Prostatitis is an infectious and inflammatory disease, which is considered one of the most common, but at the same time, poorly studied and little suitable for conservative correction, pathologies with a severe urodynamic disorder.The incidence of prostatitis in recent decades has been higher in men who are in the active reproductive phase (age group from 20 to 45 years) and who are sexually active, although until recently it was believed that the maximum risk of inflammatory processes in the prostate gland exists only in old and elderly men.
In most cases, acute inflammation of the prostate glands develops against the background of massive contamination of the prostate mucous membranes 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 for the treatment of recurrent forms of infectious prostatitis (including CPPS - chronic pelvic pain syndrome), complex therapy for inflammatory changes in the interstitial and parenchymal tissue of the gland also includes the use of modern methods, for example, laser therapy, pulsed microdestruction or .In order for the treatment to be effective and to achieve lasting remission, the man will also need to adjust his regimen, diet and lifestyle.
Basic therapy for infectious inflammation
The main goal of therapy in the treatment of any form of prostatitis is to stop inflammation and eliminate inflammatory changes, as well as relieve pain, the prevalence of which, according to various sources, varies from 35% to 67% (almost every second man suffering from prostatitis complains of pain as a dominant symptom).In acute cases, the use of mass antibacterial therapy allows you to quickly achieve a clinically significant effect, which occurs within 4-5 days.Despite the rapid relief of the condition with infectious inflammation of the prostate, it is impossible to stop the treatment with antibiotics, since most of the typical pathogens of genitourinary infections very quickly develop resistance to the drugs of this group, and stopping the therapy will lead to the chronicity of the disease.
Some of the main causative agents of prostatitis - faecal staphylococcus and Escherichia coli (Escherichia coli) - even if the conditions of 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 drugs used and increases the resistance of the selected group of bacteria to bacteria.For this reason, it is recommended to continue antibiotic therapy even if a positive result is quickly achieved for at least 4 weeks.
Why can't you choose an antibiotic yourself?
Antibiotics are the basis for the treatment of acute infectious prostatitis, but they must be prescribed by the attending physician after laboratory examination of prostate secretions, taking into account several factors: the type of pathogen identified, the degree of contamination of the mucous membranes and the resistance of a particular microorganism to certain groups of antibiotics.Experts in the field of practical urology also point out that in recent years there has been a constant increase in mixed genitourinary infections, so combinations of several antibacterial and antimicrobial agents are often used to treat acute prostatitis.
Self-medication of acute prostatitis in almost 60-70% of cases leads to the chronic passage of the infection, which is a very high rate and confirms the inadmissibility of independent choice of drugs and ignoring medical prescriptions.The importance of performing laboratory and physical diagnostics, as well as consultation with a specialist, before using antibiotics, is due to the following points.
- Bioavailability indicators.Some antibacterial drugs (for example, the most well-known and prescribed antibiotics - drugs of the penicillin group) have a low rate of penetration into prostate tissue, so their use for prostate is ineffective and impractical.Almost all aminoglycosides also have poor bioavailability.
- Degree of bactericidal effect.In case of acute damage to the prostate glands, antibiotics with a bactericidal effect should be chosen, which cause the death of the infectious pathogen.In chronic cases, it is more advisable to prescribe drugs with a bacteriostatic effect, stopping the growth of pathogenic flora and preventing its reproduction.
- General condition of the patient.Patients with severe immunosuppression, as well as with severe manifestations of febrile syndrome and intoxication should be treated in a hospital setting.Antibiotics are administered intravenously to such patients (oral dosage forms are ineffective in severe clinical cases).
Pay attention!The lack of a positive effect during the use of antibacterial therapy may indicate the development of a prostate abscess.This is an acute pathology that requires urgent hospitalization of a man and surgical opening of the abscess, followed by drainage and antiseptic treatment of the cavity.
Modern methods of treatment of chronic inflammation
Physiotherapy is a medical branch that studies and applies for therapeutic purposes various natural factors (including artificially created ones) that have a positive effect on the human body.In the complex treatment of pathologies of the genitourinary system, physiotherapy is used in the recovery phase, after the relief of acute symptoms.
The main goal of physiotherapy is to eliminate the remaining inflammatory effects and stimulate the restoration of damaged tissues.A course of physiotherapeutic treatment usually consists of 5-10 procedures lasting 10-15 minutes.To achieve a positive result (reduction in the frequency and intensity of chronic pelvic pain, normalization of urination, improvement of the rheological properties of prostate secretion, etc.) several courses may be required.
Low level laser therapy
Laser therapy is one of the most effective and popular methods for the treatment of chronic inflammation of the prostate in men, which is most often used as an adjunct after primary drug correction.The basis of laser therapy is the use of the optical range emitted by a special device - a laser.The laser can operate in pulsed and continuous mode, and the wavelength can reach up to 904 nm. The method of intravenous blood laser illumination is rarely used in urology, which is considered by many experts as the most effective and universal method of complex treatment of many urological diseases.
The main advantages of laser therapy are high efficiency, pain-free and stimulation of not only damaged but also nearby tissues.This method of physiotherapy is especially useful for congestive (stagnant) prostatitis, as laser radiation has a positive effect on microcirculation in the pelvic vessels and normalizes the output of secretions from the prostate glands.
Electrical stimulation
Electrical current stimulation is indicated for the treatment of any form of prostatitis, accompanied by erectile dysfunction and a general decrease in potency.Stimulation is performed using the endurethral method, that is, a catheter with an electrode attached to it 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 in the place where it borders the anterior ampulla of the rectum.In both cases, it is important that the bowels and bladder are empty.
Electric current treatment has a complex positive effect on the prostate gland, namely:
- eliminates fluid stagnation (blood and lymph) in the pelvic organs;
- ensures normal output of prostatic secretions;
- increased permeability of the cell membranes of the parenchymal tissue of the gland and its interstitium, which promotes faster absorption of drugs in the inflamed prostate tissue;
- reduces swelling;
- normalization of pelvic muscle tone;
- increasing the regenerative capacity of cells and local immunity (especially in chronic bacterial prostatitis).
The therapeutic effect after electrical stimulation of the prostate occurs after 2-3 procedures, but it is important not to interrupt the treatment to minimize the risks of a possible relapse.A full course usually consists of 5-7 procedures.
Pay attention!Prostate stimulation with electrical currents is particularly effective for prostatitis with severe erectile dysfunction.
Thermotherapy
Thermotherapy is also a type of physiotherapy and can be used for self-treatment of prostatitis or used in specialized physiotherapy rooms.Heat sources for heating the prostate gland can be:
- mineral applications (bischofite, paraffin, ozokerite);
- special electric lamps;
- heating pads (water, electric);
- equipment for infrared radiation.
In day hospitals and physiotherapy rooms, reflectors are often used to heat the prostate, which are an incandescent lamp with a focusing lampshade ("blue lamp").The procedure has certain contraindications, for example, 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 has been prescribed hormonal or immunomodulating therapy, it is necessary to consult a doctor about the possibility of using thermal procedures (especially if the patient is treated at home).It is unacceptable to prescribe thermal procedures with cytostatics and hemostatic drugs.
Ozone therapy
This is a very effective modern method for the treatment of prostatitis, practiced mainly in paid medical centers.Medical ozone is produced by special medical equipment called ozonizers.The gas in its pure form is highly toxic and, if inhaled, can cause acute chemical poisoning and death.To introduce ozone into the patient's blood, the gas is mixed with blood or salt (salt concentration 0.9%).
The main indication for the use of ozone therapy for inflammation of the prostate gland is chronic infectious prostatitis with frequent relapses (more than 2-3 times a year).Ozone has powerful antiseptic and bactericidal properties, therefore it is often used to disinfect premises, including industrial premises.It destroys almost all types of pathogenic and opportunistic bacteria, which most often cause inflammation of the prostate and are highly resistant to antibacterial drugs.The possibility of using this method is considered justified if the patient does not experience a stable positive dynamics after changing three antibiotics.
The ozone solution is injected using a special catheter into the prostatic part of the urethra or rectum.The course consists of 5-10 procedures.
Devices for the treatment of prostatitis
Hardware treatment of prostatitis can be carried out both in the physiotherapy room and at home (strictly after consultation with the attending physician).Many of them are devices for rectal use, so 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 epithelial lining, proctitis and paraproctitis.
It is unacceptable to introduce any foreign objects (electrodes, sensors) into the rectum in case of prolapse of the rectum, pelvic abscesses, thrombosis of hemorrhoidal veins and congenital immaturity of the innervation apparatus of the colon.
Important!Before using any device for the treatment of prostatitis and prostate adenoma, you should consult your doctor, as some of these devices may not only be useless, but 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 any possible contraindications (listed above).
Prostatitis is a serious disease that requires an integrated approach to treatment.In addition to medications and physiotherapeutic methods for the treatment of prostatitis, in some cases it is necessary to use psychocorrection, as well as correction of lifestyle, eating habits, work and rest patterns.The basic therapy during the recovery and rehabilitation period should be supplemented with auxiliary treatment methods: hirudotherapy (leeches treatment), balneotherapy (mineral water therapy), mud therapy, exercise therapy.A man should also move enough, give up bad habits and monitor his psycho-emotional state.Outside of periods of deterioration, annual sanatorium-resort treatment is indicated to consolidate the achieved result.