Chronic prostatitis - can it be cured?

The urologist diagnoses the patient with chronic prostatitis

Most of the male population explains many problems with prostatitis: erectile dysfunction and decreased libido, infertility and violations of intimate relationships. There are cases where a prolonged increase in temperature to the level of 37. 5 ° C is also explained by chronic prostatitis. And such a temperature can indicate very dangerous pathological processes in the body, including oncological nature.

People are so frightened by this diagnosis that they become neurotic, the disease has a psychosomatic character and requires appropriate treatment. In order for the treatment to be successful, it is necessary to accurately understand the cause of the appearance of the pathology and develop the correct treatment regimen.

Symptoms of chronic prostatitis

Most of the time, the disease does not have strong clinical signs, only a deterioration of the standard of living is noted. According to the international classification of the NIH, the disease belongs to category II. The pathology is caused by bacteria, which means that it is impossible to get rid of the disease without special medical treatment. No folk methods - teas, tinctures and drinks - will cure the disease, they only need time from the patients. Chronic bacterial prostatitis occurs when the pathology lasts more than three months and makes up no more than 10% of the total number of all inflammatory diseases. This is the most common type of persistent UTI in men.

Great.Patients with diabetes must be treated promptly, to maintain an adequate level of glycemia. Due to such therapeutic manipulations, the risks of developing pathology are reduced.

Pathogenesis and etiology

Chronic bacterial prostatitis is mainly caused by Escherichia coli, but there are also isolated cases where chlamydia and various mycoplasmas are pathogenic microorganisms. Germs enter the prostate either descending or ascending through the urethra, but medical science also describes options for hematogenous or lymphogenous infection. If you do not participate in the treatment for a long time, then hardening of the gland tissues is possible - a very dangerous complication that has negative consequences and is difficult to treat.

Diagnostic methods

Correct diagnosis plays a decisive role in the treatment process, minimizes the possibility of complications and allows you to fully recover from the pathology. The diagnosis is made in several stages, each of them must be treated very carefully. The symptomatology consists of patient complaints of health problems and dysuric phenomena. The complexity of clinical examinations lies in the fact that the symptoms are inconsistent, quite often their characteristics and combinations change individually.

  1. Anamnesis.The patient should tell as much detail as possible about all his discomfort. It can be pain in the lower abdomen, in the urethra. There may be discomfort in the rectum, difficulty urinating, false urge to urinate. It is very important that the patient does not hide from the doctor casual sex, hypothermia. The doctor clarifies the existence of diabetes. In some medical institutions, patients are asked to fill out a questionnaire. It reports the clinical signs of the disease, there is a score for their intensity and frequency of occurrence. A special scale enables doctors to have an objective idea of the pathological clinic.
  2. Palpation.During palpation, the doctor determines the approximate degree of enlargement of the prostate gland, checks for pain, asymmetry and tissue heterogeneity.
  3. Laboratory diagnosis.It gives the most valuable and accurate information for the correct diagnosis of chronic bacterial prostatitis. For analysis, urine samples are collected before and after prostate massage. The samples are of two glasses, they determine the number of leukocytes and bacteria before and after the massage. There is an alternative method of laboratory tests, in which the seminal fluid is examined for the content of leukocytes. In addition, all patients undergo a urethral swab examination.
  4. Instrumental diagnosis.It is not always used due to the fact that there are no typical changes in chronic prostatitis. But it allows doctors to visually see the heterogeneity of the gland tissue.
  5. Differential diagnosis.It allows you to distinguish chronic prostatitis from chronic urethritis. The diagnosis is made on the basis of a sample of four panes.

If there are difficulties with the final diagnosis, patients can be sent for consultations to other doctors:

  • the otolaryngologist must make sure that the patient does not have chronic tonsillitis.
  • a dermatologist must confirm that chronic prostatitis has a staphylococcal etiology, in which pustular skin lesions are possible.
  • when an odontogenic causative agent of chronic inflammation of the prostate is established, the dentist is advised to examine the oral cavity.

During the examination, pathologies with a similar clinic should be completely excluded. These can be sexually transmitted diseases, inflammation of the anal zone, infection of the genitourinary organs. The most difficult case is oncological neoplasms. Based on the data obtained from a comprehensive examination of the patient, adequate treatment of the pathology is prescribed.

Causes that contribute to the appearance of chronic prostatitis

In most cases, chronic prostatitis occurs due to improper treatment of the acute form. Many patients do not tolerate the full course of medication and discontinue treatment with little improvement in their health. In addition, the probability of pathology increases due to the following factors.

  1. Chaotic sex life.This refers not only to changes in sexual partners, but also to prolonged abstinence.
  2. Frequent and prolonged exposure to perineal trauma.Professional cycling or riding, sedentary work, etc. contribute to permanent injury to nearby soft tissues and blood vessels. As a result, the functionality of the prostate gland is reduced, inflammatory processes may occur due to infection.
  3. Dysfunctions of the immune system.The weakening of the body's defenses occurs due to an inappropriate lifestyle, frequent hypothermia, neurogenic and hormonal disorders.

Ways to treat chronic prostatitis

The ultimate goal of treatment is complete eradication of the pathogen. Procedures can be performed on an outpatient basis, but periodic consultations with a physician are required. The result depends not only on the optimally selected drugs, but also on the desire of the patient himself. He must follow a proper and active lifestyle, avoid hypothermia and rest. Regular intercourse has a positive effect. After the diagnosis is made, it is mandatory to check the sexual partner, in case of detection of pathogens, the treatment is mutual.

Antibiotics are used to treat chronic prostatitis, various active substances have their own advantages and disadvantages. The drugs of choice are fluoroquinolones, they are better tolerated by patients. The duration of the treatment is at least four weeks, in some cases it can even reach three months. More often, drugs are used orally, injections are used extremely rarely and only in the context of specific reactions of the body.

After the disappearance of symptoms of chronic prostatitis, treatment should be continued for at least 14 days.

Complete healing is confirmed by repeated laboratory tests. A month after completing the course, samples should be taken, in which all indicators should be normal.

Antibacterial drugs are used

Depending on the actual condition of the patient, the doctor prescribes certain antibacterial drugs.

Table: Groups of drugs for the treatment of chronic prostatitis

Drug group

Advantages and disadvantages


Pharmacokinetics is convenient for use, it has similarities in all forms for both oral and parenteral use. It accumulates well and is retained by the tissues of the gland for a long time, it is characterized by high bioavailability. The drugs are effective against atypical and typical microorganisms and are also indicated for the suppression of Pseudomonas aeruginosa. The disadvantages include a poor combination with other drugs. In addition, fluoroquinolones have a negative effect on the patient's nervous system and can cause photosensitivity.


In the tissues, the glands accumulate well and are preserved for a long time. There are forms for oral and parenteral administration. At a cost affordable to all patients, high activity was noted against a wide range of typical pathogenic bacteria. The disadvantage is that clinical trials have not confirmed the effectiveness of the drug against Pseudomonas aeruginosa and enterococcus. Certain types of Enterobacteriaceae bacteria do not react to sulfonamides. Before the appointment, it is desirable to clarify the diagnosis again, otherwise the therapeutic measures will not bring the planned effect.


They have various forms of application, with costs available to all patients. They are particularly effective against chlamydia, ureaplasma and mycoplasma. No apparent side effects were noted. Disadvantages - not active against Pseudomonas aeruginosa. Another problem is that coagulase-negative staphylococci, bacteria of the Enterobacteriaceae family, and enterococci respond poorly to the drug. Adverse effects include a high likelihood of skin lesions. Do not take if the patient has kidney or liver failure.


Advantages - very active against various types of gram-positive bacteria, proven effective against chlamydia. The tissues of the gland fill with the drug evenly and keep it for a long time. Macrolides have minimal toxicity to the body, which makes it possible to prescribe them to patients with kidney or liver problems. The disadvantage is the minimal effectiveness against gram-negative bacteria and atypical microbes.

As an addition to the main ones, it is recommended to use herbal preparations from dwarf palm extract, pollen of various plants and other plants that have anti-inflammatory and anti-androgenic effects. But this can only be as an addition to complex treatment.

If specific indications are found, some patients are prescribed aa- gland blockers. They reduce dynamic obstruction of the posterior urethra and minimize dysuria.

Common methods of influencing the prostate gland

Modern medicine allows the use of additional methods of influencing the soft tissues of the gland. Such manipulations are performed at the same time or after the end of the treatment of chronic prostatitis.

It is strictly forbidden to independently perform manipulations with the gland. Improper and unprofessional influences can have serious consequences.

If chronic prostatitis is not treated, there are risks of new, more complex pathologies. To locate them, the following influences can be assigned.

  1. thermal. Most often, transurethral microwave therapy is used, due to exposure to high temperatures, the size of prostate tissues decreases.
  2. Ultrasonic.A very effective method of affecting the prostate, there is no pain during the procedures.
  3. Cold destruction.Low temperatures remove affected prostate tissue.

In all cases, patients should know that the sooner the treatment of chronic prostatitis is started, the easier and faster the pathological process is eliminated, the less likely it is to have serious consequences, the greater the chances of complete recovery. After recovery, patients return to a normal lifestyle.

Answers to the most frequently asked questions

Prostatitis, including chronic, scares the male population with its negative consequences. The vast majority of unfounded fears are explained by extremely low medical knowledge, a large number of rumors and faith in various healers. How does medical science answer the most frequently asked questions?

Can sedentary work cause chronic prostatitis?

Previously, medical professionals used the so-called congestive chronic prostatitis when making a diagnosis. Modern diagnostic devices have shown that prostatitis is infectious and inflammatory in nature, all other physiological factors can only affect the overall health of the body and cause it. Most often, the cause of the disease is casual sexual contact, during which pathogens are transmitted. Uncomfortable underwear, non-repetitive sexual intercourse or prolonged abstinence cause erection problems. Due to stagnant or traumatic consequences, soft tissue pathologies begin to appear in the prostate gland. But according to modern medical classification, this is not prostatitis, but prostatopathy.

Problems with erection in a man with a background of chronic prostatitis or prostatopathy
Is there a link between chronic prostatitis and cycling?

Yes there is. Rumors about the positive effect on the course of chronic prostatitis of professional horse riding or cycling are based on the fact that the saddle constantly massages the perineum. Due to this, the blood supply to the prostate improves, the negative consequences of chronic prostatitis are eliminated. In fact, everything is exactly the opposite. The saddle seriously injures the arteries, disrupting the functional blood supply to the cavernous bodies. They are located on the penis. As a result, there may be problems with erectile function. You should know that all recommended gentle massages of oriental traditional medicine do not cure. It is erotic in nature, not therapeutic. They can be used as an additional psychological tool and not as the main treatment for chronic prostatitis.

The second question naturally arises - why do some urologists strongly recommend rectal massage? Everything is a little more complicated here. This massage is used during the delivery of exams. Previously, it was prescribed as an additional procedure to increase blood supply to the prostate. Modern diagnostic methods have proven the ineffectiveness of such a massage in chronic prostatitis. But there are significant risks of damage to the mucous membranes of the rectum. As practice has shown, the most effective massage of the glands is natural ejaculation during sexual intercourse.

Do problems with intimate life, pain in the lower abdomen, frequent urination always indicate chronic prostatitis?

No, not always, such symptoms may indicate other problems unrelated to prostate function. In contrast, chronic prostatitis often progresses without any noticeable symptoms and is detected incidentally. It should be taken into account that prostate adenoma, bladder dysfunction, sigmoid colon problems and neurological disorders have quite a few symptoms in common.

Can chronic prostatitis be treated with physical therapy alone?

It's impossible. How not to hope that the disease will eventually disappear by itself. Magnetotherapy, laser therapy and other procedures are prescribed as additional methods during the complex protocol treatment of chronic prostatitis. The protocol describes all medical measures, it is not recommended to cancel them.

Magnetic therapy of the prostate is included in the complex treatment of chronic prostatitis
Is treatment of chronic prostatitis always necessary?

Some patients suffer from the disease for many years, during which nothing terrible happens, in their opinion. Of course, patients have such a question. Fatal cases from chronic prostatitis have not been recorded in medical practice. But there is a sharp decline in the quality of life, in some cases hardening of the prostate may occur. In addition, the constant presence of pathological microorganisms in the body suppresses the immune system, which can cause any disease. It does not have to be related to prostate function.

Adequate medical measures and unquestionable compliance of patients with the recommendations of doctors provide a 100% guarantee for the treatment of chronic prostatitis. A prerequisite is the correct diagnosis and the optimal choice of drugs, the use of complex treatment.