Bacterial prostatitis remains undiagnosed in 50% of cases

Chronic prostatitis is one of the most common reasons for visiting a urologist^[1]. Most often, it starts developing due to an infectious agent; however, inflammation may also be the result of congestive circulatory disorders or injury. The conference titled «Evolution of Approaches to Urological Patient Management. Vital Things in Details», held in Novosibirsk, welcomed experts to discuss the causes and treatment of urological diseases.

Doctors spoke about the role the bacterial factor has in the occurrence of chronic prostatitis. «It is still believed that chronic prostatitis has abacterial nature. But it’s not true. Let’s try to unmask this disease », Ekaterina Valerievna Kulchavenya, Dr. habil. med., Professor, started her speech.

The expert drew attention to two studies on using bovhyaluronidase azoximer in chronic prostatitis involving more than 100 men. All of them passed a medical examination, submitted their ejaculate for bacterial inoculation and were divided into two groups according to the analysis results: the first group with bacterial prostatitis and the second group with abacterial one. However, the study showed that, when using molecular genetic methods, harmful bacteria that affect the development of prostatitis had been found in the group including patients with abacterial prostatitis.

The fact is that biofilms did not allow to detect the presence of bacteria, thus interfering with the disease diagnosis. When using bovhyaluronidase azoximer molecules (Longidaza^®), the biofilm volume halved, whereas the patients’ condition returned to normal.

The drug facilitated the bacterial prostatitis diagnosis and improved the therapy results due to suppressing edema, improving microcirculation, destroying biofilms, and removing «plugs» in the gland ducts, as well as de-fibrosing the overgrown connective tissue and increasing the bioavailability of antibiotics.

The results of this study proved the importance of revealing the microbial factor of the disease in order to prescribe the appropriate therapy and to get a successful treatment outcome. According to Ekaterina Valerievna Kulchavenya, «The study showed that chronic prostatitis is much more diverse in its structure: abacterial prostatitis, bacterial prostatitis, tuberculosis, and latent infectious prostatitis. Only the use of Longidaza^® made it possible to introduce this term.»

Today, as experts say, the abacterial prostatitis incidence is still dramatically overestimated, whereas bacterial prostatitis remains undiagnosed in almost half of cases, and, consequently, patients do not receive the required therapy.

Evgeny Semyonovich Shpilenya, Dr. habil. med., Professor, drew attention to the problem of identifying patients with prostatitis, «We have no summary data on prostatitis in Russia; we have only general trends suggesting that, from year to year, there are more and more problems with prostate. And here’s the real assessment on a global scale: no one in the world knows the exact number of such patients».

Patients with chronic prostatitis have fibroplastic changes, the so-called prostatic pelvic pain. Fibrosis is a pathological condition with an excessive growth of connective tissue. This is a normal reaction of the body, aimed at protecting tissues from inflammatory processes. However, if there is too much connective tissue, it can be difficult to make a correct diagnosis, and the treatment outcomes get worse due to reduced penetration of drugs into the inflamed prostate. All of this leads to the process becoming chronic. In addition, fibrosis significantly impairs the prostate gland function and negatively affects urination.

Experts consider antifibrotic drugs to be one of the recommended methods of therapy which allow to reduce the frequency of complications. According to Evgeny Shpilenya, one such drug is bovhyaluronidase azoximer (Longidaza^®). «When administering Longidaza^® in the postoperative period to prevent scaring, we improve the recovery process», he added.

Longidaza^® is an enzyme drug that helps reduce inflammation and prevents the development of fibrosis. Its use in urology is quite wide: prostatitis, surgical pathologies, prostatic hyperplasia, prevention of scaring processes, etc.

¹ https://uroweb.ru/article/chastota-khronicheskogo-prostatita-v-strukture-ambulatornogo-urologicheskogo-priema

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