Treatment of prostatitis

In the middle of the last century, it was believed that prostatitis develops in old age.Today the disease has become “younger”, diagnosed in men 30-40 years old who are fertile.Inflammation tends to become chronic, making treatment much more difficult.Doctors successfully solve men's health problems of all levels of complexity.Urologists at the medical center develop individual treatment regimens, use the best drugs and master modern methods of treating prostate diseases.

"Second Man's Heart"

The prostate is a small unpaired exocrine gland controlled by hormone action.This organ is located in the perineum, below the bladder.The wider border of the prostate covers the bladder neck.The posterior part is adjacent to the anterior wall of the rectum.The anterior part of the gland occupies a position in the pubic bone area at the junction of the pelvis.In the male body, the prostate performs three main functions:

• motility - controls the separation of urine and semen (so sperm does not enter the bladder;
• secretion - secretion production is responsible for the quality of semen and maintaining a stable erection;
• barrier - protects against infection of the upper parts of the urinary system.

Prostate function begins to manifest during puberty and becomes fully functional at ages 18–20.A decrease in the active activity of this organ is noted in men who have passed the 50-year mark.

Types and forms of prostatitis

The type of disease is determined by the cause:

1. Bacterial prostatitis.It occurs as a complication of infection and inflammation in the urinary tract (less common in other body systems).
2. Bacterial prostatitis.It develops against the background of physiological disruptions of neurological, neuropsychiatric causes, chronic diseases and unhealthy lifestyles.

The cause of the inflammatory process is congestion (stagnation) in the tissues of the gland, caused by organic disorders or infections.

Forms are classified according to the nature of the symptoms and course of the disease:

1. Acute inflammation.Characteristics of a bacterial disease.Accompanied by intense manifestation of specific symptoms.
2. Chronic prostatitis.It's not stable.After the latent period, there are relapses with obvious symptoms.In 95% of cases it is of bacterial origin.

Symptoms of chronic prostatitis often clear up while the inflammation progresses.The undulating course of the disease is what causes you to not contact a urologist in time, which then leads to expensive treatment of complications.

Causes of prostatitis

Blood stagnation and prostatic secretion occur for reasons that correspond to the classification type of the disease.

Causes of the infectious type	Causes of bacterial species
Sexually transmitted infections (STIs): bacteria (syphilis, gonorrhea, ureaplasmosis, gardnerellosis); viruses (papilloma, cytomegalovirus, genital herpes); parasites (chlamydia, trichomonas);fungus (candida). Diseases caused by bacteria in the intestines, skin, respiratory organs due to the activity of staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc.	Neuralgia, rheumatism, neurological disorders, mechanical injuries to the spine and genital organs, prostatic reflux, chronic constipation (constipation), suffering, history of urinary diseases (cystitis, urethritis, etc.), physical inactivity, diseases of the endocrine system

Provocative factors include irregular sexual intercourse (absolute absence of sex), systematic hypothermia, chronic alcoholism.

Symptoms of the acute form of the disease

Acute prostatitis is characterized by severe inflammatory manifestations in the prostate.Neighboring organs and systems are involved in this process and psycho-emotional stability is disrupted.

Main symptoms:

1. From the urinary system.Pollakiuria (frequent urination) with dripping urine, burning sensation, pain in the urethra.Urine becomes cloudy.The urge to empty the bladder is often false.
2. From the reproductive system.Perineal pain, decreased potency, painful ejaculation.During intimacy (or immediately after), discomfort appears in the area of the head of the penis and testicles.
3. From the nervous system.Acute muscle pain in the lumbar region, sacrum, and lower abdomen.
4. Psycho-emotional disorders.Increased stress, anxiety, irritability.
5. From the digestive system.Constipation, aggravating hemorrhoids.
6. From the side of the autonomic nervous system.Loss of appetite, headache, low body temperature (37–38oC), symptoms of body intoxication.Habitual actions cause rapid fatigue and the desire to lie down.

Against the background of inflammation, existing chronic diseases become worse.

Signs of chronic prostatitis

Prolonged prostatitis leads to disruption of the organ's morphological structure and functioning.During the remission period, the pathology reminds itself with increasing fatigue and decreased performance.Urinary system disorders are characterized by repeated (often erroneous) urges to empty the bladder, which become more frequent at night.

Moderate pain when urinating, after urinating, there is a feeling of incomplete urination.The mucus secreted by the prostate gland is yellowish in color and has an unpleasant odor (prostate) spontaneously flows from the urethra.

The patient is affected by chronic pelvic pain syndrome - painful sensations localized in the lower part of the abdomen, pelvis and external genital organs, in the perineum, lumbar region and sacral region.

Chronic prostatitis is accompanied by sexual health disorders:

• unstable erection accompanied by pain;
• Inhibition of sexual desire;
• rapid or difficult ejaculation (often painful).

In the context of sexual disorders, psychological and emotional instability is increasing.A man can suffer from depression and sudden mood changes - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).

During relapse, symptoms correspond to the acute form of the disease, but are less intense.Exacerbation is provoked by:

1. General hypothermia.After a long stay in cold water or frost, any chronic inflammatory disease, including prostatitis, will become worse.
2. Limited mobility.With physical inactivity, blood circulation in the pelvic organs is impaired.Blood stagnation leads to swelling of the prostate, compression of nerve endings and the urethra.
3. Alcohol abuse.The chronic inflammatory process is activated under the influence of alcohol.
4. Abstain from long-term intimate relationships.Lack of sexual intercourse leads to stagnation of prostatic secretions, causing aggravation of the condition.
5. Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.

Recurrence of the disease is caused by unhealthy eating habits.An excess of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol levels in the blood), thereby developing atherosclerosis.Cholesterol plaques impede free blood flow, causing blockages in the prostate.An excess of constipating foods in the menu leads to excessive tension in the pelvic floor muscles.

Complications of prostatitis

If acute inflammation is not treated promptly, pus will accumulate in the prostate tissues and a glandular abscess will develop.This condition is characterized by fever temperature (39oC), chills, severe pain in the perineum, ischemia (inability to independently empty the bladder).The only treatment is surgery to open the pus and urethral duct (widening the urethra using a special metal tube).

Lack of accurate diagnosis, ignoring symptoms, and long-term self-treatment of chronic prostatitis are the causes leading to dangerous complications:

• Prostate tumor is a benign tumor that can easily turn malignant (malignant) if not treated properly;
• formation of stones in the gland;
• Epididymitis is an inflammation of the testicles;
• seminal vesiculitis - inflammation of the seminal vesicles;
• infertility (the first degree of the disease requires long-term treatment, the second degree is practically impossible to treat);
• impotent;
• Sclerosis of the prostate is the death of prostate cells.

Timely prostate examination in men will help avoid serious consequences of infection.

Prostate examination

A rectal prostate exam is an uncomfortable but extremely necessary procedure.It allows early detection of serious diseases such as adenoma, prostatitis and malignant tumors.

Indications for rectal prostate examination

Every man over 40 should see a urologist at least once a year.The earlier the inflammatory process, benign and malignant tumors are diagnosed, the greater the chance of complete prostate recovery.Patients receive more gentle treatment, maintaining sexual desire, sexual activity and fertility.

Sometimes men under 40 spot the warning signs but put off seeing a urologist.Indications for urgent prostate examination are:

• pain of any intensity in the perineal area;
• erectile dysfunction;
• premature ejaculation;
• decreased amount of sperm released;
• Discomfort during sex and defecation.

Don't ignore urination problems - too frequent urination, pain, feeling of bladder not emptying, unpleasant changes in the smell and color of urine.If you notice at least one sign, be sure to make an appointment with a urologist.

How is a digital prostate exam performed?

A few hours before the procedure, you must refrain from:

• sexual intercourse;
• masturbate;
• sports;
• cycling;
• physical labor.

Before visiting the doctor, you need to empty your bladder and make a cleansing enema with saline or chamomile decoction.

Before examining the prostate, the man takes an elbow position, lies on his side, bends his legs or stands leaning forward and puts his hands on the table.The doctor puts on sterile gloves and lubricates the patient's index finger and anus with Vaseline or lubricant.

During a rectal examination of the prostate, the doctor massages the lobes of the prostate from the sides to the middle.With the help of palpation, you can evaluate:

• size and shape;
• structure and elasticity of the organ;
• symmetry of its elements;
• expressiveness of contours and longitudinal grooves;
• Presence of pain, lumps and knots.

These data help determine whether there are pathological changes in the prostate.

In addition, during the procedure, prostatic secretions will be obtained.This fluid is sent for analysis, which shows the content of bacteria, white blood cells, red blood cells and pathogenic microorganisms.

Based on the results of a digital prostate examination, your doctor may prescribe additional diagnostic measures.These include clinical analysis of urine and blood, testing for tumor markers, prostate ultrasound, and more.

Diagnosis of disease

The correct diagnosis includes several stages:

• initial consultation with a urologist;
• a set of laboratory tests;
• examine the hardware of the prostate;
• Make multiple appointments to see your doctor.

Consultation with a urologist includes:

• identify symptoms, their characteristics (duration, intensity);
• take history (past illnesses);
• clarify information about working conditions, lifestyle characteristics, habits, and regularity of sexual intercourse;
• Visual assessment of the external genitalia for the presence of rashes, redness, swelling, discharge from the urethra;
• Palpate the inguinal lymph nodes;
• rectal examination of the prostate (determination of pain, contour, density, elasticity of the gland, assessment of the condition of the interlobular septum);
• Collect biological materials for laboratory research;
• Assign tests.

A medical appointment does not have a strict time limit.In a specialized clinic, each patient is given maximum time and attention.

To differentiate between bacterial and bacterial prostatitis, to determine the form of the disease, the man will have blood tests, urine, prostatic secretions and smears from the urethra.

The doctor takes a sample of prostate secretions with his own hand during a rectal examination.For examination, disposable medical gloves are used, a lubricant (vaseline, lubricating gel, glycerin) that facilitates penetration into the rectal bulb and sterile glasses.Penetration depth does not exceed 5 cm.The urologist's expertise and experience ensure the safety and painlessness of the procedure.

Venous blood was collected using a modern vacuum cleaner.The medical center strictly adheres to aseptic regulations in collecting biological material.

laboratory testing

The study was performed by experienced experts in a clinical diagnostic laboratory.The medical center's laboratory department is equipped with modern equipment that allows tests of all levels of complexity to be performed.

The list of tests includes:

1. Culturing bacteria on smears to identify STIs.Biological material samples are grown in a nutritional environment favorable for the growth of pathogenic microorganisms.Active reproduction and formation of colonies of a particular pathogen indicate the presence of infection.Based on bacterial culture, antibiogram is performed to determine the pathogen's resistance to antibiotics.
2. General urine analysis.Deviation from the norm (leukocytosis, bacteriuria, casturia, etc.) indicates the presence of an inflammatory process.
3. A blood test for PSA (prostate-specific antigen) is a marker for tumors of the male reproductive system.It is performed using the highly accurate chemiluminescence immunoassay (CHLA) method.
4. Study of prostatic secretions (microscopy and culture).Allows you to determine inflammation, presence of bacteria (E. coli, staphylococcus, etc.)

Comprehensive screening for sexually transmitted diseases can be done using a blood sample.

Hardware diagnosis is TRUS (transrectal ultrasound) of the prostate.It is performed using a cylindrical sensor no more than 1.5 cm in diameter, inserted into the rectum.The sensor is pre-lubricated and special disposable accessories (condoms) are placed on top.The data is transmitted to a monitor, where the urologist visually evaluates pathological changes in the prostate.

Appointment repeats

At follow-up examination, the doctor:

• evaluate test results;
• develop an individual treatment regimen taking into account the type, form, nature of the prostatitis process, drug tolerance and age of the patient;
• regulation of controlled studies.

We recommend making an appointment at a time convenient to the patient over the phone or through the website by filling out an online form.

Treatment of prostatitis

At the clinic, a man can undergo a full course of treatment for prostatitis.Therapy for acute prostatitis consists of three stages:

• reduces symptoms and inflammation;
• Restore function and stabilize the gland;
• consolidates results, prevents complications.

First stage

For infectious prostatitis, antibiotics are initially prescribed to kill the infectious agent.The choice of medication is based on the results of the antibiogram.In parallel, drugs of several pharmacological groups are used:

1. Alpha adrenergic blockers.The drug relaxes the smooth muscle tissue of the prostate and bladder neck, reduces pressure inside the urethra, normalizes urine flow and reduces gland swelling.
2. Enzymes.They dilute prostatic secretions, increase the local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
3. Immunomodulator to restore immunity.
4. Nonsteroidal anti-inflammatory drugs (NSAIDs).They reduce inflammation and relieve pain.

The doctor will choose the medicine and dosage depending on the symptoms, type and form of the disease.

Second stage

Once the acute symptoms subside, they turn to medications and methods that help stabilize the gland.Drug treatment includes:

• vascular drugs (to improve blood supply to the prostate);
• immune stimulant;
• drugs that normalize the process of urine excretion;
• anti-inflammatory drugs;
• medicine to restore erection.

In complex treatment, oral and rectal suppositories (regenerating, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.

Special methods include prostate massage.Mechanical impact on the prostate allows you to:

• speed up blood circulation;
• strengthens the walls of capillaries and blood vessels;
• Activate the exchange process;
• establish an outflow of secretions;
• normalizes bladder emptying;
• increase the effectiveness of drug treatment;
• restore sexual activity.

Massage procedures are performed for therapeutic and preventive purposes.

Types of massage:

• use an expander (bougie);
• internal palpation;
• non-invasive (no penetration);
• penetrating or external hardware (performed using a special massager).

Third stage

The treatment is completed with ozone therapy and laser therapy.Rectal ozone therapy consists of daily administration of a freshly prepared ozonated isotonic sodium chloride solution.

Laser treatment of prostatitis is a progressive physiotherapy technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directive action of rectal laser:

• glandular cell regeneration;
• reduces inflammation and pain;
• enhance local immunity;
• improves blood supply to the prostate and the condition of blood vessels.

The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes.Based on the attending physician's decision, laser therapy begins with the second phase of treatment.

In addition, phytotherapeutic agents are used.

Features of treatment of chronic prostatitis

This form of prostatitis is characterized by a wave-like course, in which the exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms.In some cases, symptoms appear continuously but are mild and gradually fade.In most cases, men have to endure long-term inconvenience in the form of difficulty urinating, dull pain in the lower abdomen and perineum, and weakened fertility.Patients with this diagnosis often seek medical attention as soon as symptoms worsen.

Treatment of chronic prostatitis begins with a detailed examination to find the cause of the inflammatory process.Based on the diagnostic results, the urologist chooses drugs from several groups:

• Antibacterial drugs are prescribed to patients diagnosed with chronic bacterial prostatitis, as well as diseases of non-bacterial origin.In addition to inhibiting the activity of pathogenic microflora, drugs of this group also help reduce inflammation.
• Alpha blockers are prescribed to patients with severe urinary disorders.The medication improves urine flow rate and reduces symptoms.
• Muscle relaxants are prescribed to patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
• Urologists recommend using hormonal agents for active development of the glandular tissues of the prostate against chronic inflammation.
• Immunomodulators are used to treat chronic prostatitis of any origin, which may be allergic, bacterial, or bacterial prostatitis.

In addition, the agent is used to stimulate blood circulation in the pelvic organs and prostate, as well as potency stimulants.Treatments such as prostate massage, physical therapy (electrophoresis, shock wave therapy, UHF, etc.), a set of calisthenics exercises to relax the perineum and pelvic floor muscles, and laser therapy also help improve the prognosis.

All of these methods are widely used in clinics, helping to achieve high treatment results even when the patient is diagnosed with chronic stone-induced prostatitis, one of the complex forms of chronic prostatitis.The center's specialists pay special attention to preserving the functions of the reproductive system in men, thanks to which patients after treatment can lead a full life and even become parents.Only with complex treatment with the use of properly selected drugs, physiotherapy and prostate massage can a positive treatment result be achieved.

Prevent inflammation in the prostate

Preventive measures include:

1. Change eating habits.A balanced diet with limited foods high in fat and calories.Enrich the diet with vegetables, fruits, products good for men's health (nuts, honey, seafood, etc.).
2. Physical activity (regular exercise helps normalize blood circulation in the genital area).
3. Protected sex is the use of barrier contraception (condoms) to protect against sexually transmitted diseases.
4. Regular sexual intercourse is a pleasant and useful preventative measure against prostate congestion.
5. Limit alcohol intake.Alcohol abuse leads to decreased potency, sexual desire and inhibition of testosterone synthesis.
6. Rest completely.Psycho-emotional overload, insomnia (insomnia), and physical fatigue are the causes of bacterial prostatitis.
7. See your urologist regularly and get tested for sexually transmitted diseases.The disease is easier to prevent than to treat.

Urologists offer preventative prostate exams.