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.
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