Chronic prostatitis is an inflammatory disease characterized by lesions of the prostate and severe urodynamic disturbances. One of the causes of chronic inflammation of the prostate is inadequate or inappropriate treatment in the acute stage, when the desquamation and proliferation of the glandular epithelium is reversible and is successfully corrected with drugs within 2-3 weeks.
Treatment of chronic prostatitis includes massive antibiotic therapy aimed at eradicating the infectious pathogen, a set of measures to increase the body's immunoresistance, physiotherapeutic methods, heat therapy. Psychocorrection can also be included in the treatment regimen, as neurasthenic and neurosis-like conditions are often seen in men with long-term and recurrent prostatitis.
Why does inflammation become chronic?
Knowing the causes of chronic inflammation of the prostate is necessary to prevent exacerbations and improve the quality of life of patients. A large number of factors can affect the functional state of the glandular (glandular) tissue of the prostate gland and cause inflammation, which is based on the desquamation and proliferation of epithelial cells.
The main cause of chronic prostatitis in men is the extensive contamination of the mucous membranes of the genitourinary system by pathogenic microorganisms. In the overwhelming majority of cases (over 80%) of infectious prostatitis, Gram-negative and Gram-positive bacteria become the causative agent of the infection: enterobacteriaceae (in particular Escherichia coli), gonococci, staphylococci. Less often, the infectious and inflammatory process takes place against the background of infection with viruses, fungi and protozoa, but these forms of prostatitis are successfully treated during the acute period and rarely give relapses, subject tocorrect and timely treatment.
It should also be borne in mind that for the development of chronic aseptic prostatitis, only one acute urinary tract infection is sufficient. Therefore, personal hygiene, the use of condoms during sex, and timely treatment of diseases of the urinary tract are of great importance in preventing this disease in men. Medicine is aware of cases of hematogenous (systemic circulation) infection of the prostate in chronic sinusitis, tonsillitis and other diseases that contribute to the active growth of pathogenic flora. Therefore, the rehabilitation of foci of chronic infection is an important step in the complex treatment of prolonged or prolonged inflammation of the prostate.
Negative factors that can provoke an exacerbation of prostatitis (including a non-infectious course) are:
- injuries of the urinary tract and surgery of organs of the genitourinary system;
- regular or severe hypothermia of the pelvic organs (swimming in open water during times when the water is not hot enough or the weather is cool outside, working in refrigerators and freezers, etc. );
- hypodynamia caused by sedentary work and insufficient physical activity of a man (a 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 that determine the chemical composition and rheological properties of prostate secretions (zinc, chromium, selenium, manganese) is slowed down or impaired;
- disorders of the intimate sphere (frequent masturbation, irregular sexual relations, long periods of abstinence, frequent arousal that does not end with sexual intercourse);
- overweight;
- eating disorder (increased consumption of spicy, too salty, smoked and fatty foods).
Pay attention! Urologists note that the main pathogenic factor in the development of chronic inflammation of the prostate is posterior urethritis. It has also been noted that inflammatory changes in the prostate gland in men appear in the first few months after experiencing gonorrhea infection.
Treatment of chronic prostatitis with drugs
Treatment of chronic prostatitis with drugs is aimed only at suppressing acute symptoms during exacerbation and destruction of the infection, but drugs can not be used as the only means (the effectiveness of asuch treatment will not exceed 36%, according to Dr. Pechersky).
A complete regimen of drug therapy for prolonged or recurrent inflammation of the prostate, used today as a standard in uncomplicated diseases, is shown in the table below.
Table. Preparations for the complex treatment of chronic prostatitis.
| Pharmacological group | Objective |
|---|---|
| Antibiotics from the group of macrolides, semi-synthetic penicillins and third-generation cephalosporins with a broad spectrum of antibacterial activity. | Eradication (destruction) of pathogenic bacteria - agents responsible for infectious prostatitis, urethritis, cystitis and other urinary tract infections. |
| Antimicrobial and antiprotozoal agents. | Treatment of infections caused by pathogenic microbes and protozoa. |
| Nonsteroidal anti-inflammatory drugs (preferably in the form of rectal suppositories). | Reduction of inflammation in prostate tissue, relief of pain in perineum, intergluteal space, sacrum and groin. |
| Antiseptics in the form of rectal suppositories. | Rehabilitation of the rectal mucous membranes and prevention of its infection by prolonged prostatitis. |
| Alpha blockers. | Normalization of urination, restoration of daily urine flow. |
| Microcirculation correctors. | Elimination of congestion in the vessels of the small pelvis, restoration of normal blood and lymphatic flow. |
| Urodynamic correctors (agents affecting the metabolism in the tissues of the prostate). | Improvement of metabolic and metabolic processes in prostate tissue and its nutrition. |
| Power regulators. | Complex treatment of erectile dysfunction, improving the chemical composition, viscosity and fluidity of seminal fluid, increasing the activity of sperm (the use of drugs from this group is indicated for patients whose prostatitis is complicated byautoimmune infertility). |
The duration of the antibiotic treatment is at least 4 to 6 weeks. In no case should you take drugs with antibacterial effect without a prescription from a doctor, since the main factor in the choice of treatment is the results of microscopic examination of prostatic secretions and fluids released spontaneously as a result ofprostate massage. Some antibiotics, for example, penicillins (a combination of amoxicillin and clavulanic acid) are reserve drugs, and their incorrect use can lead not only to the absence of a clinically significant effect and the progression of pathology, but also to the development of superinfection.
Important! In some cases, men with chronic prostatitis need psycho-correction, especially if the pain syndrome is associated with changes in behavior, increased anxiety, irritability, and neurasthenia. Antidepressants with selective serotonin reuptake inhibition 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 physiotherapy methods and is a metered effect of heat on the affected area. The advantages of thermal procedures lie in the normalization of blood circulation, relief of inflammatory processes, reduction of chronic pelvic pain, which is one of the main clinical manifestations of chronic prostatitis, which reduces the quality of life ofmen. The heat also improves the penetration of medicinal substances into the prostate tissue. Therefore, in some cases, physiotherapy is used to increase the effectiveness of drug therapy (for example, electrophoresis with antibiotics). For men with a high risk of thrombus formation, rewarming is prescribed for prophylaxis, since heat has a moderate resorptive effect.
There are a large number of methods of thermal effects on the body, and the choice of a specific method of treatment should be carried out by a doctor, taking into account the clinical picture, form and stage of thedisease, the age of the man and his individual tolerance. The most effective methods of heat therapy for prostatitis are:
- thermal applications with minerals (ozokerite, paraffin, bischofite), salt or sand;
- electric heating pads;
- deep tissue heating with high resistance for a direct effect on blood vessels and nerve endings (diathermy);
- exposure to high-frequency alternating magnetic fields to eliminate pain, relieve inflammation and eliminate neurosis-like manifestations (inductothermia); ultrasound therapy
- (promotes resorption of abscesses and healing of scars formed); electrophoresis
- with introduction of electrodes into the rectum;
- impact on prostate tissue with high frequency pulse currents (darsonvalization).
In some physiotherapy rooms, chronic inflammation of the prostate is treated with hot mud applications ("mud pants"). Such procedures have a positive effect not only on the circulation of blood and lymph, but also on the production of secretion of the prostate, as well as on tissue nutrition of the inflamed organ. In some cases, the sludge is injected directly into the rectum in the form of tampons, since with this mode of administration it is possible to quickly achieve a therapeutic effect and a positive response to therapy.
Other treatments
The complex treatment scheme, in addition to drug and heat therapy, is supplemented by various procedures that the doctor prescribes, taking into account the peculiarities of the pathology in each case.
Prostate massage
This is one of the main methods of treating chronic inflammation of the prostate, which is recommended to be used in almost 90% of cases (in the absence of contraindications). Massage is an effect of the finger on the prostate to stimulate the flow of secretory fluid. The duration of the procedure is usually about 1 to 2 minutes. The criterion for a sufficient effect is the complete emptying of the prostate glands, which the patient feels as a relief (about which he should inform the doctor).
The benefits of massage are determined by the therapeutic effect that can be achieved after undergoing treatment (8 to 12 procedures). With a simple course, these are:
- normalization of muscle tone;
- improvement of blood circulation in the vessels of the prostate (thereby the transport of medicinal substances to the tissues of the affected organ is accelerated and the effectiveness of the treatment is increased);
- restoration of secretory permeability;
- normalization of the outflow of blood and lymph from the prostate (especially important in cognitive prostatitis).
The procedure is contraindicated in the acute period due to the high risk of the infection spreading to surrounding tissues and organs (hematogenous infection), other infectious diseases of the genitourinary system, the presence of cystsor stones in the prostate. Prostate massage is not prescribed for patients who have been diagnosed with lesions of tuberculous organs, adenoma or other neoplastic diseases (including cancerous lesions of the prostate). In the presence of diseases of the rectum (hemorrhoids, anal fissure, proctitis, paraproctitis), massage can lead to complications and cause a relapse of the underlying disease.
Important! Studies show that almost 42% of men refuse prostate massage due to the increased psychological discomfort associated with the peculiarities of this procedure. The doctor's work with these patients should include detailed information about the consequences of refusing treatment and possible complications, in particular infertility and persistent sexual dysfunction. In some cases, it may be advisable to prescribe mild sedatives a few days before the start of treatment.
Hot enemas
Hot enemas are home treatments for chronic prostatitis, but urologists recognize their effectiveness and recommend them for faster and more effective treatment of prostatitis. The water temperature for these enemas should be about 42 ° C. Before the procedure, it is necessary to cleanse the intestines with a regular enema or laxatives. The volume of one enema is 150-300 ml. It is recommended to empty the intestine 30 to 50 minutes after administration of the solution.
Prescriptions for chronic inflammation of the prostate are listed below.
- Dissolve 10 drops of iodine and about 20 ml of chlorhexidine in 200 ml of water. Apply at bedtime for 15 days.
- Introduce a decoction of chamomile, St. John's wort or calendula into the rectum (about 250 ml), then keep it for 1 hour. The procedure is repeated once a day for 2 weeks.
- Sea buckthorn oil (40-50 ml) is heated to 40 ° C and introduced into the rectum for 20-30 minutes. The duration of treatment is 10 to 15 days. The procedure is best done before bedtime.
- In case of severe pain syndrome, severely limiting patient mobility and impairing quality of life, novocaine microclysters can be used. Dissolve 2 ampoules of a 2% solution of novocaine in 180 ml of a stiff decoction of chamomile. Hold for at least 50 minutes. Repeat daily for 1 week.
Anti-inflammatory drugs, antiseptics, antibiotics can also be used for microclysters. The use of these drugs is allowed with the permission of a doctor strictly in the prescribed dosage.
Treatment of chronic prostatitis: step by step instructions
Using various methods of treatment is not enough to get rid of chronic prostatitis completely. If a man does not watch his diet and change his lifestyle, exacerbations will regularly occur, leading to irreversible changes in the structure and functional activity of the prostate glands and persistent dysuric and sexual disorders. In order for the effectiveness of treatment and the duration of remission to be greater, you should follow the recommendations in the instructions below for patients with chronic prostatitis.
- Step 1. If a man is diagnosed with chronic prostatitis, he should start by correcting his diet. It is necessary to exclude from the menu foods with a large amount of fat, salt and spices. Fat increases blood cholesterol levels, and salt promotes water retention and edema in prostate tissue. Spices (like various chemical additives) irritate the mucous membranes of the urinary tract, causing exacerbation of existing symptoms.
- Step 2. It is also necessary to completely eliminate alcoholic beverages, as they slow the absorption of nutrients, disrupt the circulation of blood and lymph, and negatively affect the metabolism of the prostate. If a man suffers from tobacco addiction, measures should be taken to get rid of this habit (toxic substances in tobacco smoke violate the viscosity and fluidity of secretions from the prostate and change its chemical composition).
- Step 3. Overweight men should see an endocrinologist and nutritionist for a full diagnosis and correction of body weight, taking into account any identified deviations. Obesity is the most important factor in the development of chronic prostatitis and an important step in complex therapy is weight loss in patients with high BMI.
- Step 4. To eliminate the stagnant phenomena associated with hypodynamic disorder, it is necessary to provide an adequate level of physical activity, corresponding to age and physical form. Swimming, physiotherapy exercises, stretching exercises, walking are useful for prostatitis.
- Step 5. For the normal functioning of the prostate, it is necessary to monitor the quality of sexual life. It is advisable to have a permanent sexual partner, to avoid episodes of sexual arousal if there is no possibility of re-intercourse and to be regularly checked for genital infections, which can also cause sexual intercourse. exacerbation of chronic prostatitis.
Men with recurrent prostatitis should watch out for emotional stress, avoid stressful situations, as well as prolonged exposure to cold or drafts.
Chronic prostatitis is a difficult disease to treat, especially if the patient does not follow the prescription of the attending physician and does not take a responsible approach to nutrition and diet issues. Inflammation of the prostate is dangerous with serious complications, so you need to approach the problem comprehensively. Men with this diagnosis should understand that pills alone are not enough to completely restore all prostate functions, so you should not give up on the basic chronic prostatitis treatment methods suggested by your doctor, even if they cause aprimary psychological or physical discomfort.