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. The inflammation tends to become chronic, which makes treatment much more difficult. Doctors successfully solve men's health problems of any complexity. The urologists of the medical center develop personal treatment regimens, use the best drugs and have modern methods of treating prostate diseases.

"The Second Man's Heart"

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 wider end of the prostate covers the neck of the bladder. The back adjoins the anterior wall of the rectum. The frontal part of the gland occupies a position in the pubic zone of the union of the pelvic bones. In the male body, the prostate performs three main functions:

• engine - control of the separation of urine and seminal fluid (due to this, sperm does not enter the bladder.
• secretory - production of a secret responsible for the quality of semen and maintaining a stable erection.
• barrier - protection against infection of the upper urinary tract.

The functionality of the prostate begins to manifest itself in the adolescent period, gaining full value from the age of 18–20 years. The decline in active body work 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 occurrence:

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

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

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

1. Acute inflammation. Characteristic of a bacterial type of disease. It is accompanied by a strong manifestation of specific points.
2. Chronic prostatitis. It runs erratically. Latent periods are replaced by relapses with severe symptoms. In 95% of cases it has a bacterial origin.

The symptoms of chronic prostatitis often disappear, while the inflammatory process progresses. The undulating course of the disease is the reason for the untimely visit to the urologist, then expensive treatment of complications.

Causes of prostatitis

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

Causes of an infectious species	Causes of bacterial species
Sexually Transmitted Infections (STDs): 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 injuries of the spine and genitals, endoprostatic reflux, chronic constipation (constipation), discomfort, history of urological diseases (cystitis, urethritis, etc. ), impotence, diseases of the endocrine system

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

Symptoms of an acute form of the disease

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

Main symptoms:

1. From the urinary system. Polyuria (frequent urination) with discharge of drops of urine, burning, cramps in the urethra. Urine becomes cloudy. Urges to empty the bladder are often false.
2. From the reproductive system. Perineal pain, reduced potency, painful ejaculation. During intercourse (or immediately after), discomfort occurs in the area of the penis and testicles.
3. From the side of the nervous system. Acute muscular pain in the lumbar and sacral region, in the lower part of the abdomen.
4. Psychoemotional disorders. Increased nervousness, anxiety, irritability.
5. From the digestive system. Constipation, flare-up of hemorrhoids.
6. From the side of the autonomic nervous system. Lack of appetite, headache, hypothermic body temperature (37–38 ℃), symptoms of intoxication of the body. Usual actions cause rapid fatigue, desire to lie down.

In the context 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. At the stage of remission, the pathology reminds itself with increased fatigue, reduced performance. Urinary tract disorders are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.

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

Patients are haunted by chronic pelvic pain syndrome - painful sensations of pain, located 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 difficult (often painful) ejaculation.

In the context of sexual disorders, psycho-emotional instability develops. A man is prone to depression, a sharp change 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. A flare-up is caused by:

1. General hypothermia. After a long stay in cold water or in the cold, any chronic inflammatory diseases, including prostatitis, worsen.
2. Mobility restriction. With impotence, blood circulation in 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 contact leads to stagnation of prostate secretion, which causes flare-ups.
5. Tight underwear. Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate gland.

Recurrence of the disease is caused by unhealthy 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 of which atherosclerosis develops. Cholesterol plaques interfere with the free flow of blood, causing congestion in the prostate. 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 and an abscess of the gland develops. The condition is characterized by a feverish temperature (39 ℃), chills, acute severe pain in the perineum, isuria (inability to empty the bladder on its own). The only way of treatment is the operation of open dipyotomy and bouyenosis of the urethra (dilation of the urethra with a special metal plug).

Lack of correct 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 (malignant) with incorrect treatment.
• the formation of stones in the gland.
• epididymis-orchitis - inflammation of the testicle.
• cystitis - inflammation of the seminal vesicles.
• infertility (the first degree of the disease requires long-term treatment, the second is practically untreatable).
• inability;
• Bleeding of the prostate is the death of prostate cells.

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

prostate examination

Rectal examination of the prostate 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 rectal examination

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 for a complete recovery of the prostate gland. The patient receives milder treatment, maintains sexual desire, sexual activity and the ability to conceive.

Occasionally, men under 40 show warning signs but put off 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 sexual intercourse and defecation.

Do not ignore problems with urination - very 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 should avoid:

• sexual intercourse;
• masturbation;
• I do sports;
• cycling?
• physical labor.

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

Before examining the prostate, a man takes a knee-elbow position, lying on his side with bent legs or postures, leaning forward and resting 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 gland from the sides to the center. With the help of palpation, you can assess:

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

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

In addition, during the procedure, the secret of the prostate gland is taken. This liquid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.

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

Diagnosis of the disease

Accurate diagnosis consists of several stages:

• initial consultation with a urologist.
• a set of laboratory tests;
• Examination of prostate material.
• re-appointment with doctor.

Urologist consultation includes:

• recognition of symptoms, their characteristics (prescription, intensity).
• collection of memories (past illnesses);
• clarification of information about working conditions, lifestyle characteristics, 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 interlobular septum).
• sampling of biomaterial for laboratory research.
• appointment of analyses.

Medical appointments do not have strict time limits. In a specialized clinic, each patient is given maximum time and attention.

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

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

Venous blood is obtained with modern vacutainers. The medical center strictly observes the rules of sterility for the collection of biological material.

Laboratory Tests

The studies are carried out 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 for the determination of STDs. A sample of biomaterial is planted in nutrient media favorable for the growth of pathogenic microorganisms. Active reproduction and colony formation of a particular pathogen indicate the presence of infection. Based on the bacterial culture, an antibiogram is performed - determination of the resistance of pathogens to antibiotics.
2. General urinalysis. Deviation from the norm (leucocyturia, bacteriuria, cylindruria, etc. ) indicates the presence of an inflammatory process.
3. A blood test for PSA (prostate specific antigen) is a cancer marker of the male reproductive system. It is performed by the highly accurate ICLA (chemiluminescent immunoassay) method.
4. Examination of prostatic secretion (microscopy and culture). It allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc. )

A comprehensive test for STDs can be performed on a blood sample.

Hardware diagnosis is TRUS (rectal ultrasound) of the prostate gland. It is performed using a cylindrical catheter with a diameter of no more than 1. 5 cm, which is inserted into the rectum. The sensor is pre-lubricated, special disposable nozzles (condom) are placed on top. The data is transmitted to the monitor, where the urologist visually assesses pathological changes in the prostate gland.

Readmission

During readmission, the doctor:

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

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

Treatment of prostatitis

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

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

First stage

With prostatitis of infectious etiology, antibiotics are prescribed mainly to destroy the causative agent of the infection. The choice of drug is based on the results of the antibiogram. At the same time, drugs of various pharmacological groups are used:

1. Alpha blockers. Medicines help to relax the smooth muscle tissue of the prostate, the neck of the bladder, reduce the internal pressure in the urethra, normalize the outflow of urine and reduce the swelling of the gland.
2. Enzymes. They liquefy the prostatic secretion, increase the local immunity of the organ, 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 chooses personal drugs and dosage depending on the symptoms, type, form of the disease.

Second phase

After the removal of acute symptoms proceed 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.

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

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

• accelerates blood circulation.
• strengthening the walls of capillaries and vessels.
• activation of exchange processes.
• to create an outflow of the secret.
• normalization of bladder emptying.
• increasing the effectiveness of drug therapy.
• restoration of sexual activity.

Massage procedures are performed for therapeutic and prophylactic purposes.

Types of massage:

• with the help of a expander (bougie).
• internal palpation;
• non-invasive (no penetration).
• penetrating or external material (which is carried out using a special massage).

Third stage

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

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

• regenerates the cells of the gland.
• 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. With the decision of the attending physician, the laser treatment starts from the second stage of the 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 continuously, but they are dull, mild in nature. In most cases, men endure suffering for a long time in the form of urinary 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 what caused the inflammatory process. Based on the diagnostic results, the urologist selects drugs from various groups:

• Antibacterial drugs are prescribed for patients diagnosed with chronic bacterial prostatitis, as well as for diseases of non-bacterial origin. The means of this group, in addition to suppressing the activity of pathogenic microflora, contribute to the reduction of inflammation.
• Drugs of the alpha-blocker group are prescribed to patients with severe urinary disorders. Medicines improve the rate of urine flow and relieve symptoms.
• Muscle relaxants are prescribed for patients with chronic pelvic pain and severe symptoms of chronic prostatitis in the acute stage.
• Hormonal drugs are recommended by urologists for the active growth of prostate glandular tissues in the context of chronic inflammation.
• Immunomodulators are used for chronic inflammation of the prostate of any origin, be it allergic, bacterial or bacterial prostatitis.

In addition, drugs are used that stimulate blood circulation in the pelvic organs and directly to the prostate, as well as potency stimulants. Therapeutic methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and many others), 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 clinics, which makes it possible to achieve high treatment results, even if the patient has been diagnosed with chronic fatty prostatitis, one of the forms of complicated chronic inflammation of the prostate gland. The center's specialists pay special attention to preserving the functions of the genitourinary system in men, so that patients after treatment can live a full life and even become parents. Only with complex treatment using properly selected drugs, physiotherapy and prostate massage can a positive result in treatment be achieved.

Prevention of inflammatory processes in the prostate

Preventive measures include:

1. Changing eating habits. Balanced diet with restriction of fatty and high calorie foods. Enriching the diet with vegetables, fruits, products for men's health (dry nuts, honey, seafood, etc. ).
2. Physical activity (regular sports help normalize blood circulation in the genital area).
3. Protected sex - the use of barrier contraception (condom) to protect against sexually transmitted diseases.
4. Regular sex is a pleasant and useful prevention of congestive phenomena in 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 overwork are causes of bacterial prostatitis.
7. Regular visits to the urologist and tests for STDs. The disease is easier to prevent than to cure.

Urologists provide a preventive examination of the prostate.