Symptoms and treatment of chronic prostatitis

prostatitis symptoms and treatment

Many men suffer from chronic prostatitis, but they attribute the symptoms to other diseases or waste time on ineffective treatment. From our article, you will learn comprehensive information about this male problem: causes, exact symptoms and diagnostic methods, various treatment methods.

Despite all the successes of modern medicine, the diagnosis of chronic prostatitis causes certain difficulties. This negatively affects the effectiveness of your treatment.

What is chronic prostatitis

In ICD-10 (International Classification of Diseases, 10th revision) there is no such disease as "chronic prostatitis". There is no uniform, generally accepted characteristic of this pathology. In urological practice, the classification developed by the AHI (American Institute of Health) is used. It defines the categories of prostate diseases. Those that can be called "chronic" include:

  • chronic bacterial prostatitis;
  • chronic abacterial prostatitis.

To establish this diagnosis, the following symptoms are necessary: long-lasting (at least 3 months) pain in the perineum. Thus, chronic prostatitis can be called a long-lasting inflammatory process, as a result of which the structure of the prostate gland changes and its function is impaired. But other diseases of the prostate also lead to such sad results. Therefore, the diagnosis of chronic prostatitis is difficult.


Prostatitis is one of the most common diseases in men. It has a significant impact on performance and family relationships. The patients' quality of life deteriorates to the same extent as those who have suffered a heart attack or angina pectoris.

According to various sources, every 3rd or 4th man is diagnosed with prostatitis. And most often this is not the initial or acute stage of the disease, but an already established and long-term process - chronic.

Not so long ago, it was believed that this pathology lies primarily in older men. However, the statistics refuted this idea. It is now known that chronic prostatitis is a disease of sexually active men of childbearing age.

More than 30% of patients turn to a specialist with complaints typical of the chronic form of prostatitis. Often, when visiting the doctor, the disease is complicated by simultaneous pathologies: erectile dysfunction, vesiculitis, primary or secondary infertility, epididymitis.

Causes of chronic prostatitis

The causes of chronic prostatitis vary widely. Among the many negative factors affecting human health, it is difficult to accurately isolate those that triggered the development of the disease. This is often a complex of situations and circumstances that accompany a man's life.

The main causes of chronic abacterial prostatitis are:

  • rhythm disorder (irregularity) of sexual intercourse;
  • hypodynamia, which is characteristic of overweight people;
  • prolonged stressful conditions;
  • predominance of fat-rich foods in the diet;
  • has a negative effect on the body in hazardous industries.

Chronic bacterial prostatitis is the result of incompletely healed bacterial prostatitis. Or the man ignored the diseases and did not seek help from a urologist. Therefore, no treatment was given.

Chronic prostatitis of the abacterial type develops due to exposure to infectious agents against the background of decreased immunity. Usually, such patients are diagnosed with diseases of the endocrine system.

The factors that trigger the development of chronic bacterial prostatitis are the following:

  • surgical operations on the prostate (if antibiotics were not administered before the operation);
  • refusal to use contraceptives;
  • lack of the habit of keeping the body clean.

Symptoms of chronic prostatitis

Today there are many fictions about chronic prostatitis. For this reason, a temporary violation of sexual function can be attributed to this disease. You often hear the opinion that a decrease in sexual desire and erectile dysfunction is the merit of prostatitis, and if a man is old, then chronic prostatitis.

This is not true, as there are many other causes of sexual dysfunction, and the main symptom of chronic prostatitis is pain. All other signs are considered simultaneous and indirect.

Chronic prostatitis is often confused with pelvic pain syndrome, as the symptoms of these diseases are largely similar. This is due to the formation of myofacial trigger zones near the prostate, which appear as a result of injuries and surgical interventions. Pain in these areas can be perceived as a symptom of prostatitis.

When diagnosing the disease, complaints of pain and discomfort in the perineum and pelvis lasting at least 3 months come to the fore. The pain is localized around the prostate, radiating to the sacrum, rectum, and scrotum. In case of long-term exposure to negative factors (heavy load, excessive physical activity, long time "on the feet"), the pain increases.

The characteristic symptom of the disease is premature ejaculation. Patients' sexual desire decreases, erectile dysfunction occurs. These symptoms are also typical of other diseases of the urogenital area. Therefore, it cannot be said that these are characteristics of chronic prostate disease.

An important symptom is the fading of orgasm. If the patient began to notice that the sharpness of sensations during ejaculation has disappeared, this is an opportunity to pay more attention to his health and a signal to visit a urologist.

The structure of the inflamed prostate becomes denser, the pressure on the urethra increases, and the quality of urination deteriorates. Patients with chronic prostatitis experience a frequent urge to urinate at night. The process of passing urine is accompanied by a burning sensation, pain, pain. Urinary incontinence is common.

Signs of chronic prostatitis can be fully or partially expressed. Much depends on the patient's state of health, the presence or absence of other diseases. Chronic prostatitis is characterized by an undulating course, with increasing and decreasing symptoms. In this disease, the inflammatory process is not acute.

Diagnosis of chronic prostatitis

In the presence of severe symptoms, the diagnosis of chronic prostatitis is easy. But this disease is often asymptomatic, which makes it difficult to recognize. A number of tests are performed for diagnostic purposes.

The Association of Urologists has developed questionnaires, thanks to which it is possible to identify asymptomatic chronic prostatitis. The questions are formulated in such a way that the patient's subjective feelings can be established. Not all men are able to correctly assess their erectile function, orgasm quality and other details of sexual life. Questionnaires filled out by patients provide the specialist with the information needed to make a diagnosis. In urological practice, the NIH-CPS scale is most often used.

In order to distinguish between chronic prostatitis and other diseases, a neurological examination is performed. In the list of applied diagnostic methods, determining the state of the patient's immunity.

Laboratory research methods

If you suspect chronic prostatitis, first find out whether it is bacterial or abacterial. In the first case, the causative agent or causative agents must be determined, and it must be found out which drugs they are sensitive to. For this, laboratory tests of urine and prostate secretion are carried out.

If, 10 days after the DRE, the PSA test showed an excess of the prostate-specific antigen level from 4. 0 ng/ml, this is a reason to refer the patient to a biopsy in order to rule out an oncological process.

The following research methods are recommended:

  • scraping from the urethra;
  • general and biochemical analysis of urine;
  • LHC culture of prostatic secretion.

Instrumental research methods

TRUS (transrectal ultrasound diagnostics) is performed with equipment equipped with an instrument inserted into the patient's rectum. If an irregularly shaped hypoechoic area is found, there is every reason to suspect a malignant tumor. In chronic prostatitis, scarring, compaction of the gland tissue structure, and changes in the seminal vesicles can be observed.

UDI is the main method of functional diagnostics. It allows you to find out the nature of urination, signs of urine stagnation, and its composition. The examination includes a number of tests: uroflowmetry, cystometry, measurement of residual urine volume, assessment of the pressure inside the bladder and the rate of urine outflow.

Tomography (computed tomography or magnetic resonance) is required to rule out benign and malignant tumors. These research methods are extremely informative and help to assess the condition of the prostate tissue.

Treatment of chronic prostatitis

Treatment of chronic prostatitis requires an integrated approach. One dose of medicine is not enough. Physiotherapy procedures and therapeutic exercises are necessary. In general, it can be said that chronic prostatitis is difficult to treat and requires a radical revision of lifestyle, a change of habits and, in some cases, a change of job. Urologists insist that only a series of measures will help to completely get rid of this disease or ensure long-term remission.

Regardless of whether the disease is bacterial or abacterial, prostate congestion has played a major role in its development. The viscous secretion deposited in the ducts of the gland is a favorable environment for the development of pathogenic and opportunistic microorganisms. Therefore, the main focus should be on eliminating stagnation.

The problem is solved by lifestyle changes and the inclusion of physical exercises in the daily routine.

Exercise complexes have been developed that are suitable for different life situations:

  • for men who are forced to sit most of the time (drivers, office workers, managers);
  • for overweight people;
  • for those who don't have time to exercise.

Thinking about the treatment of chronic prostatitis, you should decide on a serious review of your attitude to your health.

Treatment of acute prostatitis

Acute prostatitis requires bed rest, a special salt-free diet and sexual rest.

Course management methods:

  • Etiotropic therapy is the most effective in the treatment of prostatitis. If the prostatitis is based on an infection, the priority is a course of antimicrobial agents, which relieves the manifestations of the inflammation.
  • The pain syndrome is alleviated with painkillers, antispasmodics, rectal suppositories, microclysters and warm solutions of painkillers. NSAIDs can be used.
  • The combination of immunostimulants, immunomodulators, enzymes, vitamin complexes, and microelements has proven its effectiveness.
  • Physiotherapy methods are possible only in the subacute stage of the disease. They improve microcirculation, increase immunity: UHF, microwave oven, electrophoresis, laser, magnetotherapy.
  • Massage is another effective way to influence the prostate. It opens the channels, normalizes the blood circulation of the scrotum and pelvis.
  • Acute retention of renal filtrate can be corrected by catheterization and trocar cystostomy.
  • The purulent process means surgical intervention.
  • Psychologist consultations.

Treatment of chronic prostatitis

With long-term (at least one month) treatment of the prostate, there is no guarantee of a 100% cure. The priority of herbal preparations, immune correction, changing household habits:

  • Phytopreparations are widely used in urological practice. They are able to accumulate at the site of the most active pathological process, protect cells from oxidation, remove free radicals and prevent the growth of glandular tissue.
  • Antibacterial therapy is selected individually, based on the sensitivity of microbes to drugs.
  • Medicines that strengthen immunity not only help in the treatment of prostatitis, but also correct the negative effect of antibiotics, which interfere with the functioning of the immune system.
  • The pain syndrome is stopped by the appointment of alpha-blockers and muscle relaxants.
  • Prostate massage enables the mechanical removal of the gland's "extra" secret through the urethra, improves blood circulation and minimizes congestion.
  • Physiotherapy: laser, magnet, ultrasound, iontophoresis, seated warm baths or herbal microclysters.
  • In severe cases, intravenous fluids with diuretics are recommended. This stimulates abundant urine excretion, prevents the symptoms of poisoning, the development of ascending cystitis and pyelonephritis.
  • In case of constipation, herbal laxatives are used.
  • Together with the patient, the urologist and psychologist develop an individual, long-term program about the daily routine, the necessary rest, diet, dosed physical activity, and sexual activity.
  • In the event that the chronic process is resistant to ongoing therapy, surgical intervention is prescribed in case of blockage of urine outflow: removal of all affected tissues (transurethral resection of the prostate) or complete removal of the gland with surrounding tissues (prostatectomy). It is practiced in exceptional cases, full of impotence and urinary incontinence. Young people are not operated on because it can lead to infertility.

Recommendations for outpatient treatment

The patient should avoid situations in which the pelvic organs may be injured.

It is necessary to exclude stress on the prostate: do not ride a bicycle, do not do strength exercises, do not carry heavy loads.

In the case of sedentary work, warm-up, squatting, leg swings, running in place are required every 2-3 hours.

It is necessary to try to normalize sexual life, which is extremely important to eliminate the stagnation of prostate secretion.

It is recommended that you limit the minimum doses or completely eliminate the use of alcohol.

Drug treatment

In the case of chronic prostatitis, outpatient treatment is predominantly carried out. If the pathological process persists and remission cannot be achieved with this method, hospitalization is recommended. In a hospital, under the supervision of the medical staff, there are many more opportunities to follow the treatment regimen and monitor changes in the patient's condition.

Chronic prostatitis in men develops against the background of endocrine disorders. In this regard, 5-alpha-reductase inhibitors and alpha-1-blockers are recommended. They contribute to the normalization of the hormonal level and eliminate the symptoms of the pathology. For this purpose, drugs such as Finasteride and Terazosin are prescribed.

An integrated approach involves taking drugs such as:

Methods of treatment of bacterial chronic prostatitis

Bacterial chronic prostatitis is treated with antibiotics. The most effective drug for a given patient is determined by preliminary laboratory testing of prostate secretions.

There is no universal drug to suppress and destroy the pathogenic microflora. What works for one patient may not work for another. For this reason, there are many negative opinions about drugs advertised for the treatment of chronic prostatitis.

The drugs recommended for antibacterial therapy are fluoroquinolones. Most bacteria are sensitive to them.

Antibiotics may also be included in the treatment plan for patients with abacterial prostatitis. Such therapy is carried out for preventive purposes. According to the indications, treatment with penicillin preparations is connected.

After the antibiotic therapy is completed, the hormonal drug treatment is started.

In case of intraprostatic reflux, it is necessary to take α-blockers.

Pain relievers are effective in relieving pain.

Treatment with herbs

Many people doubt whether chronic prostatitis can be cured with herbs. The answer to this question was given by the many years of use of these health-improving agents in urological practice.

Today, the following medical complexes are recommended:

All these drugs have a beneficial effect on the work of the male urogenital system. Effective treatment of chronic prostatitis is possible when the function of urination is normalized. The components that make up herbal preparations perform this task. They help reduce the frequency of urges and eliminate the syndrome of the sluggish beam.

Phytocollections containing pumpkin extract or pumpkin seeds are recommended for patients with chronic prostatitis. The latter have a unique chemical composition and act simultaneously in three directions:

  • normalizes metabolism;
  • strengthens the walls of blood vessels;
  • activates blood circulation in the pelvic organs.

Taking herbal medicines is not considered the main method of treatment. These healing agents are considered concurrent drug therapy.

It is not a drug treatment

Non-pharmacological therapeutic methods make it possible to directly affect the prostate, increase the concentration of drugs in the tissues, and help to eliminate congestion.

For these purposes, the following methods are used: rectal ultrasound exposure;

Microwave hyperthermia is performed with a rectal probe inserted into the patient's anus. You can set the temperature required for a given type of exposure on the device. Increasing the concentration of the drug in the prostate requires heating to 38-40 °C. To achieve the antibacterial effect - 40-45 ° C.

Today, non-drug treatment focuses on laser therapy. The possibilities of this technique are wide. As a result of the laser, the following processes take place in the prostate gland:

  • activation of redox reactions;
  • improves blood microcirculation;
  • new capillaries are formed;
  • pathogenic microflora is suppressed;
  • the process of cell division is activated, which contributes to tissue regeneration.

In researching the effects of laser therapy on patients with prostatitis, one side effect was noted, but it is positive for the treatment. For those who completed the course, potency increased, erectile dysfunction disappeared, and vitality was restored. To achieve this result, a beam of a certain wavelength must be used. Low-intensity laser radiation is usually used to treat chronic prostatitis.

Patients can take part in laser treatment on their own initiative, if the attending physician does not prescribe it.

Surgical treatment of chronic prostatitis

Chronic prostatitis does not pose a threat to the patient's life, but it can significantly impair its quality. The most serious complication of this disease is the formation of stones in the tissues of the gland. Transurethral resection is used in order to get rid of prostoliths.

The operation is performed under TRUS guidance.

If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If sclerosis of the bladder neck is detected in combination with this pathology, a partial resection of the prostate is performed.

In case of blockage of the seminal and excretory ducts, endoscopic operations should be performed to eliminate violations of the permeability of the secret. For this purpose, incisions are made in the seminal vesicles and excretory ducts. In the case of an abscess, it is possible to completely remove the gland.

Exercises for the treatment of chronic prostatitis

There are many exercises that are effective in stimulating the prostate, which helps to clear congestion. This complex was developed for patients with hip joint problems. Practice shows that these exercises are useful for those who have been diagnosed with prostatitis. Classes can be held at a convenient time, the complex takes no more than 15 minutes to complete.

1. Task

  1. Lying on an exercise mat, extend both arms.
  2. They bend their knees and pull them towards themselves, simultaneously spreading them in different directions.
  3. Raise the pelvis as high as possible.
  4. Repeat 10-12 times.

Exercise 2

  1. While standing on the mat, perform deep squats.
  2. Repeat 10-12 times.

Exercise 3

  1. Lie on your stomach.
  2. Lift one leg, then the other.
  3. Repeat 10-12 times.

When performing this sequence of exercises, all movements should be smooth. This is the main condition for achieving a high therapeutic effect.

Treatment prognosis

Few men manage to completely cure chronic prostatitis. Prostatitis often goes into long-term remission. But when the conditions for activating the pathology arise, a relapse occurs. Exacerbation begins with the appearance of prostate pain. They are often associated with urinary tract disorders. At the first symptoms of a relapse, you should seek professional help.

Patients are recommended to visit the urologist regularly, at least once every six months. The condition of the prostate is studied with the same frequency, an analysis of PSA is carried out. By systematically monitoring the condition of the gland, the processes that trigger the relapse of the disease can be identified in time. But even with a long release, it cannot be guaranteed that they will not be violated.

The patient must follow the recommendations in order to prevent the aggravation of the disease. We recommend a balanced diet, excluding fatty and spicy foods. The reception of phytopreparations and traditional medicine must be agreed with the attending physician. With this approach, you can minimize the risk of exacerbation of chronic prostatitis.


In order to prevent the occurrence of an unpleasant disease for men, provoking factors should be eliminated and simple rules should be followed:

  • Lead a healthy lifestyle, give up bad habits.
  • Don't get cold.
  • Drink at least 1. 5-2 liters of water per day.
  • Strengthen immunity, walk a lot, get tough.
  • Engage in physical education and sports, participate in fitness clubs.
  • Avoid stressful situations.
  • Practice regular sex with a regular partner.