Prostatitis is an infectious and inflammatory disease, which is considered one of the most common, yet poorly studied and poorly amenable to conservative correction, pathology with severe urodynamic abnormalities.In recent decades, the incidence of prostatitis has been higher in men in the active reproductive phase (20-45 years of age) and sexually active men, although until recently it was believed that the maximum risk of prostatic inflammatory processes existed only in older and elderly men.
In most cases, acute inflammation of the prostate glands develops against the background of massive contamination of the prostate mucosa with pathogenic and opportunistic microorganisms: gonococci, staphylococci, E. coli, etc.
In addition to antibiotics, which are used both in the acute phase of the disease and in the treatment of recurrent forms of infectious prostatitis (including CPPS - chronic pelvic pain syndrome), the complex therapy of inflammatory changes in the interstitial and parenchymal tissue of the gland involves the use of modern methods, such as laser therapy, cryodestruction or pulsed microcurrent.In order for the treatment to be effective and to achieve a stable remission, the man must also modify his diet, diet and lifestyle.
Basic therapy of infectious inflammations
In the treatment of any form of prostatitis, the main goal of therapy is to stop inflammation and eliminate inflammatory changes, as well as to relieve pain, the frequency of which varies between 35% and 67% according to various sources (about every second man with prostatitis complains of pain as a dominant symptom).In acute cases, the use of massive antibacterial therapy enables the rapid achievement of a clinically significant effect, which occurs within 4-5 days.Despite the rapid relief of the condition associated with infectious inflammation of the prostate, it is impossible to stop antibiotic treatment, since most typical pathogens of urinary tract infections very quickly become resistant to drugs belonging to this group, and stopping therapy leads to the chronicity of the disease.
Some of the main pathogens of prostatitis - faecal staphylococcus and Escherichia coli (Escherichia coli) - even if the conditions for the administration and continuous use of antibiotics are met, they are able to create a thick film capsule around the membrane membrane, which reduces the bioavailability of the used drugs and increases the resistance of bacteria to the selected antibiotic group.For this reason, it is recommended to continue the antibiotic therapy even if a positive result can be achieved quickly, for at least 4 weeks.
Why can't you choose an antibiotic for yourself?
Antibiotics are the basis of treatment for acute infectious prostatitis, but these must be prescribed by the attending physician after a laboratory examination of the prostate discharge, taking into account a number of factors: the type of pathogen identified, the degree of contamination of the mucous membrane and the resistance of a given microorganism to certain groups of antibiotics.Experts in practical urology also note that the number of mixed urinary tract infections has increased steadily in recent years, so a combination of several antibacterial and antimicrobial agents is often used to treat acute prostatitis.
Self-medication of acute prostatitis in almost 60-70% of cases leads to the infection becoming chronic, which is a very high rate and confirms the unacceptability of self-selecting drugs and ignoring medical prescriptions.The importance of laboratory and physical diagnostics and consultation with a specialist before the use of antibiotics arises from the following aspects.
- Bioavailability indicators.Some antibacterial drugs (for example, the most popular and prescribed antibiotics - drugs of the penicillin group) show a low degree of penetration into the tissue of the prostate, so their use for prostatitis is ineffective and impractical.Almost all aminoglycosides have poor bioavailability.
- Degree of bactericidal effect.In case of acute damage to the prostate glands, antibiotics with a bactericidal effect, which cause the death of the infectious pathogen, should be chosen.In chronic cases, it is more appropriate to prescribe drugs with a bacteriostatic effect, which stop the growth of the pathogenic flora and prevent its reproduction.
- General condition of the patient.Patients with severe immunosuppression, as well as severe manifestations of febrile and intoxication syndrome, should be treated in a hospital setting.Such patients are given antibiotics intravenously (in severe clinical cases, oral dosage forms are ineffective).
Listen!The lack of a positive effect during the use of antibacterial therapy may indicate the formation of a prostate abscess.This is an acute pathology that requires urgent hospitalization of the man in a hospital and surgical opening of the abscess, followed by drainage and antiseptic treatment of the cavity.
Modern methods of treating chronic inflammation
Physiotherapy is a branch of medicine that examines and uses various natural factors (including artificially created ones) that have a positive effect on the human body for therapeutic purposes.In the complex treatment of pathologies of the urogenital system, physiotherapy is used in the recovery phase, after acute symptoms have subsided.
The main goal of physiotherapy is to eliminate residual inflammatory effects and stimulate the recovery of damaged tissues.A physiotherapy course usually consists of 5-10, 10-15 minute procedures.To achieve a positive result (reduction of the frequency and intensity of chronic pelvic pain, normalization of urination, improvement of the rheological properties of prostate secretion, etc.) several courses may be necessary.
Low level laser therapy
Laser therapy is one of the most effective and popular methods for the treatment of chronic prostatitis in men, which is most often used as an adjuvant after primary drug correction.Laser therapy is based on the use of an optical range emitted by a special device - a laser.The laser can operate in both pulse and continuous pulse mode, and the wavelength can reach 904 nm. In urology, the method of intravenous laser illumination of blood is rarely used, which many experts consider to be the most effective and universal method of complex treatment of many urological diseases.
The main advantage of laser therapy is its fairly high efficiency, painlessness, and stimulation of not only damaged but also nearby tissues.This physiotherapy method is particularly useful in congestive (congestive) prostatitis, as laser radiation has a positive effect on the microcirculation of the pelvic vessels and normalizes the outflow of secretions from the prostate glands.
Electrical stimulation
Electrical stimulation with current is recommended for the treatment of any form of prostatitis accompanied by erectile dysfunction and a general decrease in potency.Stimulation is carried out by the endourethral method, that is, a catheter with an electrode attached is inserted directly into the back of the urethra, where the prostate is located.In some cases, rectal electrodes can be used for treatment, which provide electrical stimulation of the prostate gland where it borders the anterior ampulla of the rectum.In both cases, it is important that the bowels and bladder are empty.
Treatment with electric current has a complex positive effect on the prostate gland, namely:
- eliminates stagnation of fluids (blood and lymph) in the pelvic organs;
- ensures the normal outflow of prostate secretion;
- increasing the permeability of the cell membranes of the parenchymal tissue and interstitium of the gland, which promotes faster absorption of drugs into the tissue of the inflamed prostate;
- reduces swelling;
- normalization of the muscle tone of the pelvic muscles;
- increasing the regeneration capacity of cells and local immunity (especially in case of chronic bacterial prostatitis).
After electrical stimulation of the prostate, the therapeutic effect appears after 2-3 procedures, but it is important not to stop the treatment in order to minimize the risk of possible relapse.A full course usually consists of 5-7 procedures.
Listen!Prostate stimulation with electrical current is particularly effective in prostatitis with severe erectile dysfunction.
Thermotherapy
Thermotherapy is also a type of physiotherapy and can be used for self-treatment of prostatitis or in special physiotherapy rooms.The heat sources of prostate warming can be:
- mineral applications (bischofite, paraffin, ozokerite);
- special electric lamps;
- heating pads (water, electric);
- devices for infrared irradiation.
In day hospitals and physiotherapy rooms, reflectors are often used to heat the prostate, which is an incandescent lamp with a focusing lampshade ("blue lamp").The procedure has certain contraindications, such as disorders of the autonomic nervous system, malignant tumors, acute infectious-inflammatory and purulent-infectious processes, active forms of tuberculosis.The use of thermal procedures in the acute period of the disease is unacceptable, as this can lead to hematogenous infection of neighboring organs and tissues (due to a sharp increase in blood circulation) and the development of serious complications, including septic blood poisoning.
Important!If a man is prescribed hormonal or immunomodulatory therapy, he should consult his doctor about the possibility of using thermal procedures (especially if the patient is treated at home).Prescribing unacceptable thermal procedures with cytostatics and hemostatic drugs.
Ozone therapy
This is a fairly effective modern method of treating prostatitis, which is practiced mainly in paid medical centers.Medical ozone is produced by special medical devices, so-called ozonizers.The gas is highly toxic in its pure form and can cause acute chemical poisoning and death if inhaled.To introduce ozone into the patient's blood, the gas is mixed with blood or saline (salt concentration 0.9%).
The main indication for the use of ozone therapy for prostatitis is chronic infectious prostatitis with frequent relapses (more than 2-3 times a year).Ozone has strong antiseptic and bactericidal properties, which is why it is often used to disinfect rooms, including industrial ones.It destroys almost all strains of pathogenic and opportunistic bacteria that most often cause prostatitis and are highly resistant to antibacterial agents.The feasibility of using the method can be considered justified if the patient does not experience stable positive dynamics after changing three antibiotics.
The ozone solution is injected into the prostate part of the urethra or rectum using a special catheter.The course consists of 5-10 procedures.
Means for the treatment of prostatitis
Hardware treatment of prostatitis can be performed in a physiotherapy room and at home (strictly after consultation with the attending physician).Many of them are devices intended for rectal use, therefore, in addition to the main contraindications directly related to the disease, it is important to consider local restrictions: acute stage of hemorrhoids, anal bleeding of unknown origin, violation of the integrity of the rectal epithelium, proctitis and paraproctitis.
Unacceptable introduction of foreign objects (electrodes, sensors) into the rectum in case of rectal prolapse, pelvic abscesses, thrombosis of hemorrhoidal veins and congenital immaturity of the innervation of the large intestine.
Important!Before using any means for the treatment of prostatitis and prostate adenoma, consult your doctor, as these means are not only useless, but can also significantly harm your health.Hardware effects on prostate tissue are unacceptable in the acute period of the disease, as well as in the presence of all possible contraindications (listed above).
Prostatitis is a serious disease that requires an integrated approach to treatment.In addition to pharmaceutical and physiotherapy methods for the treatment of prostatitis, psychocorrection is necessary in some cases, as well as correction of lifestyle, eating habits, work and rest habits.During the recovery and rehabilitation period, the basic therapy must be supplemented with additional treatment methods: hirudotherapy (leech treatment), balneotherapy (mineral water therapy), mud therapy, exercise therapy.A person should exercise enough, give up bad habits and monitor his psycho-emotional state.In addition to periods of exacerbation, annual sanatorium-resort treatment is recommended in order to consolidate the achieved result.