Treatment of prostatitis

In the middle of the last century, it was believed that prostatitis develops in old age. Today, the disease is "young" and diagnosed in fertile men of 30-40 years of age. Inflammation tends to become chronic, which complicates therapy. Doctors successfully solve men's health problems of any complexity. .

"Another Man's Heart"

The prostate is a small unpaired exocrine gland controlled by hormonal activity. The organ is located in the lower part of the small pelvis, under the bladder. The wide edge of the prostate covers the neck of the bladder. The back is adjacent to the front wall of the rectum. The frontal part of the gland is located in the pubic area of the junction of the pelvic bones. In the male body, the prostate performs three main functions:

• Motor - control of the release of urine and seminal fluid (due to this, sperm does not enter the bladder;
• secretory - the production of a secret responsible for the quality of seminal fluid and maintaining a stable erection;
• Barrier - protection from infection of the upper urinary system.

The functioning of the prostate gland begins to manifest itself during puberty, it acquires its full significance at the age of 18-20 years. A decrease in the active work of the body is observed in men who have passed the fifty-year stage.

Types and forms of prostatitis

The type of disease is determined by the underlying cause:

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

The cause of the inflammatory process is congestive (stagnation) events in the gland tissues, which are caused by organic disorders or infection.

Forms are classified according to the nature of symptoms and the course of the disease:

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

Symptoms of chronic prostatitis often disappear, while the inflammatory process progresses. The undulating course of the disease is the reason for a timely visit to a urologist, and the subsequent expensive treatment of complications.

Causes of prostatitis

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

Causes of the 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 intestines, skin, respiratory organs caused by staphylococcus, enterococcus, Escherichia coli, Proteus, Klebsiella, etc.	Neuralgia, rheumatism, neurosis, mechanical injuries of the spine and genitals, intraprostatic reflux, chronic narrowing (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system.

Provocative factors include irregular intercourse (complete lack of sex), 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 in the prostate gland. Adjacent organs and systems are involved in the process, psycho-emotional stability is disturbed.

Main symptoms:

1. from the urogenital system. Polakiuria (frequent urination) with dribbling of urine, burning, cramps in the urethra. Urine becomes cloudy. The urge to empty the bladder is often false.
2. from the reproductive system. Pain in the perineum, loss of potency, painful ejaculation. During (or immediately after) intercourse, discomfort appears in the area of the penis and testicles.
3. from 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. from the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37-38 ℃), symptoms of body intoxication. Usual actions lead to rapid fatigue, the desire to lie down.

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

Signs of chronic prostatitis

Prolonged inflammation of the prostate leads to a violation of the morphological structure and work of the organ. At the stage of remission, the pathology shows itself with increased fatigue, decreased performance. Disorders of the genitourinary system are characterized by a repeated (often false) need to empty the bladder, which is more frequent at night.

Urination is moderately painful, after passing urine there is a feeling of incomplete destruction. Prostate secret of mucous consistency with yellowish color and unpleasant smell (prostorrhoea) spontaneously comes out of the urethra.

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

Chronic prostatitis is accompanied by sexual health disorders:

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

Against the background of sexual disorders, psycho-emotional instability progresses. 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. Exacerbation is provoked by:

1. General hypothermia. After prolonged exposure to cold water or cold, any chronic inflammatory disease, including prostatitis, worsens.
2. Limitation of mobility. With hypodynamia, blood circulation in the pelvic organs is disturbed. Blood stagnation causes swelling of the prostate, which compresses the nerve endings and the urethra.
3. Alcohol abuse. The chronic course of inflammatory processes is activated by the influence of alcohol.
4. Long-term abstinence from intimate relationships. Lack of sexual intercourse leads to stagnation of prostate secretion, which leads to exacerbation.
5. tight underwear. Mechanical compression of the external genital organs 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 cholesterol concentration in the blood), as a result of which atherosclerosis develops. Cholesterol plaques prevent free blood flow, provoking prostatitis. An excess of products in the menu that cause constriction causes excessive tension of the muscles of the perineum.

Complications of prostatitis

During the timely treatment of acute inflammation, purulent masses accumulate in the tissues of the prostate and gland abscess develops. The condition is characterized by febrile temperature (39 ℃), chills, sharp intense pain in the perineum, ishuria (bladder emptying by itself). The only way of treatment is purulent opening of the urethra and bulging surgery (enlargement of the urethra with a special metal bulging).

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

• Prostate adenoma - a benign tumor that is prone to malignancy (malignant tumors) with incorrect therapy;
• the formation of stones in the gland;
• Epididymo-orchitis - testicular inflammation;
• Vesiculitis - inflammation of seminal vesicles;
• infertility (the first degree of the disease requires long-term therapy, and the second is practically incurable);
• impotence;
• Sclerosis of the prostate is the death of prostate cells.

Timely examination of the prostate in men can help prevent severe consequences of inflammatory disease.

Prostate examination

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

Indications for rectal prostate examination

All men over the age of 40 should see a urologist at least once a year. The earlier the inflammatory process, benign and malignant neoplasms are detected, the greater the chance of complete recovery of the prostate gland. The patient receives more gentle treatment, maintains sexual desire, sexual activity and the ability to conceive.

Sometimes men younger than 40 show warning signs but are put off seeing a urologist. Indications for urgent prostate examination are:

• pain of any intensity in the perineum;
• erectile dysfunction;
• early ejaculation;
• decrease in the number of released sperm;
• Discomfort during intercourse and defecation.

Don't ignore problems related to urination - too frequent runny nose, cramps, feeling of 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 digital prostate examination performed?

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

• sexual intercourse;
• masturbation;
• engaging in sports;
• by bicycle
• physical labor.

Before visiting the doctor, it is necessary to empty the bladder, make a cleansing cup with salt water or chamomile decoction.

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

During the 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 evaluate:

• size and shape;
• body texture and elasticity;
• symmetry of its elements;
• heaviness of contours and longitudinal fur;
• The presence of pain, rings and knots.

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

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

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

Diagnosis of the disease

Making an accurate diagnosis consists of several stages:

• initial consultation with a urologist;
• set of laboratory tests;
• hardware examination of the prostate;
• Re-appointment with the doctor.

Urologist consultation includes:

• identification of symptoms, their characteristics (purpose, intensity);
• collection of anamnesis (past diseases);
• Clarification of information about working conditions, lifestyle features, habits, regularity of sexual relations;
• visual evaluation of the external genital organs for the presence of rashes, redness, swelling, discharge from the urethra;
• Palpation of inguinal lymph nodes;
• palpable rectal examination of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the condition of the intermediate septum);
• sampling of biomaterial for laboratory research;
• appointment of analyses.

Medical appointments do not have strict deadlines. In a specialized clinic, each patient is given 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, prostate secretions and a smear from the urethra.

During rectal examination of the gland, the doctor takes a sample of prostate secretion with his own hand. Disposable medical gloves, lubricant (vaseline, gel-lubricant, glycerin) that facilitates penetration into the rectal ampoule, sterile glasses are used for the examination. The penetration depth does not exceed 5 cm. The safety and painlessness of the procedure is ensured by the professional qualifications and experience of urologists.

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

laboratory tests

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

The list of analyzes includes:

1. Bacteriological culture of smear to determine STI. A sample of biomaterial was planted on a nutrient medium favorable for the growth of pathogenic microorganisms. Active reproduction and the formation of colonies of a specific pathogen indicate the presence of infection. On the basis of bacterial culture, an antibiogram is carried out - determination of the resistance of pathogens to antibiotics.
2. General analysis of urine. Deviation from the norm (leukocyturia, bacteriuria, cylinder, etc. ) indicates the existence 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. Prostate secretion examination (microscopy and culture). allows you to determine inflammation, the presence of microbes (E. coli, staphylococci, etc. )

A comprehensive STI test can be done on a blood sample.

Instrumental diagnosis is TRUS (transrectal ultrasound) of the prostate gland. It is performed using a cylindrical probe, the diameter of which does not exceed 1. 5 cm, inserted into the rectum. The sensor is pre-lubricated, there are special disposable nozzles (condoms) on top. The data is transferred to the monitor, where the urologist visually assesses pathological changes in the prostate gland.

readmission

Upon re-admission, the doctor:

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

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

Prostatitis therapy

In the clinic, a man can undergo a full course of prostatitis treatment. The therapy of the course of 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.

the first stage

In prostatitis of infectious etiology, antibiotics are mainly prescribed to destroy the causative agent of infection. The choice of the drug is based on the results of the antibiogram. Medicines of several pharmacological groups are used at the same time:

1. alpha blockers. The drugs help to relax the smooth muscle tissue of the prostate, relax the neck of the bladder, reduce the internal pressure in the urethra, normalize the flow of urine and swelling of the gland.
2. enzymes. They clean the secretion of the prostate, strengthen the local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
3. Immunomodulators to restore immunity.
4. Nonsteroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.

The doctor chooses the drugs and the dose personally depending on the symptoms, type, form of the disease.

the second phase

After the removal of acute symptoms, 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;
• Medicines that normalize the process of urine excretion;
• anti-inflammatory drugs;
• Medicines to restore erection.

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

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

• accelerate blood circulation;
• strengthen the walls of capillaries and vessels;
• activation of exchange processes;
• determining the flow of the secret;
• Normalization of bladder emptying;
• increasing the effectiveness of drug therapy;
• Restoration of sexual activity.

Massage procedures are performed for therapeutic and preventive purposes.

Types of massage:

• with the help of a dilator (plug);
• internal palpation;
• non-invasive (without penetration);
• Penetrating or external equipment (made using a special massager).

The third stage

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

Laser treatment of inflammation of the prostate gland is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and avoid complications of prostatitis. Directed effect of rectal laser:

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

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

In addition, phytotherapeutic agents are used.

Peculiarities of chronic prostatitis treatment

This form of prostatitis is characterized by an undulating course, during which the exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms. In some cases, the symptoms are constantly observed, but they have an erased, mild character. In most cases, men endure discomfort 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 consult a doctor during exacerbation of symptoms.

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 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, help to reduce inflammation.
• Patients with severe urinary disorders are prescribed drugs from the group of alpha-blockers. Medicines improve the rate of urine flow and relieve symptoms.
• Muscle relaxants are prescribed in the acute stage of severe symptoms of chronic pelvic pain and chronic prostatitis.
• Against the background of chronic inflammation, hormonal drugs are recommended by urologists for the active growth of prostate glandular tissue.
• Immunomodulators are used in 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 in the prostate, as well as potency stimulants. Treatment 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 is diagnosed with chronic calculous prostatitis, one of the forms of complicated chronic inflammation of the prostate gland. Specialists of the center pay special attention to maintaining the functions of the reproductive system in men, so that patients can live a full life after therapy and even become parents. Only complex treatment with the use of correctly selected drugs, physiotherapy and prostate massage can achieve a positive result in treatment.

Prevention of prostatic inflammatory processes

Preventive measures include:

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

Urologists conduct a preventive examination of the prostate gland.