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New era in chronic prostatitis treatment!

In chronic prostatitis treatment long-termed antibiotic treatment is applied often, but this treatment is useless in many cases.

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Chronic Prostatitis Treatment

A) Bacterial Prostatit:

In this case antibiotic treatment to lead 1-6 months is required. Determining microbe, recognition of its resistance and choosing proper medicine are important. Patient must take medicines without delay.

B) Non-Bacterial Prostatit:

To make a rapid and exact solution might be difficult for such disease, of which reason is not known exactly. In these patients lowness of body immunity and stress are often conditions. It is very important for treatment of this disease that doctor to have close relationship with patient, to listen patient carefully and to understand. Investigating carefully the complaints of patient and conditions stimulating them make treatment and to find protection methods easier. It is important to use proper medicines in proper dosis and time. In this disease patience co-operation of patient and doctor is required.

In this case several treatments with different mechanisms or medicines providing relief might be used. Medicines relieving canaliculus in prostatitis, repressing inflammatory reaction, relieving muscle spasms in perineum and around and some herbal medicines are used. Antibiotic treatment might be useful rarely, but doctor must decide after all required examinations are made.

Hot application or hot water bathing and making patient spiritually relaxed will be useful. It must be avoided from stimulating factors such as cycling, sitting stable long-term, abnormal sexual life and chill. It might be useful avoiding from hot, spicy and sour meals.

If it is required, prostatitis massages are made in order to relieve fullness and to discharge canaliculus in prostatitis.

In this case several treatments with different mechanisms or medicines providing relief might be used. Medicines relieving canaliculus in prostatitis, repressing inflammatory reaction, relieving muscle spasms in perineum and around and some herbal medicines are used.

In rare cases narrowing in urinary tract might occur. These might be required to be operated with holmium laser.

Patients should be persuaded that they have not a disease to treathen their life or to occur big problems in the future in any case of treatment results. To have high spirits is very important in such diseases to be lead long. This problem will not lead life-long. Patients should not forget that one day this disease will disappear and they will have peace.

Facts about prostatitis:

Most important thing in this disease is to be sure that patient doesn’t face a serious disease. For example disease doesn’t turn into cancer.

* Correct diagnosis in determining prostatit-type is the most important key of treatment.

* Using antibiotic rotely at the beginning makes diagnosis of disease difficult.

* Treament must be completed even if complaints are cleared up or lightened.

* Even if prostatit is not died off, patient gains comfort and might live so.

* Prostatit does not turn into cancer.

* Patient should consider sexual life. In summit of disease unwillingness might occur but patient should not surrender to it.

*Complaints might hinder daily life but patient should go on without being weary of social life.

TUR-P operation is suggested as last solution for resistant chronic prostatit patients, who are irresponsive to long-termed antibiotic treatment. TUMT application is preferable alternative treatment rather than TUR-P operation particularly in these younger patients being active sexually as it damages sexual functions less and doesn’t require anaesthesia and hospitalization.



Chronic Prostatitis
Prostatitis - Prostate cancer (malign) - Prostate enlargement (benign) These three diseases are independent and different diseases from each others. One of them doesn’t turn into other. They might be together in one prostatitis at the same time.
Urinary burning, sense of urinary not discharged completely, fullness sense in perineum and pains in ovary are complaints seen frequently in prostatitis. Sometimes urinary interruption, often widdling, semen burning, fever, urinary blockage and pain in inguen might occur. Pre-ejaculation, erectile dysfunction and sexual anorexia might be seen. Prostatitis inflammation is divided as septic and aseptic and aseptic inflammations are observed more frequently. Complaints are all prostatitis are similar. While proper and long-term antibiotic treatment is applied for septic inflammations, solution for aseptic inflammation is searched differently. In septic (non-bacterial) prostatit leucocyte (white cell) in prostatitis liquid of patients is determined as laboratory finding, but microbic infection is not determined. However in some patients it is thought that veneral factors such as ureaplasma and chlamdia cause it. In recent researches there are evidences supporting it, but limitation of sexual life doesn’t provide a solution mainly. This situation called as “Prostatitis pain” (prostatodynia) is faced frequently. It is seen particularly in young and middle-aged men and makes life cheerless. It is estimated that there is a kind of tissue reaction in prostatitis, of which reason is not known exactly. Also, there are findings that these pain and disturbing senses depend on muschale spasms around perineum and inguen. Most important thing in prostatitis is to be sure that patient doesn’t have a critical health problem. Complaints might hinder daily life but for example disease doesn’t turn into cancer. Bazen idrarda kesiklik, sık idrara gitme, menide yanma, ateş, idrarda tıkanma ve kasıklarda ağrı olabilir. Erken boşalma, sertleşme bozukluğu ve cinsel isteksizlik görülebilir. Prostatın iltihapları mikroplu veya mikropsuz olarak ikiye ayrılır ve aslında mikropsuz iltihaplara daha sık rastlanır. Bütün prostatitlerde şikayetler benzerdir. Mikroplu olanlarda uzun süreli ve uygun antibiyotik tedavisi verilirken, mikropsuz prostatitin çözümü başka yollardan aranır. Mikropsuz (non-bakteriyel) prostatitte, hastalarda laboratuar bulgusu olarak, prostat sıvısında lökosit (iltihap hücresi) saptanır ama mikrobik enfeksiyon saptanmaz. Yine de bir kısım hastada üreaplasma ve klamidya gibi cinsel ilişkiyle bulaşan etkenlerin neden olduğu düşünülmektedir. Son yıllardaki araştırmalarda bunu destekleyen bulgular vardır ama cinsel hayatın kısıtlanması da, genellikle bir çözüm getirmemektedir. "Prostat Ağrısı" (Prostatodynia) diye de adlandırılan bu duruma oldukça sık rastlanır. Özellikle genç ve orta yaş erkeklerde görülür ve yaşantıyı keyifsiz hale getirir. Nedeni tam olarak bilinemeyen fakat prostat içinde bir tür doku reaksiyonu olduğu tahmin edilmektedir. Ayrıca, bu ağrı ve rahatsız edici hislerin, apış arası ve kasık civarındaki adalelerin kramplarına bağlı olduğu yönünde bulgular vardır. Prostatitte en önemlisi, hastanın önemli bir sağlık sorunuyla karşı karşıya olmadığına emin olmasıdır. Yakınmaları günlük hayatını aksatabilir ama örneğin hastalık kansere çevirmez .
Making correct diagnosis in prostatit is very important because different treatments must be applied for different types of it. Also, reason of complaints might be urinary tract infection, sexually transmitted disease, prostate enlargement and even cancer. But making correct diagnosis of all these patient might regain his health. Thus some tests are mandotary. Firstly an examination with finger from anus must be made. This examination gives precious information about all kinds of prostatitis. Here it is important that doctor should be careful not to hurry up. This special examination must be applied comfortably by explaining and preparing the patient and without hurting patient. So important information about sensitiveness of prostatitis and around tissues, pain and their structures. In unhealthy prostatitis a little pain might be felt but it doesn’t lead long. Even if there is disease in prostatitis permanent damage doesn’t occur. Only in disease called “acute bacterial prostatitis” this examination cannot be applied. In this prostatitis type, which causes fever and significant urinary difficulty and damages general status of patient, patient must be treated with serum and strong antibiotics firstly. Finger examination made without taking microbe under control relatively might cause microbes to spread in all of the body. This might constitute life-threatening risks particularly for weak patients. Prostatitis liquid example is taken in order to determine whether there is microbe in prostatit or not. To make this prostatitis liquid must be milked with finger. Before and after this application urinary is cultured, too. Culturing in semen might be required. PSA-test in blood is made. When microbe is determined, its place in prostatitis, anus or places more than one is found. According to this dosis and duration of antibiotics treatment is determined. Urinary flow rate is measured via electronic tools and it is determined whether there is a blockage during pissing or not. If any, it is investigated whether it is functional or mechanical. Anus and prostatitis are monitored via ultrasound. In the cases that situation is not clear, inner of urinary tract, prostatitis and anus is examined by refracting tool. In this method called as cystoscopy it is preffered to narcotized patient slightly not to feel pain. Öncelikle makattan parmakla muayene yapılmalıdır. Bu muayene prostatın her türlü hastalığında çok değerli bilgiler verir. Burada hekimin dikkat etmesi gereken, acele etmemesidir. Bu özel muayene hastaya anlatarak ve hazırlayarak, rahat bir ortamda ve hastanın canını yakmadan sakin bir şekilde yapılmalıdır. Böylece prostat ve çevre dokuların duyarlığı, ağrıları ve yapıları hakkında önemli fikirler edinilir. Hasta olan prostatlarda biraz daha rahatsızlık duyulabilir ama bu uzun süreli olmaz. Prostatta hastalık olsa bile, kalıcı bir hasar oluşmaz. Bu muayenenin yapılamayacağı tek durum, "akut bakteriel prostatit" denilen hastalıktır. Yüksek ateşle ve belirgin idrar zorluğuyla seyreden ve hastanın genel durumunu bozan bu prostatit türünde, hasta önce serum ve kuvvetli antibiyotiklerle tedavi edilmelidir. Mikroplar nispeten kontrol altına alınmadan yapılan parmak muayenesi, mikropların tüm vücuda yayılması neden olabilir. Bu da özellikle daha düşkün hastalarda hayati tehlike bile arz edebilir. Prostatitte mikrop olup olmadığını saptamak için prostat sıvısı örneği alınır. Bunun için parmakla prostat sıvısı sağılması gerekir. Bu işlem öncesi ve sonrasında idrarın da kültürü yapılır. Menide de kültür yapılması gerekebilir. Kanda PSA testi yapılır. Mikrop saptandığı zaman ise, idrar yolunda, prostatta, mesanede veya birden fazla yerde yerleştiği bulunur. Buna göre antibiyotik tedavisinin dozu ve süresi saptanır. İdrar debisi elektronik aletlerle ölçülür ve işeme sırasında yolda bir tıkanıklık olup olmadığı saptanır. Varsa bunun fonksiyonel mi mekanik mi olduğu araştırılır. Ultrason yapılarak, mesane ve prostatın görüntüleri alınır. Durumun tam aydınlatılamadığı durumlarda, mercekli bir alet idrar yolunun içi, prostat ve mesane incelenir. Sistoskopi denilen bu yöntemde, hastanın hafifçe uyutularak ağrı duymaması tercih edilir.