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" and is diagnosed in fertile men aged 30-40. Inflammation tends to become chronic, which makes therapy much more difficult. Doctors successfully solve men's health problems of any complexity. they develop, use the best drugs and have modern methods for the treatment of prostate diseases.

"Second Man's Heart"

The prostate is a small, odd-shaped exocrine gland that is regulated by hormonal activity. The organ is located at the bottom of the pelvis, below the bladder. The wider edge of the prostate covers the neck of the bladder. The back is adjacent to the front wall of the rectum. The anterior part of the gland is located in the pubic body at the junction of the pelvic bones. In the male body, the prostate performs three key functions:

• motor - regulation of the separation of urine and seminal fluid (thanks to this, spermatozoa do not enter the bladder;
• secretory - the production of a secret responsible for the quality of the seminal fluid and maintaining a stable erection;
• barrier - protection against infections of the upper urinary tract.

The functionality of the prostate begins to manifest itself at puberty and becomes complete by the age of 18-20. The decline in the body's active work occurs in men who have passed the fifty-year milestone.

Types and forms of prostatitis

The type of disease is determined by the cause of its occurrence:

1. Bacterial prostatitis. It occurs as a complication of infectious and inflammatory processes of the urogenital tract (less often in other body systems).
2. Abacterial prostatitis. It develops against the background of physiological failures of neurological or psychoneurological etiology, chronic diseases, and an unhealthy lifestyle.

The trigger of the inflammatory process is the stasis (congestion) phenomenon occurring in the tissues of the gland, which is caused by organ disorders or infections.

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

1. Acute inflammation. It is characteristic of a bacterial type of disease. It is accompanied by an intense manifestation of special signs.
2. Chronic prostatitis. It runs unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases, it has a bacterial origin.

Symptoms of chronic prostatitis often disappear as the inflammatory process progresses. The fluctuating course of the disease is the reason for the premature visit to the urologist and the expensive treatment of complications.

Causes of prostatitis

Stagnation of blood circulation and prostate secretion occurs for reasons corresponding to the specific classification of the disease.

Causes of an infectious species	Causes of bacterial species
Sexually Transmitted Infections (STIs): bacterial (syphilis, gonorrhea, ureaplasmosis, gardnerellosis); viral (papillomatosis, cytomegalovirus, genital herpes); parasite (chlamydia, trichomoniasis); fungal (candidiasis). Bacterial diseases of the intestines, skin, respiratory organs caused by staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc.	Neuralgia, rheumatism, neurosis, mechanical injuries of the spine and genitals, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system

Provocative factors include irregular sexual intercourse (complete lack of sex), systematic hypothermia of the body, and chronic alcoholism.

Symptoms of the acute form of the disease

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

Main symptoms:

1. From the urinary system. Pollakiuria (frequent urination) with dribbling of urine, burning sensation, spasms in the urethra. Urine becomes cloudy. Urges to empty the bladder are often false.
2. From the reproductive system. Pain in the perineum, reduced potency, painful ejaculation. During (or immediately after) intimacy, an unpleasant feeling appears in the area of the glans penis and testicles.
3. From the side 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, aggravation of hemorrhoids.
6. From the side of the autonomic nervous system. Loss of appetite, headache, subfebrile body temperature (37-38 ℃), symptoms of poisoning of the body. Usual 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 a violation of the morphological structure and performance of the organ. In the phase of remission, the pathology shows itself with increased fatigue and reduced performance. Disorders of the urinary system are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.

Urinating is moderately painful, and there is a feeling of incomplete destruction after urination. Spontaneous discharge of prostatic secretion of a mucous consistency, yellowish color and unpleasant odor (prostorrhoea) from the urethra.

Patients suffer from chronic pelvic pain syndrome - painful sensations of a painful nature localized in the lower third of the abdomen, pelvic and external genitalia, perineum, lumbar and sacral region.

Chronic prostatitis is accompanied by sexual health disorders:

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

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

In the recurrent period, the symptoms correspond to the acute form of the disease, but are less intense. Exacerbation is provoked by:

1. General hypothermia. All chronic inflammatory diseases, including prostatitis, are aggravated after prolonged exposure to cold water or cold.
2. Restriction of mobility. In case of hypodynamia, the blood circulation of the pelvic organs is disturbed. Stagnation of blood leads to swelling of the prostate, which compresses nerve endings and the urethra.
3. Alcohol abuse. The chronic course of inflammatory processes is activated under the influence of alcohol.
4. Prolonged abstinence from intimate relationships. Lack of sexual intercourse leads to stagnation of the secretion of the prostate, which provokes aggravation.
5. Tight underwear. Mechanical compression of the external genitalia disrupts the prostate's normal blood supply.

The relapse of the disease is caused by unhealthy eating habits. An abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), as a result of which atherosclerosis develops. Cholesterol plaques obstruct the free flow of blood, causing congestion in the prostate. An excess of the menu of products that cause constipation leads to excessive tension of the muscles of the perineum.

Complications of prostatitis

With premature treatment of acute inflammation, purulent masses accumulate in the tissues of the prostate, and an abscess of the gland develops. The condition is characterized by feverish temperature (39 ℃), chills, sharp, intense pain in the perineum, ischuria (inability to empty the bladder on its own). The only way to treat it is to open the urethral suppuration and urethral bougienage (enlargement of the urethra using a special metal rubber).

Lack of proper diagnosis, ignoring symptoms, long-term self-treatment of chronic prostatitis are the causes of dangerous complications:

• prostate adenoma - benign tumor prone to malignancy (malignancy) with incorrect therapy;
• formation of stones in the gland;
• epididymo-orchitis - inflammation of the testicles;
• vesiculitis - inflammation of the seminal vesicles;
• infertility (the first degree of the disease requires long-term therapy, the second is practically untreatable);
• impotence;
• sclerosis of the prostate is the death of prostate cells.

Timely examination of the prostate in men helps to avoid serious consequences of the inflammatory disease.

prostate examination

Rectal examination of the prostate is an unpleasant but extremely necessary procedure. It enables the detection of serious diseases at an early stage, such as adenoma, prostatitis, and malignant tumors.

Indications for rectal prostate examination

All men over the age of 40 should visit a urologist at least once a year. The earlier the inflammatory process, benign and malignant tumors are diagnosed, the greater the chance of a complete restoration of the prostate. The patient receives gentler treatment, preserves his sexual desire, sexual activity and fertilization ability.

Occasionally, men younger than 40 show warning signs but delay seeing a urologist. Indications for an urgent examination of the prostate are as follows:

• pain of any intensity in the perineum;
• erectile dysfunction;
• premature ejaculation;
• decrease in the amount of sperm released;
• discomfort during intercourse and defecation.

Do not ignore urination problems - too frequent urge, cramps, feeling of an empty 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 the digital prostate examination performed?

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

• sexual intercourse;
• masturbation;
• to exercise;
• cycling;
• physical work.

Before visiting the doctor, the bladder must be emptied and a cleansing enema made with salt water or chamomile decoction.

Before examining the prostate, a man assumes a knee-elbow position, lies on his side, with bent legs or standing, leans forward and rests his hands on the table. The doctor puts on sterile gloves and applies petroleum jelly or lubricant to his index finger and the patient's anus.

During a rectal examination of the prostate, the doctor massages the lobes of the prostate from side to center. You can use touch to evaluate:

• size and shape;
• the structure and flexibility of the organ;
• symmetry of its elements;
• severity of outlines and longitudinal furrow;
• pain, the presence of seals and lumps.

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

In addition, during the procedure, they receive the secret of the prostate. This fluid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.

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

Diagnosis of the disease

Establishing an accurate diagnosis consists of several stages:

• initial consultation with a urologist;
• series of laboratory tests;
• hardware examination of the prostate;
• repeat appointment with the doctor.

The urologist consultation includes the following:

• identification of symptoms, characteristics (prescription, intensity);
• collection of anamnesis (past illnesses);
• clarifying information about working conditions, lifestyle characteristics, habits, regularity of sexual relations;
• visual assessment of the external genitalia for the presence of rashes, redness, swelling, urethral discharge;
• palpation of the inguinal lymph nodes;
• palpable rectal examination of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the state of the interlobar septum);
• sampling of biological material for laboratory research;
• selection of analyses.

There is no strict time limit for medical appointments. At a specialized clinic, each patient receives maximum time and attention.

For the differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes blood, urine, prostatic discharge and a swab from the urethra.

During a rectal examination of the gland, the doctor takes a sample of the secretions from the prostate with his own hands. For the examination, disposable medical gloves, lubricant (vaseline, gel-lubricant, glycerin), which facilitates penetration into the rectal ampoule, and sterile glasses are used. The penetration depth does not exceed 5 cm. The expertise and experience of the urologists ensures the safety and pain-free operation.

Venous blood is taken with modern vacutainers. The medical center strictly adheres to the sterility rules for the collection of biological materials.

Laboratory tests

Tests are performed by experienced specialists in the clinical diagnostic laboratory. The laboratory department of the medical center is equipped with modern equipment that allows you to carry out analyzes of any complexity.

The list of analyzes includes:

1. Bacteriological smear culture to determine STIs. The biomaterial sample is planted on media suitable for the growth of pathogenic microorganisms. The active reproduction of a specific pathogen and the formation of its colonies indicate the presence of an infection. Based on the bacterial culture, an antibiogram is performed - the determination of the resistance of pathogens to antibiotics.
2. General urinalysis. Deviations from the norm (leukocyturia, bacteriuria, cylindruria, etc. ) indicate the presence of an inflammatory process.
3. The blood test for PSA (prostate specific antigen) is a tumor marker of the male reproductive system. It is performed using a high-precision ICLA method (chemiluminescence immunoassay).
4. Examination of prostate secretion (microscopy and culture). It makes it possible to determine the presence of inflammation, microbes (E. coli, staphylococcus, etc. ).

Comprehensive testing for STIs can be done with a blood sample.

Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate. This is performed with a cylindrical probe up to 1. 5 cm in diameter, which is inserted into the rectum. The sensor is pre-oiled and special disposable nozzles (condoms) are placed on top. The data is transmitted to the monitor, where the urologist visually evaluates pathological changes in the prostate gland.

Re-recording

Upon re-admission, the doctor:

• evaluates test results;
• prepares a personalized therapeutic regimen, taking into account the type and form of prostatitis, the nature of its course, drug tolerance, and the patient's age;
• designates control tests.

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

Therapy of prostatitis

At the clinic, a man can take part in a comprehensive prostatitis treatment. Course therapy for acute inflammation of the prostate consists of three stages:

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

First phase

In the case of prostatitis of infectious etiology, antibiotics are primarily prescribed to destroy the causative agent of the infection. The selection of the drug is based on the results of the antibiogram. In parallel, drugs belonging to several pharmacological groups are used:

1. Alpha blockers. Medicines help to relax the smooth muscle tissue of the prostate and bladder neck, reduce the internal pressure of the urethra, normalize the outflow of urine and reduce the swelling of the gland.
2. Enzymes. They liquefy prostate secretions, increase the organ's local immunity, enhance the antibacterial effect, and reduce inflammatory manifestations.
3. Immunomodulators to restore immunity.
4. Non-steroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.

The doctor personally selects the medicines and the dosage according to the symptoms, type and form of the disease.

Second phase

After the acute symptoms are removed, they switch to drugs and methods that help stabilize the gland. Medical treatment consists of:

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

During the complex treatment, oral drugs and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, pain-relieving) are used.

Special methods include prostate massage. The mechanical effect on the prostate makes it possible to:

• accelerates blood circulation;
• strengthens the walls of capillaries and vessels;
• activate exchange processes;
• establishing the leak of the secret;
• normalizes bladder emptying;
• increasing the effectiveness of drug therapy;
• restoration of sexual activity.

Massage treatments are performed for therapeutic and prophylactic purposes.

Types of massage:

• with the help of a dilator (bougie);
• inner touch;
• non-invasive (no penetration);
• penetrating or external hardware (using a special massager).

Third stage

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

Treatment of prostatitis with a laser is a progressive physiotherapy technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis. Directed effect 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 2-4 times a week, the duration of one procedure is 10-20 minutes. Based on the decision of the attending physician, laser therapy starts from the second stage of the treatment.

In addition, phytotherapeutic agents are used.

Characteristics of the treatment of chronic prostatitis

This form of prostatitis is characterized by an undulating course, in which the exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms. In some cases, the symptoms can be observed continuously, but they are erasable and mild in nature. In most cases, men suffer for a long time from urinary disturbances, dull pains in the lower abdomen and perineum, as well as the weakening of potency. Patients with this diagnosis often consult a doctor when symptoms worsen.

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

• Antibacterial drugs are prescribed for patients with chronic bacterial prostatitis, as well as for diseases of non-bacterial origin. In addition to suppressing the activity of pathogenic microflora, the tools of this group help to reduce inflammation.
• Drugs belonging to the group of alpha-blockers are prescribed to patients with severe urinary disorders. Medicines improve the flow rate of urine and relieve symptoms.
• Muscle relaxants are prescribed for patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
• Hormonal drugs are recommended by urologists for the active growth of prostate gland tissue against the background of chronic inflammation.
• Immunomodulators are used for chronic prostatitis of any origin, be it allergic, bacterial or abacterial prostatitis.

In addition, they use drugs that stimulate blood circulation in the pelvic organs and directly in the prostate, as well as potency stimulants. Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and many others), exercise therapy exercises to relax the muscles of the perineum and pelvic floor, and laser therapy also contribute to improving the prognosis.

All these methods are widely used in clinics, which makes it possible to achieve high treatment results, even if the patient is diagnosed with chronic calculous prostatitis, which is a form of complicated chronic inflammation of the prostate gland. The specialists of the center pay special attention to preserving the functions of the urinary system in men, so that patients can live a full life after the therapy and even become parents. A positive result can only be achieved with complex treatment, the use of properly selected drugs, physiotherapy and prostate massage.

Prevention of inflammatory processes of the prostate

The preventive measures are as follows:

1. Changing eating habits. A balanced diet with the restriction of fatty and high-calorie foods. Enriching the diet with vegetables, fruits, products for men's health (nuts, honey, seafood, etc. ).
2. Physical activity (regular sports contribute to the normalization of blood circulation in the genital area).
3. Protected sex – using contraception (condoms) to protect against sexually transmitted diseases.
4. Regular sex is a pleasant and useful prevention of stagnant prostate phenomena.
5. Alcohol restriction. Abuse of alcohol leads to a decrease in potency, libido, and inhibition of testosterone synthesis.
6. Complete relaxation. Psycho-emotional overload, insomnia (insomnia), physical overload are provocateurs of abacterial prostatitis.
7. Regular visits to a urologist and STI tests. The disease is easier to prevent than to treat.

Urologists perform preventive examinations of the prostate gland.