The relevance of studying the mechanism of development of chronic prostatitis increases in direct proportion to the increase in the number of diagnosed cases of the disease. Chronic prostatitis (CP) is known to rank high 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 affects an increasing percentage of the male population, but is also being diagnosed at an increasingly younger age, there is often a rather dismissive attitude towards the problem on the part of physicians using regimens. model for treatment that are unable to lead to recovery
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate gland, which manifests itself in the form of a chronic inflammatory process of the tissues. However, one cannot speak of PC only as a result of the penetration of pathogens into the prostate, since such a point of view justifies attempts to treat prostatitis exclusively with antibiotics, which almost never bring lasting positive results.
The main factors underlying the development of pathology can be considered complex changes in the tissues, and, consequently, the functional capabilities of the gland, which are the main cause of the development of infectious microflora. Chronic prostatitis, to a certain extent, is a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in the pelvic organs.
- Urodynamic disorder.
- Degenerative processes in the prostatic parenchyma.
- Trophic disturbance.
- inflammatory processes.
development mechanism
The penetration of pathogenic microflora into a healthy prostate is practically incapable of provoking an inflammatory process, since the microflora of the prostate has a certain resistance to pathogens present in the urethra. However, the presence of one or more of the above triggering factors leads to the development of persistent inflammation, accompanied by the appearance of scar formations (fibrotization) or areas of necrosis.
The proliferation of connective tissue in the process of scar formation causes congestive processes in the acini (ducts that ensure the excretion of secretions), which aggravate the course of the disease. Necrotization of the tissues leads to the formation of a cavernous cavity in which, in addition to the dead epithelium, a prostatic secret accumulates.
Thus, the main cause of the development of CP is not an infection, but various physiological disorders that allow the inflammatory process to become chronic.
Another distinctive feature of the disease, which makes diagnosis difficult, isflow periodicity. As a rule, under the influence of external factors or the internal state of the body, there is a periodic change in the intensity of the pathology, during which acute conditions are replaced by periods of remission.
Often, there is not only a complete absence of symptoms, but also the absence of laboratory indicators indicating the presence of infection (for example, leukocytes). Despite the positive results, this condition cannot be considered a recovery, since all physiological disorders of the gland remained unchanged.
The reasons
The main causes of circulatory disorders in the pelvic organs and stagnation of venous blood in the prostate gland are:
- Permanent 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.
- The presence in the body of a chronic infection of any localization (sinusitis, bronchitis).
- Excessive physical activity, accompanied by lack of sleep or rest, causes immune suppression.
- History of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effects on the body from the systematic use of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnant processes, impaired excretory function of the glands, decreased cellular resistance to diseases, which contribute to the creation of optimal conditions for the reproduction of pathogenic microorganisms in the gland. prostate. .
Can chronic prostatitis be cured?
Despite the availability of a large amount of systematized information on the development mechanism of the PC,its treatment is extremely difficultand it is one of the main problems in modern urological practice.
Due to the fact that the disease develops in each individual patient according to an individual scheme, accordingly, the approach to treatment should also be individual, taking into account all the physiological changes that have occurred in the prostate gland.
The anatomical characteristics of the prostate, which can be accessed through the urethra or through the rectum, significantly reduce the effectiveness of the applied therapeutic effect. In this regard, in order to achieve a relatively stable result, a long course of treatment is required (usually several months), during which the patient must strictly comply with all the doctor's requirements.
Unfortunately, a complete cure can only be achievedin 30 cases out of 100. This is mainly due to untimely seeking medical help, due to a long absence of severe symptoms, or conscious avoidance of unpleasant diagnostic and then therapeutic procedures. As a rule, at the time of treatment, atrophic processes in 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 patient compliance. with the doctor's recommendations.
Treatment
The complex of measures used in the treatment of PC includes:
antibacterial therapy
Suppression of the activity of bacterial microflora with the help of antibiotics should be carried out only after a complex of laboratory tests, based on 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. It is unacceptable to stop treatment, since the remaining microorganisms will become resistant to this group of drugs, and subsequently they will have to be replaced and an even longer course. In the treatment of prostatitis, preference is given to antibiotics that have a bactericidal effect:
- fluoroquinolones;
- azalides;
- aminoglycosides;
- tetracyclines.
If laboratory tests reveal a specific nature of the infection, for example, trichomoniasis or the viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed in parallel with antibiotics.
The use of antispasmodics and alpha blockers
The main purpose of using drugs from this series is to relieve spasm in the pelvic floor, which helps to increase blood supply, improve urine flow and reduce pain.
laxatives
To avoid excessive stress on the pelvic muscles that occurs during the act of defecation, it is advisable to use laxatives, since attempts during constipation can aggravate the patient's condition.
Physiotherapy
One of the most common methods of physical therapy is rectal massage of the prostate. The therapeutic effect of the impact of a finger on the prostate, carried out through the anus, is to squeeze out the infected secret, which is then excreted through the urethra.
Also, during massage the blood supply to the tissues increases, which has a positive effect on antibiotic therapy. To perform rectal prostate massage, the following physiotherapeutic methods are also used:
- electrical simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After stabilization of the condition, the patient must follow the rules that impose some restrictions on the usual way of life:
- Avoid water procedures in open tanks and swimming pools.
- Get checked by a doctor regularly.
- Completely refrain from drinking alcohol.
- Having a regular sex life with only one partner.
Compliance with the rules will allow you to stay in remission as long as possible and avoid exacerbations of the disease.