The causes of chronic prostatitis are generally similar to those of acute bacterial prostatitis. The ingress of microorganisms into the prostate in most cases occurs through the urethra - as a result of the throwing of urine into the ducts of the prostate gland (intraprostatic reflux of urine).
- Discomfort or pain - in the perineum, lower abdomen, groin, scrotum, penis, during ejaculation
- Changes in urination - difficulty urinating, frequent urination in small portions, a feeling of incomplete emptying of the bladder.
- The patient may complain about a number of symptoms, or about a symptom in isolation. An increase in body temperature is uncharacteristic (or insignificant).
The standard method for diagnosing prostatitis is to perform a 4-glass Meares-Stamey test. This is a microscopic and bacteriological examination of urine samples obtained from different parts of the genitourinary tract and prostate secretions. A possible alternative is the delivery of the ejaculate (sperm) for microscopic and bacteriological examination, since the ejaculate partially (at least 1/3) consists of the prostate gland. This method is more comfortable for patients, especially if they categorically refuse a rectal examination or diagnostic massage of the prostate gland in order to obtain prostate secretions.
During rectal examination, changes indicating an inflammatory process in the prostate are not always observed in patients with chronic prostatitis. That is, it is impossible to rely on the result of a rectal examination for the diagnosis of chronic prostatitis.
Chronic prostatitis treatment
Antibiotics of the fluoroquinolone group are optimal antimicrobial drugs for the treatment of chronic bacterial prostatitis. The recommended course of antibiotic therapy is 4 to 6 weeks. Such a long course is justified by scientific data showing a decrease in the likelihood of relapses of the disease.
In case of identified sexually transmitted infections, such as chlamydia trachomatis, an antibiotic of the macrolide group is prescribed.
There is evidence of decreased relaxation of the bladder neck in patients with chronic prostatitis, which leads to reflux of urine into the prostatic ducts in the urethra and causes inflammation of the prostate tissue and pain. Such patients are recommended to prescribe alpha-blockers.
Other methods that have been proven effective in just one or a few studies or are still being investigated include:
- Pelvic floor muscle training - some evidence suggests that special exercises are effective in reducing the symptoms of chronic prostatitis and chronic pelvic pain syndrome;
- acupuncture - a small number of studies indicate the advantage of acupuncture over placebo in patients with chronic prostatitis;
- extracorporeal shock wave therapy - based on the effect of significant amplitude acoustic impulses on connective and bone tissue, is widely used in the treatment of diseases of the musculoskeletal system, has recently been used in urology, its effectiveness is under study;
- behavioral therapy and psychological support - since chronic prostatitis is associated with a poor quality of life and the development of depression, these methods can improve the patient's psychological state and help reduce some of the symptoms of the disease.
You can safely start treatment, which we carry out as quickly and efficiently as possible in Tashkent. The Gatling Med clinic will make you feel confident in yourself and your health!