The public opinion chronic prostatitis is a very common urological disease of great social importance. In the minds of many men chronic prostatitis is presented as inevitable. Contribute to this publication, indicating that chronic prostatitis affects 40 - 70% of men of reproductive age. Leading world expert on this issue, Nickel JC (1999) suggests that approximately 9% of male population have manifestations of prostatitis and two-thirds of them seek medical help. In general, the problem is not HP is less relevant to men and middle aged and older.
Patients with prostatitis constitute about 8% of all outpatient visits to urologists (Collins MM et al. 1998). This is the most frequent urologic disease profile in men and 50 years and third in frequency - in men older than 50 years (after BPH and prostate cancer). In an average year urologist takes 150-250 prostatitis patients, of whom about 50 were new patients. Patients with chronic prostatitis up to 1% of all visits to general practitioners. On the clinical, social and economic importance of the problem eloquent statistics NIH (1999) that in the United States the number of visits within one year of general practitioners and urologists about HP (1850593) exceeds such index for patients with benign prostatic hyperplasia (1709053) and cancer prostate (887,341).
In assessing the importance of the problem under discussion is necessary to emphasize a clear negative impact of CP on quality of life of patients, which is comparable to that for angina, Crohn's disease and diabetes mellitus (Wenninger K. et al. 1996).
According to the known epidemiological data, up to 90% of cases occurring in abakterialny prostatitis, in which the main complaint of patients is pain. In addition, often, the disease is preceded by nervous stress. However, so far not been established whether it is a cause or consequence prostatodinii. Chronic prostatitis is associated with psycho-vegetative disorders. It is often accompanied by anxiety, anxiety, depression, problems in the intimate sphere (de la Rosette JJ, 1993).
Rx Louisiana
Monday, September 14, 2009
The course of chronic prostatitis
Chronic prostatitis different long and hard over, and in some patients for years, he proceeds without a clear clinical symptoms.
Divided into 3 stages:
I (stage alterativnyh changes)
II (stage of proliferative changes) and III (sclerosis of the prostate gland).
In I (alterativnoy) being most often the beginning of the disease indicates the appearance of pain in the rectum, perineum, lumbar-sacral region, in the testes Fire inguinal areas. At the same time can appear mucous discharge from the urethra, as well as frequent and painful urination, nocturia. Most patients note increased libido, increased frequency of spontaneous erections, decrease the duration of sexual intercourse, possible pain during ejaculation. Depending on the structure of the individual patient's awareness of their illness may impose one or the other mark on the further course of the disease and its complications.
Typically, patients with chronic prostatitis stage II on the background of persistent discomfort in the genital area is deteriorating overall health - drowsiness, weakness, fatigue, decreased libido, erectile dysfunction, dysfunction of the autonomic nervous system: sweating and hyperesthesia, vegetative dystonia.
The emerging psycho-emotional status makes it difficult to contact with the doctor, and sometimes with others, and suppresses his belief in the success of the frequently observed development of neuroses and neurosis-like states, may result in an asthenic syndrome, a syndrome of waiting, overvalued ideas syndrome, a syndrome of obsession, etc.
The clinical picture of disease in stage III acquire infravesical obstruction symptoms, although some patients may present symptoms characteristic of I and II stages of chronic prostatitis.
Rx Mississippi
Divided into 3 stages:
I (stage alterativnyh changes)
II (stage of proliferative changes) and III (sclerosis of the prostate gland).
In I (alterativnoy) being most often the beginning of the disease indicates the appearance of pain in the rectum, perineum, lumbar-sacral region, in the testes Fire inguinal areas. At the same time can appear mucous discharge from the urethra, as well as frequent and painful urination, nocturia. Most patients note increased libido, increased frequency of spontaneous erections, decrease the duration of sexual intercourse, possible pain during ejaculation. Depending on the structure of the individual patient's awareness of their illness may impose one or the other mark on the further course of the disease and its complications.
Typically, patients with chronic prostatitis stage II on the background of persistent discomfort in the genital area is deteriorating overall health - drowsiness, weakness, fatigue, decreased libido, erectile dysfunction, dysfunction of the autonomic nervous system: sweating and hyperesthesia, vegetative dystonia.
The emerging psycho-emotional status makes it difficult to contact with the doctor, and sometimes with others, and suppresses his belief in the success of the frequently observed development of neuroses and neurosis-like states, may result in an asthenic syndrome, a syndrome of waiting, overvalued ideas syndrome, a syndrome of obsession, etc.
The clinical picture of disease in stage III acquire infravesical obstruction symptoms, although some patients may present symptoms characteristic of I and II stages of chronic prostatitis.
Rx Mississippi
Chronic prostatitis and erectile dysfunction
Chronic prostatitis is an infectious and inflammatory diseases of the prostate gland which occurs mostly in young and middle-aged and symptomatic pain syndrome is manifested in various sites, a violation of the act of urination disorders and erectile function.
Erectile function is realized neyrovaskulyatornyh complex processes involving the interaction of the central, peripheral nervous systems, smooth muscle elements of the arteries and trabeculae of the penis. The term "erectile dysfunction" in recent years replacing the widely used practical urologists, the term "impotence" and characterizes the state, which has resulted in failure to achieve and maintain an erection sufficient for sexual activity [NIH Consensus Conference: Impotence, 1993].
Disorders of sexual function observed in chronic prostatitis may manifest disorders of erection, ejaculation and reduced sexual drive (libido). It is believed that sexual dysfunction in patients with chronic prostatitis characterized by phasic development.
Erectile dysfunction, is observed in patients with chronic prostatitis, mainly due to psychogenic or neurotic syndromes. Neurotic symptoms, in turn, are divided into primary, with a direct violation of the sexual function and secondary, with the involvement of this sector in a picture of neurosis.
The prevalence of erectile dysfunction (ED) significantly increases with age. According Karadeniz T. et al. (2003), it is observed in 5% of cases in men younger than 40 years and more than 15% of cases in elderly patients up to 70 years. According to the Massachusetts study of men of different ages, the overall prevalence of ED among men aged 40 to 70 years was 52%.
Other studies of epidemiology of erectile dysfunction confirm its identification in a relatively small (up to 10%) percentage of cases in men aged 18 to 40 years (Kinsey et al., 1988). Thus, it is obvious that the frequency of ED increases progressively with age. Interestingly, these data are comparable with the results of studies Nickel J. C. (1999) - an authoritative expert in the study of chronic prostatitis.
It is noted that erectile dysfunction develops within 15-30% of the total number of patients with chronic prostatitis. The few works that describe the prevalence of erectile dysfunction, depending on the form of chronic prostatitis prove that it is most pronounced and frequent in patients with chronic bacterial prostatitis. Thus, erectile dysfunction may occur as early bacterial inflammation of the prostate, and in the outcome of the disease.
The contemporary literature reflects the view that the main causative factor of erectile dysfunction in patients with chronic prostatitis are violations of mental or neuro-activity. Thus, vaskulogennaya and neurological components, hormonal imbalance, unhealthy lifestyle and alcohol abuse, smoking, consumption of drugs, obesity and physical inactivity - are mostly attributed to the etiological factors of erectile dysfunction in patients aged more or gerontology group.
On the other hand, the detailed functional and neurological examination abakterialnym patients with chronic prostatitis / chronic pelvic pain syndrome, especially the categories of NIH-IIIB, often reveal the presence of neurologically - due to violations of the function of the pelvic floor and lower urinary tract. Therefore, in our opinion, patients with ED associated abakterialnomu chronic prostatitis, it is necessary to take into account the possible presence of underlying neurological disease of the central or peripheral nervous system, which can lead to development of symptoms of dysfunction of the lower urinary tract, pelvic pain and erectile dysfunction.
The most significant therapeutic effect in treating erectile dysfunction in patients with chronic prostatitis observed when using the method of psychosexual and medical therapy. Patients with chronic prostatitis with significant psychological disorders psychosexual therapy can be used as a monotherapy and in combination with other treatments. An interesting fact that psychosexual treatment involving the interaction of sexual partner, gives positive results, as in psychogenic and organic in the ED.
Rx Virginia
Erectile function is realized neyrovaskulyatornyh complex processes involving the interaction of the central, peripheral nervous systems, smooth muscle elements of the arteries and trabeculae of the penis. The term "erectile dysfunction" in recent years replacing the widely used practical urologists, the term "impotence" and characterizes the state, which has resulted in failure to achieve and maintain an erection sufficient for sexual activity [NIH Consensus Conference: Impotence, 1993].
Disorders of sexual function observed in chronic prostatitis may manifest disorders of erection, ejaculation and reduced sexual drive (libido). It is believed that sexual dysfunction in patients with chronic prostatitis characterized by phasic development.
Erectile dysfunction, is observed in patients with chronic prostatitis, mainly due to psychogenic or neurotic syndromes. Neurotic symptoms, in turn, are divided into primary, with a direct violation of the sexual function and secondary, with the involvement of this sector in a picture of neurosis.
The prevalence of erectile dysfunction (ED) significantly increases with age. According Karadeniz T. et al. (2003), it is observed in 5% of cases in men younger than 40 years and more than 15% of cases in elderly patients up to 70 years. According to the Massachusetts study of men of different ages, the overall prevalence of ED among men aged 40 to 70 years was 52%.
Other studies of epidemiology of erectile dysfunction confirm its identification in a relatively small (up to 10%) percentage of cases in men aged 18 to 40 years (Kinsey et al., 1988). Thus, it is obvious that the frequency of ED increases progressively with age. Interestingly, these data are comparable with the results of studies Nickel J. C. (1999) - an authoritative expert in the study of chronic prostatitis.
It is noted that erectile dysfunction develops within 15-30% of the total number of patients with chronic prostatitis. The few works that describe the prevalence of erectile dysfunction, depending on the form of chronic prostatitis prove that it is most pronounced and frequent in patients with chronic bacterial prostatitis. Thus, erectile dysfunction may occur as early bacterial inflammation of the prostate, and in the outcome of the disease.
The contemporary literature reflects the view that the main causative factor of erectile dysfunction in patients with chronic prostatitis are violations of mental or neuro-activity. Thus, vaskulogennaya and neurological components, hormonal imbalance, unhealthy lifestyle and alcohol abuse, smoking, consumption of drugs, obesity and physical inactivity - are mostly attributed to the etiological factors of erectile dysfunction in patients aged more or gerontology group.
On the other hand, the detailed functional and neurological examination abakterialnym patients with chronic prostatitis / chronic pelvic pain syndrome, especially the categories of NIH-IIIB, often reveal the presence of neurologically - due to violations of the function of the pelvic floor and lower urinary tract. Therefore, in our opinion, patients with ED associated abakterialnomu chronic prostatitis, it is necessary to take into account the possible presence of underlying neurological disease of the central or peripheral nervous system, which can lead to development of symptoms of dysfunction of the lower urinary tract, pelvic pain and erectile dysfunction.
The most significant therapeutic effect in treating erectile dysfunction in patients with chronic prostatitis observed when using the method of psychosexual and medical therapy. Patients with chronic prostatitis with significant psychological disorders psychosexual therapy can be used as a monotherapy and in combination with other treatments. An interesting fact that psychosexual treatment involving the interaction of sexual partner, gives positive results, as in psychogenic and organic in the ED.
Rx Virginia
Subscribe to:
Posts (Atom)