Prostatitis refers to prostate inflammation.

But it is not always due to an infection diagnosable. However, often a bacterial infection extends from the urinary tract to the prostate.

According to symptoms duration, it can be classified into:

  • Acute acute, sudden symptoms);
  • Chronic (symptomatology persistent for more than 3 months, usually less intense than in acute illness).

In the pre-antibiotic era, acute prostatitis was the most frequent. One of the factors that contributed to this situation was a decrease in the population’s immunological potential, as a result of poor environmental situation, abuse of tobacco consumption and alcohol among men, and an increase in STDs. Nowadays, about 98% of the cases are latent forms of chronic prostatitis, which is the most frequent cause of recurrent urinary tract infection in men.

The chronic inflammatory process in male sexual organs has, as a rule, a diffused character, but primary pathological focus is in a single organ. The most common men urogenital diseases, which are often associated with urinary infections, are:

  • Prostatitis – prostate inflammation;
  • Vesiculitis – inflammation of the seminal vesicles;
  • Colliculitis – inflammation of the seminal colliculus.

Those often evolve towards chronic form.

Prostatitis Clinical Chart

Following recent studies, we can conclude that prostatitis clinical condition is characterized by:

  • Sexual alterations;
  • Reproductive disorders;
  • Pain syndromes;
  • Urinary changes;
  • Psychoneurological disorders of difficult treatment.

The prostate normal functioning has three protective barriers:

1. Morphological and functional resistant structure. The presence of a negative psycho-emotional state (pronounced asthenia or depression), and in case of organic changes in the genital organs (trauma, intoxications, changes in perfusion, etc.) contribute to this barrier-breaking;

2. Adequate physiological tone and internal genital organs vascularization – this barrier is affected in cases of hyperdynamic, sexual dysrhythmias, hypothermia and androgenic insufficiency;

3. Anti-infectious barrier – his barrier is broken down when local immunobiological reactions, which occur together with neurocirculatory asthenia, androgenic insufficiency, microbial or drug intoxication, among others, are weakening.

The androgenic function is very important in physiological defense mechanisms since the androgens’ normal level allows them to preserve the genital organ tone, activated secretion in the prostate, and produces enough secretion bactericidal components.

Individuals who have prostatitis usually experience an androgen/estrogen imbalance, that occurs often due to steroid hormones metabolic changes, inducing prostate tonic disorders and lower pelvic organ congestion, and experiencing bile duct inflammation or decreased liver function.

Along with these inflammatory conditions developing self-injury and hormonal degeneration.

The main factors that contribute to prostatitis and other male sexual diseases development are:

  • Venous congestion;
  • Muscle atony in pelvis minor organs.

These may be caused by sexual act interruption or prolongation, sexual excesses, chronic constipation because of proctitis and/or sigmoiditis, sinusitis, sedentary lifestyle, and/or hypothermia.

Some enabling factors also can be considered:

  • Trauma caused by instrumental examinations;
  • Gross manipulations;
  • General septic state;
  • Inflammation of liver and bile ducts;
  • Tonsillitis, otitis, dental caries, chronic endocarditis, chronic pneumonia, intoxications.

Prostatitis Symptoms

Subjective and objective prostate inflammation symptoms can be extremely variables and polymorphic.

Local symptoms

  • Pain or constant weight in bladder;
  • Anus pain;
  • Pain or unease in the area between anus and testicles;
  • Testicles and/or groin pain;
  • Need of urination more frequently;
  • Awake to urinate with varying frequency;
  • Pain and/or a burning sensation when passing urine;
  • Shape changes, size and prostrate consistency;
  • Inconstant urine flow;
  • Lower back pain;

Functional Symptoms

  • Painful or impossible orgasm;
  • Premature ejaculation;
  • Delayed or impossible ejaculation;
  • Erectile dysfunction/impotency;
  • Hematospermia (blood in sperm);
  • Hypoactive sexual desire;
  • Ejaculated volume changes.

Sexual function disorders are often the only complaint noticed or highlighted by prostatitis sufferers.

General Symptoms

  • Sleep disorders;
  • Easy fatigue;
  • Anxiety;
  • Depressive tendency;
  • Irritability;
  • General weakness;
  • Chills/fever.

Treatment *

The treatment has five objectives:

  • General and local immunotherapy;
  • Normalization of prostate perfusion;
  • Recovery of secretion flow of prostate and seminal vesicles, Littre and Cowper glands, due to the increase in tone of pelvic and perineal muscles and muscular prostatic fibers;
  • Recovery of morphological and structural elements in tissues with pathogenic changes;
  • Normalization of the entire range of functions of the injured organs.

These goals are achieved through an integrated treatment that may include: low-level laser therapy (strengthens microcirculation, has an anti-inflammatory effect, analgesic, antioxidant, restores general, sexual, genital and penile homeostasis, normalizing sexual function and energy, and strengthening body’s autoimmune defense capacity), antibiotic therapy, prostate massage, and others that may be necessary.

The considerable improvement in lymphatic and blood flows in the irradiated area contributes to a greater and more effective inflow of antibiotics into the prostate, which allows to decrease the doses of drugs administered.

Our clinical experience shows that the treatment plan may include other parameters in addition to those already described, such as hormonal optimization, lifestyle and eating behavior changes, physical exercise practice, and risk factors elimination. One of the risk factors to be considered is not using a condom during sexual intercourse. Female intimate microbiota naturally presents several bacteria (which being part of and necessary for women, can be harmful to men), the use of condoms prevents the passage of these bacteria to male urethra ducts and consequently prevents them from reaching prostate, eliminating one of the most common risk factors in prostatitis development.

* The treatment plan recommended always requires a prior medical evaluation to observe its indication.

© Clínica do Poder – José Pereira da Silva, Lda

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