronic prostatitis. Chronic prostatitis: symptoms, diagnosis and treatment What are the signs of chronic prostatitis

Chronic inflammation of the prostate gland occurs in men of any age. In most cases, the catalyst is an infectious factor: Trichomonas, staphylococci and gonococci. Bacteria that enter the body provoke inflammation of the urethral canal, the prostate gland itself.

The chronic form of prostatitis is often asymptomatic. The disease itself is determined only after the transition to an acute form. Late diagnosis is also explained by the fact that the first symptoms of chronic prostatitis in men are often ignored.

Statistics show a constant “rejuvenation” of the disease. Increasingly, patients aged 30 years are turning to urologists.

Chronic prostatitis - what is it?

The prostate gland is located under the bladder. The main functions are reduced to protecting the vesica urinaria from the ingress of seminal fluid, as well as the production of prostate secretion, a necessary component of male semen. Inflammation of the gland tissue, provoked by infection, congestion and other factors, gradually becomes permanent.

Chronic prostatitis leads to degenerative changes. The structure of the tissues gradually deforms. Often, against the background of inflammation, stones appear in the ducts. Some types of prostatitis cause the development of cancer.

An international classification system has been developed to facilitate differentiation between different prostate diseases.

Chronic prostatitis - causes

It is generally accepted that inflammation of the prostate gland is caused by two main factors: bacterial and abacterial.

The first is associated with the entry of pathogens and infections into the patient’s body. Most often, the catalyst is sexually transmitted bacteria.

The second cause of occurrence is not associated with an infectious agent. The catalyst for inflammation can be:

• Hypothermia of the body.
• Hormonal imbalances associated with aging and irregular sex life.
• Bad habits.
• Injury to the pelvic organs.
• Stagnation caused by metabolic disorders and a sedentary lifestyle.

After diagnosing prostatitis, the root cause of chronic prostatitis must be determined. The course of therapy is prescribed based on what exactly caused the inflammation. Bacterial and non-infectious prostatitis are treated differently.

Urologists name several additional factors that aggravate the situation and influence the severe course of the disease:

• Sexual abstinence.
• Inferior ejaculation (choosing interrupted sexual intercourse as a method of contraception).
• Stress.
• Bad habits – alcohol abuse and smoking.
• Poor nutrition.
• Inflammatory diseases suffered in the past. They often act as a cause of prostatitis in chronic form.

Inflammation is accompanied by destructive changes in the prostate gland, which makes it possible to classify the disease into several categories.

Classification of chronic inflammation of the prostate

Varieties of prostatitis received their own ICD-10 code - N41. To clarify the diagnosis and differentiate the infection of the catalyst, a separate classification B95-B97 is used. The symptom rating scale divides the disease into several groups and subgroups:

• I - acute inflammation, accompanied by a sharp rise in temperature and fever.
• II - chronic prostatitis, provoked by an infectious factor.
• III - class includes a disease in which pelvic pain syndrome begins to manifest itself. It is customary to distinguish two subgroups:
  1. IIIA - there are signs of an inflammatory process. Low-grade fever is maintained.
  2. IIIB - no inflammation.
• IV - prostatitis in which there are no symptomatic manifestations. Deviations from the norm are detected exclusively by instrumental diagnostic methods.

According to the ICD code:

• N41.1 is diagnosed with chronic prostatitis.
• N41.8 inflammatory diseases of the prostate gland.
• N41.9 an exact diagnosis has not been made.

How does chronic prostatitis manifest itself - its symptoms

The first signs of chronic prostatitis in men appear at an advanced stage of the disease. Often, early development does not have clinical manifestations. Symptoms, even if present, are temporary, short-term in nature and of low intensity.

According to clinical manifestations, three stages of prostatitis development are distinguished:

• Initial indirect signs of chronic prostatitis - as already noted, the onset of the disease is not expressed by clearly distinguishable symptoms. Manifestations are subtle or absent altogether.
  Signs you should pay attention to: burning sensation during ejaculation, decreased potency, painful urination.
• Secondary signs of chronic inflammation of the prostate - at this stage, pathological changes occur in the structure of tissues, the appearance of scar-like formations, and a decrease in genitourinary function.
  The stage is characterized by a sharp deterioration in potency and urination, increased sweating, severe pain in the pelvic area, lumbar spine, and scrotum.
• Signs of an advanced disease - the prostate ceases to function normally. Healthy tissues begin to metamorphose. The gland increases in size. Blood and pus appear in the urine, there is a constant feeling of incomplete emptying of the bladder, and night trips to the toilet become more frequent. Erectile function decreases so much that we can talk about complete sexual impotence.

In addition to the symptoms characteristic of each stage of development, there are general signs that appear throughout the entire course of the disease.

Pain syndrome

Chronic prostatitis in the late stage of development has pronounced symptoms. Characteristic clinical manifestations are pain of severe intensity that does not go away on its own and requires the use of analgesics and antispasmodics.

Pain syndrome accompanies the entire period of development of the disease. During the primary signs of prostatitis, discomfort and burning in the urethral canal are of low intensity and are therefore often ignored. Pain is often falsely attributed to radiculitis or fatigue. After pain relief or taking an antispasmodic such as No-Shpa, the symptom usually goes away.

Over time, the clinical picture becomes more intense. The pain syndrome manifests itself more intensely and remains after taking analgesics. Unpleasant sensations accompany every act of urination, defecation and ejaculation.

The pain radiates from the spine to the scrotum, sometimes to the limbs, and is accompanied by cramps and numbness. Skin rashes, itching and burning of tissue in the prostate and genital areas are a normal reaction of the body to internal inflammation.

Temperature increase

Chronic inflammation of the prostate gland in acute form is accompanied by heat and fever. There is a sharp increase in temperature, reaching 39-40°. The indicators are stable. Body temperature does not decrease even after taking antipyretics.

Sluggish prostatitis is characterized by a low-grade fever. Constant indicators of chronic inflammation, within 37-37.2°.

Reducing the temperature and taking medications on your own to reduce external manifestations is strictly prohibited!

Dysuria

The first signs of chronic prostatitis appear in various urination disorders. Over time, the symptoms become more intense, which helps to identify the disease. Manifestations of dysuria:

• Frequent urge to go to the toilet at night.
• Feeling of incomplete emptying of the bladder.
• Hematuria (blood in urine), purulent discharge.
• Pain during urination.

Clinical signs and the intensity of their manifestation directly affect the diagnosis and require mandatory additional research. Symptoms may indicate other inflammatory diseases of the genitourinary system, etc.

Genital dysfunctions

Chronic prostatitis leads to the appearance of scar formations that impair blood supply. Lack of nutrients leads to the following manifestations:

• Decreased potency - with chronic prostatitis, sexual disorders are observed. One of the characteristic symptoms is a normal erection, which sharply decreases during sexual intercourse. In the advanced stage, stable potency occurs.
• Infertility - after the appearance of scars in the seminal ducts, the viability of sperm decreases. Inflammation changes the structure and composition of the ejaculate. In the advanced stage, the sperm thickens and lumps appear.
• Pain during sexual intercourse - discharge from the urethral canal is observed. During sexual relations, discomfort and painful symptoms are felt, especially during ejaculation. Often psychosomatic reasons lead to persistent impotence of the patient.

The main symptoms of chronic prostatitis: pain, increased body temperature, dysuria, dysfunction of the genital organs. When making a diagnosis, the intensity and duration of the period from the onset of clinical signs, as well as related symptoms, are taken into account.

How can chronic inflammation of the prostate be detected?

Prostatitis has no symptoms that can accurately differentiate the disease. Some disorders of the genitourinary system have similar symptoms. An accurate diagnosis can be made only after a complete examination of the patient, including laboratory tests and methods of instrumental detection of the disease.

Having suspected the presence of disturbances in the functioning of the pelvic organs, the urologist will prescribe a mandatory rectal examination. If tissue changes are detected upon palpation, several laboratory tests are prescribed.

Laboratory research methods

Clinical blood and urine tests differentiate the presence of an inflammatory process and can often explain the catalyst for the development of the disease. When making a diagnosis, additional information will be required from the results of the following laboratory tests:

• Cytological and bacteriological analysis of urine. The PSA level is established. Protein levels increase sharply with inflammation of the gland tissue.
• Taking a smear from the urethra.
• Microscopy of prostate secretions - based on the results, malfunctions in the prostate gland are determined. Differentiate cancer from chronic tissue inflammation.
  Sowing prostate secretions is prohibited during an acute period of the disease, accompanied by high body temperature, exacerbation of hemorrhoids, or fissures in the anus.
• Tests for STIs (sexually transmitted infections) - one of the common catalysts for inflammation of the prostate gland is pathogenic microorganisms.
  Trichomonas, staphylococci and gonococci can all cause the disease. Prostatitis develops during the active phase of bacterial proliferation, and after the infection has already been cured.

Laboratory tests are an obligatory component of the diagnosis of prostatitis and the subsequent choice of treatment method.

Instrumental detection of the disease

There are three main methods of testing for prostatitis. Each instrumental diagnostic method provides information about changes in the structure of gland tissue and has its own indications and contraindications:

• Tomography - MRI is often prescribed to diagnose chronic prostatitis. The study allows you to obtain a layer-by-layer image of the prostate. MRI signs accurately indicate chronic inflammation, and also indicate the beginning of tissue degeneration into a malignant formation.
  Magnetic resonance technology is absolutely harmless, but has contraindications due to the inability to study patients with pacemakers, metal staples and shunts (left during surgical operations).
• Transrectal TRUS is an informative method that reliably indicates the presence of inflammation. Sonographic signs of structural changes in the prostate gland according to the type of chronic prostatitis include: deviations from the norm in volume and size, structure, and the presence of pathological formations.
  Ultrasound techniques are not prescribed for acute inflammation of the rectum, the presence of cracks in the anus, or hemorrhoids.
• Ultrasound - transabdominal technique has no contraindications. The method is less informative compared to TRUS and MRI. Sonographic signs make it difficult to determine the space of the abdominal cavity. Diagnostic results are often controversial and require clarification. The advantage of ultrasound is the simplicity and speed of the study.

The accuracy of the echographic picture largely depends on the experience of the doctor conducting the study.

Differential search for disease

After receiving the results of clinical and biochemical studies, the symptoms of chronic inflammation of the prostate gland are assessed. Common diagnostic standards have been developed that are valid throughout the world.

To facilitate the task of the urologist, the NIH-CPSI symptom index has been invented, made in the form of a questionnaire or questionnaire. The doctor fills out the fields in the document and then makes a diagnosis.

There are computer programs based on the NIH-CPSI index. The doctor is required to fill out a questionnaire, and the system will independently conduct a summary assessment of symptoms for chronic prostatitis. The effectiveness of the technique has been proven all over the world.

After calculating the results of the questionnaire, when making a diagnosis, an additional assessment of instrumental and clinical studies is taken into account: the presence of echo signs of chronic prostatitis, an increased PSA level, identification of an infectious marker by microscopy of secretions. The more data the urologist has, the more accurate the result will be.

What is dangerous about chronic prostatitis - its consequences

The consequences of chronic prostatitis in men are disorders in the functioning of the genitourinary system. These include:

• Impotence.
• Acute urinary retention.
• Infertility.

Fibrous changes that accompany advanced disease cause the development of oncology. Normal tissues degenerate into malignant ones. Therefore, preventing functional changes in the prostate gland in order to prevent the development of cancer is an extremely important task facing the urologist.

When making a diagnosis, the presence of prostatic intraepithelial neoplasia, a harbinger of oncology and fibrous changes, is taken into account. Advanced disease often leads to the need for surgery: prostatectomy.

Diagnosis of prostatitis and differentiation of the disease from related disorders of the pelvic organs is an important task for doctors and patients. Detection of the first symptoms depends entirely on the man himself. If you experience any discomfort when urinating, decreased erection, or persistent low-grade fever, these are reasons to immediately seek professional medical help. Delay is dangerous!

is a prolonged inflammation of the prostate gland, leading to disruption of the morphology and functioning of the prostate. It manifests itself as a prostatic triad: pain in the pelvis and genitals, urinary disorders, sexual disorders. Diagnostics includes palpation of the gland, examination of prostate secretions, ultrasound, uroflowmetry, urethroscopy, and puncture biopsy of the prostate gland. Complex medication and physiotherapeutic treatment, prostate massage, and instillation of the posterior urethra are indicated. Surgical intervention is advisable for complicated forms of chronic prostatitis.

ICD-10

N41.1

General information

Chronic prostatitis is the most common male disease: about 50% of men suffer from some form of prostate inflammation. Chronic prostatitis most often affects men aged 20 to 40 years, who are in the period of greatest sexual, reproductive and labor activity. In this regard, the identification and treatment of chronic prostatitis in modern andrology acquires not only a medical, but also a socially significant aspect.

Causes

However, for the development of chronic prostatitis, it is not so much the presence and activity of microorganisms that is important, but the state of the pelvic organs and blood circulation in them, the presence of concomitant diseases, and the level of protective mechanisms. Therefore, a number of factors can contribute to the occurrence of chronic prostatitis. First of all, these are urological diseases - pyelonephritis, cystitis, urethritis, urethral stricture, uncured acute prostatitis, orchitis, epididymitis, etc.

A microbial etioagent can enter the prostate from distant foci of infection, for example, in the presence of sinusitis, tonsillitis, caries, chronic bronchitis, pneumonia, pyoderma, etc. Local and general hypothermia, overheating, exposure to a humid environment, fatigue, and poor nutrition predispose to chronic inflammation. , rare urination, etc.

Non-bacterial chronic prostatitis is usually associated with congestive (congestive) phenomena in the prostate gland, caused by stasis of the venous circulation in the pelvic organs and impaired drainage of the prostate acini. Local congestion leads to overflow of the prostate vessels with blood, swelling, incomplete emptying of secretions, disruption of the barrier, secretory, motor, and contractile functions of the gland.

Stagnant changes are usually caused by behavioral factors: prolonged sexual deprivation, the practice of interrupted or prolonged sexual intercourse, excessive sexual activity, physical inactivity, chronic intoxication, occupational hazards (vibration). The development of non-bacterial inflammation is predisposed by pathology of the pelvic organs and the nervous structures that innervate them (for example, spinal cord injuries), prostate adenoma, hemorrhoids, constipation, androgen deficiency, and other causes.

Classification

According to the modern classification of prostatitis, developed in 1995, there are three categories of the disease:

• II. Chronic prostatitis of bacterial origin.
• III. Inflammation of non-bacterial origin / pelvic pain syndrome is a symptom complex that is not associated with obvious signs of infection and lasts for 3 or more months.
• III A. Chronic process with the presence of an inflammatory component (detection of leukocytes and infectious agents in the prostate secretion);
• III B. Chronic pathology with the absence of an inflammatory component (leukocytes and pathogens in the prostate secretion).
• IV. Asymptomatic chronic prostatitis (no complaints when leukocytes are detected in prostatic secretions).

In the presence of an infectious component, they speak of bacterial (infectious) chronic prostatitis; in the absence of microbial pathogens – non-bacterial (non-infectious). It is believed that in 90-95% of all cases there is non-bacterial inflammation and only in 10-5% - bacterial inflammation.

Symptoms of chronic prostatitis

The disease manifests itself with local and general symptoms. Local manifestations include the prostatic triad, characterized by pain, dysuria and sexual dysfunction. The pain is constant, aching in nature, localized in the perineum, genitals, above the pubis, in the groin. The pain syndrome intensifies at the beginning and end of urination, with pain radiating to the head of the penis, scrotum, sacrum, and rectum.

Pain may increase after sexual intercourse or due to prolonged abstinence; weaken or intensify after orgasm, become more intense immediately at the moment of ejaculation. The intensity of the pain syndrome varies from sensations of discomfort to severe manifestations that disrupt sleep and performance. Pain with limited localization in the sacrum is often regarded as osteochondrosis or radiculitis, and therefore the patient can be treated independently for a long time, without resorting to the help of a doctor.

Urination is frequent and painful. In this case, there may be difficulty in starting voiding, weakening or intermittency of the urine stream, a feeling of incomplete emptying of the bladder, frequent urges at night, and a burning sensation in the urethra. The presence of floating threads can be detected in the urine. After defecation or physical activity, discharge (prostatorrhea) appears from the urethra, caused by a decrease in prostate tone. There may be itching, a feeling of cold or increased sweating in the perineum, local changes in skin color associated with stagnation of blood circulation.

Chronic prostatitis is accompanied by severe sexual dysfunction. The phenomena of dyspotence can be expressed in deterioration, painful erection, prolonged and frequent nocturnal erections, difficulty or early ejaculation, loss of sexual desire (decreased libido), erased orgasms, hemospermia, infertility. Sexual disorders are always difficult for a man to experience and lead to psycho-emotional disorders, including neurosis and depression, which further worsen sexual function.

Exacerbations are accompanied by a slight increase in body temperature and deterioration in well-being. The general condition is characterized by increased irritability, lethargy, anxiety, fatigue, loss of appetite, sleep disturbance, decreased ability to work, creative and physical activity. Almost a quarter of patients have no symptoms of the disease for a long time, which leads to a late visit to an andrologist.

Complications

Diagnostics

The information necessary for the diagnosis of chronic prostatitis is obtained through a comprehensive laboratory and instrumental examination. The primary examination includes clarifying the anamnesis and complaints, conducting an external examination of the genitals for discharge, rashes, irritations, and a digital rectal examination of the prostate in order to determine the contours, boundaries, consistency, and soreness of the gland.

To determine structural and functional changes in the prostate gland, prostate ultrasound (TRUS) is indicated. Important methods in the diagnosis of chronic prostatitis are the study of prostate secretions, general urine analysis, bacteriological examination of a smear from the urethra and urine, a 3-glass urine sample, PCR and RIF examination of scrapings for pathogens of sexually transmitted infections, determination of prostate-specific antigen (PSA). Clinically significant is the detection of causative agents of chlamydia, mycoplasmosis, herpes, cytomegalovirus, trichomoniasis, gonorrhea, candidiasis, as well as nonspecific bacterial flora.

Collection of prostate secretions for examination is carried out after urination and massage of the prostate gland. Signs of the disease are an increase in the number of leukocytes in the field of view, a decrease in the number of lecithin grains, and the presence of pathogenic microflora. A general urine test may reveal leukocyturia, pyuria, and erythrocyturia. Bacteriological culture of urine allows us to identify the degree and nature of bacteriuria. In case of reproductive disorders, a spermogram and MAR test are indicated.

The degree and causes of urination disorders can be determined by urodynamic studies (uroflowmetry, cystometry, profilometry, electromyography). With the help of these studies, chronic prostatitis can be differentiated from stress urinary incontinence, neurogenic bladder, etc. For hematuria, hemospermia, and obstructive urination, endoscopic examination is indicated - urethroscopy, cystoscopy. To exclude adenoma and prostate cancer, a PSA determination is required, in some cases a prostate biopsy with morphological examination of tissue is required.

Treatment of chronic prostatitis

The disease is not easy to cure, but it should be remembered that recovery is still possible and largely depends on the patient’s mood, the timeliness of his contact with a specialist, and the strict adherence to all the urologist’s instructions. The basis for the treatment of a bacterial inflammatory process is antimicrobial therapy in accordance with an antibiogram lasting at least 2 weeks. To reduce pain and inflammation, NSAIDs (diclofenac, ibuprofen, naproxen, piroxicam) are prescribed; To relax the muscles of the prostate, restore urodynamics and outflow of prostatic secretions, the use of a-blockers (tamsulosin, alfuzosin) is indicated.

In order to improve drainage of the prostate gland, local microcirculation and muscle tone, a course of therapeutic prostate massage is carried out. A prostate massage session should end with the release of at least 4 drops of prostate secretion. Prostate massage is contraindicated in acute bacterial prostatitis, prostate abscess, hemorrhoids, prostate stones, rectal fissures, prostate hyperplasia and prostate cancer.

To relieve pain, paraprostatic blockades and acupuncture may be recommended. Physiotherapy is important in treatment with the prescription of medicinal electrophoresis, ultrasound, ultraphonophoresis, magnetic therapy, laser magnetotherapy, inductometry, mud therapy, SMT, hot sitz baths at a temperature of 40 - 45 ° C, enemas with hydrogen sulfide and mineral waters, instillations into the urethra.

If complications develop, surgical treatment is indicated: elimination of urethral strictures; TUR of the prostate or prostatectomy for prostate sclerosis; transurethral resection of the bladder for sclerosis of its neck, puncture and drainage of prostate cysts and abscesses; circumcision for phimosis caused by recurrent urinary tract infections, etc.

Prognosis and prevention

The prognosis is determined by the timeliness and adequacy of treatment, the patient’s age, and the presence of concomitant pathologies. Prevention of the disease requires compliance with sexual hygiene, timely treatment of urogenital and extragenital infections, normalization of the regularity of sexual life, sufficient physical activity, prevention of constipation, and timely emptying of the bladder. To exclude relapses, dynamic examinations by an andrologist (urologist) are necessary; preventive courses of physiotherapy, multivitamins, immunomodulators; exclusion of hypothermia, overheating, stress, bad habits.

Long-term inflammation of the prostate gland, which periodically worsens, is called chronic prostatitis. A constant inflammatory process directly affects the functioning of the prostate.

Chronic prostatitis is the most common pathology in men, which is observed in almost 30% of the stronger sex.

Chronic prostatitis.

Classification of chronic prostatitis

• Acute course of prostatitis.
• Bacterial chronic prostatitis.
• Chronic prostatitis is not bacterial in nature. Accompanied by chronic pelvic pain syndrome - symptoms not associated with the presence of infection. Lasts three months or longer.
• III A – chronic prostatitis with the presence of an inflammatory component (infectious agents and leukocytes were found in the prostate secretion).
• III B – chronic prostatitis with the absence of an inflammatory component (pathogens and leukocytes were not found in the prostate).
• Chronic prostatitis is asymptomatic (no symptoms in the presence of leukocytes in the prostate secretion).

The risk of disease is increased in people

1. Who lead an irregular intimate life, and also practice interrupted sexual intercourse as a way to prevent unwanted pregnancy.
2. Office workers and drivers (a sedentary lifestyle causes blood stagnation in the pelvis).
3. Who wear tight underwear.
4. Those with alcohol and nicotine addiction.

Causes

Bacterial prostatitis

Bacterial prostatitis.

• Hereditary predisposition.
• Regular hypothermia.
• Long-term abstinence.
• Delayed emptying of the bladder.
• Sedentary lifestyle.
• Diseases of the genitourinary system (urethritis, pyelonephritis, cystitis).
• Sexually transmitted diseases: chlamydia, gonorrhea, trichomoniasis.

Not bacterial inflammation

Venous congestion in the pelvis, provoked by a sedentary lifestyle.

• Stagnation of blood in the veins, provoked by a sedentary lifestyle.
• Wearing tight pants, underwear or shorts.
• Congestion caused by constant compression of the perineum.
• Irregular sex life. Sexual intercourse increases blood circulation in the veins of the prostate.
• Alcohol, nicotine, drug addiction.
• Sedentary lifestyle.

Symptoms

Painful syndrome in the lower abdominal cavity.

• Weak stream of urine, discomfort during urination.
• Feeling of the bladder not emptying.
• Sharp periodic pain.
• Painful syndrome in the lower abdominal cavity.
• Pain in the perineum, radiating to the scrotum.
• Decreased libido, weak erection, rapid ejaculation. Morning involuntary erection periodically disappears or is absent altogether.
• After intimacy, aching pain may appear in the head of the penis, which goes away after about half an hour.

Complications

Potency disorders (irregular erection, impotence, weak ejaculation or its complete absence, etc.).

Diseases that provoke the development of chronic prostatitis:

• Vesiculitis (inflammation of the appendages, seminal vesicles, testicles).
• Potency disorders (irregular erection, impotence, weak ejaculation or its complete absence, etc.).
• Infertility. The cause may be complications of diseases or psychological problems.
• Prostate cancer. The number of free radicals in chronic prostatitis may increase, which can trigger the growth of cancer cells.
• Prostate sclerosis. Changing the size and compaction of organ tissue affects its functioning. Regular retention of urine in the bladder and malfunctioning of the urethra are the main causes of the pathology.
• Psychological problems. Decreased libido, erectile dysfunction and other signs of chronic prostatitis lead to a man’s self-esteem decreasing and he is in constant stress. The patient may experience depression, nervous breakdowns, irritability, etc.

Diagnostics

If symptoms are present, diagnosing chronic prostatitis will not be difficult. In case of asymptomatic pathology, in addition to a standard examination or questioning of the patient, the use of additional research methods is required: laboratory and instrumental. It is imperative to determine the state of the patient’s immune and nervous systems.

Questionnaires and questionnaires allow you to obtain complete information about the patient’s health status, pain intensity, urination disorders, ejaculation, erection and psycho-emotional mood.

Laboratory diagnostics

Scraping from the urethra.

Laboratory diagnostic methods make it possible to determine the nature of chronic prostatitis: bacterial or abacterial, and also to determine the type of pathogen as accurately as possible. If in the fourth urine sample or prostate secretion the leukocyte count in the prostate is above 10, chronic inflammation of the gland is confirmed. If bacteria are not sown when leukocytes are elevated, the material is examined for the presence of STD pathogens (Sexually Transmitted Diseases).

• A smear from the urethra is examined in the laboratory for the presence of leukocytes, fungal, viral or bacterial flora.
• A scraping from the urethra is examined using PCR to detect pathological microorganisms that are sexually transmitted.
• A microscopic examination of prostate secretion is performed. The number of leukocytes, amyloid bodies, macrophages and Trousseau-Lallement is counted. In addition, immunological and bacteriological studies are carried out, with the help of which the amount of nonspecific antibodies is determined.
• Ten days after the digital rectal examination, blood is taken to determine its PSA level. If the level exceeds 4.0 ng/ml, then the patient is prescribed a prostate biopsy to confirm or exclude the presence of a malignant tumor in the gland.

The diagnosis is made based on the results of the studies.

Instrumental diagnostics

Ultrasound device.

TRUS of the gland allows you to identify the form and stage of the pathology. Ultrasound helps to exclude other diseases, monitor the effectiveness of the therapy used, determine the size of the prostate, the echo structure of the organ, as well as the density and uniformity of the seminal vesicles. Myography and urodynamic studies of the pelvic floor muscles help identify neurogenic disorders that often accompany chronic prostatitis.

CT, tomography and MRI are used to establish a differential diagnosis, in particular, prostate cancer. These methods will help identify pathologies in the pelvic organs or spinal column.

Treatment of chronic prostatitis

Medication

Folk remedies

1. Pumpkin seeds. Raw pumpkin seeds are peeled. Take 20 pieces before meals three times a day, for three to four months.




Pumpkin seeds.

2. Camomile tea. It is recommended to prepare daily in quantities sufficient for daily consumption. Place 30 g of chamomile in a bowl and pour boiling water (200 ml) over it. After leaving for half an hour, strain, carefully squeezing out the flowers. Divide the infusion into equal parts and drink the day before. The product eliminates pain and relieves inflammation in the male gland.




Chamomile infusion.

3. 500 ml linden honey. Take 500 g of honey, aloe leaves and red wine. In a glass bowl, combine honey, crushed aloe and wine. Leave in the refrigerator for a week. Drink a teaspoon of tincture before meals.




Linden honey.

4. Infusion of celandine. Take a drop of juice for half a glass of boiled water. Drink the solution in the morning after breakfast. Increase the dosage by one drop daily. The maximum dose is 30 drops. Then reduce the dosage by one drop per day. At the end of the course, take a two-week break, after which the medicine can be taken again.




Infusion of celandine.

5. Parsley juice. To treat chronic prostate problems, finely chop the stems and leaves of parsley or grind them in a mortar. Place the mixture on cheesecloth and strain the resulting juice. Take the medicine before meals, preferably 30 minutes before. The dose of juice per reception is one or two tablespoons. Frequency of administration three times a day.




Parsley juice.

6. Propolis. Propolis tincture with alcohol is taken for chronic prostatitis for six months. Grate 100 g piece of propolis on a fine grater. Pour 200 ml of pure medical alcohol into the crushed mass. Place the solution in a glass container and store for at least 10 days in a dark place, shaking every three days. Strain the tincture.




Propolis.

Suppositories made from propolis reduce inflammation in the gland, relieve pain and restore all cells of the organ. Freeze 7 grams of propolis and finely grate. Melt one hundred grams of goat fat and combine it with propolis. Make candles from the cooled mixture, 1.5 - 2 cm long.

Diet

Proper nutrition for inflammation of the prostate gland is the path to recovery.

If you have chronic prostatitis, you should not go to extremes and exclude any foods. Nutrition must be complete so that a man can receive all the necessary vitamins, minerals and nutrients. Dietary restrictions can cause the gland to not receive the important elements it needs to function. The diet of a patient with chronic prostatitis should consist of easily digestible foods so that the body does not spend a lot of effort on digesting food. The body needs strength to fight pathology. It is not recommended to practice fasting without consulting a specialist. Refusal to eat will lead to loss of strength, which is unacceptable for a patient suffering from chronic prostatitis. It is recommended to carry out fasting days. Poor nutrition can disrupt the functioning of the prostate gland, so adjusting the daily diet is part of the course of therapy.

Surgical treatment

Surgical intervention is performed only if the development of pathology poses a threat to the life and health of a man.

Endoscopic intervention– a modern method of surgical treatment in which invasive intervention is minimized. The patient's rehabilitation occurs faster. indicated for blockage of the excretory and seminal ducts, sclerosis of the seminal tubercle. The operation is indicated for diagnosing sclerosis of the prostate and seminal vesicle, the presence of calcifications in the gland, and adenoma. If during the operation the secretion is thick, serous-purulent and viscous, then the gland is completely removed using electrical resection, performing pinpoint coagulation of the vessels and installing a trocar cystostomy. In case of exacerbation of the pathology, surgical intervention is strictly contraindicated.

Physiotherapeutic treatment

Physiotherapy for prostatitis is prescribed by a doctor, based on factors such as the patient’s age, form of the disease, and the presence of other serious diseases.

1. Thermotherapy— using specific equipment, controlled, uniform heating of the male gland and urethra is performed. The procedure is carried out using the transuretal or transrectal method, when heating is carried out through the rectum or urethra. Thermal effects enhance local arterial and capillary blood flow, increase the number of functionally active capillaries, increase the body's protective properties, maximally stimulate lymph flow and the removal of harmful particles, and optimize local metabolism.
2. Laser therapy— the course of treatment is determined individually, depending on the form and stage of the pathology. On average, five to seven procedures are enough. They act on the organ through the skin or transrectally. Promotes speedy recovery and relief of symptoms.
3. Needle ablation— outpatient minimally invasive intervention. Used to eliminate the symptoms of prostatitis.

Other treatments

Prostate massage.

1. Prostate massage- Helps cure and prevent the development of the disease. The procedure is performed by a specialist using antiseptics and aseptics to prevent infection from entering the organ. It can cause acute urinary retention and the spread of inflammation (even sepsis) if hyperplastic changes are observed in the organ. Massage is contraindicated in cases of severe stagnation of blood in the veins, stones and cysts in the prostate. The best way to rid the prostate of stagnant secretions is natural ejaculation.
2. Bladder exercises- when the muscle tone of the bladder and its sphincter is weakened, urinary incontinence occurs. To eliminate these symptoms, special exercises are effective.
3. Instillation- medications are infused into the back of the urethra. To make the procedure painless, local anesthesia is performed. The number of sessions is determined individually by the specialist. May lead to complications.

Are you drafted into the army with prostatitis?

Prostatitis is not included in the list of diseases that are an obstacle to compulsory military service. A man is not subject to conscription only if he must undergo treatment in a hospital at least three times a year according to the testimony of a specialist.

How to live with chronic prostatitis

Chronic prostatitis is not a death sentence.

Men who regularly undergo treatment for chronic prostatitis lead a normal lifestyle. They do not have problems with ejaculation and erection. A man suffering from a chronic form of prostatitis may not limit his intimate life. If there is no discomfort or pain during sexual intercourse, it will not only do no harm, but will also be extremely beneficial! However, it is worth remembering that an overly active sex life can lead to an exacerbation of the pathology. If the prostate inflammation has not spread to nearby internal organs, there should be no problems conceiving children. If sperm is released during sexual intercourse, conception is possible. It is advisable to undergo a spermogram analysis to determine sperm viability.

Prevention

Simple rules for the prevention of chronic prostatitis:

• The chronic stage is always a consequence of late diagnosed, incorrectly treated or untreated acute prostatitis. Therefore, you need to undergo regular medical examinations with a urologist.
• Protect the pelvic area from hypothermia and injury.
• Get rid of nicotine and alcohol addiction.
• To live an active lifestyle.
• Avoid stressful situations.

Any man between the ages of 20 and 50 can develop chronic prostatitis. It is necessary to follow simple preventive measures to reduce the risk of developing pathology.

Chronic prostatitis– one of the most common diseases among mature men. Inflammation of the prostate gland significantly reduces the quality of life, causing psychosomatic and sexual disorders. The lack of sufficient information about the nature of this disease makes the treatment of chronic prostatitis a difficult task, requiring a lot of patience from both the patient and his attending physician.

Prostatitis is an inflammatory and degenerative lesion of the prostate gland

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The American National Institute of Health (NIH USA) has developed and proposed the following classification chronic prostatitis:

• chronic bacterial prostatitis;
• chronic non-bacterial prostatitis (with and without signs of inflammation);
• chronic asymptomatic prostatitis.

Modern andrologists adhere to this classification in the diagnosis and treatment of inflammatory diseases of the prostate. Acute prostatitis is distinguished separately. Knowing which category the identified pathology belongs to, the doctor will be able to select the optimal treatment regimen and achieve significant success in treating the disease.

Causes and risk factors

The division into bacterial and non-bacterial chronic prostatitis is not accidental. Various causes of the disease determine treatment tactics and largely influence the outcome of the disease.

Chronic bacterial prostatitis

Chronic bacterial prostatitis is detected in 10-15% of patients. The direct cause of the development of the disease is the penetration of pathogenic and opportunistic flora into the prostate. By definition, the prostate gland is free of bacteria. Infection of the prostate is possible through the urethra, as well as hematogenously and lymphogenously. During examination, the following microorganisms are most often detected:

• E. coli (up to 95%);
• Proteus;
• Klebsiella;
• pseudomonas.

Representatives of gram-positive flora (staphylococci, streptococci) are quite rare. In some cases, there is a growth of two or more microorganisms (mixed infection). Infection with pathogenic flora (chlamydia, gonococci, etc.) is possible.

The microorganisms detected during the examination are mostly representatives of normal microflora. Under normal conditions, they do not cause harm to the body and exist peacefully on the mucous membranes of the urinary system and digestive tract. Under certain conditions, opportunistic flora grows and multiplies, which leads to inflammation of the prostate tissue and the appearance of all symptoms of the disease.

Risk factors development of chronic bacterial prostatitis:

• lack of personal hygiene;
• hypothermia;
• genital injuries;
• inflammatory diseases of the urinary system;

All this leads to a decrease in local and general immunity and the natural proliferation of opportunistic flora in the prostate. It is possible that infection can occur through the urethra due to inflammatory diseases of the genital tract. The likelihood of developing prostatitis increases with existing...

Chronic nonbacterial prostatitis

There are several theories regarding the occurrence of this form of the disease:

1. Chemical inflammation theory. The reflux of urine into the prostate during urination leads to the deposition of urates and the development of inflammation. Urethro-prostatic reflux is promoted by narrowing of the urethra () and other developmental anomalies.
2. Immune theory. The version is based on autoimmune damage to prostate tissue as a result of exposure to bacterial antigens. The hereditary predisposition to this form of pathology is considered.
3. Neurogenic theory. Disruption of innervation in the pelvic area provokes and leads to the development of prostatitis.

In the development of non-bacterial prostatitis, the following also deserve special attention: risk factors:

• long sedentary work;
• sedentary lifestyle;
• bad habits;
• stress and emotional overload;
• long-term sexual abstinence (see).

These risk factors provoke the development of congestion in the prostate and lead to disruption of microcirculation in the pelvic organs. The microbial factor plays a role only in the initial stages of disease development. In the future, its importance decreases, and autoimmune processes and trophic disorders in the tissues of the prostate gland come to the fore.

According to statistics, 85-90% of men are diagnosed with non-bacterial chronic prostatitis (not directly related to infection with pathogenic or opportunistic bacteria).

Symptoms

Chronic prostatitis occurs mainly in men aged 25-40 years. With age, the likelihood of developing the disease increases. In old age, inflammation of the prostate gland is often combined with adenoma - a benign tumor of the prostate.

Signs chronic prostatitis:

• dull aching pain in the lower abdomen;
• irradiation of pain to the groin area, scrotum, perineum, lower back, sacrum;
• increased discomfort during sexual intercourse and during bowel movements.

Very typical urinary disorders:

• frequent urination;
• excretion of urine in small portions;
• the appearance or intensification of pain when urinating;
• sluggish and intermittent stream of urine.

The last symptom is characteristic of prostate adenoma, which often occurs against the background of chronic prostatitis.

With a long course of the disease, disorders in the sexual sphere are noted:

• decreased libido;
• deterioration of erection;
• reducing the duration of sexual intercourse;
• nagging pain in the lower abdomen after ejaculation;
• lack of spontaneous morning erection.

Chronic prostatitis is one of the leading causes of erectile dysfunction, in which a man cannot achieve and maintain an erection sufficient for full sexual intercourse. This condition significantly disrupts the course of life and can cause depression and other psycho-emotional disorders.

Chronic asymptomatic prostatitis occurs without any clinical manifestations. The disease is detected by chance during an examination by a urologist. Despite the absence of symptoms, inflammation of the prostate gland can lead to serious complications, causing erectile dysfunction and other health problems.

Complications

Advanced prostatitis provokes the development of the following conditions:

• prostate abscess;
• cystitis and pyelonephritis (inflammation of the bladder and kidneys);
• vesiculitis (inflammation of the seminal vesicles);
• erectile disfunction;
• infertility.

The sooner the disease is identified and treatment is started, the greater the chances of a favorable outcome of the disease.

Diagnostics

The following methods are used to identify chronic prostatitis:

Examination by a urologist

During a personal appointment, the doctor focuses on the patient’s complaints. The external genitalia must be examined and performed. During palpation, the doctor assesses the size and shape of the gland. In the case of chronic prostatitis, the organ will be slightly enlarged in size. The procedure is combined with collection for microbiological examination.

Four-glass sample

The main method for identifying the inflammatory process in the prostate and distinguishing it from other diseases. The collection of material takes place in several stages. In the morning, after abstaining from going to the toilet for 5-6 hours, a man urinates in two jars - for the first (initial) and for the second (middle) portion of urine. In the first portion, the contents of the urethra are washed away, in the second - the contents of the bladder. The third portion of urine is collected after prostate massage and allows you to assess the condition of the prostate gland. Separately, prostate secretions are collected for bacteriological culture.

A urine test evaluates two parameters: the number of white blood cells and red blood cells. With prostate diseases, the level of leukocytes increases in the third portion of urine. Normally, their number does not exceed 10 in the field of view.

Microbiological examination

When conducting a three-glass test, not only the number of leukocytes is assessed, but also material is taken for bacteriological culture. If chronic prostatitis is suspected, the doctor is especially interested in the third portion of urine. Based on the examination results, the doctor can identify the causative agent of the disease and select the optimal antibacterial therapy.

Of diagnostic importance is the detection of opportunistic bacteria in a titer of more than 10 3 CFU/ml or the detection of clearly pathogenic microorganisms in any quantity.

Bacteriological culture of prostate secretion

Bacteriological culture of prostate fluid makes it possible to assess the nature of the process (infectious or not) and determine the type of pathogen

Before collecting the third portion of urine during a prostate massage, the doctor takes the secreted secretion for bacteriological examination. The obtained result also allows you to determine the diagnosis and treatment tactics.

Diagnostic criteria for chronic bacterial prostatitis:

• Detection of opportunistic microorganisms in the third portion of urine or prostate secretion in a titer above 10 3 CFU/ml.
• Detection of opportunistic bacteria in the third portion of urine or prostate secretion, the number of which is significantly (10 times) higher than in the second portion of urine.
• Detection of pathogenic microorganisms in the third portion of urine or prostate secretion.

Ultrasound

Ultrasound examination allows you to assess the size of the organ and identify concomitant pathologies. Often chronic prostatitis is combined with.

Principles of treatment

The goal of therapy for chronic prostatitis is to eliminate the inflammatory process, activate blood flow and improve nutrition of the organ. When pathogenic or conditionally pathogenic microorganisms are detected in high titers, their elimination is carried out. Particular attention is paid to lifestyle correction and stimulation of the body's defenses.

Drug treatment

The following are used to treat chronic prostatitis: medicines:

• are selected taking into account the identified pathogen.
• Anti-inflammatory drugs to reduce inflammation and relieve pain.
• Means that facilitate urination (relax the muscles of the urethra and stimulate the outflow of urine.).
• Drugs that increase blood flow in the pelvic organs.

The choice of antibiotic will depend on the pathogen identified. When choosing a drug, one should take into account its ability to penetrate the blood-prostatic barrier and accumulate in the tissues of the prostate gland. These conditions correspond to drugs from the group of fluoroquinolones. Macrolides and tetracyclines are also used to treat chronic prostatitis.

Upon receipt of the results of bacteriological examination and confirmation of the bacterial nature of the disease, treatment continues for up to 4-6 weeks. This approach allows not only to get rid of the causative agent of the disease, but also to prevent relapse of prostatitis.

Unfortunately, antibacterial therapy is not always effective. Many microorganisms exist safely in the prostate secretion for a long time and become resistant to antibiotics. Bacteria form special biofilms and form colonies of microorganisms covered with a complex polysaccharide structure. Antibacterial drugs for the most part are not able to penetrate this biological barrier, which significantly reduces the effectiveness of the therapy. This problem can be avoided by the use of modern antibiotics, which are capable of not only penetrating the prostate tissue and heating it, but also passing through biofilms and infecting bacteria that are under such serious protection.

Non-drug therapy

Among non-drug treatment methods, special attention is paid. The procedure stimulates blood supply to the prostate gland, eliminates congestion and facilitates the removal of secretions. A combination of massage and long-term use of antibacterial drugs is the main way to relieve a man of the unpleasant symptoms of chronic prostatitis.

How does chronic prostatitis affect potency?

Chronic inflammation of the prostate gland threatens the development of erectile dysfunction. With this pathology, there is a decrease in sexual desire, the frequency and strength of erections decreases, and orgasms become painful. In advanced cases, sexual life becomes impossible.

Is it possible to cure chronic prostatitis without antibiotics?

Antibacterial therapy is considered one of the key methods of treating chronic prostatitis. In most cases, it is impossible to cope with the disease without antibiotics.

Is it possible to cure chronic prostatitis with folk remedies?

It is not possible to get rid of chronic prostatitis using traditional medicine methods alone. To achieve the optimal effect, complex treatment is carried out using antibiotics, herbal preparations, anti-inflammatory drugs and physiotherapy methods.

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Unfortunately, more and more often young men, and sometimes even teenagers, are diagnosed with chronic.

It is a consequence of frequent inflammation of the prostate gland and transition to a chronic latent form.

The disease is characterized by long-term development with uncharacteristic symptoms, which are usually blurred or virtually absent. Although it is believed that chronic prostatitis inevitably occurs against the background of the acute stage, in practice this form of the disease is often detected by chance during routine examinations.

The symptoms of the disease depend on the nature of the inflammatory process, the duration of the disease, the degree of damage to neighboring organs, and. The type of life (active or passive) a man leads also plays an important role.

Causes that provoke the occurrence of a chronic form of the disease:

• infection of the genitourinary system and prostate gland (ureaplasmosis, chlamydia, candidiasis, mycoplasmosis, gonococcal and herpesvirus infections);
• disruption of blood flow in the pelvis, which leads to;
• decreased immunity of various etiologies;
• physical inactivity and sedentary work;
• irregular intimate life, interruption of sexual intercourse without orgasm;
• overwork, injuries and damage;
• abuse of alcohol and spicy foods;
• urinary retention and stool disturbance ().

All these reasons lead to stagnation and inflammation. They facilitate the penetration of infections, and this can lead to complications, as well as impotence and complete infertility.

Chronic prostatitis is divided into three main types:

• bacterial, in which an infection is detected;
• when the secretion contains no pathogenic microflora;
• prostatodynia, when symptoms characteristic of the chronic form of prostatitis are present, but pathological changes in the prostate secretion are not detected (this is called chronic pelvic pain syndrome).

Symptoms of chronic prostatitis:

• pain and cramping in the rectum during bowel movements;
• and the inability to completely empty the bladder;
• decrease and erections;
• pulling sensations in the sacral and groin areas;
• dullness of sensations or their complete absence during orgasm.

There is also an asymptomatic form of the disease. Often it does not manifest itself for a long time and is determined by the results, as well as by laboratory tests of prostate secretions.

If at least one of the signs appears, a man should consult a doctor and undergo the examinations that he prescribes.

How to cure chronic prostatitis?

Treatment of chronic prostatitis is one of the most difficult challenges facing modern medicine.

The disease occurs in a latent form and is not always detected at the initial stage.

Men consult a doctor when symptoms of exacerbation with complications appear. Therefore, treatment depends on the phase of the disease, the degree of bacterial or viral damage and the nature of the pathological process.

To completely cure a patient, it is necessary to carry out a whole. Only this approach allows you to achieve a positive result.

Effective medications and their use regimen

For the treatment of bacterial chronic prostatitis, they are used that can suppress pathogenic microflora.

Thus, antibacterial drugs of such groups as fluoroquinolones (, Moxifloxacin), macrolides (Erythromycin, Spiramycin), tetracyclines (, Oxytetracycline), cephalosporins ().

Tavanic tablets

In the chronic form of the disease, antibacterial drugs are used for quite a long time to achieve a good therapeutic effect. The duration of treatment depends on many factors; the required period of therapy can vary from 2 to 6 weeks.

Also, to treat the chronic form of the disease, medications are needed that improve blood flow, relieve congestion, antispasmodics and painkillers.

Medicines used for the chronic form of the disease include:

• , which has an antiandrogenic, vasoprotective effect. Used in the treatment of non-bacterial chronic prostatitis and;
• , which improves the condition of the prostate gland and microcirculation, reduces the degree of edema, prevents thrombus formation and normalizes the secretory function of epithelial cells;
• , which has wound healing, anti-inflammatory and regenerating effects;
• , which has a locally irritating and pronounced vasodilating effect.

Only a doctor can prescribe drug therapy; you cannot self-medicate with prostatitis.

Rectal massage of the prostate gland

An effective method to cure chronic prostatitis is. It can be done in and even.

The most effective way is a bougie massage. A special device is inserted into the urethra, after which light massaging movements are performed.

A similar procedure should be performed by a specialist in a hospital setting. through the anus using a finger with a full bladder. The prostate is in contact with the anterior wall of the rectum and is located 5 cm from the anus.

Most doctors believe that rectal massage should be done in a hospital setting to prevent complications and achieve maximum therapeutic effect.

Therapeutic gymnastics and physiotherapy

Many men consider rectal massage unacceptable for themselves, despite its effectiveness. For this category of patients, doctors have developed special physical procedures.

Physiotherapeutic treatment methods include:

• hydromassage;
• acupuncture and stimulation of the sacrum and lumbar region;

Exercises and physical procedures are selected individually in each case, since there are some contraindications, and only a specialist will help prescribe a safe and effective method.

Principles of nutrition

In the chronic form of the disease, therapeutic diet therapy deserves special attention.

The principles and goals of the diet are as follows:

• minimize irritating factors so as not to provoke additional inflammation;
• ensure normal blood supply and prevent the occurrence of atherosclerosis;
• if possible, reduce the frequency of urination;
• normalize the functioning of the gastrointestinal tract;
• boost immunity.

• alcohol;
• carbonated drinks;
• smoked meats, butter, as well as fatty meats and rich broths;
• spicy, sour and highly salty foods;
• mushrooms, liver, kidneys and semi-finished products;
• foods that cause increased gas formation (legumes, cauliflower).

But it is useful to use:

• all types of dairy products, especially homemade cottage cheese, yogurt;
• fresh juices and compotes;
• fish and lean meat;
• porridge;
• products containing (seafood, pumpkin seeds).

The diet should be varied and balanced in nutrients; to select a diet, it is better to consult a nutritionist.

How to get rid of an illness using folk remedies?

They have also worked well for chronic prostatitis. They are simple and safe, but still, any method has its own indications and contraindications, which is determined by the individual characteristics of the body and the presence of concomitant diseases.

In folk medicine it is widely used:

• drinking fresh juices of carrots, beets, cucumbers, elderberries;
• use with coniferous pine concentrate;
• microenemas and suppositories with other medicinal herbs;
• honey therapy, use.

It is also useful to consume pumpkin seeds, which have a stimulating effect on the prostate gland and contain all the necessary microelements for its normal functioning.

There are many effective folk methods for getting rid of chronic prostatitis, but first you need to consult a doctor.

Surgical methods of therapy

In cases where drug therapy and other complex conservative treatment methods do not give the desired result, and at the same time negative dynamics of the pathological process are observed, surgical intervention is resorted to.

Types of operations for chronic prostatitis:

• drainage, used for purulent inflammation and;
• resection, which involves removing part of the gland. With this option, surgical access is carried out through an incision or punctures on the abdomen, through the urethra;
• when the gland is completely removed. Used in extreme cases, mainly for malignant adenoma;
• circumcision- a rare and not always effective method of surgery that involves cutting off the foreskin.

Surgical intervention for chronic prostatitis is a last resort; in order not to lead to such a condition, it is necessary to consult a doctor at the first symptoms.

Approximate cost of a course of medication treatment

The treatment of chronic prostatitis is so individual and varied that pricing is influenced by many factors; the cost of therapy can vary within very wide ranges.

It all depends on the ongoing process, the duration of the required treatment, the medications and procedures used. Therefore, in each specific case the price will be individual.

Possible consequences of repeated inflammation

Under unfavorable conditions, the inflammatory process can recur. Frequent exacerbations of the disease lead to irreversible changes and serious complications.

Not only pain and discomfort occur, the entire genitourinary and reproductive systems suffer, potency may decrease, or complete impotence may occur.

And in advanced forms, cancer (adenoma) develops as a consequence. We must remember that any disease is easier to prevent than to treat, especially in a chronic form.

Strengthen immunity;

avoid, if necessary, take sedatives of natural origin (valerian, motherwort, peony).