Treatment of prostatitis

In the middle of the last century, prostatitis was thought to occur in old age.Today, the disease has become “younger,” more common in fertile men aged 30-40 years.Inflammation often becomes chronic, making treatment more difficult.Doctors successfully solve any complex men's health problem.The urologists at the medical center develop individual treatment plans, use the best medications and are knowledgeable about modern methods of treating prostate diseases.

"The Heart of a Second Man"

The prostate is a small, unpaired exocrine gland that is controlled by hormonal activity.This organ is located at the bottom of the pelvis, just below the bladder.The wider edge 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 the pubic area at the junction of the pelvic bones.In the male body, the prostate performs three key functions:

• Motility - controls the separation of urine and semen (so sperm does not enter the bladder;
• Secretion - produces secretions responsible for semen quality and maintaining a stable erection;
• Barrier - protects against infection in the upper part of the urinary system.

The function of the prostate begins during puberty and is fully functional by the age of 18-20 years.A decrease in the active function of this organ has been recorded in men over the age of fifty.

Types and forms of prostatitis

The type of disease is determined by the cause:

1. Bacterial prostatitis.It is a complication of infections and inflammatory processes in the genitourinary tract (less commonly in other body systems).
2. Nonbacterial prostatitis.It develops in the context of neurological, psychoneurological etiology, chronic disease, and physiological disruptions of unhealthy lifestyles.

The trigger of the inflammatory process is the phenomenon of congestion (stagnation) of glandular tissue caused by organic disease or infection.

These forms are classified according to the nature of symptom presentation and course:

1. Acute inflammation.Characteristics of bacterial diseases.Accompanied by intense manifestations of specific symptoms.
2. Chronic prostatitis.It's unstable.After the incubation period, significant symptoms will relapse.In 95% of cases, it is of non-bacterial origin.

Symptoms of chronic prostatitis usually disappear, while the inflammatory process progresses.The fluctuating course of the condition is a reason for not promptly contacting a urologist, which subsequently leads to expensive treatment of complications.

Causes of prostatitis

The causes of stagnation of blood circulation and prostate secretion correspond to the classified type of disease.

Infectious causes	Causes of bacterial species
Sexually transmitted infections (STIs): Bacteria (syphilis, gonorrhea, ureaplasmosis, Gardnerellosis); viral (papillomatosis, cytomegalovirus, genital herpes); Parasites (chlamydia, trichomoniasis); fungi (candidiasis). Bacterial diseases of the intestines, skin, and respiratory organs caused by Staphylococcus, Enterococcus, Escherichia coli, Proteus, Klebsiella, etc.	Neuralgia, rheumatism, neurosis, mechanical damage to the spine and reproductive organs, intraprostatic reflux, chronic constipation (constipation), pain, history of urinary system diseases (cystitis, urethritis, etc.), lack of exercise, diseases of the endocrine system

Predisposing factors include sexual intercourse irregularity (complete absence of sexual intercourse), systemic hypothermia, and chronic alcoholism.

Symptoms of the acute form of the disease

Acute prostatitis is characterized by severe inflammation of the prostate.This process involves adjacent organs and systems, and psycho-emotional stability is disrupted.

Main symptoms:

1. From the urinary system.Frequent urination (frequent urination) with dribbling, burning, and urethral pain.Urine becomes cloudy.The urge to empty your bladder is usually wrong.
2. From the reproductive system.Perineal pain, decreased sexual ability, and painful ejaculation.Discomfort may occur in the glans penis and testicular area during (or immediately following) intimacy.
3. From the nervous system.Acute muscle pain in the lumbosacral region and lower abdomen.
4. Psycho-emotional disorders.Increased tension, anxiety, and irritability.
5. From the digestive system.Constipation, hemorrhoids worsen.
6. From an autonomic nervous system perspective.Loss of appetite, headache, low body temperature (37-38°C), and body poisoning symptoms.Habitual behavior can lead to rapid fatigue and a desire to lie down.

In the context of inflammation, existing chronic diseases can worsen.

Symptoms of chronic prostatitis

Long-term inflammation of the prostate leads to disruption of the organ's morphological structure and performance.During the remission phase, the pathological state reminds itself of itself with increased fatigue and decreased performance.Urinary tract disease is characterized by repeated (often erroneous) urges to empty the bladder that become more frequent at night.

There is moderate pain during urination and a feeling of incomplete emptying after urination.Prostatic discharge is yellowish in color, has an unpleasant odor (prostatic leakage), and has a mucus consistency that spontaneously flows out of the urethra.

Patients suffer from chronic pelvic pain syndrome - pain concentrated in the lower third of the abdomen, pelvic and external genital organs, perineal area, lumbar and sacral areas.

Chronic prostatitis with sexual health disorders:

• Unstable and painful erection;
• suppresses sexual desire;
• Ejaculation is accelerated or difficult (often painful).

In the context of sexual disorders, psycho-emotional instability develops.Men are prone to depression and sudden mood changes - from aggression to apathy.Eventually, this leads to absolute sexual impotence (impotence).

During relapses, symptoms correspond to the acute form of the disease but are less severe.The reasons for deterioration are:

1. Hypothermia is common.Any chronic inflammatory disease, including prostatitis, can worsen after prolonged exposure to cold water or frost.
2. Restrictions on mobility.Due to lack of physical activity, blood circulation in the pelvic organs is compromised.Stagnant blood causes the prostate to swell, compressing nerve endings and the urethra.
3. alcoholism.Chronic processes of inflammatory processes are activated under the influence of alcohol.
4. Long-term abstinence from intimate relationships.Lack of sexual intercourse can cause prostate secretion to stagnate, leading to worsening of the condition.
5. Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate gland.

Relapse of the disease is caused by unhealthy eating habits. Too many fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), which leads to atherosclerosis.Cholesterol plaques obstruct free blood flow, causing congestion in the prostate. Too many constipation-causing foods on the menu can cause excessive tension in the perineal muscles.

Complications of prostatitis

If acute inflammation is not treated promptly, purulent masses can accumulate in the prostate tissue and form a glandular abscess.The condition is characterized by fever (39°C), chills, severe pain in the perineum, and sciatica (inability to empty the bladder independently).The only treatment is surgery to open the pus in the urethra and bougie (using a special metal bougie to dilate the urethra).

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

• Prostatic adenomas are benign tumors that can easily become malignant (malignant) if not treated properly;
• Stone formation in glands;
• Epididymo-orchitis is inflammation of the testicles;
• Seminal vesiculitis - inflammation of the seminal vesicles;
• Infertility (first-level disease requires long-term treatment, second-level disease is almost impossible to treat);
• Impotence;
• Prostatic sclerosis is the death of prostate cells.

Prompt prostate examination in men will help avoid the serious consequences of inflammatory diseases.

Prostate examination

A prostate rectal exam is an unpleasant but extremely necessary procedure.It allows early detection of serious diseases such as adenomas, prostatitis and malignancies.

Indications for prostate rectal examination

Every man over the age of 40 should see a urologist at least once a year.The earlier inflammatory processes, benign and malignant tumors are diagnosed, the greater the chance of complete recovery of the prostate.Patients receive milder treatments and retain their sexual desire, sexual activity, and ability to fertilize.

Sometimes men under 40 recognize warning signs but put off seeing a urologist.Indications for an emergency prostate exam are:

• Pain of any intensity in the perineum;
• erectile dysfunction;
• premature ejaculation;
• The amount of sperm released decreases;
• Discomfort during sexual intercourse and defecation.

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

How to perform a digital prostate examination?

In the hours before surgery, you must avoid:

• sexual contact;
• masturbation;
• participate in sports;
• Cycling;
• labor.

Before seeking medical attention, you will need to empty your bladder and give a cleansing enema with saline or chamomile decoction.

Before examining the prostate, men assume a knee-elbow position, lie on their side with their legs bent, or stand leaning forward with their hands on a table.The doctor puts on sterile gloves and lubricates the index finger and the patient's anus with Vaseline or lubricant.

During a prostatectal exam, the doctor massages the prostate lobes from the sides to the center.With the help of palpation, you can assess:

• size and shape;
• texture and elasticity of organs;
• the symmetry of its elements;
• expressiveness of contours and longitudinal wrinkles;
• Pain, lumps, and knots are present.

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

Additionally, during surgery, prostate secretions are obtained.The fluid is sent for analysis, which shows the content of bacteria, white blood cells, red blood cells and pathogenic microorganisms.

Depending on the results of a digital prostate exam, your doctor may prescribe additional diagnostic measures.These include clinical analysis of urine and blood, tumor marker testing, prostate ultrasound, and more.

Diagnosis of disease

Making an accurate diagnosis involves several stages:

• An initial consultation with a urologist;
• a set of laboratory tests;
• Prostate hardware examination;
• Repeat appointments with your doctor.

A consultation with a urologist includes:

• Identify symptoms and their characteristics (duration, intensity);
• Record medical history (previous illnesses);
• Clarify information about working conditions, lifestyle characteristics, habits and sexual relationship patterns;
• Visually assess external genitalia for rash, redness, swelling, and urethral discharge;
• Palpate inguinal lymph nodes;
• Rectal examination with prostate palpation (to determine the pain, contour, density, elasticity of the gland, and to assess the condition of the septal membranes);
• Collect biological materials for laboratory research;
• Test assignment.

There are no strict time limits for medical appointments.In a dedicated clinic, each patient receives the utmost time and attention.

To differentiate between bacterial and bacterial prostatitis and to determine the form of the disease, men need blood, urine, prostate secretions and urethral smears.

Doctors use their hands to collect a sample of prostate secretions during a rectal examination of the gland.During the examination, use disposable medical gloves, a lubricant that helps penetrate the rectal ampulla (petroleum jelly, gel lubricant, glycerin), and sterile spectacles.Penetration depth does not exceed 5 cm.The professional qualifications and experience of the urologist ensure that the procedure is safe and painless.

Venous blood is collected using modern vacuum blood collection tubes.The medical center strictly adheres to sterile rules for the collection of biological materials.

laboratory testing

Studies are conducted in clinical diagnostic laboratories by experienced experts.The laboratory department of the medical center is equipped with modern equipment and can perform tests of any complexity.

The test list includes:

1. Bacteriological culture of smear to identify sexually transmitted infection.The biological material samples are grown on a nutrient medium that is conducive to the growth of pathogenic microorganisms.Active reproduction and colony formation of specific pathogens indicate the presence of infection.Based on bacterial culture, an antimicrobial spectrum is performed to determine the pathogen's resistance to antibiotics.
2. General urinalysis.Deviations from normal values (leucocyturia, bacteriuria, cylindruria, etc.) indicate the presence of an inflammatory process.
3. The PSA (prostate specific antigen) blood test is a tumor marker for the male reproductive system.It was performed using a high-precision chemiluminescent immunoassay (CHLA) method.
4. Study of prostate secretions (microscopic examination and culture).Allows you to determine inflammation, presence of microorganisms (E. coli, Staphylococcus, etc.)

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

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

Repeat appointment

After rescheduling, the doctor:

• evaluate test results;
• Develop an individual treatment plan taking into account the type, form, nature of the course, drug tolerance and patient age of prostatitis;
• Controlled studies are prescribed.

We can make appointments at a time convenient for the patient by phone or by filling out an online form through our website.

Prostatitis treatment

At the clinic, men can receive full treatment for prostatitis.The treatment course for acute inflammation of the prostate consists of three stages:

• Relieve symptoms and inflammation;
• Function is restored and glands are stabilized;
• Consolidate results and prevent complications.

first stage

For prostatitis of infectious etiology, antibiotics are first used to eliminate the infectious agent.The choice of drug is based on the results of the antimicrobial spectrum.Simultaneous use of drugs from several pharmacological groups:

1. Alpha adrenergic blockers.These medications help relax the smooth muscle tissue of the prostate and bladder neck, reduce intraurethral pressure, normalize urine outflow, and reduce glandular swelling.
2. Enzymes.They dilute the prostate secretions, increase the local immunity of the organ, enhance the antibacterial effect, and reduce the manifestations of inflammation.
3. Immunomodulators restore immunity.
4. Nonsteroidal anti-inflammatory drugs (NSAIDs).They reduce inflammatory processes and relieve pain.

The doctor personally selects the drug and dosage based on the symptoms, type and form of the disease.

second stage

After acute symptoms resolve, they continue using medications and methods that help stabilize the glands.Medication treatments include:

• Vascular medications (to improve blood supply to the prostate);
• immune boosters;
• Medications that normalize the urinary excretion process;
• anti-inflammatory drugs;
• Drugs to restore erections.

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

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

• Accelerate blood circulation;
• Strengthens capillary and blood vessel walls;
• Activate the exchange process;
• Establish the outflow of secretions;
• normalizes bladder emptying;
• Improve the effectiveness of drug treatments;
• Restoration of sexual activities.

Massage procedures are performed for therapeutic and preventive purposes.

Massage type:

• using dilators (bougies);
• Internal palpation;
• Non-invasive (no penetration);
• Penetrative or external hardware (performed using a special massager).

The third stage

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

Treating prostate inflammation with laser is a progressive physical therapy technique that allows you to quickly achieve positive dynamics and prevent the complications of prostatitis.Directional effects of rectal laser:

• regenerative gland cells;
• Relieve inflammation and pain;
• Enhance local immunity;
• Improves the blood supply and vascular condition of the prostate.

The frequency of treatment is 2-4 times per week and the duration of a procedure is 10-20 minutes.At the discretion of the attending physician, laser treatment begins with the second phase of treatment.

In addition, phytotherapeutics are used.

Treatment features of chronic prostatitis

This form of prostatitis is characterized by a wave-like course, in which exacerbations of chronic prostatitis are replaced by periods of complete absence of unpleasant symptoms.In some cases, symptoms continue to be observed but gradually disappear and are mild.In most cases, men will endure long-term inconveniences such as difficulty urinating, dull pain in the lower abdomen and perineum, and reduced sexual ability.People with this diagnosis usually see a doctor when their symptoms worsen.

Treatment of chronic prostatitis begins with a detailed examination aimed at identifying the cause of the inflammatory process.Depending on the diagnosis, the urologist chooses drugs from several groups:

• Antimicrobial drugs are used to diagnose patients with chronic bacterial prostatitis as well as nonbacterial diseases.In addition to inhibiting the activity of disease-causing microbiota, this group of drugs also helps reduce inflammation.
• Alpha-blocker drugs are used in patients with severe urinary tract disorders.Medications can increase urine flow and relieve symptoms.
• Muscle relaxants are used in patients with chronic pelvic pain and significant symptoms of the acute phase of chronic prostatitis.
• Urologists recommend the use of hormonal drugs against the background of chronic inflammation to promote active growth of prostate glandular tissue.
• Immunomodulators can be used to treat chronic inflammation of the prostate from any source, whether allergic, bacterial, or nonbacterial prostatitis.

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

All these methods are widely used in clinical practice and can achieve high therapeutic effects even when patients are diagnosed with chronic calculus prostatitis (a form of complex chronic inflammation of the prostate).The center's experts pay special attention to preserving the function of the male genitourinary system, so patients after treatment can live a fulfilling life and even become parents.Positive therapeutic results can only be achieved with a combination of correctly selected medications, physical therapy and prostate massage.

Prevents the inflammatory process of the prostate

Preventive measures include:

1. Change your eating habits.Eat a balanced diet that limits fat and high-calorie foods.Enrich your diet with vegetables, fruits, men's health products (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 prevent sexually transmitted diseases.
4. Regular sex is an enjoyable and useful way to prevent prostate congestion.
5. Limit alcohol consumption.Alcohol abuse can lead to decreased sexual performance, libido, and suppression of testosterone synthesis.
6. Get a complete rest.Mental and emotional overload, insomnia (insomnia), and physical fatigue are all predisposing factors for nonbacterial prostatitis.
7. Visit your urologist regularly and get checked for sexually transmitted infections.This disease is easier to prevent than to treat.

Urologists provide preventive exams of the prostate.