Chronic prostatitis is one of the most common reasons why men between 30 and 50 see a urologist. Pain in the perineum, the testicles or low in the abdomen, discomfort during ejaculation, frequent and urgent urination – the symptoms go on for months and often do not respond well enough to medication alone. In many of these men no bacterium is found – the underlying problem is chronic inflammation, poor blood supply and constant tension in the pelvic floor muscles.
High-intensity laser therapy is a non-invasive method aimed at exactly these mechanisms. The laser light penetrates deep into the tissues through the skin – without incisions and without instruments in the urethra – and is used for its anti-inflammatory, pain-relieving and muscle-relaxing effect. With Dr Penev it is part of a combined plan, not a treatment on its own.
When it is recommended
Laser therapy can be helpful for:
- chronic prostatitis and chronic pelvic pain syndrome with symptoms lasting more than three months;
- chronic bacterial prostatitis – as an addition to the antibiotic;
- painful pelvic floor spasm that keeps the symptoms going even after the infection has been cured;
- pain during ejaculation and erection problems linked to prostatitis.
The method is not used for acute prostatitis, active infection, unexplained PSA results or a suspected tumour, or for skin conditions in the treatment area; if you have an implanted electronic device, tell the doctor beforehand.
Severe pain in the perineum with a high temperature and shivering, or being unable to pass urine, are signs of acute prostatitis or urinary retention – an emergency. Do not wait for a booked appointment; go to an emergency department or call 112 (the European emergency number).
How it is done
The procedure is carried out at the practice, lying down, with only the treatment area uncovered. Dr Penev directs the laser applicator at the skin of the perineum and above the pubic bone, over the prostate and the pelvic floor. You feel a deep warmth, without pain. One session takes approximately 10–15 minutes and needs no anaesthetic.
The laser is given as a course – usually 6 to 10 sessions, two or three times a week. At the same time Dr Penev prescribes medication according to the type of prostatitis (alpha-blockers, anti-inflammatories, herbal preparations and, if a bacterium has been confirmed, an antibiotic), shows you how to relax your pelvic floor and discusses your lifestyle with you – physical activity, avoiding long periods of sitting and getting chilled.
Preparation
Therapy begins only after a full prostate check – a conversation about your symptoms, a rectal examination, an ultrasound scan with residual urine measurement, a urine test and, over the age of 45, a PSA test – to confirm the diagnosis and rule out other causes of the pain. For the sessions themselves it is enough to have showered and not to have applied any creams; tell the doctor about the medicines you take and about any implants.
After the procedure / Results
Immediately after the session you can drive and work; there may be slight redness of the skin, which passes quickly. The effect builds up gradually – some men feel relief after the third or fourth session, while for others the change comes towards the end of the course. The result is assessed with a symptom questionnaire before and after treatment.
Chronic prostatitis has a variable course and no single method works the same for everyone – in some patients the relief is longer-lasting, while others need a maintenance course or a change of medication. The scientific evidence for laser therapy is still limited, so it is used as an addition to established treatment, not instead of it. Dr Penev will tell you realistically what to expect.
Where it is done
Laser therapy is given by appointment at Dr Penev’s urology practice in Plovdiv, 5 Anri Barbyus St, depending on the equipment available and the indications. Patients from Karlovo can have their initial consultation at Vita Med Medical Centre, Karlovo, and plan the course in Plovdiv. The addresses and phone numbers are on the Contact page.
Price
An initial consultation is €50 and a follow-up consultation €30. The price of the course depends on the number of sessions and is confirmed when you book.
Chronic pelvic pain is not something you have to live with. Book an appointment with Dr Penev – after a thorough examination he will assess whether laser therapy is suitable for you.
Frequently asked questions
Can the laser replace antibiotics?
No. When a bacterial infection has been confirmed, antibiotic treatment is essential and laser therapy only complements it. In chronic pelvic pain without infection, antibiotics are usually not needed, but there too the laser is part of a combined plan, not a treatment on its own.
How long does the effect last, and can the course be repeated?
In some men the relief lasts for months, especially when the lifestyle changes are also kept up. If the symptoms come back, a maintenance course can be given again at the doctor's discretion.
Are there any side effects or risks?
The laser works through the skin without damaging it, so side effects are rare and mild – brief redness or a feeling of warmth. No effect on fertility is expected, as the testicles are not treated, and no rest is needed after the procedure.
Will my sexual function improve?
Chronic prostatitis is often linked to pain during ejaculation and weaker erections. When the pain and the pelvic floor spasm ease, these symptoms also improve in some men, but the effect is individual and cannot be promised in advance.
Is the therapy suitable for an enlarged prostate?
Laser therapy does not reduce the size of the prostate and does not treat benign prostatic hyperplasia. For difficulty passing urine caused by an enlarged prostate, medication is used and, if needed, endoscopic surgery.
The information on this website is for general education and does not replace an examination and consultation with a doctor. If you have urgent symptoms, seek medical help immediately or call 112.