Treatment of the prostate in men: what drugs to take

Prostatitisis an inflammatory disease of the prostate gland.It manifests itself as frequent urination, pain in the penis, scrotum, rectum, sexual disorders (erectile dysfunction, early ejaculation, etc.), sometimes urinary retention, and blood in the urine.The diagnosis of prostatitis is established by a urologist or andrologist based on a typical clinical picture and the results of a rectal examination.Additionally, an ultrasound of the prostate and culture of prostatic secretions and urine are performed.Treatment is conservative - antibacterial therapy, immunotherapy, prostate massage, lifestyle correction.

General information

Prostatitis is inflammation of the seminal (prostate) gland - prostate.It is the most common disease of the genitourinary system in men.Most often it affects patients aged 25-50 years.According to various data, prostatitis affects 30-85% of men over the age of 30 years.Possible abscess formation of the prostate gland, inflammation of the testicles and appendages, which threatens infertility.Ascending infection leads to inflammation of the upper parts of the genitourinary system (cystitis, pyelonephritis).

The pathology develops with the penetration of an infectious agent that enters the prostate tissue from the organs of the genitourinary system (urethra, bladder) or from a remote inflammatory focus (pneumonia, influenza, sore throat, furunculosis).

Causes of prostatitis

Staphylococcus aureus, Enterococcus, Enterobacter, Pseudomonas, Proteus, Klebsiella and E. Coli can act as infectious agents in acute cases.Most microorganisms belong to the conditionally pathogenic flora and cause prostatitis only in the presence of other predisposing factors.Chronic inflammation is usually due to polymicrobial associations.

The risk of developing the disease increases with hypothermia, a history of specific infections and conditions accompanied by congestion in the prostate tissue.The following predisposing factors are identified:

• General hypothermia (one-time or permanent, associated with working conditions).
• A sedentary lifestyle, a profession that forces a person to be in a sitting position for a long time (computer operator, driver, etc.).
• Constant constipation.
• Disturbances in the normal rhythm of sexual activity (excessive sexual activity, prolonged abstinence, incomplete ejaculation during “habitual” sexual intercourse devoid of emotional overtones).
• The presence of chronic diseases (cholecystitis, bronchitis) or chronic infectious foci in the body (chronic osteomyelitis, untreated caries, tonsillitis, etc.).
• Past urological diseases (urethritis, cystitis, etc.) and sexually transmitted diseases (chlamydia, trichomoniasis, gonorrhea).
• Conditions that cause suppression of the immune system (chronic stress, irregular and poor nutrition, regular lack of sleep, overtraining in athletes).

A decisive role in the occurrence of prostatitis is played by congestion in the prostate tissue.Disruption of capillary blood flow causes increased lipid peroxidation, swelling, exudation of prostate tissue and creates conditions for the development of an infectious process.

Symptoms of prostatitis

Acute prostatitis

There are three stages of acute prostatitis, which are characterized by the presence of a certain clinical picture and morphological changes:

• Acute catarrhal.Patients complain of frequent, often painful urination, pain in the sacrum and perineum.
• Acute follicular.The pain becomes more intense, sometimes radiating to the anus, and intensifies during defecation.Urination is difficult, urine flows out in a thin stream.In some cases, urinary retention is observed.Low-grade fever or moderate hyperthermia is typical.
• Acute parenchymal.Severe general intoxication, hyperthermia up to 38-40°C, chills.Dysuric disorders, often acute urinary retention.Sharp, throbbing pain in the perineum.Difficulty in defecation.

Chronic prostatitis

In rare cases, chronic prostatitis becomes the outcome of an acute process, however, as a rule, a primarily chronic course is observed.The temperature occasionally rises to subfebrile levels.The patient notes mild pain in the perineum, discomfort during urination and defecation.The most characteristic symptom is scanty discharge from the urethra during defecation.The primarily chronic form of the disease develops over a significant period of time.It is preceded by prostatosis (stagnation of blood in the capillaries), which gradually turns into abacterial prostatitis.

Chronic prostatitis is often a complication of the inflammatory process caused by the causative agent of a specific infection (chlamydia, trichomonas, ureaplasma, gonococcus).Symptoms of a specific inflammatory process in many cases mask the manifestations of prostate damage.There may be a slight increase in pain when urinating, mild pain in the perineum, scanty discharge from the urethra during defecation.A minor change in the clinical picture often goes unnoticed by the patient.

Chronic inflammation of the prostate gland can be manifested by a burning sensation in the urethra and perineum, dysuria, sexual dysfunction, and increased general fatigue.The consequence of potency disorders (or fear of these disorders) is often mental depression, anxiety and irritability.The clinical picture does not always include all of the listed groups of symptoms; it varies among different patients and changes over time.There are three main syndromes characteristic of chronic prostatitis: pain, dysuria, sexual disorders.

There are no pain receptors in prostate tissue.The cause of pain in chronic prostatitis is the almost inevitable involvement of nerve pathways in the inflammatory process due to the abundant innervation of the pelvic organs.Patients complain of pain of varying intensity - from mild, aching to intense, disturbing sleep.There is a change in the nature of pain (increasing or weakening) during ejaculation, excessive sexual activity or sexual abstinence.The pain radiates to the scrotum, sacrum, perineum, and sometimes to the lumbar region.

As a result of inflammation in chronic prostatitis, the volume of the prostate increases, compressing the urethra.The lumen of the ureter decreases.The patient experiences frequent urge to urinate and a feeling of incomplete emptying of the bladder.As a rule, dysuric phenomena are expressed in the early stages.Then compensatory hypertrophy of the muscular layer of the bladder and ureters develops.Symptoms of dysuria weaken during this period, and then increase again with decompensation of adaptation mechanisms.

In the initial stages, dyspotence may develop, manifesting itself differently in different patients.Patients may complain of frequent nighttime erections, lost orgasm, or deterioration of erection.Accelerated ejaculation is associated with a decrease in the threshold level of excitation of the orgasmic center.Pain during ejaculation can cause refusal of sexual activity.Subsequently, sexual dysfunctions become more pronounced.At an advanced stage, impotence develops.

The degree of sexual disorder is determined by many factors, including the sexual constitution and psychological mood of the patient.Impaired potency and dysuria can be caused both by changes in the prostate gland and by the suggestibility of the patient, who, if he is diagnosed with chronic prostatitis, expects the inevitable development of sexual disorders and urinary disorders.Psychogenic dyspotence and dysuria develop especially often in suggestible, anxious patients.

Impotence, and sometimes the very threat of possible sexual disorders, is difficult for patients to tolerate.Often there is a change in character, irritability, grumpiness, excessive concern for one’s own health, and even “sickness.”

Classification

In modern urology there is no uniform classification of the disease.However, practicing doctors prefer this option for classifying the inflammatory process in the prostate:

According to the course of the disease:

• Acute prostatitis.It accounts for more than 50% of cases of the disease in people no older than 30-35 years.
• Chronic option.It is considered a non-age category.It does not manifest itself for a long time; the impetus for its development is a cold or infection.

For the reason that caused the pathology:

• Bacterial inflammation of the prostate gland, predominates in men under 40 years of age, occurs against the background of ultrasonography, and does not extend beyond the boundaries of the organ.
• Non-bacterial pathological changes in the gland, predominantly chronic.
• Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.

According to the nature of structural changes in the prostate gland:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention.Clinically resembles prostate adenoma.
• Calculous inflammation of the prostate gland occurs due to the formation of stones inside the prostate.Considered as a harbinger of cancer.
• Congestive prostatitis, the result of a sedentary lifestyle, is diagnosed in every second patient.

Signs of the disease

If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:

• Disorder of urination with the occurrence of an intermittent, weak stream of urine, unusually short, causing splashing, difficulty and pain before urination.Frequent urge to empty the bladder occurs mainly at night.
• Soreness, which is localized in the lower abdomen, radiates to the scrotum, perineum, and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in sperm (consistency, quantity).

Complications

In the absence of timely treatment of acute prostatitis, there is a significant risk of developing a prostate abscess.When a purulent focus forms, the patient’s body temperature rises to 39-40°C and can become hectic in nature.Periods of fever alternate with severe chills.Sharp pain in the perineum makes urination difficult and makes defecation impossible.

Increasing swelling of the prostate gland leads to acute urinary retention.In rare cases, the abscess spontaneously ruptures into the urethra or rectum.When opened, purulent, cloudy urine with an unpleasant, pungent odor appears in the urethra; when opened, the feces contain pus and mucus into the rectum.

Chronic prostatitis is characterized by a wave-like course with periods of long remissions, during which inflammation in the prostate is latent or manifests itself with extremely scant symptoms.Patients who are not bothered by anything often stop treatment and turn only if complications develop.

The spread of infection along the urinary tract causes the occurrence of pyelonephritis and cystitis.The most common complication of the chronic process is inflammation of the testicles and epididymis (epdidymo-orchitis) and inflammation of the seminal vesicles (vesiculitis).The outcome of these diseases is often infertility.

Diagnostics

The characteristic clinical picture simplifies the process of diagnosing acute and chronic prostatitis.It is mandatory to:

Treatment of prostatitis

Treatment of acute prostatitis

Patients with an uncomplicated acute process are treated by a urologist on an outpatient basis.In case of severe intoxication or suspicion of a purulent process, hospitalization is indicated.Antibacterial therapy is carried out.Drugs are selected taking into account the sensitivity of the infectious agent.Antibiotics are widely used that can penetrate well into the prostate tissue and act on it.

With the development of acute urinary retention due to prostatitis, they resort to installing a cystostomy rather than a urethral catheter, since there is a danger of the formation of a prostate abscess.When an abscess develops, an endoscopic transrectal or transurethral opening of the abscess is performed.

Treatment of chronic prostatitis

Treatment of chronic prostatitis should be comprehensive, including etiotropic therapy, physiotherapy, correction of immunity:

• Antibiotic therapy.The patient is prescribed long courses of antibacterial drugs (for 4-8 weeks).Selection of the type and dosage of antibacterial drugs, as well as determination of the duration of the course of treatment is carried out individually.The drug is selected based on the sensitivity of the microflora based on the results of culture of urine and prostate secretions.
• Prostate massage.Gland massage has a complex effect on the affected organ.During the massage, the inflammatory secretion accumulated in the prostate gland is squeezed into the ducts, then enters the urethra and is removed from the body.The procedure improves blood circulation in the prostate, which minimizes congestion and ensures better penetration of antibacterial drugs into the tissue of the affected organ.
• Physiotherapy.To improve blood circulation, laser exposure, ultrasonic waves and electromagnetic waves are used.If it is impossible to carry out physiotherapeutic procedures, the patient is prescribed warm medicinal microenemas.

In case of chronic, long-term inflammation, consultation with an immunologist is indicated to choose the tactics of immunocorrective therapy.The patient is given recommendations for lifestyle changes.Making certain changes in the lifestyle of a patient with chronic prostatitis is both a therapeutic and preventive measure.The patient is recommended to normalize sleep and wakefulness, adjust the diet, and engage in moderate physical activity.

Treatment of acute prostatitis

Acute prostatitis requires bed rest, a special, salt-free diet, and sexual rest.

Methods of course treatment:

• The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, a course of antimicrobial agents is a priority, which relieves the manifestations of inflammation.
• Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers.NSAIDs may be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes, and a combination of microelements have proven their effectiveness.
• Physiotherapeutic methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
• Massage is another effective method of influencing the prostate.It opens the ducts, normalizes blood circulation in the scrotum and pelvis.
• Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
• The purulent process involves surgical intervention.
• Psychologist consultations.

Treatment methods for prostatitis

Antibacterial therapy is most effective for treating prostatitis.Herbal medicine, immunocorrectors and hormonal drugs can also be used as prescribed by a doctor.

In the absence of acute symptoms, prostatitis can be treated with physiotherapy.In case of abscesses and suppurations, surgical intervention is recommended.

Treatment with drugs

Treatment of prostatitis through antibacterial therapy must begin with bacterial culture, the purpose of which is to assess the body’s sensitivity to this type of antibiotic.If urination is impaired, the use of anti-inflammatory drugs gives a good result.

Medicines are taken in tablets, in acute cases - as a dropper or intramuscularly.Rectal suppositories are effective for treating chronic forms of prostatitis: with their help, medications reach their goals faster and have minimal effect on other organs.

Blood-thinning and anti-inflammatory drugs have also proven themselves to be effective.

Antibacterial therapy

Antibiotics are an effective remedy in the fight against bacterial prostatitis.In order to achieve the desired effect and not harm the body, the choice of medication, dosage and treatment regimen should be made by a doctor.To correctly select the most effective medications, he will have to find out what type of pathogen caused prostatitis, and also test the patient for tolerance to antibiotics of a particular group.

Antibiotics from the fluoroquinolone group have proven themselves to be effective in the treatment of chronic prostatitis.Their action is aimed at suppressing bacterial infection and strengthening the body's own immunity.In addition to this, the bacteriostatic antibiotic trimethoprim is recommended for the prevention and treatment of concomitant diseases of the genitourinary system.

To treat prostatitis caused by mycoplasma and chlamydia, you can additionally take medications from the group of macrolides and tetracyclines, which slow down the spread of infection.

The duration of taking antibacterial drugs is from 2 to 4 weeks.In case of positive dynamics, the course may be extended.

Physiotherapy

Physiotherapeutic techniques in the treatment of prostatitis are aimed at activating blood circulation in the pelvic area, improving metabolic processes in the prostate gland, and cleansing the ducts.If physiotherapy is combined with taking antibiotics, the effect of the latter is enhanced.

The main methods include:

• magnetic therapy;
• laser therapy;
• electrophoresis;
• warming up;
• ultrasound;
• mud therapy;
• high frequency irradiation;
• physical therapy.

One of the oldest methods, transrectal massage of the prostate gland, according to modern research, has no proven effectiveness.

Non-specific treatments

Nonspecific methods of treating prostatitis include:

• hirudotherapy;
• therapeutic fasting;
• acupuncture;
• diet according to the Ostrovsky method;
• alkalization of the body using the Neumyvakin method.

We strongly recommend that you discuss all non-traditional methods of treating prostatitis with your doctor.

Surgical treatment

Surgical methods are used in complex and emergency cases:

• for drainage of purulent abscesses, which are removed by laparoscopic methods through a puncture;
• in case of difficulty urinating due to damage to the urinary tract;
• with a large volume of the affected area;
• with a significant number of stones in the body of the gland.

Stones and sclerotic tissue are removed using endoscopic methods.In case of a large affected area or multiple stones, resection of the prostate is resorted to.

Transurethral resection is also effective for bacterial prostatitis.In this way, the risk of relapse can be reduced.

Folk remedies

Folk remedies for the treatment of prostatitis are unlikely to be effective on their own, but in combination with medication and physiotherapeutic methods they may be applicable.These include: beekeeping products, decoctions of herbs and seeds, tinctures of garlic, ginger, beaver stream, fresh vegetables, pumpkin seeds.

In acute cases of the disease, you must consult a doctor, and in no case should you self-medicate!If a purulent abscess ruptures, death is possible.

Suppositories for prostatitis

When treating prostatitis, rectal suppositories are much more effective than tablets, if only because the rectum is much closer to the prostate, which means the medicine will act faster.

The composition of drugs for the treatment of prostatitis can be completely different; they are prescribed to solve a particular problem.

1. Antibacterial agents are especially effective for prostatitis caused by chlamydia.
2. Painkillers are used for symptomatic treatment; they relieve pain well.
3. Immunostimulants help improve blood circulation, relieve swelling, and are used in complex therapy.
4. Herbal medicines have a mild effect.They, like candles on bee products, are used as an addition to the main treatment.
5. Ichthyol-based compositions promote blood flow in the intestinal mucosa area, which accelerates the attenuation of inflammatory processes and slightly improves immunity.
6. Enzyme-based products prevent the formation of scar tissue.It is recommended to take it as part of complex therapy with antibiotics, anti-inflammatory and painkillers.

Ancillary drugs

For the symptomatic treatment of prostatitis in men, for example, relieving pain when urinating, you can additionally take antispasmodics, which relax smooth muscles and thereby quickly relieve pain.

General health is promoted by blood-thinning and anti-inflammatory dietary supplements based on bee products, pumpkin oil, and palm fruit extracts.

Diet and lifestyle

For the treatment of prostatitis, a proper, balanced diet and a healthy lifestyle are very important.Food should not contain spicy, fried, salty or pickled foods.In acute cases, alcohol is strictly prohibited.

Food should contain sufficient fiber to prevent constipation.Protein content should be reduced.It is advisable to supplement the diet with herbs, ginger, and pumpkin seeds.

Consequences of untreated prostatitis

Even if the symptoms of prostatitis have not appeared for a long time, it is necessary to undergo regular examination by a urologist.Incompletely cured prostatitis may be accompanied by the formation of calcifications, which will then have to be removed along with the gland.Experts are confident that there are no other ways to remove or dissolve stones.

In addition, pathogenic microorganisms can migrate to neighboring organs, causing inflammation.Advanced prostatitis can cause the development of adenoma and prostate cancer.

Prognosis and prevention

Acute prostatitis is a disease that has a pronounced tendency to become chronic.Even with timely adequate treatment, chronic prostatitis becomes the outcome in more than half of patients.Recovery is not always achieved, however, with correct consistent therapy and following the doctor’s recommendations, it is possible to eliminate unpleasant symptoms and achieve long-term, stable remission in a chronic process.

Prevention consists of eliminating risk factors.It is necessary to avoid hypothermia, alternate sedentary work with periods of physical activity, and eat regularly and nutritiously.For constipation, laxatives should be used.One of the preventive measures is the normalization of sexual life, since both excessive sexual activity and sexual abstinence are risk factors in the development of prostatitis.If symptoms of a urological or sexually transmitted disease appear, you should consult a doctor promptly.