Protocol for diagnosis and treatment of prostatitis

N 1673n On approval of the standard of primary health care for chronic prostatitis (examination for diagnosis and treatment)

N 1673n On approval of the standard of primary health care for chronic prostatitis (examination for diagnosis and treatment)

See help about standards of care

In accordance with Article 37 of the Federal Law of November 21, 2011 6724; 2012, N 26, Art. 3442, 3446) order:

Approve the standard of primary health care for chronic prostatitis (examination for diagnosis and treatment) according to the annex.

Registration N 27484

A standard of medical care has been approved that defines the basic requirements for the diagnosis and treatment of patients with chronic prostatitis (examination for diagnosis and treatment). The standard is recommended for use in the provision of primary health care.

N 1673n On approval of the standard of primary health care for chronic prostatitis (examination for diagnosis and treatment)

Registration N 27484

This order comes into force 10 days after the date of its official publication

N 134/1 (special edition)

Chronic prostatitis treatment protocol

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For the treatment of erectile dysfunction in men, depending on the causes of their development, various methods are used. One of them is the use of local negative pressure (LOP-therapy) in the form of an effect on the cavernous bodies of the penis. This therapeutic technique was proposed by the sexologist R. V. Beleda, it passed the appropriate clinical approbation and received a copyright certificate.

Principle of operation and rationale for LOD

The therapeutic mechanism of local negative pressure consists in a positive effect on the cavernous bodies of the sexual body by stimulating blood flow in them. one). This creates a negative pressure (an average of 150-300 mm Hg below atmospheric pressure), the skin, tissues and cavernous bodies of the penis are mechanically stretched, which leads to an effect on various nerve receptors (chemo-, baro- and thermoreceptors) fabrics.

1 - LOD-therapy and its effects.

In addition to increasing the intensity of blood flow in the cavernous bodies, LOD therapy additionally has several physiological effects, which include:

• a higher degree of saturation of the tissues of the penis with oxygen from the blood due to the low partial pressure in them;
• improvement of the functional state of small capillaries of the tissues of the penis, their opening and increasing the flow of blood into them;
• increasing the intensity of metabolic processes (metabolism) in tissues by improving blood circulation, lymph circulation and intercellular fluid;
• local increase in temperature in the tissues of the penis under the influence of negative pressure, it contributes to better absorption of oxygen and nutrients from the blood and interstitial fluid;
• an increase in the number of nerve impulses from various receptors in the tissues of the penis, which enter the corresponding centers of the spinal cord and then the brain, leading to the reflex development of an erection.

Therefore, the use of local negative pressure for the penis is physiologically justified in various disorders of functional activity, including those of a psychogenic nature.

Indications for LOD-therapy

The use of the technique of local negative pressure on the penis is indicated for various functional disorders and somatic pathologies, which include:

• circulatory disorders in the tissues of the penis, primarily associated with a lack of functional activity of the sphincters of the cavernous bodies, responsible for their sufficient filling with arterial blood;
• psychogenic erection disorders that develop as a result of various neurotic conditions, emotional experience of a man associated with the expected possibility of failure in relation to a full-fledged sexual intercourse (syndrome of anxious expectation of sexual failure);
• initial debut forms of potency disorders, which were identified for the first time;
• chronic inflammatory processes in the prostate gland (chronic prostatitis), testicles and seminiferous tubules;
• certain forms of potency disorders in men against the background of age-related involution (fading of functional activity) of the reproductive system;
• diagnostic impact of local negative pressure on the penis of a man to determine the causes of the development of functional vascular disorders;
• Peyronie's disease is a curvature of the penis due to fibrotic changes in the cavernous bodies, to a greater extent the deformation manifests itself during an erection, which can also lead to pain;
• copulative dysfunction (impossibility of sexual intercourse) in men after undergoing surgical interventions on the urethra (urethra);
• comprehensive sexual rehabilitation of men after adenomectomy (removal of the hypertrophied, enlarged part of the prostate gland);
• problems with erection after suffering cavernitis (inflammation of the cavernous bodies);
• intermittent priapism - periodic painful erections of the penis, which often develop at night;
• carrying out complex rehabilitation measures after vascularization (treatment aimed at improving blood circulation) of the penis.

Also, LOD therapy is performed as a rehabilitation measure after undergoing various plastic surgeries on the penis of a man, including various congenital malformations (hypospadias, epispadias, micropenis).

Contraindications for LOD-therapy

LOD-therapy is a medical procedure, which is possible only after the exclusion of the presence of possible contraindications. They are conditionally divided into general and local (local) contraindications.

General contraindications include various pathological conditions of the whole body of a man:

• febrile conditions (intoxication of the body and fever) with various infectious, bacterial or viral pathologies;
• malignant or benign neoplasms (tumors) of various localization in the body, including prostate adenoma;
• hypertension (prolonged increase in blood pressure) of the 3rd stage of the course;
• Various pathology of the heart in the stage of decompensation, accompanied by the development of heart failure;
• atherosclerosis (deposition of cholesterol on the walls of blood vessels with the formation of atherosclerotic plaques that reduce their lumen) of the vessels of the brain or heart;
• peptic ulcer (formation of a defect in the mucous membrane) of the stomach or duodenum;
• chronic somatic pathology of internal organs in the acute stage (glomerulonephritis, pancreatitis, hepatitis);
• diseases of the blood system, especially accompanied by a decrease in its clotting and the development of a tendency to bleed, as well as taking anticoagulants (drugs that reduce blood clotting);
• Erectile dysfunction of the penis caused by various pathologies of the internal organs, cardiovascular or endocrine system.

Local contraindications for LOD include various pathological changes in the penis, tissues of the pelvic area, and internal genital organs:

• pronounced varicose veins (formation of extensions in the form of nodules) of the spermatic cord of 2 or 3 degrees of severity;
• groin hernias;
• thrombophlebitis (inflammation with intravascular thrombus formation) of the veins of the pelvic area and lower extremities;
• acute or chronic pathology of the testicles and their appendages of various origins;
• inflammatory processes of the pelvic organs;
• Phimosis (narrowing of the foreskin of the glans penis) or paraphimosis (an emergency condition, which consists in the infringement of the glans penis by the foreskin behind the coronal sulcus).

Log Therapy Method for

Log therapy is carried out in a medical institution under the supervision of a doctor. During the procedure, the doctor monitors the common state of the patient, and also periodically asks questions about his well-being. It necessarily draws attention to the condition of the skin of the penis, which becomes hyperemic (acquires intensive red staining) by increasing the tide of the blood. Also during the procedure there is a passive erection of the penis.

Modern devices for conducting fuses are equipped with special fuses that do not allow air loss in a minibar of over a certain value. In case of deterioration of the general condition of the patient, the emergence of severe pain in the field of penis, the procedure is stopped. Air loss as a whole lasts 15-20 seconds, then the pressure is aligned, after which the session is repeated, over one procedure is performed up to 15 sessions of Log exposure. The course of treatment may include up to 20 procedures of LD-therapy, on average they are held 3 times a week, the last 8-10 days can be performed daily.

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Possible complications

The procedure of Lod is small-acting, so if it is properly used, it rarely leads to complications to which include:

• edema and hyperemia (redness) of extreme flesh.
• Point hemorrhages in the skin due to damage to the vessels of the microcirculatory bed.

In general, the procedures of Log therapy lead to a noticeable improvement in the erectile function, the increase in the libido in most men.

Doctor of general practice Krivoguz I. m.

Immunomodulators for prostatitis: most effective drugs

With inflammation of the prostate gland, the entire organism of the man is affected. Immunity is weakened, the protective barrier is reduced. In this case, immunomodulators will help - preparations designed specifically for restoring or regulating the body's protective forces. In the article, we will tell about the most effective immunomodulators with the prostate and features of their application.

Classification of preparations

The pharmaceutical industry shares immunomodulators not two groups: immunostimulators - an incentive immunist system and immunosuppressors - a depressing protective barrier. For the treatment of prostatitis, the first group, about it and tell you more.

The effect of drugs is essential not only for improving immunity. The substances included in drugs increase the resistance of the body. Depending on the method of obtaining, immunomodulators are divided into three categories.

In the treatment of diseases associated with inflammation of the prostate gland, not all are used. Consider the main immunomodulators appointed with the prostate in men.

Viferon - Features and Application with prostatitis

Additional components are vitamins E and C. In combination with interferon, they increase the action of the latter.

The main effect of the immunomodulator is the restoration of the immune system of the man after infections caused by various pathogenic microflora. Additional properties of Viferon:

• displays toxins;
• has an antioxidant action;
• reduces foci of inflammation.

The listed actions are important when prostatitis. During the disease, the tissue of the prostate gland is affected, and the drug accelerates recovery. The medicine has no contraindications. Exception - the sensitivity of the body to components.

Polyoxide - description, composition, action

Produced in the form of yellow or orange tablets, cylindrical shape. Contains excipients - stearic acid, betaarten, lactose and others. Effective to increase immunity after the body's damage to fungi, bacteria and viruses. Assigns with various diseases, including under prostatitis.

Polyoxidonium has the same properties as Viferon. Additionally increases the stability of the body when infection in the respiratory tract or the gastrointestinal tract. Compatible with other drugs, including antibiotics and antihistamines. It is contraindicated to children under 12 years old and people with individual intolerance to components.

Cycloferon with prostatitis - features and contraindications

The second name of the drug is "Meglumin Acridonacetate". Immunomodulator, increasing the resistance of the body and reduces the intensity of the inflammatory process. The medicine is included in the list of vital funds.

Is mainly effective against various kinds of viruses, including influenza, herpes, HIV and others. It helps and in the treatment of prostatitis, if the disease is caused by viral pathogens. In addition to regulating the immune system, it suppresses the growth and development of cancer cells.

Cycloferon has a number of contraindications for males:

• children under 4 years old;
• liver disease, including cirrhosis;
• hypersensitivity to the active substance.

With caution, this drug should be used by men with endocrine system disorders. In such a case, constant monitoring by an endocrinologist is necessary.

What is Genferon useful for prostatitis

Peptide drug, available in the form of white suppositories. Genferon contains 3 main components that have different effects and reinforce each other.

The drug is injected through the rectum, the active substance quickly enters the prostate gland. Taken every 12 hours. Among the contraindications are allergic diseases in the acute stage and individual intolerance. In rare cases, after using the drug, the temperature rises, chills appear, appetite decreases.

Derinat and its effect on prostatitis

The active substance is sodium deoxyribonucleate, the auxiliary is sodium chloride. Available in the form of drops, solutions for injection and washing of wounds. An effective immunomodulator for prostatitis and benign prostatic hyperplasia (adenoma). Has a number of unique properties:

• anti-inflammatory;
• anticancer;
• detoxifying;
• antioxidant.

Increases the body's resistance to various pathogens, including streptococci. Quickly reaches therapeutic concentration in the body, the duration of which is 5 hours. It has no particular contraindications. An exception is to be taken with caution by men with diabetes mellitus. There are cases when the drug increased blood sugar levels.

Lykopid and its properties

Synthetic preparation produced in the form of white tablets. Corrects innate and acquired immunity, helps protect the body from viruses, bacteria and fungi. Often prescribed for chronic prostatitis and other forms caused by infections.

Does not depress the central nervous system, has an antitumor effect. May be useful in the treatment of prostate adenoma.

Contraindicated in the following cases:

• metabolic disorder;
• autoimmune diseases;
• increased body temperature;
• Individual intolerance.

In some cases, it causes a slight short-term increase in temperature, even more rarely - diarrhea. No other side effects have been identified.

Transfer factor - a modern immunomodulator

Let's finish the review with this drug. Today, according to practicing urologists, this is the most powerful drug that corrects the work of the human immune system. Transfer factor is useful in various diseases, including autoimmune diseases.

The peculiarity of the remedy is that it does not directly treat the disease. The transfer factor activates the body's defense mechanism and helps it cope with the disease on its own. The drug has no contraindications, it is prescribed even for pregnant women. Does not cause toxic conditions and allergic reactions.

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Conclusion

Despite the seeming harmlessness of most of the described means, do not forget that these are still medicines. Independent "appointment" and use for the treatment of prostatitis is unacceptable. Visit a urologist or andrologist. A qualified doctor will be able to tell whether the chosen remedy is suitable or not. Remember that treating prostatitis without medical supervision increases the risk of developing benign prostatic hyperplasia and prostate cancer.

International protocol for the treatment of prostatitis

Prostatitis is a common disease that is diagnosed every year in more and more young men. There are many reasons why this disease can occur. The main ones are stress, sedentary lifestyle, untreated infectious diseases and irregular sex life.

Indeed, a modern man rarely goes in for sports and does not have the opportunity to build relationships with a girl, which is due to constant employment and fatigue. For the treatment of prostatitis, various methods can be used, the effectiveness of which has already been proven many times.

Among them, your attending physician will be able to choose the most optimal option after the diagnosis and examination. At the same time, it is very important not to delay the visit to a specialist, since the early start of treatment guarantees excellent results and the opportunity to forget about such an unpleasant problem forever.

Effective methods of therapy and disease prevention

One of the most common forms of prostatitis is chronic, which involves severe pain and serious consequences. It is very important to distinguish it from other stages of the development of this disease in time, which will allow you to choose the most effective method of treatment and achieve the desired results in the shortest possible time. To prevent this problem, a man needs to carefully monitor his health throughout his life and undergo a preventive examination by a qualified specialist twice a year, which will identify the problem at an early stage.

One of the main rules for you will be the transition to a healthy lifestyle, increasing the amount of fresh vegetables and fruits in the diet, as well as outdoor activities. It is advisable to minimize the amount of foods in the diet that contain wheat. Make sure that sex is regular and protected so that you never find out about such a problem as prostatitis!

If you have already been diagnosed with a chronic form of the disease, then it is too late to think about prevention! Start treatment now to return to normal life in the coming months! Unfortunately, this form of the disease is very difficult to succumb to the methods used, but an integrated approach will allow you to get the first results!

Recent studies have shown that the third category of illness can occur even due to stress and constant anxiety. For such patients, aerobics and acupuncture can be the most effective methods, which will allow you to achieve visible results already in the first month.

But according to the Stanford Protocol, the treatment of prostatitis provides for an integrated approach that combines:

• medication use;
• psychological treatment, which involves the use of progressive paradoxical relaxation;
• physical therapy, which is a unique combination of yoga assan and other exercises aimed at working the muscles in the pelvic area.

Medications are selected by the doctor in accordance with the patient's condition and the stage of the disease. To select the most effective therapy, a mandatory diagnostic examination is required, the duration of which depends on a large number of factors. This approach will allow you to get the desired results in the shortest possible time and get rid of this problem forever.

Drug therapy

Patients who have confirmed bacterial prostatitis are given antibiotic therapy. In this case, various antibiotics can be used, their action is directed to the prostate gland. The duration of such treatment will depend on the severity of the clinical manifestations of the disease and can be up to 8 weeks. Moreover, even after the complete elimination of such signs and infections, the disease does not disappear, and its symptoms continue to prevent the patient from leading a normal life.

Quite often, specialists in our country prescribe immunostimulants and allopurinol to their patients. Their action is aimed at strengthening the immune system, eliminating inflammation in the prostate and reducing uric acid in the blood and urine of the patient. But, unfortunately, the clinical result of such therapy has not been proven, so these methods cannot be used as a guaranteed way to get rid of the disease.

Therefore, instead of them, doctors also use systemic enzyme therapy and hormonal correction, the action of which is aimed at correcting the patient's hormonal status and restoring normal hormone levels.

Additional measures are other medications, the use of which will achieve more noticeable results:

• non-specific drugs with anti-inflammatory action;
• herbal ingredients;
• drugs whose action is aimed at increasing or decreasing the tone of the muscles of the bladder;
• antidepressants and sedatives.

But various dietary supplements are not able to affect the process of treating prostatitis in any way, so you should not trust advertising and spend money on ineffective drugs!

Massage therapy techniques

Modern medicine in most cases does not accept the use of prostate massage as a complex therapy. But still, many leading experts in our country use it to get more noticeable results in the shortest possible time. The main purpose of this effect is to squeeze out the secret into the urethra. In addition to this study, it has been proven that massage can restore normal duct patency and significantly improve the penetration of the medications used into the tissues.

Also, some doctors are convinced that prostate massage can be an excellent way to improve blood circulation and muscle tone of the gland, as well as make the accumulated microorganisms more sensitive to the action of prescribed antibiotics. But during the massage, the finger is able to reach only a certain part of the gland, which in case of bacterial prostatitis can easily lead to acute urinary retention.

Therefore, such treatment is not recommended for those patients who have been diagnosed with this particular type of disease, especially in combination with benign hyperplasia. Such an impact will also have a negative effect in cases where the patient has prostate cysts, a purulent process has begun, or venous stasis has been diagnosed. In these cases, massage will only injure the gland, which can lead to a noticeable deterioration in the patient's condition.

Methods, the effectiveness of which has not yet been proven

The treatment of prostatitis can also be carried out with the help of special bladder training by increasing the time intervals between urination up to 5 hours. Additionally, an infusion of medicinal substances into the posterior urethra can be used, which is typical exclusively in our country. The effectiveness of this method has not been proven as a result of studies, so it cannot be used as the main therapy. In addition, in some cases, there are even negative consequences, which are well known to doctors around the world.

To obtain visible results, specialists often use physiotherapy, which will remain one of the most affordable methods. In this case, laser and magnetotherapy can be used, as well as various types of prostate massages and even aspiration. Good results can be achieved in the course of complex therapy and the use of microclysters. This treatment protocol is widely used, it is used by many leading specialists in our country.

It is a well-known fact that these physiotherapy methods are used exclusively in our country and nowhere else in the world. This is due to the fact that the problem of prostatitis has been of concern to the whole world for the past few years, and therefore more modern methods of therapy are constantly emerging that provide better results.

But in some cases, surgical intervention can really provide the desired results. But such an effect can only be used after complications of the chronic form, which led to a deterioration in the outflow of urine. In this case, the specialist will select the most effective method of exposure to eliminate negative consequences and quickly obtain the first results of therapy. The main thing is to consult an experienced doctor who can accurately determine the best technique.

Unfortunately, even surgery is only 50% effective, so it is not considered the best way to restore normal prostate function. Also, radical removal of the prostate has not been proven to solve this problem.

Other techniques that also apply

A fairly large number of leading experts are convinced that prostatitis is a psychosomatic disease. It is for this reason that his treatment should be comprehensive and consist not only of the use of selected medications, but also of psychotherapy, which will achieve much better results. This is an auxiliary therapy that will allow the patient to effectively get rid of accumulated stresses and not worry that the chosen methods did not provide quick results.

But segmental and neural therapy show good results and are really able to provide positive changes. These methods are a combination of yoga postures, thermal procedures, various massage techniques, as well as the use of anesthetics and regular exercise aimed at maximum relaxation and elimination of accumulated stress.

At the same time, regardless of the chosen method, therapy is a difficult path, since additional problems and symptoms may appear in the process of using various drugs and techniques. In addition, some of the methods described earlier have not been proven effective, which makes it even more difficult to choose the most suitable option for you.

To speed up the treatment process and prevent negative consequences, you should seek professional help and start treatment even in the early stages of the disease. This approach will allow you to quickly get the first results and get rid of such an unpleasant problem as prostatitis forever!

Another problem on the way to effective treatment is untimely or inadequate diagnosis.Often, in order to save personal time and money, patients seek help from young specialists whose years of experience do not yet allow them to select the most effective individual therapy plan for each patient. It is best not to risk your health and life by immediately contacting a specialist whose qualifications there is no doubt! It will definitely help you get back to your normal lifestyle! Trust your health to experienced professionals who have many years of experience!