There are several forms of prostatitis, differing in symptoms and the course of the inflammatory process. Although, in general, this disease is well studied, there is a form about which little is known: it is bacterial prostatitis. This condition is also called chronic pelvic pain syndrome and, according to the latest information, it occurs in one in five men on the planet. Despite its widespread occurrence, the disease is still a mystery to doctors and is very difficult to treat.
Bacterial and non-infectious prostatitis: what's the difference?
Bacterial or non-bacterial prostatitis is often confused with non-infectious prostatitis. In fact, these are two different diseases with different manifestations and causes of development.
Chronic bacterial prostatitis is a disease without clear symptoms of inflammation in the prostate. Furthermore, in the vast majority of cases, a thorough examination does not allow establishing the presence of an inflammatory process in the organ. At the same time, non-infectious prostatitis is an inflammatory disease with well-defined and well-studied causes. Non-infectious prostatitis is caused by a violation of prostate trophism as a result of stagnation of prostate secretion and development of the inflammatory process. Non-infectious prostatitis is most commonly diagnosed in older patients, whereas non-bacterial prostatitis can occur in men of all age groups.
To avoid confusion, nonbacterial prostatitis is also called chronic pelvic pain syndrome, which perfectly characterizes the main symptoms of this complex disease.
typical symptoms
With little need, painful discomfort is felt.
The signs of bacterial prostatitis are not similar to the symptoms of prostate inflammation, so many doctors assume the neurological nature of the development of this disease.
In bacterial prostatitis, the symptoms are as follows:
- constant pain in the pelvic region;
- increased pain syndrome during urination;
- severe discomfort with ejaculation;
- general physical illness;
- nervous tension.
As a rule, pelvic pain occurs for a long time, anywhere from three months to six months. The pain syndrome is painful, monotonous, it can pass on its own without the use of analgesics and come back spontaneously. Pain radiates to testicles, perineum, anus. Sometimes there are short-lived episodes of acute "nervous" pain in the lower back, abdomen, and groin.
Patients complain of worsening erection. During ejaculation he feels intense tension, ejaculation is accompanied by sharp pain. During urination, intense pain attacks are also possible.
Simultaneously with these symptoms, a strong emotional depression occurs. The man is tense, susceptible to stress, some patients have insomnia and neurosis-like states.
Causes of bacterial prostatitis
A fall as a result of a back injury can cause illness.
Nonbacterial prostatitis is not well understood, so doctors provide the likely causes of this condition.
The exact mechanism of development and pathogenesis of chronic abacterial prostatitis remains to be established.
Presumably, the disease may have the following reasons for development:
- inflammation of the pelvic floor ligaments and tendons;
- autoimmune process;
- an increase in pelvic floor ligaments;
- back injuries and chronic spinal diseases;
- violation of blood microcirculation in the prostate;
- neuropsychiatric reasons;
- intracellular parasites and prostate pathogens.
Inflammation of the pelvic floor ligaments and tendons can develop due to infectious diseases of the nearby organs of the genitourinary system. As a result, the infection spreads to the ligaments, which become inflamed and enlarge, compressing and irritating nearby nerve endings. The pain a man feels at the same time can radiate along the nerves, giving way to the lower back, groin, abdomen, or anus.
Another suspected cause of chronic abacterial prostatitis or CABD is autoimmune processes in the body. As a result of this failure, the immune system begins to perceive prostate cells as a foreign element and attacks them with immune system cells, which leads to the appearance of typical symptoms of bacterial prostatitis.
Another suspected cause is viral prostatitis, suffered by the patient in childhood. As the prostate in boys is not yet sufficiently developed, the viral inflammation of this organ may not have vivid symptoms and develop into a chronic form, which in an adult male manifests as pelvic pain syndrome.
The disease can also be associated with various back conditions, injuries or osteochondrosis as a result of compression of the spinal nerve roots, which causes pain and rupture of the prostate.
Some doctors have suggested that this disease may be due to congenital circulatory failure of the prostate, due to which the prostate is unable to cope with its function. Over time, this leads to the onset of the chronic pain characteristic of abacterial prostatitis.
In addition, there is a theory that CABD may be caused by neuropsychiatric disorders, eg severe stress, neurosis and vascular dystonia. In this case, the pathology must be considered a psychosomatic illness.
Another theory states that the disease may be associated with parasites or intracellular microorganisms, whose size is so small that they do not allow detection of the causative agent of the disease by conventional methods.
Risk factors
Smoking can contribute to prostate problems.
Presumably, the risk factors for the development of chronic pelvic pain syndrome in men are:
- previous prostate diseases;
- chronic stress;
- back injury;
- pelvic organ hypothermia;
- urogenital infections;
- chronic testicular disease;
- bad habits;
- circulatory disorders of Organs pelvic organs;
- hypodynamics;
- pelvic injury.
The risk of developing the disease increases if the man does not eat properly. Deficiency in essential vitamins and trace elements can affect not only general well-being but also prostate function.
Differential diagnosis
To make a diagnosis of chronic pelvic pain syndrome, the following conditions are required:
- long-lasting pain for a period of three months;
- the absence of pathogenic microorganisms in the prostatic secretion;
- absence of chronic foci of infection in the body;
- discomfort with ejaculation.
To make the diagnosis, differential diagnosis is performed with prostate cancer, neurological syndromes, spinal pathologies, leading to irritation of the spinal nerve roots.
A general urological exam is mandatory - palpation of the prostate, transrectal ultrasound of the organ, study of the composition of the prostatic secretion. You should also rule out inflammatory diseases of the testicles, bladder, and kidney pathologies, which can manifest as pain syndrome from different locations.
It is imperative to be examined by a neurologist and therapist. You should also consult a proctologist to rule out rectal pathologies.
treatment methods
An integrated approach is used in the treatment of bacterial prostatitis. Therapy is selected by the urologist, taking into account the characteristics of the patient's disease course. This takes into account the general health and psycho-emotional state of the man.
Therapy includes the following methods:
- symptomatic treatment;
- prostate massage;
- physiotherapy methods.
As needed, treatment can be supplemented with sedatives, homeopathy, and herbal remedies.
drug therapy
Before using drug therapy, you need to consult your doctor.
For the symptomatic treatment of abacterial prostatitis, drugs from the following groups are prescribed:
- broad-spectrum antibiotics with antimicrobial action;
- nonsteroidal anti-inflammatory drugs;
- antispasmodics and analgesics;
- alpha blockers;
- sedatives and antidepressants.
In the treatment of non-bacterial prostatitis, antibacterial agents are used, however paradoxical it may seem. The fact is that the theory of microorganisms that cannot be seen under a microscope remains open, which is why antibacterials are prescribed for prevention. Urologists claim that these medications help to quickly eliminate the symptoms of the disease, so their use is fully justified.
Antispasmodics and analgesics are used to reduce pain. Nonsteroidal anti-inflammatory drugs can also be used as symptomatic therapy.
To facilitate the urination process, the administration of alpha-blockers is recommended.
It should be noted that the optimal treatment regimen is individually selected for each man. One should not self-medicate, taking the drugs from the groups listed without thinking, it is best to rely on an experienced specialist.
Prostate massage and physiotherapy
In general, treatment of abacterial prostatitis with medications shows good results. Other methods are needed to consolidate the therapeutic effect.
Prostate massage improves organ functionality, prevents stagnation of prostatic secretions, normalizes blood circulation and metabolic processes. He is appointed in a course of 10 procedures.
Like physical therapy, magnetic effects, ultrasound therapy, electrophoresis with vasodilators and other methods are prescribed. In addition, patients receive spa treatment, eg mud therapy.
folk remedies
Motherwort herbal tinctures are good for treating illnesses.
It is possible to treat non-bacterial prostatitis with folk remedies only after consulting a doctor, otherwise this treatment will not help but only worsen the state of health.
For the treatment of non-bacterial prostatitis with folk remedies, you can use:
- decoctions of sedative herbs to improve general health - chamomile, lemon balm, mother shrub, valerian;
- microclysters with anti-inflammatory decoctions of St. John's wort, calamus, yarrow;
- hot sitz baths with calamus, soda, or nettle decoction;
- pumpkin seed oil suppositories;
- tampons with honey and propolis.
The use of any of the funds listed must be agreed with your physician. Suppositories are prepared as follows: melt five parts of cocoa butter in a bain-marie, then add one part honey and one part propolis (or two parts pumpkin seed oil). Then the dough is cooled, suppositories 4 cm long and 1 cm in diameter are formed and cooled in the refrigerator. These suppositories should be injected into the rectum after an evening cleansing enema for two weeks.
Possible complications and prevention
Bacterial prostatitis requires timely diagnosis and treatment. Otherwise, pelvic pain syndrome can cause infertility, impotence, vesiculitis, and other problems with the male genitourinary system.
To prevent the development of the disease, it is necessary to lead an active lifestyle and to eat well. It is important to maintain immunity to prevent hypothermia of Organs pelvic organs. Men need a regular sex life with a constant partner to prevent the development of stagnation processes in the prostate. It is also necessary to have regular preventive exams with a urologist.