Antibacterial therapy of prostatitis is not the only method of treatment.Antibacterial drugs are prescribed only if there are appropriate indications, mainly for periodic exacerbations and increased severity of disease manifestations.
The effectiveness of drugs for the treatment of prostatitis
It is known that different antibiotics can overcome the prostate barrier to different extents, which is why their concentration in the prostate gland, and hence their effectiveness in the treatment of prostatitis, is different.Therefore, from the drugs to which the greatest sensitivity of the flora was found, those with the maximum ability to penetrate the prostate are chosen.Such an approach to the treatment of prostate adenoma can significantly speed up recovery.
Broad-spectrum drugs for the treatment of prostatitis
Another condition for the effectiveness of the drug used to treat prostatitis is that it has a wide spectrum of antibacterial action.This is due to the fact that it is quite difficult to reliably determine the flora living in the prostate.Those with a broad spectrum of antibacterial activity primarily include drugs from the penicillin group.Tetracycline drugs have valuable properties in terms of penetration through the prostate barrier and the breadth of antibacterial action.
Modern drugs from the fluoroquinol group
The new antibacterial agents that have a significant advantage over the others are drugs from the fluoroquinolone group.These drugs have a wider spectrum of antimicrobial action and the ability to accumulate in the prostate in high concentrations when taken orally.In addition to the direct antibacterial effect, fluoroquinolones almost never cause immunodeficiency in the patient and, what is particularly important, microorganisms do not develop resistance to them.
Tetracycline drugs are also widely used as antibacterial therapy.
A young patient who is prescribed a course of antibacterial therapy should know that the drugs used can have a spermotoxic effect.Therefore, between the use of these drugs and the planned conception, it is necessary to have an interval of at least 4 months, exceeding the complete cycle of spermatogenesis.
Antibacterial drugs are usually prescribed for chronic bacterial prostatitis or infectious chronic prostatitis.For non-infectious chronic prostatitis, treatment tactics remain controversial and controversial.Such patients are prescribed antibacterial drugs in the hope of curing a latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not from the first visit.As a rule, within no more than a few days, the doctor examines the patient to detect an infection.During this period, symptomatic therapy is recommended, usually with an anti-inflammatory effect in the form of 50 mg of diclofenac or 100 mg in suppositories, which have an anti-edematous and analgesic effect.
After establishing the type of bacteria and their sensitivity, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.Treatment is carried out for 4 or more weeks (minimum 28 days) under clinical and bacteriological control.
If the effect is positive in patients with recurrent chronic prostatitis, the use of an antibacterial drug is recommended to be extended to 6-8 weeks.Sometimes antibiotic therapy is extended to 16 weeks with virtual cure after that.If there is no positive result, the used antibacterial drug is abandoned, but not earlier than 2 weeks of treatment.The ideal antibacterial drug should be fat-soluble, non-binding to serum proteins, and weakly alkaline so that it is maximally concentrated in the prostate gland itself rather than in the plasma.The best in terms of these requirements are the fluoroquinolones, which have the best pharmacological properties in the treatment of chronic prostatitis;they create a sufficient concentration in the prostate gland, in its secretions and semen, and are active against most bacteria found in chronic prostatitis.
So, a necessary condition for maximum effectiveness of antibacterial therapy in chronic prostatitis is compliance with the following general principles:
- isolation and determination of the microflora that causes prostatitis and identification of its sensitivity to antimicrobial agents;
- selection of the most effective drugs that do not cause side effects;
- determination of effective doses, methods and frequency of administration, taking into account the characteristics of the effect of the selected drug;
- timely initiation of treatment and a sufficiently long course of antimicrobial therapy to ensure the maximum possible effect;
- a combination of antibacterial drugs, both among themselves and with drugs and procedures that improve the antimicrobial effect, reduce the frequency of complications and improve microcirculation in the prostate;
- carrying out complex therapy, taking into account the characteristics of the patient's general state of health.
Sometimes, with long-term or excessively active antibacterial therapy, intestinal dysbiosis (reduction in the number and activity of normal intestinal microflora) develops.In these cases, it is recommended to use drugs that promote its recovery.
Results of drug treatment of prostatitis
The strategy and tactics of antibacterial therapy are complex and varied, but their use can improve the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, a more or less long period of well-being may occur.But, as a rule, sooner or later the painful sensations that caused anxiety return.Therefore, the use of antibacterial drugs alone is not considered sufficient.Good results are achieved with a therapeutic program aimed at increasing local and general resistance.In this case, you can count on the success of antibacterial therapy or long-term remission.
Improvement of microcirculation in the prostate
In all forms of chronic prostatitis, in addition to affecting the microflora, they seek to restore microcirculation in the prostate, improve the outflow of secretion from the ducts of the gland, increase the intensity of metabolic processes in the focus of inflammation and local and general resistance.
Nonsteroidal anti-inflammatory drugs are considered an important step in the treatment of chronic prostatitis.Their positive influence on microcirculation has been proven.
Anticongestive treatment includes measures aimed at reducing venous stasis in the small pelvis: stopping interrupted sexual intercourse, sedentary lifestyle, frequent alcohol consumption, etc.For varicose veins of the lower extremities and hemorrhoids, which can also cause prostatitis, surgical treatment of these diseases is carried out.In congestive non-infectious prostatitis, only decongestant therapy is carried out.
The complex for the treatment of chronic prostatitis includes special drugs with a highly effective effect.In some cases of exacerbation of chronic prostatitis in the presence of dysuric phenomena caused by venous stasis, drugs are used that reduce the tone of the smooth muscles of the prostate to reduce the urge to urinate.But only a doctor can recommend them.
Pain relief due to prostatitis
Since the presence and severity of pain in prostatitis serves as the main indicator for the patient, which determines his attitude to the disease and affects the manifestation of depression, analgesic therapy in the treatment of chronic prostatitis is one of the most important components of the general treatment of the disease.Pain syndromes observed in chronic prostatitis are very diverse in their localization, duration and degree of intensity.In this regard, the method of using analgesic drugs is of great importance.
Oral administration is quite effective and temporarily relieves pain.Rectal administration of painkillers in suppositories and microenemas is even more effective, as they use the combined effect of analgesics and anti-inflammatory agents, as well as temperature effects.To change the tone of the gland, belladonna extract can be added to suppositories.
Strengthening the immune system
In the treatment of chronic prostatitis, it is very important to increase the reactivity of the body and its defenses, which usually help to cope with any disease.In chronic prostatitis, the body's defenses are reduced.In this regard, without the use of general immunological treatment of chronic prostatitis it is very difficult to achieve success.
Sometimes a drug is used to treat chronic prostatitis, which increases the body's reactivity.Having a pyrogenic (increasing body temperature) effect, the drug exacerbates chronic inflammation of the prostate gland and transforms it into an acute one, which promotes recovery, since it is easier to treat inflammatory diseases in the acute stage.The drug works when it quickly enters the bloodstream.Therefore, it is administered intravenously, starting with small doses, daily, gradually and carefully increasing the dose.Using this method of intravenous administration, patients with chronic prostatitis should be treated as an inpatient, so that they are under observation.The drug is administered daily for 9-10 days in a row.In the midst of the artificially induced exacerbation of chronic inflammation of the prostate gland, from about the 4th day, the introduction of 1-2 antibiotics and sulfonamide or another drug in fairly high doses begins.To improve blood supply to the prostate gland, physical therapy is performed at the same time, and daily massage is performed to improve the outflow of prostatic secretions.The therapeutic effect in the form of improvement or recovery is obtained to varying degrees in almost every patient.
Hormonal therapy
It is necessary to use sex hormone preparations with prostatitis very carefully.In patients suffering from chronic prostatitis for years and decades, such a need may arise.However, it is better to use them after determining the content of sex hormones in the blood serum (testosterone, estradiol, prolactin, FSH, LH).Simpler tests can also be performed, for example, cytological examinations of scrapings from the scaphoid fossa of the urethra.If there is an imbalance of sex hormones, hormonal drugs can be included in the treatment scheme.
Enzymes may also be prescribed to help remove scarring in the prostate gland during long-term disease.
Men who suffer from chronic prostatitis for a long time, as we already know, experience sexual dysfunction.The latter is divided into copulatory, reproductive and hormonal.For the majority of patients with prostatitis, fortunately, hormone levels do not suffer significantly.
If the copulatory function or the ability to have sexual intercourse is impaired, there is a decrease in erection, "weakening" of orgasm and impaired ejaculation.Eliminating these symptoms and normalizing sex life largely depends on the underlying disease - prostatitis.The more successful its treatment, the faster the symptoms of the sexual disorder disappear or decrease.
Treatment of sexual disorders due to emergent neurosis includes psychotherapy, sedatives (tranquilizers) and prescription of other drugs depending on the symptoms of sexual disorder.This therapy shows how the symptoms of prostatitis can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, you can use LOD therapy, which consists in creating a vacuum in the vessel in which the penis is placed.Due to the created negative pressure, the cracks in the cavernous bodies of the penis expand and blood flows to them.The penis enlarges and an erection occurs.
Repeated procedures lead to an increase in the gaps in the cavernous bodies, to a more stable blood supply to the organ, and ultimately to an improvement in erectile function.The positive effect in chronic prostatitis is also manifested through increased sexual activity, which has a powerful psychotherapeutic effect.
The phallus decompression (PLD) method for prostatitis is performed daily or every other day.The course of treatment is 10-15 procedures.It is useful to combine phallus decompression with instillation massage of the prostate, as this increases the rate of absorption of the drugs after the procedure is completed.
Instillations
This type of therapy includes techniques that allow direct and direct delivery of the drug to its destination.During instillation therapy with this method, drugs are administered through the external opening of the urethra using a conventional disposable syringe with a disposable conical cannula (soft hollow tube) or a syringe.The optimal volume of the administered medicinal mixture is 5 ml.Before the procedure, you must urinate to make sure your bladder is empty.
During application, it is recommended to imitate urination, i.e.to relax, then the excess medicine will enter the bladder and be expelled with the first portion of urine;the head of the penis should be pressed with fingers or a special clamp - this will prevent the backflow of the injected solution after removing the cannula or syringe.And in order for the solution to reach the prostate faster, it is recommended that when introducing it, you carefully stroke the filled urethra with the fingers of your free hand to the perineum.
After the procedure, you must resist the urge to urinate, otherwise the administered medicinal mixture will immediately flow back.This mixture consists of the same drugs as for oral administration: antibiotics, analgesics, antispasmodics, anti-inflammatory drugs.
Instillation therapy for prostatitis allows the use of various drugs, the choice of which depends on the nature of the disease, as well as on the compatibility of the administered drugs.Oil mixtures should not be used because of the risk of fat embolism (occlusion of blood vessels);in no case should you make the mixture yourself, as you can make a mistake in the dosage, which will lead to unpleasant and even dangerous consequences.
Suppositories (candles)
In the treatment of prostatitis, therapy with suppositories (suppositories) is widely used.The action of the drugs included in the suppositories takes place mainly through the general blood flow, and not through the mucosa of the intestinal wall.
The use of candles has a pronounced psychotherapeutic effect.Usually, patients tend to use any suppositories for self-treatment of prostatitis, regardless of their composition.Especially often, patients use suppositories with propolis, as well as with thiotriazoline (0.5 g per suppository), which have a complex anti-inflammatory and membrane-stimulating effect.In addition to medicinal suppositories, magnetic suppositories are also used in the treatment of prostatitis.
Micro enemas
Microenemas are usually used to treat prostatitis, which are often called traditional prostatitis treatment.The basis for their use is the simultaneous temperature and healing effect.Micro enemas are usually used before going to bed.
As medicinal substances, they use aqueous infusions of chamomile, calendula, sage or motherwort, boiled with boiling water before applying the microenema.After the infusion has cooled to a temperature of 40 ° C, the drug is administered into the rectum.A small volume is injected - no more than 100 ml of liquid.Medicines must be absorbed in the rectum, ie.stools immediately after microenema administration are undesirable.
Aqueous infusions of herbs can be replaced with 1 teaspoon of alcoholic infusion (marigold, lemon balm or chamomile), which are diluted in 100 ml of warm water before use.You can add 1.0 g of antipyrine or 10 drops of iodine tincture to the infusion.The effectiveness of micro enemas is well known and needs no proof.Microclysters are usually used simultaneously with antibacterial agents as the final stage of more active local procedures or as an independent therapeutic effect for mild pain symptoms.
A very important point is that the use of medication alone does not lead to a good and long-lasting effect.It is necessary to perform prostate drainage procedures in combination with drug therapy - only then the effect is guaranteed/