Chronic prostatitis is an inflammatory disease characterized by prostate lesions and severe urodynamic abnormalities. One of the causes of chronic inflammation of the prostate is inadequate or untimely treatment in the acute stage, when embryonic epithelial embroidery and proliferation is reversible and is successfully corrected with medication within 2-3 weeks.
The treatment of chronic prostatitis includes a huge antibiotic therapy aimed at eradicating the infectious pathogen, a package of measures to increase the body's immune resistance, physiotherapy methods, and heat therapy. Psychocorrection may also be included in the therapeutic system, as neurastenic and neurotic-like conditions are often observed in men with long-term and recurrent prostatitis.
Why does inflammation become chronic?
Knowledge of the causes of chronic inflammation of the prostate is necessary to prevent exacerbations and improve patients' quality of life. There are a number of factors that can affect the functional state of the prostate gland (glandular) tissue and cause its inflammation, which is caused by the embezzlement and proliferation of epithelial cells.
The main cause of chronic prostatitis in men is extensive contamination of the mucous membranes of the urogenital system with pathogenic microorganisms. In the vast majority of cases (more than 80%), infectious prostatitis is caused by gram-negative and gram-positive bacteria: enterobacteria (especially Escherichia coli), gonococci, staphylococci. Less frequently, the infectious and inflammatory process underlies the infection of viruses, fungi, and protozoa, but such forms of prostatitis are treated quite successfully during the acute period and relapses are rarely given with correct and timely therapy.
It should also be borne in mind that a single acute infection of the urinary tract is sufficient for the development of chronic aseptic prostatitis, so personal hygiene, the use of condoms during intercourse and the timely treatment of urinary tract diseases are of great importance in the prevention of the disease. in men. Medicine is aware of cases of hematogenous (through the systemic circulation) infection of the prostate in chronic sinusitis, tonsillitis and other diseases that contribute to the active growth of the pathogenic flora, therefore the rehabilitation of foci of chronic infectionin case of inflammation.
Negative factors that can cause exacerbation of prostatitis (including non-infectious course) include:
- urinary tract injuries and surgery of organs of the urogenital system;
- regular or severe hypothermia of the pelvic organs (swimming in open reservoirs during periods when the water is not hot enough or the weather is cold outside, working in refrigerators and freezers, etc. );
- hypodynamics caused by sedentary work and insufficient physical activity in men (sedentary lifestyle is one of the main factors in the development of chronic cognitive prostatitis);
- bad habits in which the absorption of the most important macro- and microelements (zinc, chromium, selenium, manganese), which determine the chemical composition and rheological properties of prostate secretion, is slowed down or deteriorated;
- disorders in the intimate sphere (frequent masturbation, irregular sexual intercourse, long abstinence, frequent arousal that does not end with sexual intercourse);
- overweight;
- eating disorder (increased consumption of spicy, too salty, smoked and fatty foods).
Listen! Urologists note that the leading pathogenetic factor in the development of chronic inflammation of the prostate is posterior urethritis. It has also been noted that inflammatory changes occur in the prostate of men in the first months after gonorrheal infection.
Treatment of chronic prostatitis with medication
Medication for chronic prostatitis is only aimed at suppressing acute symptoms during exacerbation and eradicating the infection, but medications should not be used as the sole means (the effectiveness of such treatment does not exceed 36%, according to Dr. Pechersky).
The full treatment regimen for chronic or recurrent prostatitis, which is currently used as a standard for uncomplicated diseases, is shown in the table below.
Table. Preparations for the complex treatment of chronic prostatitis.
| Pharmacology Group | Purpose of the application |
|---|---|
| Antibiotics from the group of macrolides, semisynthetic penicillins and third-generation cephalosporins with broad-spectrum antibacterial activity. | Pathogenic bacteria - elimination of pathogens of infectious prostatitis, urethritis, cystitis and other urinary tract infections. |
| Antimicrobial and protozoal agents. | Treatment of infections caused by pathogenic microbes and protozoa. |
| Non-steroidal anti-inflammatory drugs (preferably in the form of rectal suppositories). | Reduces inflammation in prostate tissue, relieves pain in the perineum, intergluteal space, sacrum and groin. |
| Antiseptics in the form of rectal suppositories. | Rehabilitation of rectal mucosa and prevention of infection with prolonged prostatitis. |
| Alpha blockers. | Normalize urination, restore daily urine output. |
| Microcirculation correctors. | Eliminate congestion in the pelvic vessels, restore normal blood and lymph flow. |
| Correctors of urodynamics (agents that affect metabolism in prostate tissues). | Improving metabolism and metabolic processes in prostate tissue and nutrition. |
| Potency regulators. | Complex treatment of erectile dysfunction, improvement of the chemical composition, viscosity and fluidity of the seminal fluid, increase of sperm activity (drugs in this group are indicated for patients whose prostatitis is complicated by autoimmune infertility). |
The duration of antibiotic treatment is at least 4-6 weeks. Under no circumstances should antibacterial drugs be taken without a prescription, as the leading factor in selecting therapy is the microscopic examination of prostate secretions and fluid released spontaneously as a result of prostate massage. Some antibiotics, such as penicillins (a combination of amoxicillin and clavulanic acid), are spare drugs and their improper use can lead not only to a lack of clinically significant effect and progression of pathology, but also to the development of superinfection.
Important! In some cases, men with chronic prostatitis need psychocorrection, especially when the pain syndrome is combined with behavioral changes, increased anxiety, irritability, and neurasthenia. Selective serotonin reuptake inhibitors are used to suppress these symptoms.
Physiotherapy
Heat therapy is the main method of treating chronic prostatitis outside periods of exacerbation (after regression of acute symptoms). Heat therapy refers to the methods of physiotherapy and the effect of heat on the affected area. The benefits of thermal procedures are the normalization of blood circulation, the alleviation of inflammatory processes, the reduction of chronic pelvic pain, which is one of the main clinical manifestations of chronic prostatitis, which reduces the quality of life of men. Heat improves the penetration of drugs into the prostate tissue, so in some cases physiotherapy is used to increase the effectiveness of drug therapy (e. g. , electrophoresis with antibiotics). In men at high risk of blood clots, warm-up is prescribed for prophylaxis because heat has a moderate absorption effect.
There are many methods of thermal effects on the body, and the choice of a particular method of treatment must be made by a physician, taking into account the clinical picture, form and stage of the disease, one's age and individual tolerance. The most effective methods of heat therapy for prostatitis are:
- thermal applications with minerals (ozokerite, paraffin, biscophite), salt or sand;
- electric heating pads;
- Deep heating of high-strength tissues for direct action on blood vessels and nerve endings (diathermy);
- Exposure to high-frequency alternating magnetic fields to relieve pain, alleviate inflammation, and eliminate neurotic-like manifestations (inductothermia);
- ultrasound therapy (promotes the absorption of abscesses and the healing of scars);
- electrophoresis by introducing electrodes into the rectum;
- exposure of prostate tissue to high-frequency pulse currents (darsonvalization).
In some physiotherapy rooms, chronic inflammation of the prostate is treated with a hot mud treatment ("pants"). Such procedures have a positive effect not only on blood and lymph circulation, but also on the production of prostate secretions and the tissue nutrition of the inflamed organ. In some cases, the sludge is injected directly into the rectum in the form of a tampon, as this method of administration rapidly achieves a therapeutic effect and a positive response to therapy.
Other treatments
In addition to medication and thermotherapy, the complex treatment scheme is supplemented by various procedures prescribed by the doctor, taking into account the specifics of the pathology in each case.
Prostate massage
This is one of the main methods of treating chronic inflammation of the prostate gland and should be used in almost 90% of cases (in the absence of contraindications). Massage is a finger action on the prostate to stimulate the outflow of secretory fluid. The duration of the procedure is usually about 1-2 minutes. The criterion for a sufficient effect is complete emptying of the prostate glands, which the patient perceives as relief (you must inform your doctor about this).
The benefits of massage are determined by the therapeutic effect that is achieved after a course of treatment (procedures 8-12). In a complex course, these are:
- normalization of muscle tone;
- improving blood circulation in the prostate vessels (this speeds up the delivery of drugs to the tissues of the affected organ and increases the effectiveness of the therapy);
- restoration of secretory interoperability;
- Normalization of blood and lymph outflow from the prostate gland (especially significant in cognitive prostatitis).
In the acute period, the procedure is contraindicated due to the high risk of infection spreading to surrounding tissues and organs (hematogenous infection), other infectious diseases of the urogenital system, the presence of cysts or stones in the prostate. Prostate massage is not prescribed for patients diagnosed with tuberculous organ damage, adenoma, or other cancers (including prostate cancer). In the presence of diseases of the rectum (hemorrhoids, rupture of the rectum, proctitis, paraproctitis), massage can cause complications and trigger a relapse of the underlying disease.
Important! Studies show that almost 42% of men refuse prostate massage because of the increased psychological discomfort associated with the specifics of the procedure. The physician's work with such patients should include detailed information on the consequences of refusing treatment and possible complications, particularly infertility and persistent sexual dysfunction. In some cases, it is advisable to prescribe mild sedatives a few days before starting treatment.
Hot enemas
Hot enemas are home treatments for chronic prostatitis, but urologists recognize their effectiveness and recommend them for faster, more effective treatment of prostatitis. The water temperature of these enemas should be around 42 ° C. Prior to the procedure, the intestines should be cleaned with regular enemas or laxatives. The volume of one enema is 150-300 ml. It is recommended that the bowel be emptied within 30-50 minutes after administration of the solution.
The following are recipes for chronic prostate inflammation.
- 10 drops of iodine and approx. Dissolve 20 ml of chlorhexidine in 200 ml of water. Apply at bedtime for 15 days.
- A decoction of chamomile, St. John's wort or calendula should be introduced into the rectum (approximately 250 ml) and kept for 1 hour. The procedure is repeated once a day for 2 weeks. Sea buckthorn oil (40-50 ml) was heated to 40 ° C and administered rectally for 20-30 minutes. The cure is 10-15 days. It is best to do the procedure before going to bed.
- In the case of severe pain syndrome, which significantly limits the patient's mobility and impairs the quality of life, microcycles with novocaine may be used. Dissolve 2 ampoules of 2% novocaine solution in 180 ml of steep chamomile broth. Hold for at least 50 minutes. Repeat daily for 1 week.
Anti-inflammatory, antiseptic, antibiotic can also be used for microcycles. The use of these drugs is permitted with the permission of a physician, strictly at the indicated dose.
Treating chronic prostatitis: step by step
Different treatments are not enough to completely get rid of chronic prostatitis. If a man does not monitor his diet and does not change his lifestyle, exacerbations regularly occur, leading to irreversible changes in the structure and functional activity of the prostate glands, as well as permanent dysuric and sexual disorders. To increase the effectiveness of treatment and the duration of remission, you should follow the recommendations for patients with chronic prostatitis listed in the instructions below.
- Step 1. If a person is diagnosed with chronic prostatitis, they should start by correcting their diet. Foods high in fat, salt and spices should be excluded from the menu. Fats increase blood cholesterol levels, and salt promotes fluid retention and edema in prostate tissue. Spices (like various chemical additives) irritate the urinary tract mucosa, provoking exacerbation of existing symptoms.
- Step 2 There is also a need to completely eliminate alcoholic beverages as they slow down the absorption of nutrients, disrupt blood and lymph circulation, and negatively affect prostate metabolism. If a man suffers from tobacco addiction, measures should be taken to get rid of this habit (toxic substances in tobacco smoke disrupt the viscosity and fluidity of prostate secretions and change its chemical composition).
- Step 3: Overweight men should consult an endocrinologist and nutritionist for a comprehensive diagnosis and correction of body weight, taking into account the abnormalities identified. Obesity is the most important factor in the development of chronic prostatitis, and weight loss in patients with high BMI is an important stage of complex therapy.
- Step 4. Physical activity appropriate to age and physical fitness should be provided to eliminate congestion associated with hypodynamic abnormalities. Swimming, physiotherapy exercises, stretching exercises, walking are useful in case of prostatitis.
- Step 5. The quality of sex life should be monitored for the normal functioning of the prostate. It is advisable to have a permanent sexual partner, to avoid episodes of sexual arousal if there is no possibility of further intercourse, and to check for genital infections regularly, which can also trigger the exacerbation of chronic prostatitis.
Men with recurrent prostatitis should monitor for emotional stress, avoid stressful situations, and be exposed to persistent cold or drafts.
Chronic prostatitis is a disease that is difficult to treat, especially if the patient does not follow the doctor's instructions and is not responsible for nutrition and dosage issues. Inflammation of the prostate is dangerous for severe complications, so you need to take a comprehensive approach to the problem. Men with such a diagnosis should understand that the tablets alone are not sufficient to fully restore all prostate function, and therefore the physician-recommended methods of basic therapy for chronic prostatitis should not be abandoned, even if they cause primary psychological or physical discomfort.