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 in their 30s and 40s. Inflammation tends to become chronic, which makes therapy much more difficult. Doctors successfully solve men's health problems of any complexity. Medical center urologists develop personal treatment regimens, use the best drugs and have modern methods of treating prostate diseases.

"The Heart of the Second Man"

The prostate is a small, unpaired gland of external secretion, controlled by hormonal activity. The organ is located at the bottom of the small pelvis, under the bladder. The wider edge of the prostate covers the neck of the bladder. The back is adjacent to the anterior wall of the rectum. The frontal part of the gland occupies a place in the pubic zone of the junction of the bones of the pelvis. In the male body, the prostate performs three key functions:

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

The functionality of the prostate begins to manifest itself during the puberty period and takes on its full value around the age of 18 to 20 years. The decline in the active work of the body is recorded in men who have passed the milestone of fifty years.

Types and forms of prostatitis

The type of disease is determined by the cause of the appearance:

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 failures of neurological, psychoneurological etiology, chronic diseases, 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.

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-like disease. It is accompanied by an intense manifestation of specific signs.
2. Chronic prostatitis. Works unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases, it has an abacterial origin.

Symptoms of chronic prostatitis are often erased, while the inflammatory process progresses. The undulating course of the disease is the reason for the untimely visit to the urologist, followed by expensive treatment of complications.

Causes of prostatitis

Stagnation of blood circulation and prostatic 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); 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, neurosis, mechanical damage to the spine and genitals, intraprostatic reflux, chronic obstipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system

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

Symptoms of an 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, psycho-emotional stability is disturbed.

Main symptoms:

1. From the urinary system. Pollakiuria (frequent urination) with discharge of urine droplets, burning, cramps in the urethra. The urine becomes cloudy. Urges to empty the bladder are often false.
2. Of the reproductive system. Pain in the perineum, decreased potency, painful ejaculation. During intimacy (or immediately after), discomfort occurs in the glans area of the penis and testicles.
3. From the side of the nervous system. Sharp muscular pains in the lumbar and sacral region, in the lower abdomen.
4. Psycho-emotional disorders. Increased nervousness, anxiety, irritability.
5. Of the digestive system. Constipation, exacerbation of hemorrhoids.
6. From the side of the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37–38℃), body intoxication symptoms. Habitual actions cause rapid fatigue, a desire to go to bed.

Against the background of inflammation, existing chronic diseases are exacerbated.

Signs of chronic prostatitis

Prolonged inflammation of the prostate leads to a violation of the morphological structure and performance of the organ. At the stage of remission, the pathology is remembered with increased fatigue, a decrease in performance. Disorders of the urinary system are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.

Urination is moderately painful, after excretion of urine there is a feeling of incomplete devastation. From the urethra, a prostatic secret of mucous consistency of yellowish color, an unpleasant odor (prostorrhea) flows spontaneously.

Patients are haunted by chronic pelvic pain syndrome - painful sensations of a painful nature, localized in the lower third of the abdomen, pelvic and external genital organs, in the perineum, lumbar and sacral regions.

Chronic prostatitis is accompanied by sexual health disorders:

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

Against the background of sexual disorders, psycho-emotional instability progresses. A man is prone to depression, a sharp change in mood - from aggressiveness 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. After a long stay in cold water or in the cold, all chronic inflammatory diseases, including prostatitis, worsen.
2. Mobility restrictions. With hypodynamia, blood circulation in the pelvic organs is disturbed. Stagnation of blood 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. Prolonged abstinence from intimate relationships. Lack of sexual intercourse leads to stagnation of prostate secretion, which provokes an 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 concentration of cholesterol in the blood), as a result, atherosclerosis develops. Cholesterol plaques interfere with free blood flow, causing prostate congestion. An excess in the menu of products that cause constipation leads to excessive tension in the muscles of the perineum.

Complications of prostatitis

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

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

• prostate adenoma - a benign tumor prone to malignancy (malignancy) with incorrect treatment;
• the formation of stones in the gland;
• epididymo-orchitis - 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);
• incapacity;
• sclerosis of the prostate is the death of prostate cells.

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

prostate exam

A rectal prostate exam is an unpleasant, but extremely necessary procedure. It allows you to detect such serious diseases as adenoma, prostatitis, malignant tumors at an early stage.

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 a full restoration of the prostate. The patient receives milder treatment, retains sexual desire, sexual activity and ability to fertilize.

Sometimes men under 40 have warning signs but delay seeing a urologist. Indications for urgent prostate examination are:

• 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 neglect problems with urination - too frequent urges, 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 a digital prostate exam performed?

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

• sexual contact;
• masturbation;
• play sports;
• bike;
• physical work.

Before a visit to the doctor, you need to empty your bladder, make a cleansing enema with salt water or chamomile decoction.

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

During a 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:

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

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

Also, during the procedure, the secret of the prostate is obtained. This liquid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.

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

Diagnosis of the disease

Making an accurate diagnosis involves several steps:

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

The consultation of a urologist includes:

• identification of symptoms, their characteristics (prescription, intensity);
• collection of anamnesis (past illnesses);
• clarification of information about working conditions, lifestyle features, habits, regularity of sexual relations;
• visual assessment of the external genitalia for the presence of rashes, redness, swelling, discharge from the urethra;
• palpation of inguinal lymph nodes;
• palpation rectal examination of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the condition of the interlobar septum);
• sampling of biomaterials for laboratory research;
• analysis appointments.

Medical appointments are not time-limited. In a specialized clinic, each patient receives maximum time and attention.

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

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

Venous blood is collected using modern aspirators. The medical center strictly observes the rules of sterility for the collection of biological material.

Laboratory tests

Studies are carried out by experienced specialists of the clinical diagnostic laboratory. The laboratory department of the medical center is equipped with modern equipment that allows you to perform analyzes of any complexity.

The list of analyzes includes:

1. Bacteriological culture of a smear for the determination of STIs. A sample of biomaterial is planted on nutrient media favorable to the growth of pathogenic microorganisms. Active reproduction and colony formation of a particular pathogen indicates the presence of an infection. Based on a bacterial culture, an antibiogram is performed - determining 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 by the high-precision ICLA method (chemiluminescent immunoassay).
4. Examination of prostatic secretion (microscopy and culture). Determines inflammation, the presence of microbes (E. coli, staphylococcus, etc. )

A full examination for STIs can be done on a blood sample.

Hardware diagnosis is TRUS (transrectal ultrasound) of the prostate. It is carried out using a cylindrical probe with a diameter of not more than 1. 5 cm, inserted into the rectum. The sensor is pre-lubricated, special disposable nozzles (condoms) are placed on top. The data is transmitted to the monitor, where the urologist visually assesses pathological changes in the prostate.

Readmission

On readmission, the doctor:

• evaluates test results;
• draws up a personal treatment regimen, taking into account the type, form, nature of the course of prostatitis, tolerance to drugs, age of the patient;
• name control studies.

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

Prostatitis therapy

In the clinic, a man can undergo a comprehensive treatment for prostatitis. Course therapy for acute inflammation of the prostate consists of three stages:

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

First stage

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

1. Alpha blockers. The drugs help relax the smooth muscle tissue of the prostate gland and bladder neck, reduce internal pressure in the urethra, normalize the outflow of urine and reduce swelling of the gland.
2. Enzymes. They liquefy prostatic secretion, increase the local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
3. Immunomodulators for the restoration of immunity.
4. Nonsteroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.

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

Second stage

After the elimination of acute symptoms, they switch to drugs and methods that help stabilize the gland. The medical treatment consists of:

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

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

Special methods include prostate massage. The mechanical impact on the prostate allows:

• accelerate blood circulation;
• strengthen the walls of capillaries and vessels;
• activate exchange processes;
• establish an exit from secrecy;
• normalize bladder emptying;
• increase the effectiveness of drug therapy;
• restore sexual activity.

Massage procedures are carried out for therapeutic and prophylactic purposes.

Type of massage:

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

Third step

The treatment is completed with ozone therapy and laser therapy. Rectal ozone therapy consists of the daily administration of a freshly prepared ozonized isotonic 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 glandular cells;
• relieves inflammation and pain;
• strengthens local immunity;
• improves blood supply to the prostate, the condition of the vessels.

The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes. By decision of the attending physician, laser therapy is started from the second stage of treatment.

In addition, phytotherapeutic agents are used.

Features 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 are observed permanently, but they have a faded and benign character. In most cases, men experience inconveniences for a long time in the form of urination disorders, dull pains in the lower abdomen and perineum, and weakening of potency. Patients with such a diagnosis often turn to the doctor during an exacerbation of symptoms.

Treatment of chronic prostatitis begins with a detailed examination to determine 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 diseases of non-bacterial origin. Means of this group, in addition to suppressing the activity of pathogenic microflora, help to reduce inflammation.
• Drugs from the group of alpha-blockers are prescribed to patients with severe urinary disorders. Medications improve urine flow and relieve symptoms.
• Muscle relaxants are prescribed to 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 glandular tissues of the prostate against the background of chronic inflammation.
• Immunomodulators are used for chronic inflammation of the prostate of any origin, whether it is allergic, bacterial or abacterial prostatitis.

In addition, drugs are used to 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 much more), a set of exercise therapy exercises to relax the muscles of the perineum and floorpelvic, as well as laser therapy also help improve the prognosis.

All these methods are widely used in clinics, which allows 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. Specialists of the center pay special attention to preserving the functions of the genitourinary system in men, so that patients after therapy can lead a full life and even become parents. Only with complex treatment with the use of correctly selected drugs, physiotherapy and prostate massage can a positive result be achieved in treatment.

Prevention of inflammatory processes in the prostate

Preventive measures include:

1. Change eating habits. Balanced diet with restriction of fatty and caloric foods. Enrichment of the diet with vegetables, fruits, male health products (nuts, honey, seafood, etc. ).
2. Physical activity (regular sports contribute to the normalization of blood circulation in the genital area).
3. Safe sex - the use of barrier contraception (condom) to protect against sexually transmitted diseases.
4. Regular sexual intercourse is a pleasant and useful prevention of congestive phenomena of the prostate.
5. Alcohol restriction. Alcohol abuse leads to a decrease in potency, libido, inhibition of testosterone synthesis.
6. Complete rest. Psycho-emotional overload, insomnia (insomnia), physical overstrain 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 perform a preventive examination of the prostate.