There are several forms of prostatitis, which differ in symptoms and the course of the inflammatory process. Despite the fact that, in general, this disease is quite well studied, there is one form about which still little is known - this 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 such a widespread frequency, the disease remains 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, they are two different diseases with different manifestations and causes of development.
Chronic abacterial prostatitis is a disease without clear symptoms of inflammation of the prostate. In addition, in the overwhelming majority of cases, a detailed examination does not allow to establish the presence of an inflammatory process in the organ. At the same time, non-infectious prostatitis is an inflammatory disease, the causes of which are well defined and well studied. Non-infectious prostatitis is caused by a violation of the trophism of the prostate, as a result of which the secretion of the prostate stagnates and the inflammatory process develops. Non-infectious prostatitis is most often diagnosed in older patients, while non-bacterial prostatitis can occur in men of all age groups.
To avoid confusion, non-bacterial 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 arises.
The signs of abacterial prostatitis are not similar to the symptoms of inflammation of the prostate, which is why many doctors assume the neurological nature of the development of this disease.
With abacterial prostatitis, the symptoms are as follows:
- constant pain in the pelvic area;
- increased pain syndrome during urination;
- severe discomfort with ejaculation;
- general physical ailment;
- nervous tension.
Typically, pelvic pain occurs for a long time, from three to six months. Pain syndrome is painful, monotonous, it can pass on its own without the use of painkillers, and then return spontaneously. The pain radiates to the testicles, perineum, anus. Sometimes there are short-term episodes of stabbing "nerve" pain in the lower back, abdomen, groin.
Patients complain of worsening erection. During ejaculation, he feels intense tension, ejaculation is accompanied by severe pain. During urination, attacks of severe pain are also possible.
Along with these symptoms, there is a strong emotional depression. The man is tense, sensitive to stress, some patients present states of insomnia and neurosis.
Causes of abacterial prostatitis
A fall, and as a result of a back injury, can cause illness.
Non-bacterial prostatitis is not well understood, so doctors give the probable causes of this disease.
The exact mechanism of the development and pathogenesis of chronic abacterial prostatitis has not yet been established.
Presumably, the disease can have the following reasons for development:
- inflammation of the ligaments and tendons of the pelvic floor;
- autoimmune process;
- an increase in pelvic floor ligaments;
- back injuries and chronic diseases of the spine;
- violation of the microcirculation of blood in the prostate;
- neuropsychiatric reasons;
- intracellular parasites and pathogens of the prostate.
Inflammation of the ligaments and tendons of the pelvic floor can develop due to infectious diseases of the organs of the genitourinary system, located in the immediate vicinity. As a result, the infection spreads to the ligaments, they inflame and increase in size, compressing and irritating nearby nerve endings. The pain that a man feels at the same time can radiate down the nerves, leading to the lower back, groin, lower abdomen or anus.
Another suspected cause of chronic abacterial prostatitis or CABD is the autoimmune processes in the body. As a result of such a failure, the immune system begins to perceive the prostate cells as a foreign element and attack them with immune cells, which leads to the appearance of symptoms typical of bacterial prostatitis.
Another suspected cause is viral prostatitis, suffered by the patient in childhood. Since the prostate in boys is not yet sufficiently developed, the viral inflammation of this organ may not show any sharp symptoms and turn into a chronic form, which in an adult man manifests itself as a syndrome ofpelvic pain.
The disease can also be associated with various pathologies of the back, injuries or osteochondrosis, as a result of which compression of the nerve roots of the spine occurs, which causes pain and disruption of the prostate.
Some doctors have suggested that this disease could be due to congenital circulatory failure of the prostate, due to which the organ cannot cope with its function. Over time, this leads to the appearance of chronic pain characteristic of abacterial prostatitis.
Additionally, there is a theory that CABD can be caused by neuropsychiatric disorders, for example, severe stress, neuroses, and vascular dystonia. In this case, the pathology should be considered a psychosomatic illness.
Another theory claims that the disease may be associated with intracellular parasites or microorganisms, the size of which is so small that they do not allow detection of the causative agent of the disease by standard 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;
- hypothermia of the pelvic organs;
- urogenital infections;
- chronic testicular disease;
- bad habits;
- circulatory disorders of the pelvic organs;
- hypodynamia;
- pelvic injury.
The risk of developing the disease increases if a man does not eat properly. Deficiency of vitamins and essential microelements can affect not only general well-being, but also the work of the prostate.
Differential diagnosis
To make a diagnosis of chronic pelvic pain syndrome, the following conditions are necessary:
- long-term 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 a diagnosis, a differential diagnosis is made with prostate cancer, neurological syndromes, pathologies of the spine, leading to irritation of the roots of the spinal nerves.
A general urological examination is imperative - palpation of the prostate, transrectal ultrasound of the organ, study of the composition of prostatic secretion. You should also exclude inflammatory diseases of the testes, bladder and kidneys, which can be manifested by pain syndrome of different localization.
It is imperative to be examined by a neurologist and a therapist. You should also consult a proctologist to rule out rectal pathologies.
Processing methods
An integrated approach is used in the treatment of bacterial prostatitis. Therapy is selected by the urologist, taking into account the features of the course of the disease in the patient. This takes into account the general state of health and the psycho-emotional state of the man.
Therapy includes the following methods:
- symptomatic treatment;
- prostate massage;
- physiotherapy methods.
If needed, treatment can be supplemented with sedatives, homeopathy and herbal remedies.
Drug therapy
Before using any drug treatment, you should consult your doctor.
For the symptomatic treatment of bacterial prostatitis, drugs of the following groups are prescribed:
- antibiotics of a wide spectrum of 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, paradoxical as it may sound. The point is that the theory of microorganisms that cannot be seen under a microscope remains open, which is why antibacterial agents are prescribed for prevention. Urologists say that these drugs help to quickly eliminate the symptoms of the disease, therefore their use is fully justified.
Antispasmodics and pain relievers are used to reduce pain. Nonsteroidal anti-inflammatory drugs can also be used as symptomatic therapy.
To facilitate the process of urination, the administration of alpha-blockers is indicated.
It should be noted that the optimal treatment regimen is selected individually for each man. You should not self-medicate, recklessly taking the drugs of the listed groups, it is better to trust an experienced specialist.
Prostate massage and physiotherapy
Usually, treatment of bacterial prostatitis with medication works well. Other methods are needed to consolidate the therapeutic effect.
Massage of the prostate improves the functionality of the organ, prevents stagnation of prostatic secretions, normalizes blood circulation and metabolic processes. He is named in a course of 10 procedures.
As physiotherapy, magnetic effects, ultrasound therapy, electrophoresis with vasodilators and other methods are prescribed. In addition, patients receive thermal treatment, for example mud therapy.
Folk remedies
Motherwort herb tinctures are good for treating ailments.
It is possible to treat non-bacterial prostatitis with folk remedies only after consulting a doctor, otherwise such treatment will not help, but will 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 overall health - chamomile, lemon balm, motherwort, valerian;
- microclysters with anti-inflammatory decoctions of St. John's wort, calamus, yarrow;
- warm sitz baths with a decoction of calamus, soda or nettle;
- pumpkin seed oil suppositories;
- honey and propolis tampons.
The use of any of the listed funds should be agreed with your doctor. Suppositories are prepared as follows: five parts of cocoa butter are melted in a double boiler, then one part of honey and one part of propolis (or two parts of pumpkin seed oil) are added. Then the mass is cooled, suppositories 4 cm long and 1 cm in diameter are formed and cooled in the refrigerator. Such suppositories should be injected into the rectum after a cleansing enema at night for two weeks.
Possible complications and prevention
Bacterial prostatitis requires prompt diagnosis and treatment. Otherwise, pelvic pain syndrome can lead to infertility, impotence, vesiculitis, and other problems of the male genitourinary system.
To prevent the development of the disease, it is necessary to lead an active lifestyle and eat well. It is important to maintain immunity, prevent hypothermia of the pelvic organs. Men need a regular sex life with a constant partner to prevent the development of stagnant processes in the prostate. It is also necessary to undergo regular preventive examinations with a urologist.