Treatment of prostatitis

Prostatitis (lat. prostatitis) is an acute or chronic inflammation of the prostate, diagnosed in 35-40% of men aged 25-55 years old. The older the patient, the higher the risk of developing prostatitis.

When inflamed, the prostate enlarges and begins to compress the urethra. This process causes a narrowing of the lumen of the ureter, as a result of which the man begins to experience a frequent urge to urinate and he has a feeling of incomplete emptying of the bladder. In the initial stage, the symptoms of prostatitis may be mild. However, over time, prostatitis becomes the cause of sexual dysfunction. In addition, the pathology can lead to a number of complications:

• prostate abscess;
• cystitis.

Prostatitis or prostate adenoma?

These two diseases are often confused or mistaken for the same thing. At the same time, they have different natures and flow patterns.

Special features	Prostatitis	HBP
Age of patients	20 to 45 years old	over 45 years old
Nature of the disease	inflammatory process	tumor
Pain syndrome	present in acute form	appears at stages 2-3 of the disease
Fever	pronounced	absent
Urination disorder	appears in acute form	always present
Power weakening	observed in both cases

Prostatitis primarily requires drug treatment, while prostate adenoma is a benign tumor that is surgically removed. At the same time, prostate adenoma can cause prostatitis. That is why any inflammatory process in the pelvic organs requires timely examination and treatment.

Causes of prostatitis

Infectious

Prostatitis can be caused by:

• Staphylococcus aureus;
• enterococcus;
• Pseudomonas aeruginosa;
• sexually transmitted infections;
• chronic infectious diseases (tonsillitis, sinusitis, etc. );
• other opportunistic pathogens.

Stagnant

Prostatitis appears as a result of:

• sedentary lifestyle;
• sedentary work;
• long periods of abstinence;
• excessive sexual activity;
• interruption of sexual intercourse.

The listed factors contribute to the disruption of capillary blood flow and the formation of stagnant processes in the prostate tissue.

Prostatitis begins to develop more intensely when favorable factors appear, including:

• chronic constipation;
• hypothermia;
• unbalanced diet;
• urological diseases;
• frequent stress;
• intoxication of the body due to smoking or drinking alcohol;
• perineal injuries.

Types and symptoms of prostatitis

Depending on the form of its occurrence, prostatitis in men is divided into:

Acute prostatitis. One of the first signs of the course of the disease is a pronounced pain syndrome, which appears against the background of a rapidly developing inflammatory process. Prostate swelling occurs, triggered by exposure to pathogenic microflora. The condition requires emergency medical attention. In turn, acute prostatitis can take the following forms:

• catarrhal (frequent painful urination, pain in the sacrum and perineum, difficulty defecating);
• follicular (the pain intensifies and begins to radiate towards the anus, when going to the toilet, urine flows out in a thin stream, the body temperature rises to 37. 5 ºС);
• parenchymal (body temperature rises to 38-40 ºC, general intoxication of the body is observed, acute shooting pain in the groin area is noted, acute urinary retention occurs).

Chronic prostatitis is practically asymptomatic or has mild symptoms. In men, the temperature rises from time to time to 37-37. 5 ºC, there is slight pain in the perineum, which intensifies during urination or defecation. Additionally, you might encounter:

• weakening of erection;
• accelerated ejaculation;
• reduction in the severity of sexual sensations.

In some cases, chronic prostatitis becomes the result of an acute process, when the patient notices the so-called false improvement and refuses to consult a urologist. As a rule, self-medication at home leads to a number of complications: prostate abscess or adenoma, inflammation of the bladder, loss of fertility, etc.

Depending on the cause, prostatitis can be:

• herpetic,
• bacterial,
• infectious,
• fungal,
• purulent,
• chlamydia,
• gonorrhea,
• calculator,
• fibrous,
• stagnant.

Diagnosis of prostatitis

Palpation allows you to determine the size, shape and structure of organic tissues.

Laboratory research. Allows you to diagnose prostatitis and other prostate diseases at an early stage or in chronic cases in the absence of pronounced symptoms.

• general blood and urine analysis;
• a biochemical blood test is carried out to clarify the picture of the disease and determine the involvement of other internal organs and systems in the inflammatory process;
• PSA blood test;
• urine culture with antibiotic sensitivity test.
• smear for urogenital infections to detect STDs.

Ultrasound is performed to identify structural changes in prostate tissue and detect neoplasms (cysts, tumors).

TRUS is carried out through the rectum and allows you to obtain the most complete information about the state of the gland and bladder.

MRI allows you to get detailed, layer-by-layer images of the prostate and surrounding tissues in three different projections.

Treatment of prostatitis

Treatment methods depend on the identified causative agent of prostatitis, so the patient must undergo a comprehensive examination.

Treatment of acute prostatitis

Antibacterial therapy. Before prescribing antibiotics, the doctor will refer the patient for tests aimed at identifying the causative agent of the infection. After that, drugs are selected that help suppress the activity of pathogenic microorganisms and eliminate the inflammatory process.

Symptomatic treatment. Additionally, the urologist can prescribe antipyretics, pain relievers, diuretics, laxatives, vitamins, immunomodulators and other medications.

Surgery. Performed in case of complications. For example, if an abscess develops, the doctor may perform a transurethral or transrectal opening of the abscess; in case of acute urinary retention, a cystoma may be necessary.

Treatment of chronic prostatitis

Antibacterial therapy. The duration of treatment lasts from 14 to 28 days and must be completed even if the signs of prostatitis have disappeared after a week. Antibiotics are used to eliminate infections and suppress inflammatory processes in the body.

Symptomatic treatment. Depending on the indications, the urologist can prescribe painkillers, antispasmodics, anti-inflammatories, immunomodulators, blood vessels and others to the patient.

Manual or material massage. One of the most effective methods for treating prostatitis in men. Prostate massage helps to remove stagnant secretions, improve blood and lymphatic circulation, and restore the metabolism of the affected organ.

Physiotherapeutic treatment. Depending on the indications, the urologist may prescribe electrical stimulation, laser or magnetotherapy. The procedures help improve blood circulation, have an anti-inflammatory effect and help restore reproductive function.

Prostatitis prevention

It is much easier to prevent prostatitis than to treat it later. To do this, simply follow the following recommendations:

Annual review. It is necessary to visit a urologist every year, even if there are no complaints about your health.

Sporting activities. Regular physical activity helps improve metabolic processes throughout the body, including the prostate.

Refusal of promiscuous sexual relations. Sex is very important for men's health, but frequent changes in sexual partners can cause bacterial prostatitis and related complications.

Balanced diet. You must eat at least 3 times a day. The diet should include low-fat fish and meat, cereals, fermented milk products, fresh vegetables and fruits. It is advisable to limit consumption or completely avoid carbonated drinks, fatty and smoked foods, pastries and spices.

Rejection of bad habits. Drinking alcohol and smoking reduce immunity and put additional stress on the body, creating favorable conditions for the development of many diseases.

Questions and answers

Question: How to distinguish acute prostatitis from chronic prostatitis?

Answer: It is necessary to start with the fact that in its acute form the disease usually occurs in people under 30-35 years old. Chronic prostatitis is considered unrelated to aging. The disease in its acute form usually manifests itself quickly with the following symptoms:

• a sharp increase in body temperature (up to 40 degrees);
• a severe headache appears;
• fever begins.

Acute prostatitis is also characterized by constant pain in the groin, back and perineum.

In its chronic form, prostatitis, on the contrary, may not present any symptoms for a long time. Over time, a person develops fever and periodic pain appears in the anus, scrotum, back and perineum.
Urination is impaired, purulent discharge from the anus and urethra begins. Chronic prostatitis also leads to erectile dysfunction. Ejaculation begins to be painful and sexual intercourse is not pleasant.

Question: What happens if prostatitis is left untreated?

Answer: If a person does not receive treatment for diagnosed prostatitis, complications and concomitant pathologies may develop.

1. Vesiculitis. This disease is characterized by inflammatory processes in the seminal vesicles. As a result, pus enters the ejaculate and the quality of sperm decreases. Vesiculitis often leads to a complete loss of reproductive functions.
2. Colliculitis. Disease in which inflammatory processes affect the seminal tubercle. As a result, during sexual intercourse, a man experiences severe pain, which leads to an interruption of orgasm. Without therapy, a person develops impotence of a psychological nature.
3. Abscess. It is formed in the prostate and causes intoxication of the body. Its rupture can lead to an increase in symptoms and, in some cases, lead to death.
4. Infertility. This occurs against the background of deterioration in sperm quality and inflammatory processes in the testicles, spermatic cord and vesicles.
5. Against the background of prostatitis, immunity often deteriorates. About a third of all cases of the disease without treatment end in the development of oncology. Prostatitis should be treated in a specialized andrology clinic.

Question: Where should I go for prostatitis treatment?

Answer: The diagnosis is usually made by a urologist based on a study of symptoms. To confirm prostatitis, various studies are usually prescribed:

• general blood and urine tests;
• STD smear;
• secret research;
• urine flowmetry;
• ultrasound.

In some cases, a biopsy and spermogram are also prescribed.