Chronic prostatitis: causes, clinical symptoms and treatment

Prostatitis is a disease characterized by the development of the inflammatory process in the prostate gland of various etiologies, currents and with a variety of clinical symptoms.


  • 1 Epidemiology
  • 2 etiology of the disease
  • 3 Way
  • 4 infection penetration predisposing factors
  • 5 Classification of prostatitis
  • 6 Clinical symptoms of chronic prostatitis treatment of prostatitis
  • 7 Methods
  • 8 in Tours in chronic prostatitis


Prostatitis is the most common disease of the reproductive system in men. It is diagnosed in 30% of males aged 30 to 50 years old .

Etiology of

The main cause of the disease are infectious( more often bacterial) and non-infectious inflammatory processes that develop as a result of various disorders of function, circulation and stagnation in the prostate .Infectious agents will most often be pathogenic bacteria, various viruses and fungi. Chronic

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bacterial prostatitis arises, basically, as a result of an acute process( with late or inadequate treatment), or develops as a separate disease. The etiology of this form, as a rule, are the following pathogenic microorganisms: chlamydia, trichomonads, mycoplasmas, ureaplasmas. If the microbial flora is not detected in the secretion of the prostate, this may be due to the fact that the bacteria, mycoplasmas and chlamydia are represented as L-form. Sometimes among the pathogens of the disease can be found and representatives of anaerobic environment.

The cause of inflammation of the non-infectious prostate will most often be exposure to factors of a physical or chemical nature( prolonged stagnation of secretion or blood in the prostate).Also, often the cause of the disease can not be detected.

Paths of penetration of infection prostate enlargement

Pathogenic flora enters the prostate ascending way through the urethra in the presence of urethritis, cystitis, after manipulations with the help of endoscopic equipment. In this bacterial inflammation of the prostate occurs as a result of infection of the urinary tract due to the casting of the infected portion of urine into the prostate. Infection of the infectious agent into the prostate through the blood from various infectious foci in the body( furuncle, carbuncle, sinusitis, carious teeth, etc.) is also much less frequent, lymphogenically from the rectum, if there is a pathology in it.

Predisposing factors

In the development of the non-bacterial form of prostatitis, the factors contributing to its development are the slowing of blood flow in venous vessels and the prostate secretion( congestive prostatitis ), as it has a bactericidal effect. Also to the emergence of both forms of the disease predispose the infection of the lower urinary tract, the long absence of sexual intercourse, the presence of irregular sex life, excessively frequent interruptions of sexual acts, sedentary lifestyle and work, chronic constipation, alcohol abuse, spicy and spicy food.

Classification of prostatitis

carrying out and results of ultrasound of the prostate

One of the most popular is the classification proposed by the National Institutes of Health in 1995 in the United States. According to her, prostatitis is acute and chronic. Among the chronic forms distinguish bacterial and non-bacterial. Chronic non-bacterial prostatitis( also called chronic pelvic pain syndrome) is divided into:

  • Chronic pelvic pain syndrome, with the presence of leukocytes in a prostatic secret;
  • Chronic pain syndrome in a pelvic non-inflammatory character, in which signs of an inflammatory process are not detected.

Among others, there are still chronic prostatitis with no clinical symptoms, the diagnosis in which occurs as a result of microscopic examination of prostate tissue .

Clinical symptoms of chronic prostatitis

Symptomatic in this pathology is very diverse and is divided into four main features: the presence of pain, violation of the act of urine, a decrease in sexual capabilities and various psychological disorders .

Pain syndrome is the most common symptom in chronic inflammation of the prostate. Pain can have a connection with the process of urination, with ejaculation or appear at rest. About 80% of patients complain of the onset of pain at rest, which is associated with damage to the nervous structures of the prostate of a mechanical nature( due to the resulting swelling of the gland and stagnation of secretions in its lobules) or chemical( as a result of inflammatory products).The intensity of the pain syndrome in a state of rest can vary from a simple feeling of heaviness to severe pain, requiring the withdrawal of anesthetic medication. Localization can also be varied, with irradiation in the perineum, sacrum, testicles, penis and scrotum.

The appearance of soreness with urination can be explained by the transition of the inflammatory process to the spermatic tubercle, the posterior part of the urethra and the neck of the bladder. And, depending on the affected area, the pain points can be located near the urethral opening, in the perineal region or behind the pubis. In this case, pain can be given to the testicles at the time of urination. reverse urine flow with prostatitis

It is also possible the occurrence of a pain attack in the process of erection, which is explained by the increase in blood filling of the prostate. Soreness during ejaculation will occur as a result of pronounced inflammation of the seminal tubercle and the mouths of the ducts that eject the seed. The appearance of pain after ejaculation is associated with the effect on the surface of the mucosa containing inflammatory substances of the secretion of the prostate.

There are practically all patients with a violation of the act of urination due to chronic prostatitis expressed in the increase of diuresis or its difficulty( while the urine follows a flaccid trickle).Often, urination becomes more frequent only at night. Also, some patients note the appearance of indomitable urge to empty the bladder. If the disease is accompanied by chronic inflammation of the urethra, then the appearance of soreness during the act. The severity of these symptoms is different.

Also a common complaint in the presence of chronic prostatitis is a different violation of sexual functions, and this can both appear simultaneously with other symptoms of the disease, and arise after years from the onset of the disease. Patients report premature ejaculation with a normal erection process. Complaints are also made about the weakening of the erection and the appearance of soreness, its accompanying.

Violation of the activity of the autonomic nervous system in chronic prostatitis is manifested by the intensification of the work of the sweat glands and secretion of profuse secretion, sleep disturbances, fast-onset fatigue, weakness, drowsiness, irritability and decreased activity and performance.

chronic prostatitis - an actual problem of modern men

Depending on the degree of activity of the inflammation occurring in the prostate, three phases of the course of the disease are distinguished: active, latent and remission. In the stage of remission, there are no clinical symptoms of the disease. The appearance and intensification of all clinical signs of pathology are noted in the active phase.

For chronic prostatitis is characterized by a prolonged course, frequent resistance to drug therapy and the onset of remission only after a comprehensive treatment with antibacterial and anti-inflammatory drugs. Complications of the disease can be the development of infertility and sclerosis of the prostate.

In recent years, there has been an increase in the number of patients, the outcome of chronic inflammation of the prostate in whom the development of her sclerosis is becoming. As a result of the ongoing process of inflammation in the prostate gland, a partial and later complete replacement of the organ tissue with a mass of collagen fibers takes place. For clinical symptoms of sclerosis of the prostate is characterized by a variety of symptoms. Patients note a change in the process of urination, its elongation in time, a decrease in the urine stream, its thinning, the appearance of a feeling of incomplete emptying of the bladder after the act. About 30% of patients complain of the appearance of blunt pains, giving away in the area above the pubis, in the perineum, testicles and rectum.

Methods of treatment of prostatitis

Therapy of this pathology must necessarily have a complex character and affect the causative factors and links of the pathogenetic mechanism. Treatment will depend on the patient's age, clinical symptoms, the phase of the process taking place in the gland, the state of the patient's immune system, and the involvement of neighboring organs. The basic principles of therapy, which applies both local effects on the prostate and drugs: exercise therapy for chronic prostatitis

  • With infectious etiology use of antibacterial drugs that contribute to the elimination of the causative agent of the disease. It is always necessary to sow the secretion of the prostate, identify the pathogen and determine its sensitivity to antibacterial agents. Antibiotics that penetrate well into the gland tissue include fluoroquinolones, tetracyclines and macrolides;
  • Symptomatic treatment to eliminate underlying symptoms. The main group of drugs used is? -adrenoconverters;
  • Normalization of blood flow in the prostate. To do this, use medicines made from the extract of the prostate gland of animals: vitaprost, prostatilen. Also used funds of other groups( kurantil, trental, eskuzan, troxevasin).Actively apply physiotherapy: prostate massage, UHF, ultrasound, electrophoresis, laser therapy, acupuncture, etc.;
  • Elimination of stasis secretions in the lobules of the gland( for dilution use enzymatic drugs - trypsin, streptokinase);
  • Strengthening the state of the immune system;
  • Hormone therapy( with prolonged course of the process, androgen replacement therapy).

If conservative treatment methods are ineffective, surgical therapy is used, which is often necessary for sclerosis of the prostate.

Video Examination in Chronic Prostatitis