Treatment of prostatitis: the most effective drugs and treatment regimens

Prostatitisis an inflammatory disease of the prostate gland. Manifested by frequent urination, pain in the penis, scrotum, rectum, sexual disorders (erectile dysfunction, premature ejaculation, etc. ), sometimes urinary retention, blood in the urine. The diagnosis of prostatitis is established by a urologist or andrologist according to the usual clinical picture, the results of a rectal examination. In addition, ultrasound of the prostate, bakposev prostate secretion and urine are performed. Treatment is conservative - antibiotic therapy, immunotherapy, prostate massage, lifestyle correction.

signs of prostatitis in men

General information

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

Pathology develops with the penetration of infectious agents that enter the prostate tissue from organs of the genitourinary system (urethra, bladder) or from a distant inflammatory focus (with pneumonia, influenza, tonsillitis, furunculosis).

healthy and diseased prostate

Causes of prostatitis

As an infectious agent in the acute process, Staphylococcus aureus (Staphylococcus aureus), Enterococcus (Enterococcus), Enterobacter (Enterobacter), Pseudomonas (Pseudomonas), Proteus (Proteus), Klebsiella (Klebsiella) and Escherichia coli (E. Coli) can act. . Most microorganisms belong to the conditionally pathogenic flora and cause prostatitis only in the presence of other predisposing factors. Chronic inflammation is usually caused by a polymicrobial association.

The risk of developing this disease increases with hypothermia, a history of infection and certain conditions accompanied by congestion in the prostate tissue. There are the following predisposing factors:

  • General hypothermia (one-time or permanent, associated with work conditions).
  • Sedentary lifestyle, profession that forces a person to be in a sitting position for a long time (computer operator, driver, etc. ).
  • Persistent constipation.
  • Violation of the normal rhythm of sexual activity (excessive sexual activity, prolonged abstinence, incomplete ejaculation during "normal" sexual intercourse without emotional coloring).
  • The presence of chronic diseases (cholecystitis, bronchitis) or chronic infectious focus 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, frequent sleep deprivation, overtraining in athletes).

It is assumed that the risk of developing pathology increases with chronic intoxication (alcohol, nicotine, morphine). Several studies in the field of modern andrology prove that chronic perineal trauma (vibration, tremors) in drivers, motorcyclists and cyclists is a provoking factor. However, most experts believe that all these conditions are not the real cause of the disease, but only contribute to the worsening of the latent inflammatory process in the prostate tissue.

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

Symptoms of prostatitis

Acute prostatitis

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

  • Acute catarrhal. Patients complain of frequent, often painful urination, pain in the sacrum and perineum.
  • Acute follicles. The pain becomes stronger, sometimes radiating to the anus, aggravated by defecation. Urination is difficult, urine flows out in a thin stream. In some cases, there is urinary retention. A subfebrile state or moderate hyperthermia is typical.
  • Acute parenchyma. Severe general poisoning, hyperthermia up to 38-40°C, chills. Screening disorders, often - acute urinary retention. Sharp, throbbing pain in the perineum. Difficulty defecating.

Chronic prostatitis

In rare cases, chronic prostatitis becomes the result of an acute process, however, as a rule, the main chronic course is observed. The temperature sometimes rises to subfebrile values. The patient noted some pain in the perineum, discomfort during urination and defecation. The most characteristic symptom is a slight discharge from the urethra during defecation. The main chronic form of the disease develops over a long period of time. It is preceded by prostatosis (blood stagnation in the capillaries), gradually turning into abacterial prostatitis.

Chronic prostatitis is often a complication of the inflammatory process caused by certain infectious agents (chlamydia, trichomonas, ureaplasma, gonococcus). Symptoms of certain inflammatory processes in many cases mask the manifestation of prostate damage. Perhaps a slight increase in pain during urination, mild pain in the perineum, a slight discharge from the urethra during defecation. Slight changes in the clinical picture are often not noticed by the patient.

Chronic inflammation of the prostate gland can be manifested by a burning sensation in the urethra and perineum, dysuria, sexual disturbances, increased general fatigue. The consequences of potential violations (or fear of these violations) are often mental depression, anxiety and irritability. The clinical picture does not always include all the groups of symptoms listed, differs in different patients and changes over time. There are three main syndrome characteristics of chronic prostatitis: pain, discharge, sexual dysfunction.

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

As a result of inflammation in chronic prostatitis, the volume of the prostate increases, squeezing the urethra. The lumen of the ureter is reduced. The patient has a frequent urge to urinate, a feeling of incomplete emptying of the bladder. As a rule, the phenomenon is detected at an early stage. Then compensatory hypertrophy of the muscle layer of the bladder and ureter develops. Symptoms of dysuria during this period weaken, and then increase again with the decompensation of the adaptive mechanism.

In the early stages, dyspotency may develop, which manifests itself differently in different patients. Patients may complain of frequent nocturnal erections, blurred orgasms, or worsening erections. Accelerated ejaculation is associated with a decrease in the threshold level of orgasmic center excitation. Painful sensations during ejaculation can cause rejection of sexual activity. In the future, sexual dysfunction becomes more pronounced. In advanced stages, impotence develops.

The level of sexual disorders is determined by many factors, including the sexual constitution and psychological mood of the patient. Violation of potency and dysuria can be caused by both changes in the prostate gland and the suggestion of the patient, who, if he has chronic prostatitis, expects the inevitable development of sexual disorders and urinary disorders. Especially often psychogenic dyspotency and dysuria develop in suggested, anxious patients.

Impotence, and sometimes the threat of possible sexual harassment, is difficult for patients to accept. Often there are changes in character, irritability, resentment, excessive concern for one's own health, and even "care for the disease. "


In the absence of timely treatment of acute prostatitis, there is a high risk of developing a prostate abscess. With the formation of a purulent focus, the patient's body temperature rises to 39-40 ° C and can become busy in nature. Periods of heat alternate with severe chills. Sharp pain in the perineum makes it difficult to urinate and defecate.

Increased prostate edema leads to acute urinary retention. Rarely, an 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 stool contains pus and mucus in the rectum.

Chronic prostatitis is characterized by an undulating course with long periods of remission, where inflammation in the prostate is latent or manifests itself with very weak symptoms. Patients who are not bothered by anything often stop treatment and switch only when complications develop.

The spread of infection through the urinary tract causes pyelonephritis and cystitis. The most common complications in the chronic process are inflammation of the testicles and epididymis (epdidymo-orchitis) and inflammation of the seminal vesicles (vesiculitis). The consequence of this disease is often infertility.


The characteristic clinical picture facilitates the diagnosis process in acute and chronic prostatitis. Required to:

Treatment of prostatitis

Treatment of acute prostatitis

Patients with uncomplicated acute processes are treated by urologists on an outpatient basis. With severe intoxication, suspicion of a purulent process, hospitalization is indicated. Antibacterial therapy is carried out. Preparations are selected taking into account the sensitivity of infectious agents. Antibiotics are widely used that can penetrate well into prostate tissue.

With the development of acute urinary retention against the background of prostatitis, they use a cystostomy installation, and not a urethral catheter, because there is a danger of prostate abscess formation. With the development of an abscess, endoscopic transrectal or transurethral opening of the abscess is performed.

Treatment of chronic prostatitis

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

  • Antibiotic therapy. The patient is prescribed a long course of antibacterial drugs (within 4-8 weeks). Selection of the type and dose of antibacterial drugs, as well as determining the duration of the treatment course is carried out individually. This drug is selected based on the sensitivity of the microflora according to the results of urine cultures and prostate secretions.
  • Prostate massage.Glandular massage has a complex effect on the affected organ. During the massage, the inflammatory secret accumulated in the prostate gland is squeezed out into the duct, then enters the urethra and is removed from the body. This 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 vibrations are used. If it is impossible to carry out physiotherapeutic procedures, the patient is prescribed warm medical microclysters.

In chronic, long-term inflammation, consultation of an immunologist is indicated to choose immunocorrective therapy tactics. Patients are advised about lifestyle changes. Making certain changes in the lifestyle of patients with chronic prostatitis is a curative and preventive measure. The patient is recommended to normalize sleep and wakefulness, prescribe a diet, carry out moderate physical activity.

For the treatment of prostatitis, antibiotic therapy is most effective. Phytotherapy, immunocorrectors and hormonal preparations can also be used as prescribed by the doctor.

If there are no acute symptoms, prostatitis can be treated with physiotherapy methods. In case of abscess and suppuration, surgical intervention is recommended.

Treatment with drugs

Treatment of prostatitis through antibiotic therapy should begin with bakposev, the purpose of which is to assess the body's sensitivity to this type of antibiotic. In urinary disorders, a good result is the use of anti-inflammatory drugs.

Medicines are taken in tablets, in acute cases - in the form of drops or intramuscularly. For the treatment of chronic forms of prostatitis, rectal suppositories are effective: with their help, drugs achieve their goals faster and have minimal effects on other organs.

Blood thinning and anti-inflammatory drugs have also proven themselves well.

Antibacterial therapy

Antibiotics are effective drugs in the fight against bacterial prostatitis. To achieve the desired effect and not harm the body, the choice of medicine, dosage and treatment regimen should be managed by a doctor. For the correct selection of the most effective drug, he needs to know the type of pathogen that causes prostatitis, and also examine the patient for tolerance to a certain group of antibiotics.

For the effective treatment of chronic prostatitis, antibiotics of the fluoroquinolone group have proven themselves well. Their actions are aimed at blocking bacterial infections and strengthening the body's own immunity. In addition, bacteriostatic antibiotics are recommended for the prevention and treatment of concomitant diseases of the genitourinary system.

Treatment of prostatitis caused by mycoplasma and chlamydia can also be done with macrolide and tetracycline drugs, which slow the spread of the infection.

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


Physiotherapy methods in the treatment of prostatitis aim to activate blood circulation in the pelvic area, improve metabolic processes in the prostate gland, and clean the ducts. If physiotherapy is combined with taking antibiotics, then the effect of the latter is enhanced.

The main methods include:

  • magnetotherapy;
  • laser therapy;
  • electrophoresis;
  • warm up;
  • ultrasound;
  • mud treatment;
  • high frequency irradiation;
  • physiotherapy.
prostate massage for the treatment of prostatitis

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

Treatment is not specific

Non-specific treatments for prostatitis include:

  • hirudotherapy;
  • curative fasting;
  • acupuncture;
  • diet according to the Ostrovsky method;
  • body alkalinization according to the Neumyvakin method.

All non-traditional methods of treating prostatitis are strongly recommended to be coordinated with your doctor.


Surgical methods are used in complex and emergency cases:

  • for purulent abscess drainage, which is removed by laparoscopic method through puncture;
  • in violation of urination due to damage to the urinary tract;
  • with a large amount of affected area;
  • with a large number of stones in the body of the gland.

Stones and sclerosed tissue are removed endoscopically. With a large area of damage or multiple stones, resection of the prostate should be performed.

Transurethral resection is also effective for bacterial prostatitis. Therefore, it is possible to reduce the risk of relapse.

People's recovery

inflammation of the prostate

Treatment of prostatitis with folk remedies is unlikely to be effective by itself, but in combination with medical and physiotherapeutic methods it can be used. These include: beekeeping products, decoction of herbs and seeds, garlic tincture, ginger, beaver flow, fresh vegetables, pumpkin seeds.

In acute cases of the course of the disease, you must consult a doctor, and you should not self-medicate! If a purulent abscess breaks, a fatal outcome is possible.

Candles for prostatitis

Treatment of prostatitis with rectal suppositories is much more effective than tablets, if only because the rectum is closer to the prostate, which means the medicine will work faster.

The composition of drugs for the treatment of prostatitis can be completely different, they are prescribed to solve specific problems.

  1. Antibacterial agents are particularly effective for prostatitis caused by chlamydia.
  2. Painkillers are used for symptomatic treatment, they relieve pain well.
  3. Immunostimulants improve blood circulation, relieve swelling, and are used in complex therapy.
  4. Phytopreparations have a mild effect. They, like wax on bee products, are used in addition to the main treatment.
  5. The composition based on ichthyol promotes blood flow in the intestinal mucosa, which accelerates the reduction of the inflammatory process and slightly improves immunity.
  6. Enzyme-based products prevent the formation of scar tissue. It is recommended to take as part of a complex therapy with antibiotics, anti-inflammatory drugs and analgesics.

Auxiliary drugs

For the symptomatic treatment of prostatitis in men, such as pain relief during urination, you can also take antispasmodics that relax smooth muscles and thus relieve pain quickly.

Blood-thinning and anti-inflammatory nutritional supplements based on bee products, pumpkin seed oil, palm fruit extracts contribute to general recovery.

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, pickled food. In acute form, alcohol is strictly prohibited.

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

Treatment is not medicine

Non-drug therapy methods allow you to act directly on the prostate, increasing the concentration of drugs in its tissues, helping to relieve congestion.

Microwave hyperthermia is performed using a rectal probe inserted into the patient's anus. On the device, you can set the required temperature for a certain type of exposure. To increase the concentration of the drug in the prostate requires heating to 38-40°C. To get an antibacterial effect - 40-45 ° C.

Today, non-drug treatments focus on laser therapy. The possibilities of this technique are vast. Under the influence of the laser, the following processes occur in the prostate gland:

  • activation of redox reactions;
  • improve blood microcirculation;
  • new capillaries are formed;
  • pathogenic microflora is suppressed;
  • the process of cell division is activated, which contributes to tissue regeneration.

During the period of research on the effect of laser therapy on patients with prostatitis, side effects, but positive for the purpose of treatment, have been observed. For those who have completed the course, potency increases, erectile dysfunction is eliminated, and vitality is restored. To achieve this result, it is necessary to use a beam with a certain wavelength. In general, low-intensity laser radiation is used to treat chronic prostatitis.

Patients can, on their own initiative, undergo a course of laser therapy, if not prescribed by the attending physician.

Surgical treatment of chronic prostatitis

Chronic prostatitis does not pose a threat to the patient's life, but can significantly reduce its quality. The most serious complication of this disease is the formation of stones in the glandular tissue. To free it from prostol, transurethral resection is used.

Surgery is performed under TRUS control.

If complications such as prostate sclerosis occur, transurethral electrosurgery is performed. If, in combination with this pathology, sclerosis of the bladder neck is observed, a partial resection of the prostate is performed.

With blockage of the seminal and excretory ducts, endoscopic operations are indicated to eliminate violations of secretory patency. For this purpose, incisions are made in the seminal vesicles and excretory ducts. With an abscess, complete removal of the gland is possible.

As a result of untreated prostatitis

due to untreated prostatitis

Even if the symptoms of prostatitis do not appear for a long time, it is necessary to undergo frequent examinations by a urologist. Prostatitis that does not heal completely may be accompanied by the formation of calcifications, which then need to be removed together with the gland. Experts are sure that there is no other way to remove or dissolve stones.

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

Prediction and prevention

Acute prostatitis is a disease that has a clear tendency to become chronic. Even with adequate timely treatment, more than half of patients end up with chronic prostatitis. Recovery is far from always achieved, however, with the correct consistent therapy and according to the doctor's recommendations, it is possible to eliminate unpleasant symptoms and achieve long-term stable remission in chronic processes.

Prevention is to eliminate risk factors. It is necessary to avoid hypothermia, alternate between sedentary work and periods of physical activity, eat regularly and fully. For constipation, laxatives should be used. One of the preventive measures is the normalization of sexual life, because both excessive sexual activity and sexual abstinence are risk factors in the development of prostatitis. If symptoms of urological or venereal diseases appear, you should see a doctor in time.