MEN’S HEALTH IN FOCUS: WHAT YOU SHOULD KNOW ABOUT PROSTATITIS

Prostatitis is a common condition among men characterized by inflammation of the prostate gland. It can be an uncomfortable and painful problem; however, modern medicine offers a variety of strategies that can help manage this condition. In this article, we review the symptoms of prostatitis, disease classification, lifestyle and dietary recommendations, as well as the main therapeutic approaches used in its management.

What symptoms may indicate prostatitis?

The symptoms of prostatitis can vary significantly depending on its type, but most commonly include:

• - difficulty or pain during urination, frequent urination, and a feeling of incomplete bladder emptying;
• - pain in the lower abdomen, scrotum, perineum, glans penis, or inner thighs;
• - a feeling of pressure in the perineum, anus, or the area anterior to the anus;
• - pain during ejaculation, sometimes accompanied by blood in the semen;
• - reduced libido and erectile dysfunction;
• - general weakness and increased fatigue.

Diagnostic methods

Prostatitis is most often diagnosed based on clinical symptoms combined with laboratory and instrumental diagnostic methods. Laboratory tests evaluate the presence of leukocytes, bacteria, and erythrocytes in urine or prostatic secretions, and bacteriological cultures may be performed to identify the infectious agent. Instrumental methods, including digital rectal examination and transrectal ultrasound of the prostate, are used to assess the condition of the prostate gland and detect structural changes.

Main forms of the disease

Acute bacterial prostatitis. A sudden and severe bacterial inflammation of the prostate gland, often accompanied by systemic intoxication, high fever (39–40 °C), chills, and severe perineal pain. This condition requires immediate medical attention, as prostate swelling may lead to acute urinary retention.

Chronic bacterial prostatitis. A long-term inflammatory condition caused by bacterial infection, characterized by periods of exacerbation and remission. The most common cause is recurrent urinary tract infections and bacterial colonization.

Chronic nonbacterial prostatitis (Chronic Pelvic Pain Syndrome – CPPS). A long-lasting inflammatory condition without evidence of infection, and the most common form of prostatitis in men aged 20–50 years. Based on laboratory findings, two types are distinguished: inflammatory CPPS (leukocytes present in prostate secretion/urine, but bacteria not detected) and non-inflammatory CPPS or prostatodynia (leukocytes and bacteria not detected).

Asymptomatic inflammatory prostatitis. Inflammation of the prostate gland without noticeable symptoms, usually detected incidentally during medical examinations for other conditions.

Key principles of therapeutic management

            The approach to supporting prostate health should be comprehensive and individualized, taking into account the course of the disease and potential complications.

Key recommendations include: regular sexual activity to improve prostate drainage, increased physical activity, taking regular breaks during work in a static posture, engaging in swimming, walking or running, as well as avoiding hypothermia (especially of the pelvic area) and harmful habits. Kegel exercises may be beneficial for strengthening the pelvic floor muscles and improving blood circulation.

Nutrition should be balanced and complete. It is recommended to limit the consumption of spicy, fried foods, spices, and smoked products. Establish an adequate drinking regimen, consuming a sufficient amount of fluids (water, juices, herbal infusions).

Important aspects include weight control, stress avoidance, and regular urological check-ups. Strict adherence to the doctor's recommendations, prescribed medication, and physiotherapy procedures is the key to a successful outcome.

Depending on the type and severity of prostatitis, the doctor may prescribe different groups of medications.

Antibiotics – prescribed in the presence of bacterial forms of prostatitis. In such cases, they play a key role in treatment by eliminating the causative agent of the infection. The choice of the type and regimen of antibacterial therapy should be made exclusively by a physician, based on the sensitivity of the pathogens, the severity of the disease, and other individual patient characteristics. It is crucial to strictly follow the doctor's recommendations—self-medication is unacceptable.

Anti-inflammatory drugs – used to eliminate the inflammatory process and oedema of the prostate gland, reduce the intensity of pain and burning, and to facilitate urination.

Alpha-blockers – help quickly relieve urination by relaxing the smooth muscles of the bladder neck, prostate gland, and its capsule. They reduce spasm, improve urine outflow, relieve congestion, and help reduce discomfort.

5-alpha-reductase Inhibitors – inhibit the conversion of testosterone to dihydrotestosterone, eliminating the hormonal stimulus for prostate enlargement, thereby improving urine flow and reducing symptoms in significant hyperplasia.

Physiotherapy procedures (UHF, magnetic therapy, laser therapy), physical therapy, and prostate massage provide additional benefits for improving the condition and positive symptom dynamics.

            Phytotherapy is one of the components of comprehensive support for prostate health. Biologically active substances from medicinal plants can favorably influence the course of the disease and the dynamics of prostatitis symptoms. Plant components have been proven to have a multifaceted effect on the activity of the inflammatory process, help reduce edema and irritation of prostate tissues, and possess antioxidant and general tonic properties.

It is important to note that the physician is the key figure in selecting the therapeutic strategy and prescribing medications. Strict adherence to these recommendations will help reduce the frequency of recurrences and significantly improve the quality of life for patients with inflammatory processes of the prostate.

Guideline 00245 https://guidelines.moz.gov.ua/documents/3131
Prostatitis Classification System  https://www.msdmanuals.com/uk/professional/multimedia/table/nih-consensus-classification-system-for-prostatitis?
Prostatitis Lori Lerner, Leonard G. Gomella 2025