There are several forms of prostatitis, which differ in symptoms and in the course of the inflammatory process. Despite the fact that this disease is generally fairly well studied, there is one form that little is known about - abacterial prostatitis. This condition is also known as chronic pelvic pain syndrome and, according to the latest information, occurs in one in five men in the world. Despite its widespread occurrence, the disease remains a mystery to doctors and very difficult to treat.
Abacterial and Non-Infectious Prostatitis: What's the Difference?
Abacterial 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 with no obvious symptoms of inflammation in the prostate. In addition, in the vast majority of cases, a detailed examination does not allow the detection of an inflammatory process in the organ. At the same time, non-infectious prostatitis is an inflammatory disease with clearly defined and well-studied causes. 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 commonly diagnosed in the elderly, while non-bacterial prostatitis can occur in men of all ages.
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
Painful discomfort is felt when there is little need.
Signs of abacterial prostatitis do not resemble symptoms of inflammation of the prostate, so many doctors assume the neurological nature of the development of this disease.
With abacterial prostatitis, the symptoms are as follows:
- constant aching pain in the pelvic area;
- increased pain syndrome when urinating;
- severe discomfort when ejaculating;
- general physical complaints;
- Nervous tension.
Pelvic pain usually occurs for a long time, ranging from three months to six months. Pain syndrome is painful, monotonous, can pass on its own without the use of analgesics, and then spontaneously return. The pain radiates to the testicles, perineum, anus. Sometimes there are short-term episodes of "nervous" pain in the lower back, lower abdomen, groin.
Patients complain of worsening erection. During ejaculation, he feels a lot of tension, the ejaculation is accompanied by sharp pain. Severe attacks of pain are also possible when urinating.
Concurrent with these symptoms is severe emotional depression. The man is tense, prone to stress, some patients have insomnia and neurosis-like conditions.
Causes of Abacterial Prostatitis
A fall and a back injury as a result can lead to illness.
Non-bacterial prostatitis is not well understood, so doctors give the likely causes of this disease.
The exact mechanism of the development and pathogenesis of chronic abacterial prostatitis has not yet been clarified.
The disease can presumably have the following reasons for the development:
- inflammation of the ligaments and tendons of the pelvic floor;
- Autoimmune process;
- an increase in the ligaments of the pelvic floor;
- Back injuries and chronic diseases of the spine;
- violation of the microcirculation of blood in the prostate;
- neuropsychiatric reasons;
- intracellular parasites and pathogens in the prostate.
Infectious diseases of the organs of the genitourinary system, which are located in the immediate vicinity, can develop inflammation of the ligaments and tendons of the pelvic floor. As a result, the infection spreads to the ligaments, they become inflamed and increase in size, squeezing and irritating the nearby nerve endings. The pain a man feels at the same time can radiate along the nerves and give way to the lower back, groin, lower abdomen, or anus.
Another suspected cause of chronic abacterial prostatitis, or CABD, is autoimmune processes in the body. As a result of such a failure, the immune system begins to perceive the cells of the prostate as a foreign element and to attack with immune cells, which leads to the appearance of typical symptoms of abacterial prostatitis.
Another suspected cause is viral prostatitis, which the patient suffers from in childhood. Since the prostate is not sufficiently developed in boys, viral inflammation of this organ may not have vivid symptoms and turn into a chronic form, which in an adult man is manifested by pelvic pain syndrome.
The disease can also be linked to various back disorders, injuries, or osteochondrosis, which causes compression of the spinal nerve roots, causing pain and disruption of the prostate.
Some doctors have suggested that this disease is 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.
In addition, there is a theory that CABD can be caused by neuropsychiatric disorders, such as severe stress, neurosis, and vascular dystonia. In this case, the pathology must be considered a psychosomatic disease.
Another theory suggests that the disease may be associated with intracellular parasites or microorganisms that are so small in size that they do not allow the detection of the causative agent of the disease by standard methods.
Risk factors
Smoking can contribute to prostate problems.
Presumably, the risk factors for developing chronic pelvic pain syndrome in men are:
- previous diseases of the prostate;
- 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 when a man does not eat properly. A lack of vitamins and essential micro-elements 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 required:
- long-term pain over a period of three months;
- the absence of pathogenic microorganisms in prostate secretion;
- Lack of chronic foci of infection in the body;
- Ejaculation discomfort.
To make a diagnosis, differential diagnosis is carried out with prostate cancer, neurological syndromes, pathologies of the spine, which lead 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 the prostate secretion. You should also exclude inflammatory diseases of the testicles, bladder and kidney pathology, which can manifest itself as a pain syndrome of different localization.
An examination by a neurologist and therapist is mandatory. You should also consult a proctologist to rule out rectal pathologies.
Treatment methods
An integrated approach is used in the treatment of abacterial prostatitis. Therapy is selected by the urologist, taking into account the peculiarities 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.
If necessary, treatment can be supplemented with tranquilizers, homeopathy, and herbal remedies.
Drug therapy
Before using drug therapy, it is necessary to consult your doctor.
For the symptomatic treatment of abacterial prostatitis, drugs of the following groups are prescribed:
- Antibiotics with a broad spectrum of antimicrobial activity;
- Non-steroidal anti-inflammatory drugs;
- antispasmodic and analgesic agents;
- Alpha blockers;
- Sedatives and antidepressants.
As paradoxical as it may sound, antibacterial agents are used in the treatment of non-bacterial prostatitis. The fact is that the theory of microorganisms that can not be seen through a microscope remains open, so antibacterial agents are prescribed for prevention. Urologists say that these drugs help to quickly get rid of the symptoms of the disease, so their use is fully justified.
Antispasmodic and pain relievers are used to relieve pain. Nonsteroidal anti-inflammatory drugs can also be used as symptomatic therapy.
Alpha-blockers are indicated to make urination easier.
It should be noted that the optimal treatment regimen is selected individually for each man. You should not self-medicate and mindlessly take the drugs of the listed groups. Better to trust an experienced specialist.
Prostate massage and physiotherapy
In general, drug treatment for abacterial prostatitis has shown good results. Other methods are needed to consolidate the therapeutic effect.
Prostate massage improves the functionality of the organ, prevents the stagnation of prostate secretions, normalizes blood circulation and metabolic processes. He is appointed in 10 procedures.
As physical therapy, magnetic effects, ultrasound therapy, electrophoresis with vasodilators and other methods are prescribed. In addition, patients are shown spa treatments such as mud therapy.
Home remedies
Feverfew 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, it will only aggravate the state of health.
To treat non-bacterial prostatitis with folk remedies, you can use:
- Decoctions of soothing herbs to improve general health - chamomile, lemon balm, feverfew, valerian;
- Microclysters with anti-inflammatory decoctions of St. John's wort, calamus, yarrow;
- warm hip baths with calamus, soda or nettle decoction;
- Suppositories with pumpkin seed oil;
- Tampons with honey and propolis.
The use of any of the listed agents must be agreed with your doctor. Suppositories are prepared as follows: five parts of cocoa butter are melted in a water bath, 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 with a length of 4 cm and a diameter of 1 cm are formed and cooled in the refrigerator. Such suppositories should be injected into the rectum at night for two weeks after a cleansing enema.
Possible complications and prevention
Abacterial prostatitis requires timely 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 properly. It is important to maintain immunity to prevent hypothermia in 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 medical examinations from a urologist.