treatment of prostatitis

In the middle of the last century it was believed that prostatitis develops with age. Today, the disease has become "younger" and is diagnosed in fertile 30-40-year-old men. Inflammation tends to become chronic, which significantly complicates therapy. Doctors successfully solve men's health problems of any complexity. The urologists of the medical center develop individual therapy concepts, use the best medicines and have modern methods of treating prostate diseases.

"The Heart of the Second Man"

The prostate is a small unpaired gland with an external secretion controlled by hormonal activity. The organ is located at the bottom of the small pelvis under the bladder. The wider rim 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 occupies a place in the pubic zone of the junction of the pelvic bones. In the male body, the prostate performs three key functions:

• motor control of the separation of urine and seminal fluid (due to this, sperm does not get into the bladder;
• secretory - production of a secret responsible for the quality of seminal fluid and maintaining a stable erection;
• Barrier - protection against infections of the upper urinary system.

The functionality of the prostate begins to manifest itself at puberty and reaches its full value by the age of 18-20 years. The decline in the active work of the body is noted in men who have passed the fifty-year milestone.

Types and forms of prostatitis

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

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 disorders of neurological, psychoneurological etiology, chronic diseases, unhealthy lifestyle.

The triggers of the inflammatory process are congestive (stagnation) phenomena in the glandular tissue, provoked by organic disorders or infections.

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

1. acute inflammation. Characteristic of a bacterial type of disease. It is accompanied by an intense manifestation of specific signs.
2. Chronic prostate inflammation. Runs unstable. Latencies are replaced by relapses with severe symptoms. In 95% of cases it has an abacterial origin.

Symptoms of chronic prostatitis are often erased as the inflammatory process progresses. The wavy course of the disease is the reason for the untimely visit to the urologist, subsequent 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); Parasites (chlamydia, trichomoniasis), fungi (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 genital organs, intraprostatic reflux, chronic constipation (constipation), stress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system

Provoking factors are irregular sexual 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 inflammation in 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 urine droplets, burning, cramps in the urethra. The urine becomes cloudy. The urge to empty the bladder is often wrong.
2. From the reproductive system. Pain in the perineum, decreased potency, painful ejaculation. During intimacy (or immediately after) there are complaints in the area of \u200b\u200bthe 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. Psychoemotional 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 ℃), signs of intoxication of the body. Habitual actions cause rapid fatigue, a 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 performance of the organ. At the stage of remission, the pathology is reminiscent of itself with increased fatigue, reduced performance. Disorders of the urinary system are characterized by repeated (often false) urges to urinate, which become more frequent at night.

Urination is moderately painful, after urination there is a feeling of incomplete devastation. An unpleasant odor (prostorrhea) spontaneously flows from the urethra, a prostate secret of a slimy consistency with a yellowish color.

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

Chronic prostatitis is accompanied by sexual health disorders:

• unstable erection, accompanied by pain;
• suppression of libido;
• accelerated 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 relapsing phase, 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, chronic inflammatory diseases, including prostatitis, worsen.
2. restriction of mobility. With hypodynamia, blood flow to the pelvic organs is disturbed. Blood stagnation leads to swelling of the prostate, which squeezes 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, provoking its exacerbation.
5. Tight underwear. Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.

A relapse of the disease is caused by unhealthy eating habits. The excess 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 disrupt the free flow of blood and lead to blockage of the prostate. An excess of products that cause constipation leads to excessive tension in the perineal muscles.

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 fever (39 ℃), chills, sharp severe pain in the perineum, ischuria (inability to empty the bladder on its own). The only treatment option is surgery to open the suppuration and urethral bougie (expanding the urethra with a special metal bougie).

Lack of 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 the wrong therapy;
• the formation of stones in the gland;
• epididymitis - inflammation of the testicle;
• 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 will help to avoid the serious consequences of an inflammatory disease.

prostate check

A rectal examination of the prostate is an uncomfortable but extremely necessary procedure. It allows you to detect at an early stage such serious diseases as adenomas, prostatitis and malignant tumors.

Indications for rectal prostate 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 of full recovery of the prostate. The patient receives a gentler treatment, retains sexual desire, sexual activity and the ability to conceive.

Occasionally, men under 40 show warning signs but put off seeing a urologist. Indications for an urgent examination of the prostate are:

• pain of any intensity in the perineum;
• erectile dysfunction;
• early ejaculation;
• Decrease in the amount of seeds released;
• Discomfort with sexual intercourse and bowel movements.

Do not ignore problems with urination - too frequent urination, cramps, a 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 a digital prostate exam performed?

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

• sexual contact;
• Masturbation;
• Do sports;
• To go biking;
• physics lab.

Before visiting a 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, lies on his side with his legs bent or stands, leans forward and rests 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 exam of the prostate, the doctor massages the prostate lobes from the sides toward 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 furrow;
• the presence of pain, seals and knots.

This data can be used to determine whether there are any pathological changes in the prostate.

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

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

diagnosis of the disease

Making an accurate diagnosis consists of several steps:

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

The urological consultation includes:

• Identification of symptoms, their characteristics (regulation, intensity);
• Collection of medical history (past illnesses);
• Clarification of information about working conditions, lifestyle features, habits, regularity of sexual relations;
• visual assessment of the external genital organs for rashes, redness, swelling, discharge from the urethra;
• palpation of the 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 biomaterial for laboratory research;
• Appointment of analyzes.

Doctor appointments do not have strict deadlines. In a specialized clinic, every patient is given the maximum amount of time and attention.

For a differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes blood, urine, prostatic secretion and a smear from the urethra.

During a rectal examination of the gland, the doctor personally takes a sample of the prostate secretion. For the examination, disposable medical gloves, a lubricant (vaseline, gel lubricant, glycerin) that facilitates penetration into the rectal ampoule, sterile glasses are used. The depth of penetration is no more than 5 cm. The professional qualifications and experience of the urologists ensure that the procedure is safe and painless.

Venous blood is taken with modern Vacutainers. When removing biological material, the hospital strictly adheres to the rules of sterility.

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 perform analyzes of any complexity.

The list of analyzes includes:

1. Bacteriological culture of a swab to determine STIs. A sample of biomaterial is planted on nutrient media favorable for the growth of pathogenic microorganisms. Active reproduction and formation of colonies of a particular pathogen indicate the presence of infection. On the basis of the bacterial culture, an antibiogram is carried out - 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. A blood test for PSA (prostate specific antigen) is a tumor marker of the male reproductive system. It is carried out using the high-precision ICLA method (chemiluminescent immunoassay).
4. Examination of the prostate secretion (microscopy and culture). Allows you to determine inflammation, the presence of microbes (E. coli, staphylococci, etc. )

A full screening for STIs can be done with a blood sample.

Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate. It is performed using a cylindrical probe 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 put on. The data is transmitted to the monitor, where the urologist visually assesses pathological changes in the prostate.

resumption

Upon readmission, the doctor must:

• evaluates the test results;
• draws up a personal therapeutic scheme, taking into account the type, form, nature of the course of prostatitis, drug tolerance, patient age;
• 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.

therapy of prostatitis

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

• alleviating symptoms and inflammation;
• restoration of functions, stabilization of the condition of the gland;
• Consolidation of results, avoidance of complications.

First stage

With prostatitis of infectious etiology, antibiotics are prescribed mainly to destroy the causative agent of infection. The choice of drug depends 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 and bladder neck, reduce internal pressure in the urethra, normalize urine outflow, and reduce gland swelling.
2. enzymes. They liquefy the prostate secretion, increase 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 pain syndrome.

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

second phase

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

• vascular drugs (to improve blood flow to the prostate);
• immunostimulants;
• drugs that normalize the process of urination;
• anti-inflammatory drugs;
• Drugs to restore erection.

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

One of the special methods is the prostate massage. Mechanical action on the prostate allows:

• accelerate blood circulation;
• strengthen the walls of capillaries and vessels;
• activate exchange processes;
• to establish an outlet of mystery;
• normalize the emptying of the bladder;
• increase the effectiveness of drug therapy;
• Restoration of sexual activity.

Massage procedures are carried out for therapeutic and prophylactic purposes.

Types of massage:

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

Third section

The treatment is rounded off by ozone and laser therapy. Rectal ozone therapy consists of daily administration of freshly prepared ozonated isotonic saline solution.

Treatment of inflammation of the prostate with a laser is an advanced physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis. Directivity of the rectal laser:

• regenerates glandular cells;
• relieves inflammation and pain;
• strengthens local immunity;
• improves blood circulation in the prostate, the condition of the vessels.

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

In addition, phytotherapeutics are used.

Features of the treatment of chronic prostatitis

This form of prostatitis is characterized by a wavy 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 inconveniences in the form of disturbances in urination, dull pain in the lower abdomen and perineum, as well as weakness in potency for a long time. Patients with such a diagnosis often turn to the doctor during a worsening 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 to patients who have been 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 reduce inflammation.
• Drugs of the alpha-blocker group 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 the glandular tissue of the prostate against the background of chronic inflammation.
• Immunomodulators are used in chronic inflammation of the prostate of any origin, be it allergic, bacterial or nonbacterial prostatitis.

In addition, drugs are used that stimulate blood circulation in the pelvic organs and directly in the prostate, as well as sexual enhancers. Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and much more), a movement therapy exercise package to relax the perineum and pelvic floor muscles and laser therapy also contribute to improving the prognosis.

All of 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. The specialists of the center pay special attention to maintaining the functions of the genitourinary system in men, so that after therapy, patients can lead a full life and even become parents. A positive result of treatment can only be achieved with complex treatment with properly selected drugs, physiotherapy and prostate massage.

Prevention of inflammatory processes in the prostate

Preventive measures include:

1. change eating habits. Balanced diet with restriction of high-fat and high-calorie foods. Enrichment of the diet with vegetables, fruits, products for men's health (nuts, honey, seafood, etc. ).
2. Physical activity (regular exercise helps normalize blood circulation in the genital area).
3. Protected sex - the use of barrier contraceptives (condoms) to protect against sexually transmitted diseases.
4. Regular sex is a convenient and useful way to prevent congestion in the prostate.
5. alcohol restriction. Alcohol abuse leads to a decrease in potency, libido and inhibition of testosterone synthesis.
6. Complete calm. Psycho-emotional overload, insomnia (insomnia), physical overwork are provocateurs of abacterial prostatitis.
7. Regular visits to the urologist and screening for STIs. The disease is easier to prevent than to treat.

Urologists offer a preventive examination of the prostate.