Prostatitis is an infectious and inflammatory disease, which is considered one of the most common, but at the same time little studied and poorly amenable to conservative correction pathologies with severe urodynamic disturbance.The incidence of prostatitis in recent decades has been higher among men in the stage of active reproduction (age group from 20 to 45 years) and sexually active men, although until recently it was believed that the maximum risk of inflammatory processes in the prostate is only in older and older men.
In most cases, acute inflammation of the prostate glands develops against the background of massive contamination of the mucous membranes of the prostate with pathogenic and opportunistic microorganisms: gonococci, staphylococci, E. coli, etc.
The complex therapy of inflammatory changes in the interstitial and parenchymal tissue of the gland includes, in addition to antibiotics 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), also the use of modern methods, for example, laser therapy, cryodestruction or pulsed microcurrents.In order for the treatment to be effective and achieve a stable remission, the man must also adjust his regimen, diet and lifestyle.
Basic therapy for infectious inflammations
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, ranges from 35% to 67% (approximately every second man suffering from prostatitis complains of pain as the dominant symptom).In acute cases, the use of massive antibacterial therapy allows you to quickly achieve a clinically significant effect, which occurs within 4-5 days.Despite the rapid relief of the disease in infectious prostate inflammation, it is not possible to discontinue antibiotic therapy because most of the typical pathogens of urogenital infections very quickly develop resistance to drugs in this group and discontinuation of therapy leads to chronification of the disease.
Some of the main causative agents of prostatitis - fecal staphylococci and Escherichia coli (Escherichia coli) - even when the conditions for administration and continuous use of antibiotics are met, can form a thick film capsule around the membrane membrane, which reduces the bioavailability of the drugs used and increases the resistance of bacteria to the selected group of antibiotics.For this reason, it is recommended to continue antibiotic therapy for at least 4 weeks, even if the positive result is rapid.
Why you can't 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 a laboratory study of prostatic secretion, 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 note that in recent years there has been a steady increase in mixed urogenital infections, which is why 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 infection becoming chronic, which is a very high rate and confirms the inadmissibility of independent selection of drugs and disregard of doctor's prescriptions.The importance of laboratory and physical diagnostics as well as consulting a specialist before using antibiotics arises from the following points.
- Bioavailability indicators.Some antibacterial drugs (for example, the most popular and commonly prescribed antibiotics - drugs of the penicillin group) penetrate little into the prostate tissue, so their use in prostatitis is ineffective and impractical.Almost all aminoglycosides also have poor bioavailability.
- Degree of bactericidal effect.In the event of acute damage to the prostate glands, antibiotics with a bactericidal effect should be chosen, which lead to the death of the infectious pathogen.In chronic cases, it is more advisable to prescribe drugs with a bacteriostatic effect that stop the growth of pathogenic flora and prevent their reproduction.
- General condition of the patient.Patients with severe immunosuppression as well as severe manifestations of fever and intoxication syndrome should be treated in hospital.Such patients are administered antibiotics intravenously (oral dosage forms are ineffective in severe clinical cases).
Pay attention!The lack of a positive effect during the use of antibiotic therapy may indicate the development of a prostate abscess.This is an acute pathology that requires emergency hospitalization of a man and surgical opening of the abscess, followed by drainage and antiseptic treatment of the cavity.
Modern methods for treating chronic inflammation
Physiotherapy is a branch of medicine that studies and applies various natural (including artificially created) factors for therapeutic purposes that have a positive effect on the human body.In the complex treatment of diseases of the genitourinary system, physiotherapy is used in the recovery period after relief of acute symptoms.
The main goal of physical therapy is to eliminate residual inflammatory effects and stimulate repair of damaged tissue.A physiotherapeutic treatment usually consists of 5-10 treatments lasting 10-15 minutes.To achieve a positive result (reducing the frequency and intensity of chronic abdominal pain, normalizing urination, improving 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 of treating chronic prostatic inflammation in men and is most often used as an adjuvant after primary drug correction.The basis of laser therapy is the use of the optical range of a special device - a laser.The laser can work in pulsed and continuous pulsed mode and the wavelength can reach up to 904nm. In urology, the method of intravenous laser irradiation of blood is rarely used, which is considered by many experts to be the most effective and universal method for the complex treatment of many urological diseases.
The main advantages of laser therapy are its relatively high efficiency, painlessness and stimulation of not only damaged but also surrounding tissues.This method of physiotherapy is especially useful for congestive (stagnant) prostatitis, since laser radiation has a positive effect on microcirculation in the pelvic vessels and normalizes the outflow of secretions from the prostate glands.
Electrical stimulation
Electrical stimulation with current is indicated for the treatment of any form of prostatitis that is accompanied by erectile dysfunction and a general decrease in potency.Stimulation is carried out using the endourethral method, which means that a catheter with an attached electrode is inserted directly into the back of the urethra, where the prostate is located.In some cases, treatment may involve the use of rectal electrodes, which provide electrical stimulation to the prostate at the point where it borders the anterior ampulla of the rectum.In both cases it is important that the bowel and bladder are empty.
Treatment with electrical currents has a complex positive effect on the prostate glands, namely:
- eliminates stagnation of fluid (blood and lymph) in the pelvic organs;
- ensures normal outflow of prostate secretions;
- Increasing the permeability of the cell membranes of the parenchymal tissue of the gland and its interstitium, which promotes faster absorption of drugs into the tissue of the inflamed prostate;
- reduces swelling;
- Normalization of muscle tone of the pelvic muscles;
- Increasing the regenerative ability 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 stop treatment in order to minimize the risk of a possible relapse.A full course usually consists of 5-7 procedures.
Pay attention!Prostate stimulation with electrical currents is particularly effective in prostatitis with severe erectile dysfunction.
Thermotherapy
Thermotherapy is also a form of physiotherapy and can be used to self-treat prostatitis or in specialized physiotherapy rooms.Heat sources for warming the prostate can be:
- mineral applications (bishopite, paraffin, ozokerite);
- special electric lamps;
- heating pads (water, electric);
- Infrared radiation devices.
In day clinics and physiotherapy rooms, reflectors are often used to warm 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, as well as active forms of tuberculosis.The use of thermal procedures in the acute phase of the disease is unacceptable, as this can lead to hematogenous infection of neighboring organs and tissues (due to a sharp increase in blood flow) and the development of serious complications, including septic blood poisoning.
Important!If a man is prescribed hormonal or immunomodulatory therapy, it is necessary to talk to a doctor about the possibility of using thermal procedures (especially if the patient is being treated at home).It is unacceptable to prescribe thermal procedures with cytostatics and hemostatic agents.
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 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 solution (salt concentration 0.9%).
The main indication for the use of ozone therapy for inflammation of the prostate is chronic infectious prostatitis with frequent relapses (more than 2-3 times per year).Ozone has strong antiseptic and bactericidal properties, therefore it is often used to disinfect premises, including industrial buildings.It destroys almost all strains of pathogenic and opportunistic bacteria that most often cause inflammation of the prostate and have high resistance to antibacterial drugs.The feasibility of this method is considered justified if the patient does not feel stable positive dynamics after changing three antibiotics.
The ozone solution is injected into the prostatic part of the urethra or rectum using a special catheter.The course consists of 5-10 procedures.
Devices for the treatment of prostatitis
Hardware treatment of prostatitis can be carried out both in a physiotherapy room and at home (only after consulting the attending physician).Many of them are devices for rectal use.Therefore, in addition to the main contraindications directly related to the disease, it is important to take into account local restrictions: acute stage of hemorrhoids, anal bleeding of unknown origin, violation of the integrity of the epithelial mucosa of the rectum, proctitis and paraproctitis.
In cases of rectal prolapse, pelvic abscesses, thrombosis of hemorrhoidal veins and congenital immaturity of the innervation apparatus of the large intestine, the introduction of foreign bodies (electrodes, sensors) into the rectum is unacceptable.
Important!Before using devices to treat prostatitis and prostate adenoma, you should consult your doctor, as some of these devices can not only be useless, but also cause significant harm to your health.Hardware effects on prostate tissue are unacceptable in the acute phase of the disease, as well as in the presence of possible contraindications (listed above).
Prostatitis is a serious disease that requires an integrated treatment approach.In addition to drug and physiotherapeutic methods of treating prostatitis, in some cases it is necessary to use psychocorrection, as well as correction of lifestyle, eating habits, work and rest habits.The basic therapy during the recovery and rehabilitation period should be supplemented by supportive treatment methods: hirudotherapy (leech treatment), balneotherapy (mineral water therapy), mud therapy, exercise therapy.A man should also get enough exercise, give up bad habits and monitor his psycho-emotional state.Outside periods of exacerbation, annual sanatorium treatment is indicated to consolidate the achieved result.