Chronic prostatitis is an inflammatory disease characterized by lesions of the prostate gland and severe urodynamic disorders. One of the causes of chronic inflammation of the prostate is inadequate or untimely treatment in the acute stage, when the desquamation and proliferation of the glandular epithelium is reversible and is successfully corrected with medication in 2-3 weeks.
The treatment of chronic prostatitis includes a massive antibiotic therapy aimed at the eradication of the infectious agent, a set of measures to increase the body's immune resistance, physiotherapeutic methods, heat therapy. Psycho-correction can also be included in the therapy regimen, as neurasthenic and neurosis-like conditions are often seen in men with long-standing, 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. There are a large number of factors that 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 vast majority of cases (over 80%) of infectious prostatitis, gram-negative and gram-positive bacteria become the causative agent of infection: enterobacteria (in particular, Escherichia coli), gonococci, staphylococci. Less often, the infectious and inflammatory process progresses against the background of infection by viruses, fungi and protozoa, but such forms of prostatitis are treated quite successfully during the acute period and rarely relapse, subject to correct and timely therapy. .
It should also be noted that for the development of chronic aseptic prostatitis, a single acute urinary tract infection is sufficient, therefore, personal hygiene, use of condoms during sexual intercourse and treatmentTimely urinary tract diseases are of great importance in preventing this disease in men. Medicine knows cases of hematogenous infection (through the systemic circulation) of the prostate in chronic sinusitis, tonsillitis and other diseases that contribute to the active growth of pathogenic flora, therefore, the sanitation of chronic infection foci is aimportant stage in the complex treatment of prolonged or prolonged inflammation of the prostate.
Negative factors that can cause exacerbation of prostatitis (including non-infectious course) are:
- urinary tract injuries and surgery on the organs of the genitourinary system;
- regular or severe hypothermia of the pelvic organs (swimming in open water during periods when the water is not warm enough or the weather is cool outside, working in refrigerators and freezers, etc. );
- hypodynamics 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 altered;
- disorders in the intimate sphere (frequent masturbation, irregular sexual relations, long periods of abstinence, frequent excitement that does not end with intercourse);
- overweight;
- eating disorder (increased consumption of spicy, overly salty, smoked and fatty foods).
Pay attention! Urologists note that the main pathogenetic factor in the development of chronic inflammation of the prostate is posterior urethritis. Inflammatory changes in the prostate in men were also observed to appear during the first few months after a gonorrhea infection.
Treatment of chronic prostatitis with drugs
Treatment of chronic prostatitis with drugs is aimed only at suppressing acute symptoms during an exacerbation and destruction of infection, but drugs cannot be used as the only means (the effectiveness of such treatment will not exceed 36%, according to Dr. Pechersky).
The following table presents a comprehensive drug treatment regimen for prolonged or recurrent prostate inflammation that is currently used as standard in uncomplicated disease.
Table. Preparations for the complex treatment of chronic prostatitis.
| Pharmacological group | Purpose of the application |
|---|---|
| Antibiotics from the group of macrolides, semisynthetic penicillins and third generation cephalosporins with a broad spectrum of antibacterial activity. | Eradication (destruction) of pathogenic bacteria: causative agents of infectious prostatitis, urethritis, cystitis and other urinary infections. |
| Antimicrobial and antiprotozoal agents. | Treatment of infections caused by pathogenic microbes and protozoa. |
| Non-steroidal anti-inflammatory drugs (preferably in the form of rectal suppositories). | Reduction of inflammation in the tissues of the prostate, relief of pain in the perineum, intergluteal space, sacrum and groin. |
| Antiseptics in the form of rectal suppositories. | Rehabilitation of the rectal mucosa and prevention of its infection with prolonged prostatitis. |
| Alpha blockers. | Normalization of urination, restoration of daily urine output. |
| Microcirculation correctors. | Elimination of congestion in the vessels of the small pelvis, restoration of normal blood and lymphatic flow. |
| Urodynamic correctors (agents that affect metabolism in the tissues of the prostate). | Improvement of metabolic and metabolic processes in the tissues of the prostate gland and its nutrition. |
| Power regulators. | Complex treatment of erectile dysfunction, improving the chemical composition, viscosity and fluidity of seminal fluid, increasing sperm activity (the use of drugs from this group is indicated for patients whose prostatitis is complicated by autoimmune infertility). |
The duration of antibiotic treatment is at least 4-6 weeks. In no case should you take drugs with antibacterial effect without a prescription, since the main factor in the selection of therapy is the results of a microscopic examination of prostate secretions and spontaneously released fluids as a result of prostate massage. Some antibiotics, for example, penicillins (a combination of amoxicillin with 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 ofa superinfection.
Important! In some cases, men with chronic prostatitis need psycho-correction, especially if the pain syndrome is combined with behavioral changes, increased anxiety, irritability, and neurasthenia. Selective serotonin reuptake inhibition antidepressants are used to suppress these symptoms.
Physiotherapy
Heat therapy is the main method of treating chronic prostatitis outside of periods of exacerbation (after regression of acute symptoms). Heat therapy refers to physiotherapy methods and is a dosed effect of heat on the affected area. The benefits of heat treatments are 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 of men. 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, antibiotic electrophoresis). For men at high risk of thrombosis, warming is prescribed for prevention, since heat has a moderate resorption effect.
There are a large number of methods of thermal effects on the body, and the choice of a specific treatment method should be made by a doctor, taking into account the clinical picture, the form and stage of the disease, ageof man and his individual tolerance. The following thermotherapy methods are most effective for prostatitis:
- thermal applications with minerals (ozokerite, paraffin, bischofite), salt or sand;
- electric heating pads;
- deep heating of high resistance tissues for a direct effect on blood vessels and nerve endings (diathermy);
- exposure to alternating high-frequency magnetic fields to eliminate pain, relieve inflammation and eliminate neurosis-like manifestations (inductothermia);
- ultrasound therapy (promotes resorption of abscesses and healing of formed scars);
- electrophoresis with the introduction of electrodes into the rectum;
- Exposure to prostate tissue by high frequency impulse currents (darsonvalization).
In some physical therapy rooms, chronic inflammation of the prostate is treated with applications of hot mud ("mud pants"). Such procedures have a positive effect not only on the circulation of blood and lymph, but also on the production of prostate secretions, as well as on the tissue nutrition of the inflamed organ. In some cases, the mud is injected directly into the rectum in the form of tampons, since with this method 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 pharmacotherapy and thermal therapy, is complemented by various procedures prescribed by the doctor, 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 advisable to use in almost 90% of cases (in the absence of contraindications). Massage is an effect of the fingers on the prostate to stimulate the discharge of secretory fluid. The duration of the procedure is usually about 1-2 minutes. The criterion for a sufficient effect is the complete emptying of the prostate glands, which the patient perceives 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 a course of treatment (8-12 procedures). With a hassle-free course, these are:
- normalization of muscle tone;
- improvement of blood circulation in the vessels of the prostate (due to this, the transport of medicinal substances to the tissues of the affected organ is accelerated and the effectiveness of therapy increases);
- restoration of secretory permeability;
- normalization of blood and lymph outflow from the prostate gland (especially important in cognitive prostatitis).
The procedure is contraindicated during the acute period due to the high risk of spreading the infection to the surrounding tissues and organs (hematogenous infection), with other infectious diseases of the genitourinary system, the presence of cysts or stones in the prostate. Prostate massage is not prescribed for patients who have been diagnosed with tuberculous organic damage, adenoma or other neoplastic diseases (including cancerous lesions of the prostate gland). In the presence of diseases of the rectum (hemorrhoids, anal fissure, proctitis, paraproctitis), massage can cause complications and lead to a relapse of the underlying disease.
Important! Studies show that almost 42% of men reject prostate massage due to increased psychological discomfort associated with the peculiarities of this procedure. The physician's work with these patients should include detailed information on the consequences of refusing treatment and possible complications, in particular infertility and persistent sexual dysfunction. In some cases, it may be advisable to prescribe light 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 and more effective treatment of prostatitis. The water temperature for these enemas should be around 42 ° C. Before the procedure, it is necessary to cleanse the intestines with a regular enema or laxatives. The volume of an enema is 150 to 300 ml. It is recommended to empty the intestine in an hour 30-50 minutes after the administration of the solution.
Listed below are recipes for chronic inflammation of the prostate.
- Dissolve 10 drops of iodine and approximately 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 then kept 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 course of treatment is 10-15 days. The procedure is best done before bedtime.
- In case of severe pain syndrome, which significantly limits the mobility of the patient and impairs quality of life, microclysters with novocaine can be used. Dissolve 2 ampoules of a 2% solution of novocaine in 180 ml of a deep decoction of chamomile. Hold for at least 50 minutes. Repeat every day for 1 week.
Anti-inflammatory, antiseptic, and antibiotic medications can also be used from microclyster medications. The use of these drugs is allowed with the permission of a doctor strictly in the indicated dosage.
Treatment of chronic prostatitis: step by step instructions
Using various treatment methods is not enough to completely get rid of chronic prostatitis. If a man does not control his diet and does not change his lifestyle, exacerbations will occur regularly, leading to irreversible changes in the structure and functional activity of the prostate glands and persistent sexual and dysuric disorders. In order for the effectiveness of treatment and the duration of remission to be higher, you must adhere to the recommendations set out 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. Fats increase blood cholesterol levels and salt promotes fluid retention and edema in prostate tissue. Spices (like various chemical additives) irritate the mucous membranes of the urinary tract, causing an exacerbation of existing symptoms.
- Step 2. It is also necessary to completely eliminate alcoholic beverages, as they slow the absorption of nutrients, disrupt blood and lymphatic circulation, and negatively affect prostate metabolism. If a man suffers from tobacco addiction, steps must be taken to get rid of this habit (toxic substances in tobacco smoke alter the viscosity and fluidity of prostate secretions and change their 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 identified deviations. Obesity is the most important factor in the development of chronic prostatitis and an important stage in complex therapy is weight loss in patients with a high BMI.
- Step 4. To eliminate the stagnation phenomena associated with hypodynamic disorder, it is necessary to provide an adequate level of physical activity, corresponding to age and physical fitness. Swimming, physical therapy exercises, stretching exercises, walking are useful for prostatitis.
- Step 5. For the normal functioning of the prostate, it is necessary to control the quality of sexual life. It is advisable to have a permanent sexual partner, avoid episodes of sexual arousal if there is no possibility of more sexual intercourse, and regularly monitor for genital infections, which can also cause an exacerbation of chronic prostatitis.
Men with recurrent prostatitis should manage emotional stress, avoid stressful situations, and prolonged exposure to cold or drafts.
Chronic prostatitis is a disease that is difficult to treat, especially if the patient does not follow the prescription of the treating physician and does not take a responsible approach to nutrition and diet problems. Inflammation of the prostate is dangerous with serious complications, so you need to address the problem comprehensively. Men with this diagnosis must understand that the pills alone are not enough to fully restore all the functions of the prostate gland, so they should not abandon the basic therapy methods for chronic prostatitis suggested by their doctor, even if they causeprimary psychological or physical complaints.