The importance of studying the mechanism of the development of chronic prostatitis increases in direct proportion to the increase in the number of diagnosed cases of the disease. It is known that chronic prostatitis (CP) takes a leading place among urological diseases and is the result of many factors that are an integral part of modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
Since the disease not only covers an ever-increasing percentage of the male population, but is also diagnosed at an ever-younger age, doctors often show a rather dismissive attitude, using standard treatments that are incapable of treatment. for recovery.
What is chronic prostatitis
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate gland, which is manifested in the chronic inflammatory process of the tissues. However, we cannot talk about CP only as a result of the penetration of pathogens into the prostate, since this view justifies the treatment of prostatitis exclusively with antibiotics, which almost never brings lasting positive results.
The main factors behind the development of the pathology can be considered the complex changes of the tissues and, accordingly, the functional capabilities of the gland, which are the main causes of the development of the infectious microflora. Chronic prostatitis is to some extent a collective diagnosis that combines several factors:
- Reduced immunity.
- Stagnant processes in the pelvic organs.
- Urodynamic disorder.
- Degenerative processes in the prostate parenchyma.
- Trophic disturbance.
- inflammatory processes.
Development mechanism
The penetration of the pathogenic microflora into a healthy prostate gland is practically unable to cause an inflammatory process, since the microflora of the prostate has a certain resistance to the pathogens present in the urethra. However, the presence of one or more of the above provoking factors leads to the development of persistent inflammation, which is accompanied by the appearance of scar formations (fibrotization) or necrotic areas.
The proliferation of connective tissue in the process of scar formation causes stagnant processes in the acini (channels that ensure secretion), which aggravate the course of the disease. The death of the tissues leads to the formation of a cavernous cavity, in which, in addition to the dead epithelium, the secret of the prostate also accumulates.
Thus, the main cause of the development of CP is not infection, but various physiological disorders that allow the inflammatory process to become chronic.
Another distinguishing characteristic of the disease, which complicates the diagnosis, isflow periodicity. As a general rule, as a result of external factors or the internal state of the body, the intensity of the pathology changes periodically, during which acute conditions are replaced by periods of remission.
Often, not only the complete absence of symptoms, but also the absence of laboratory indicators (for example, leukocytes) indicating the presence of infection. Despite the positive results, this condition cannot be considered a cure, as all the physiological abnormalities of the gland have remained unchanged.
The reasons
The main causes of circulatory disorders of the pelvic organs and stagnation of venous blood in the prostate gland:
- Constant stay in a sitting position.
- Hypothermia of the whole body or directly in the pelvic region.
- Systematic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- Presence of chronic infection of any localization (sinusitis, bronchitis) in the body.
- Excessive physical activity accompanied by lack of sleep or rest causes immunosuppression.
- History of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to the systematic use of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnant processes, the deterioration of the excretory function of the glands, and a decrease in the resistance of cells to diseases, which contributes to the creation of optimal conditions necessary for the reproduction of pathogenic microorganisms in the prostate gland. .
Can chronic prostatitis be cured?
Despite the large amount of systematic information available on the mechanism of CP development,treatment is extremely difficultand one of the leading problems of modern urological practice.
Given that the disease progresses according to an individual pattern in each patient, accordingly, the treatment approach should be individual, taking into account all the physiological changes that have occurred in the prostate gland.
The anatomical features of the prostate accessible through the urethra or the rectum significantly reduce the effectiveness of the applied therapeutic effect. In this regard, to achieve a relatively stable result, a long (usually several months) therapy is required, during which the patient must strictly comply with all the requirements of the doctor.
Unfortunately, a full recovery can only be achieved then30 out of 100 cases. The reason for this is primarily premature medical help, the long-term absence of serious symptoms or the conscious avoidance of unpleasant diagnostic and then therapeutic procedures. As a general rule, during treatment, the atrophic processes of the prostate are irreversible, and even with long-term treatment, it is only possible to completely eliminate symptoms and achieve stable remission, the duration of which depends on the patient's cooperation. with the doctor's recommendations.
Treatment
The complex of measures used in the treatment of CP includes the following:
Antibacterial therapy
Suppression of the activity of the bacterial microflora with the help of antibiotics should be carried out only after a complex laboratory test, according to the results of which the most effective drug is prescribed.
As a general rule, the duration of antibiotics is determined by the severity of the disease and is at least 30 days. Interruption of treatment is unacceptable, as the remaining microorganisms become resistant to this group of drugs and subsequently require replacement and even longer treatment. Antibiotics with a bactericidal effect are preferred in the treatment of prostatitis:
- Fluoroquinolones;
- Azalides;
- aminoglycosides;
- Tetracyclines.
If the laboratory tests reveal the specific nature of the infection, such as trichomoniasis or the viral origin of prostatitis, nitroimidazoles or antiviral drugs are prescribed in parallel with antibiotics.
Use of anticonvulsants and α-blockers
The main purpose of using drugs belonging to this series is to relieve spasm of the pelvic floor, which helps to increase blood supply, improve the outflow of urine and reduce pain.
Laxatives
In order to avoid excessive use of the pelvic muscles during defecation, it is advisable to use laxatives, as attempts during constipation can worsen the patient's condition.
Physiotherapy
One of the most common methods of physiotherapy is prostate rectal massage. The action of the finger through the anus on the prostate squeezes out the infected secretion, which is then discharged through the urethra.
In addition, the blood supply to the tissues increases during the massage, which has a positive effect on the antibiotic therapy. The following physiotherapy methods are also used to perform rectal prostate massage:
- Electrical simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the stabilization of the condition, the patient must follow the rules that impose certain restrictions on the usual lifestyle:
- Avoid water treatment in open reservoirs and pools.
- See a doctor regularly.
- Abstain from alcohol consumption completely.
- Have a regular sex life with a partner.
Adherence to the rules will allow you to remain in remission as long as possible and avoid aggravation of the disease.