Treatment of prostatitis

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

"The Heart of the Second Man"

The prostate is a small, unpaired exocrine gland controlled by hormonal activity.The organ is located at the bottom of the pelvis, below the bladder.The widest edge of the prostate covers the neck of the bladder.The posterior part is adjacent to the anterior wall of the rectum.The frontal part of the gland occupies a place in the pubic area of the junction of the pelvic bones.In the male body, the prostate performs three key functions:

• motor - control of the separation of urine and seminal fluid (as a result, sperm do not enter the bladder;
• secretory - production of secretions responsible for the quality of seminal fluid and the maintenance of a stable erection;
• barrier - protection against infection of the upper parts of the urinary system.

Prostate functionality begins to manifest during puberty and becomes fully functional between the ages of 18 and 20.A decline in the active functioning of the organ is recorded in men who have crossed the fifty-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 infectious and inflammatory processes in the urogenital tract (less often in other body systems).
2. Abacterial prostatitis.It develops against the background of physiological disturbances of neurological, psychoneurological etiology, chronic diseases and an unhealthy lifestyle.

The trigger of the inflammatory process is a congestive phenomenon (stagnation) in the tissues of the gland, caused by organic disorders or infection.

The forms are classified according to the nature of the manifestation of symptoms and the course of the disease:

1. Acute inflammation.Characteristic of a bacterial type disease.Accompanied by an intense manifestation of specific symptoms.
2. Chronic prostatitis.It's unstable.Latency periods are followed by relapses with pronounced symptoms.In 95% of cases, it is of abacterial origin.

The symptoms of chronic prostatitis often fade as the inflammatory process progresses.The undulating course of the disease is the cause of untimely contact with a urologist, which subsequently leads to expensive treatment of complications.

Causes of prostatitis

Stagnation of blood circulation and prostatic secretion occurs for reasons corresponding to the type of classification of the disease.

Infectious causes	Causes of bacterial species
Sexually transmitted infections (STIs): bacterial (syphilis, gonorrhea, ureaplasmosis, gardnerellosis); viral (papillomatosis, cytomegalovirus, genital herpes); parasitic (chlamydia, trichomoniasis);fungal (candidiasis). Bacterial diseases of the intestines, skin, respiratory organs caused by the activity of staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc.	Neuralgia, rheumatism, neuroses, mechanical damage to the spine and genitals, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc.), sedentary lifestyle, diseases of the endocrine system

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

Symptoms of the acute form of the disease

Acute prostatitis is characterized by severe manifestations of inflammation of the prostate.Adjacent organs and systems are involved in the process and psycho-emotional stability is disrupted.

Key symptoms:

1. Of 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. Of the reproductive system.Pain in the perineum, decreased potency, painful ejaculation.During intimacy (or immediately after), discomfort appears in the head of the penis and testicles.
3. Of the nervous system.Acute muscle pain in the lumbar and sacral region, in the lower abdomen.
4. Psycho-emotional disorders.Increased nervousness, anxiety, irritability.
5. From the digestive system.Constipation, exacerbation of hemorrhoids.
6. On the side of the autonomic nervous system.Lack of appetite, headache, low body temperature (37-38 ℃), symptoms of body intoxication.Habitual actions cause rapid fatigue and a desire to lie down.

Against the background of inflammation, existing chronic diseases worsen.

Signs of chronic prostatitis

Prolonged inflammation of the prostate leads to disruption of the morphological structure and performance of the organ.In the remission phase, the pathology is remembered with increased fatigue and decreased performance.Urinary system disorders are characterized by repeated (often false) urges to empty the bladder, becoming more frequent at night.

Urination is moderately painful, after urinary excretion there is a feeling of incomplete emptying.A prostatic secretion of mucous consistency, yellowish in color and unpleasant odor (prostatorrhea) flows spontaneously from the urethra.

Patients suffer from chronic pelvic pain syndrome - painful painful sensations localized in the lower third of the abdomen, in the pelvic and external genitals, in the perineal region, in the lumbar and sacral regions.

Chronic prostatitis is accompanied by sexual health disorders:

• unstable erection accompanied by pain;
• suppression of libido;
• accelerated or difficult (often painful) ejaculation.

Against the background of sexual disorders, psycho-emotional instability progresses.A man is prone to depression and sudden mood changes - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).

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

1. General hypothermia.After a long stay in cold water or frost, possible chronic inflammatory diseases, including prostatitis, worsen.
2. Limitation of mobility.With physical inactivity, blood circulation in the pelvic organs is impaired.Blood stagnation leads to swelling of the prostate, which compresses the nerve endings and the urethra.
3. Alcohol abuse.The chronic course of inflammatory processes is activated under the influence of alcohol.
4. Long-term abstinence from intimate relationships.Lack of sexual intercourse leads to stagnation of prostate secretions, which causes exacerbation.
5. Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.

Relapse of the disease is caused by poor eating habits.The abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), which leads to the development of atherosclerosis.Cholesterol plaques obstruct the free flow of blood, causing congestion in the prostate.An excess of constipating foods in the menu leads to excessive tension in the perineal muscles.

Complications of prostatitis

If acute inflammation is not treated in time, purulent masses accumulate in the prostate tissues and an abscess of the gland develops.The disease is characterized by feverish temperature (39 ℃), chills, severe sharp pain in the perineum, ischuria (inability to empty the bladder independently).The only method of treatment is an operation aimed at opening the suppuration and bougienage of the urethra (expansion of the urethra using a special metal bougie).

Lack of correct diagnosis, neglect of symptoms, long-term self-medication of chronic prostatitis are the reasons for the development of dangerous complications:

• prostate adenoma is a benign tumor prone to malignancy (malignancy) if improperly treated;
• formation of stones in the gland;
• Epididymo-orchitis is an inflammation of the testicle;
• vesiculitis - inflammation of the seminal vesicles;
• infertility (the first degree of the disease requires long-term treatment, the second is practically incurable);
• impotence;
• Prostate sclerosis is the death of prostate cells.

A timely examination of the prostate in men will help avoid serious consequences of inflammatory disease.

Prostate exam

A digital rectal examination of the prostate is an unpleasant but extremely necessary procedure.It allows early detection of serious diseases such as adenomas, prostatitis and malignant tumors.

Indications for digital rectal examination of the prostate

Every man over 40 should see a urologist at least once a year.The earlier the inflammatory process, benign and malignant neoplasms are diagnosed, the greater the chances of complete restoration of the prostate.The patient receives more gentle treatment, retains libido, sexual activity and the ability to fertilize.

Sometimes men under 40 discover warning signs, but postpone a visit to the urologist.The indications for an urgent prostate examination are:

• pain of any intensity in the perineal region;
• erectile dysfunction;
• premature ejaculation;
• decrease in the volume of sperm released;
• discomfort during sexual intercourse and defecation.

Do not ignore problems with urination - too frequent urge, pain, feeling of unemptied bladder, 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?

Several hours before the procedure, you must refrain from:

• sexual contact;
• masturbation;
• playing sports;
• ride a bike;
• physical work.

Before consulting a doctor, you need to empty your bladder and do a cleansing enema with salt water or chamomile decoction.

Before examining the prostate, the man takes a knee-elbow position, lies on his side with his legs bent, or stands leaning forward and places his hands on the table.The doctor puts on sterile gloves and lubricates his index finger and the patient's anus with petroleum jelly or lubricant.

During a digital rectal examination of the prostate, the doctor massages the lobes of the prostate from the sides towards the center.With the help of palpation, you can assess:

• size and shape;
• texture and elasticity of the organ;
• symmetry of its elements;
• expressiveness of contours and longitudinal furrow;
• the presence of pain, bumps and knots.

These data make it possible to determine whether there are pathological changes in the prostate.

Additionally, during the procedure, prostate secretions are obtained.This liquid is sent for analysis, which shows the content of bacteria, leukocytes, red blood cells and pathogenic microorganisms.

Based on the results of a digital prostate examination, the doctor may prescribe additional diagnostic measures.These include clinical urine and blood analysis, tumor marker tests, prostate ultrasound, etc.

Diagnosis of the disease

Making an accurate diagnosis includes several steps:

• first consultation with a urologist;
• a set of laboratory tests;
• physical examination of the prostate;
• repeated appointment with the doctor.

The consultation with a urologist includes:

• identification of symptoms, their characteristics (duration, intensity);
• take anamnesis (past illnesses);
• clarification of information on working conditions, lifestyle features, habits and regularity of sexual relations;
• visual assessment of the external genitalia for the presence of rash, redness, swelling, discharge from the urethra;
• palpation of the inguinal lymph nodes;
• rectal palpation of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the state of the interlobar septum);
• collection of biomaterials for laboratory research;
• allocation of tests.

A medical appointment is not subject to strict deadlines.In a specialized clinic, each patient receives maximum time and attention.

For differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes tests of blood, urine, prostate secretions and a smear from the urethra.

The doctor takes a sample of prostate secretion from his own hand during a rectal examination of the gland.For the examination, disposable medical gloves, lubricant (vaseline, lubricating gel, glycerin) facilitating penetration into the rectal bulb and sterile glasses are used.The penetration depth does not exceed 5 cm.The professional qualifications and experience of urologists guarantee the safety and painlessness of the procedure.

Venous blood is collected using modern vacutainers.The medical center strictly complies with the rules of sterility for the collection of biological material.

Laboratory tests

The research is carried out by experienced specialists in a clinical diagnostic laboratory.The laboratory department of the medical center is equipped with modern equipment for carrying out tests of any complexity.

The list of tests includes:

1. Bacteriological culture of a smear to determine STIs.A sample of biomaterial is planted on a nutrient medium favorable to the growth of pathogenic microorganisms.Active reproduction and colony formation of a particular pathogen indicate the presence of an infection.Based on a bacterial culture, an antibiogram is performed to determine the resistance of pathogens to antibiotics.
2. General urine analysis.A deviation from the norm (leukocyturia, bacteriuria, cylindruria, etc.) indicates the presence of an inflammatory process.
3. A blood test for PSA (prostate specific antigen) is a tumor marker of the male reproductive system.It is carried out using a very precise chemiluminescence immunoassay (CHLA) method.
4. Study of prostate secretions (microscopy and culture).Allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc.)

A comprehensive STI screening can be done using a blood sample.

The hardware diagnosis is TRUS (transrectal ultrasound) of the prostate.It is carried out using a cylindrical sensor with a diameter of no more than 1.5 cm, inserted into the rectum.The sensor is pre-lubricated and special disposable accessories (condom) are placed on it.The data is transmitted to a monitor, where the urologist visually assesses pathological changes in the prostate.

Repeat appointment

When renewing the mandate, the doctor:

• evaluates test results;
• establishes a personal treatment regimen taking into account the type, form, nature of the course of prostatitis, drug tolerance and age of the patient;
• prescribes control studies.

We offer to make an appointment at a time convenient for the patient by telephone or via the website by filling out the online form.

Prostatitis therapy

At the clinic, a man can undergo comprehensive treatment for prostatitis.Treatment of acute prostate inflammation includes three stages:

• relief of symptoms and inflammation;
• restoration of functions, stabilization of the gland;
• consolidation of results, prevention of complications.

First step

For prostatitis of infectious etiology, antibiotics are initially prescribed to destroy the infectious agent.The choice of medication is based on the results of the antibiogram.At the same time, drugs from several pharmacological groups are used:

1. Alpha-adrenergic blockers.The drugs help relax the smooth muscle tissues of the prostate and bladder neck, reduce internal pressure in the urethra, normalize the flow of urine, and reduce swelling of the gland.
2. Enzymes.They dilute prostate secretions, increase local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
3. Immunomodulators to restore immunity.
4. Nonsteroidal anti-inflammatory drugs (NSAIDs).They reduce the inflammatory process and relieve pain.

The doctor personally selects drugs and dosage depending on the symptoms, type and form of the disease.

Second step

Once the acute symptoms are relieved, they move on to medications and methods that help stabilize the gland.Drug treatment includes:

• vascular drugs (to improve blood supply to the prostate);
• immunostimulants;
• drugs that normalize the process of urinary excretion;
• anti-inflammatory drugs;
• medicines to restore erections.

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

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

• accelerate blood circulation;
• strengthen the walls of capillaries and blood vessels;
• activate exchange processes;
• establish flow of secretions;
• normalize bladder emptying;
• increase the effectiveness of drug treatment;
• restore sexual activity.

Massage procedures are carried out for therapeutic and preventive purposes.

Types of massages:

• using a dilator (candle);
• internal palpation;
• non-invasive (no penetration);
• penetrating or external material (performed using a special massager).

Third step

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

Treatment of prostate inflammation with a laser is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directional action of the rectal laser:

• regenerates gland cells;
• relieves inflammation and pain;
• strengthens local immunity;
• improves blood supply to the prostate and the condition of blood vessels.

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

Additionally, phytotherapeutic agents are used.

Features of treatment of chronic prostatitis

This form of prostatitis is characterized by a wave course, in which an exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms.In some cases, symptoms are observed constantly, but have an attenuated and mild character.In most cases, men experience inconvenience for a long time in the form of impaired urination, dull pain in the lower abdomen and perineum, and weakened potency.Patients with this diagnosis often turn to a doctor precisely during an exacerbation of symptoms.

Treatment of chronic prostatitis begins with a detailed examination aimed at finding out the cause of the inflammatory process.Based on the diagnostic results, the urologist selects drugs from several groups:

• Antibacterial drugs are prescribed to patients diagnosed with chronic bacterial prostatitis, as well as for diseases of non-bacterial origin.In addition to suppressing the activity of pathogenic microflora, drugs of this group help to reduce inflammation.
• Alpha-blocker drugs are prescribed to patients with severe urinary disorders.Medications improve urine flow and relieve symptoms.
• Muscle relaxants are prescribed to patients suffering from chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
• Urologists recommend using hormonal agents for the active growth of prostate gland tissue against the background of chronic inflammation.
• Immunomodulators are used for chronic inflammation of the prostate of any origin, whether allergic, bacterial or abacterial prostatitis.

Additionally, agents are used to stimulate blood circulation in the pelvic organs and the prostate itself, as well as potency stimulants.Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and much more), a set of exercise therapy exercises to relax the muscles of the perineum and pelvic floor, as well as laser therapy also help to improve the prognosis.

All these methods are widely used in the clinic, which makes it possible to achieve high treatment results, even if the patient is diagnosed with chronic calculous prostatitis, one of the forms of complicated chronic inflammation of the prostate.The center's specialists pay special attention to preserving the functions of the genitourinary system in men, thanks to which patients after therapy can lead a full life and even become parents.Only with complex treatment using correctly selected medications, physiotherapy and prostate massage can a positive treatment result be achieved.

Prevention of inflammatory processes in the prostate

Preventive measures include:

1. Change eating habits.A balanced diet with few fatty and high-calorie foods.Enrich the diet with vegetables, fruits, products for men's health (nuts, honey, seafood, etc.).
2. Physical activity (regular exercise helps to normalize blood circulation in the genital area).
3. Safe sex is the use of barrier contraception (condoms) to protect against sexually transmitted diseases.
4. Regular sexual relations constitute a pleasant and useful prevention of congestive phenomena of the prostate.
5. Limit alcohol.Alcohol abuse leads to a decrease in potency, libido and inhibition of testosterone synthesis.
6. Complete rest.Psycho-emotional overload, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
7. Regular visits to the urologist and examinations for STIs.The disease is easier to prevent than to treat.

Urologists offer preventive prostate exams.