What you need to know about abacterial prostatitis

Prostatitis is a disease associated with an inflammatory process in the prostate. Prostatitis is chronic and acute, depending on the duration of the disease. Chronic prostatitis develops when the illness lasts more than three months.

Chronic pelvic pain syndrome is a disease that is not infectious, but has similar symptoms with bacterial prostatitis.

Today modern medicine has a deep and proven information about how appears and develops chronic prostatitis, abacterial especially. In most cases, this type of prostatitis etiology, pathophysiology and pathogenesis of this disease remain unknown.

Classification of prostatitis

Today the most commonly used classification of prostatitis, proposed by the national Institute of health, USA in 1995.

This classification of prostatitis based on clinical signs, the presence of leukocytes and bacteria in the prostate secretion, urine and semen.

• Category 1 — Acute bacterial prostatitis
• Category 2 — Chronic bacterial prostatitis
• Category 3 — Chronic abacterial prostatitis or chronic pelvic pain syndrome: noninflammatory and inflammatory
• Category 4 is Asymptomatic inflammatory prostatitis

Category I

Acute bacterial prostatitis considered to be an acute infectious inflammation of the prostate with signs of inflammation.

Category II

This type of prostatitis is accompanied by appropriate symptoms and an increase in the number of leukocytes and bacteria in the prostate secretion, urine and semen.

Category III

This syndrome is accompanied by pain, which is not terminated within 3 months, however, in the prostate secretion, sperm and urine are no pathogenic microorganisms.

This type of disease is divided into inflammatory and non-inflammatory the presence or absence of an elevated number of white blood cells.

Category III A

Inflammatory syndrome in a patient observed the pain and symptoms of prostatitis, increased level of leukocytes in the prostate secretion, urine, and ejaculate.

There are no pathogens in these samples.

Category III B

Inflammatory syndrome in a patient observed the pain and symptoms of prostatitis, but not the level of leukocytes in the prostate secretion, urine, and ejaculate.

And there are no pathogens in samples obtained during prostate massage.

Category IV

Asymptomatic inflammatory prostatitis has no symptoms,typical for prostatitis.

This kind of disease is detected randomly during histological examination of tissue samples of the prostate.

Chronic pelvic pain syndrome in men

The reasons for the development

The first reason

The cause can be microorganisms that are simply impossible to define the classical microbiological methods studies. This is such microorganisms as chlamydia trachomatis, urealyticum Ureaplasma, Mycoplasma of hominis, genital viruses, pathogens that evolve without oxygen.

The prostate gland may act as a reservoir for bacteria that cannot be detected by standard microbiological study.

In order to detect such micro-organisms, it is necessary to use special methods such as the method of molecular diagnosis, inoculation of special media for the detection of anaerobic pathogens.

The second reason

The second reason for the development of inflammation in this type of prostatitis can be vnutripsihicheskoy reflux, i.e. the reflux of urine into the ducts of the prostate from the urethra. In this case, it throws sterile urine, in which no pathogenic microbes.

This can occur due to the anatomical prerequisites of the structure of the prostate gland, as well as increased pressure in the urethra, which appears due to mechanical or functional causes. Urine reflux provokes inflammatory reaction, resulting in a damaged neuro-muscular system and prostate gland.

The third reason

A third reason for the inflammatory syndrome is considered to be an immune or autoimmune process.

Non-inflammatory chronic pelvic pain syndrome

The evaluation of patients with non-inflammatory syndrome of chronic pelvic pain is the only correct data are indicators obtained during the special urodynamic studies. This study suggests, does the prostate gland neuromuscular changes.

These changes disrupt the coordination of muscle contractions of the prostate, pelvic floor and bladder neck. However, it is impossible to determine whether these changes are primary or occur as a result of exposure to a certain damaging factor.

Male organs, which are responsible for the development of chronic pelvic pain syndrome-dependent anatomical and functional changes:

• Prostatic urethra. Increases vnutriuretralnami pressure, narrowing of the urethra and development of hypersensitivity.
• The neck of the bladder. Body narrows hipertrofiada and there is a functional stenosis.
• Pelvic floor. Develops pain in the muscles of the pelvic floor, pseudodictionary, there is muscle tension.
• Prostate.Vnutripsihicheskoy increases the pressure that is fixed by the reflux of urine into the ducts of the prostate gland.

Treatment of abacterial prostatitis

Treatment completely depends on the causes of the disease.

To treat this type of prostatitis is usually used methods that are used for chronic neuropathic pain syndromes:

• analgesics,
• a-blockers,
• anti-inflammatory drugs,
• anticonvulsants and muscle relaxants
• neuromuscular therapy
• rectal diathermy,
• tricyclic antidepressants, tranquilizers, sedatives,
• psychotherapy,
• physical therapy
• membrane,
• preparations of phosphorus,
• vegetable adaptogenes,
• the blockade of nerves,
• corticosteroids or immunosuppressants,
• novocaine and hloretilom blockade
• intracutaneous autohemotherapy,
• prostate massage,
• antiholinesteraznae drugs
• therapy pelvic floor: ischemic compression of trigger points, strengthening and stretching the back and pelvis, training the bladder, stimulation of sacral nerves
• microwave hyperthermia,
• transurethral needle ablation
• transurethral resection of the prostate,
• the incision of the bladder neck for obstructive-stenotic complications
• polypeptide drugs that improve the microcirculation in the prostate gland,
• medications that strengthen blood vessels and improve microcirculation.

Diagnosis

All of these violations are the result of adrenergic stimulation. Patients with chronic pelvic pain syndrome are often depressed, they are constantly plagued by disturbing thoughts. During the examination of patients with chronic pelvic pain syndrome can be detected pain in certain points of the pelvis, perineum and penis.

During histological examination of the prostate in the syndrome of chronic pelvic pain can be identification and preparation of inflammatory changes that strongly resemble the symptoms of chronic bacterial prostatitis.