Antibacterial therapy is not the only treatment for prostatitis.Antibacterial drugs are prescribed only if there are appropriate indications, mainly with periodic exacerbations and an increase in the severity of disease manifestations.
The effectiveness of drugs for the treatment of prostatitis
It is known that different antibiotics can cross the prostatic barrier to different degrees, and therefore their concentration in the prostate gland and therefore their effectiveness in the treatment of prostatitis are different.Therefore, the drugs with the greatest sensitivity of the flora are selected, which have the maximum penetration into the prostate.A similar approach to the treatment of prostate adenoma can significantly speed up the recovery process.
A wide range of drugs for the treatment of prostatitis
Another condition for the effectiveness of the drug used in the treatment of prostatitis is that it has a broad-spectrum antibacterial effect.This is due to the fact that it is quite difficult to reliably determine the flora living in the prostate.Those with broad-spectrum antibacterial activity primarily include drugs of the penicillin group.Tetracycline preparations have valuable properties in terms of penetration into the barrier of the prostate gland and the breadth of the antibacterial effect.
Modern drugs of the fluoroquinol group
New antibacterial agents that have a significant advantage over others are drugs from the fluoroquinolone group.These drugs have a wider spectrum of antimicrobial action and have the ability to accumulate in the prostate gland in high concentrations when taken orally.In addition to the direct antibacterial effect, fluoroquinolones almost never cause immunodeficiency in the patient, and especially important microorganisms do not resist them.
Tetracycline preparations are also widely used as antibacterial therapy.
A young patient 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 intended conception, there should be a gap of at least 4 months, exceeding the full cycle of spermatogenesis.
Antibacterial drugs are usually prescribed for chronic bacterial prostatitis or infectious chronic prostatitis.Treatment tactics for non-infectious chronic prostatitis remain controversial and controversial.Such patients are prescribed antibacterial drugs in the hope of curing the latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not from the first visit.As a rule, in no more than a few days, the doctor examines the patient to detect the infection.In this period, symptomatic therapy is recommended, usually 50 mg of diclofenac or 100 mg in suppositories with anti-inflammatory effect, which has an anti-edema and analgesic effect.
After determining the type of bacteria and their sensitivity, antibacterial drugs are prescribed, the most effective of which are fluoroquinolones.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, it is recommended to extend the use of the antibacterial drug for 6-8 weeks.Sometimes the antibiotic treatment is then extended up to 16 weeks with practical treatment.If there is no positive result, the used antibacterial drug is abandoned, but not later than 2 weeks of treatment.An ideal antibacterial drug should be fat-soluble, not bound to serum proteins, and weakly alkaline, so that it is maximally concentrated in the prostate itself, not in the plasma.In terms of these requirements, the best are fluoroquinolones, which have the best pharmacological properties in the treatment of chronic prostatitis;they create a sufficient concentration in the prostate gland, its secretions and spermatozoa and are active against most bacteria found in chronic prostatitis.
Thus, a necessary condition for the maximum effectiveness of antibacterial therapy for chronic prostatitis is to observe the following general principles:
- isolation and identification of the microflora causing prostatitis, determination of its sensitivity to antimicrobial agents;
- selection of the most effective drugs that do not cause side effects;
- determination of effective doses, application methods and frequency, 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;
- combination of antibacterial drugs both with each other and with drugs and procedures that increase the antimicrobial effect, reduce the frequency of complications and improve microcirculation in the prostate;
- to carry out complex therapy taking into account the characteristics of the patient's general health.
Sometimes with long-term or excessively active antibacterial therapy, intestinal dysbiosis develops (decrease in the number and activity of normal intestinal microflora).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 its use can increase the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, a more or less prolonged period of well-being may occur.But, as a rule, sooner or later the painful sensations that cause anxiety return.Therefore, the use of antibacterial drugs in itself 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 addition to affecting the microflora in all forms of chronic prostatitis, they try to restore microcirculation in the prostate, improve the release of secretions from the gland ducts, increase the intensity of metabolic processes in the inflammatory site, and local and general resistance.
Nonsteroidal anti-inflammatory drugs are considered an important step in the treatment of chronic prostatitis.Their positive effect on microcirculation has been proven.
Anticongestive treatment includes measures aimed at reducing venous stagnation in the pelvis: stopping sexual intercourse, sedentary lifestyle, frequent alcohol consumption, etc. For varicose veins of the lower extremities and hemorrhoidal veins, which can cause prostatitis, surgical treatment of these diseases is carried out.For congestive non-infectious prostatitis, only decongestant therapy is carried out.
The treatment complex for chronic prostatitis includes highly effective special drugs.In some cases of exacerbation of chronic prostatitis, dysuric phenomena caused by venous stagnation, drugs that reduce the tone of the smooth muscles of the prostate are used to reduce the urge to urinate.But only a doctor can recommend them.
Pain relief due to prostatitis
Analgesic therapy in the treatment of chronic prostatitis is one of the most important components of the general treatment of the disease, since the presence and severity of pain during prostatitis play the role of the main indicator that determines the patient's attitude to the disease and affects the manifestation of depression.Pain syndromes observed in chronic prostatitis are very diverse in terms of localization, duration and intensity.In this regard, the method of using analgesic drugs is of great importance.
Oral (oral) administration is quite effective and temporarily relieves pain.Rectal use of painkillers in suppositories and microenemas is more effective, because they use the combined effect of analgesics and anti-inflammatory drugs, as well as the effect of temperature.Belladonna extract can be added to suppositories to change the tone of the gland.
Strengthening the immune system
During the treatment of chronic prostatitis, it is very important to increase the reactivity of the body and its defense, which usually helps to overcome any disease.With chronic prostatitis, the body's defenses decrease.In this regard, it is very difficult to achieve success without using general immunological treatment for chronic prostatitis.
Sometimes a drug is used to treat chronic prostatitis, which increases the reactivity of the body.The drug, which has a pyrogenic (increased body temperature) effect, enhances chronic inflammation in the prostate gland and turns it into an acute form, which promotes healing, because it is easier to treat inflammatory diseases in the acute stage.The drug works when it enters the bloodstream quickly.Therefore, starting with small doses, daily, gradually and carefully increasing the dose, it is given intravenously.Using this intravenous route, patients with chronic prostatitis should be treated as inpatients so they can be observed.The medicine is applied every day for 9-10 consecutive days.At the height of the artificial exacerbation of chronic inflammation in the prostate gland, from about the 4th day, the application of 1-2 antibiotics and a sulfonamide or other drugs in a sufficiently high dose begins.Physiotherapy is performed simultaneously to improve blood supply to the prostate gland, and daily massage is performed to improve the outflow of prostate secretions.The therapeutic effect in the form of improvement or recovery is achieved in almost every patient to varying degrees.
Hormone therapy
Sex hormone preparations for prostatitis should be used very carefully.Such a need may arise in patients suffering from chronic prostatitis for years and decades.However, it is better to use them after determining the content of sex hormones (testosterone, estradiol, prolactin, FSH, LH) in the blood serum.Simpler tests can also be performed, for example, cytological studies 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 regimen.
Enzymes may also be prescribed to dissolve scar tissue 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.Fortunately, in the vast majority of patients with prostatitis, hormonal levels do not suffer significantly.
If the copulatory function or the ability to have sex is disturbed, there is a decrease in erection, "withering" of orgasm, and a violation of ejaculation.The elimination of these symptoms and the normalization of sex life mainly depend on the main disease - prostatitis.The more successful its treatment, the faster the symptoms of sexual dysfunction disappear or decrease.
Treatment of sexual disorders due to neurosis includes psychotherapy, sedatives (sedatives) and 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 the case of erectile dysfunction, after the main treatment, you can use LOD therapy, which consists of creating a vacuum in the vein where the penis is placed.Due to the created negative pressure, cracks in the cavernous bodies of the penis expand and blood flows into them.The penis grows and an erection occurs.
Repeated procedures lead to an increase in cavities in the cavernous bodies, a more stable blood supply to the organ, and as a result, an improvement in erectile function.A positive effect in chronic prostatitis is also manifested by an increase in sexual activity, which has a strong psychotherapeutic effect.
Phallodecompression (PLD) 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 gland, because it increases the rate of absorption of drugs after the procedure is completed.
Instillation
This type of therapy involves techniques that allow the drug to be delivered directly and directly to its destination.During instillation therapy with this method, drugs are administered through the external opening of the urethra using a disposable conical cannula (a soft hollow tube) or a regular disposable syringe with a syringe.The optimal volume of the administered drug mixture is 5 ml.Before the procedure, you need to urinate to make sure the bladder is empty.
During reception, it is recommended to imitate urination, that is, to rest, then the excess drug will enter the bladder and be excreted with the first part of urine;you need to squeeze the head of the penis with your fingers or a special clamp - this will prevent the injected solution from flowing back after the cannula or syringe is removed.In order for the solution to reach the prostate faster, when applying it, it is recommended to carefully press the filled urethra with the fingers of your free hand towards the perineum.
After the procedure, you must resist the urge to urinate, otherwise the applied medicinal mixture will immediately flow back.This mixture contains the same drugs as administered orally: 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 the compatibility of the administered drugs.Due to the risk of fat embolism (clogging of blood vessels), fat mixtures should not be used;in no case should you make the mixture yourself, because you can make a mistake in the dosage, which will lead to unpleasant and even dangerous consequences.
Candles (candles)
Suppository therapy (suppositories) is widely used in the treatment of prostatitis.The effect of the drugs included in the suppositories is not through the mucous membrane of the intestinal wall, but mainly through the general blood flow.
The use of candles has a clear psychotherapeutic effect.Patients usually tend to use any suppositories for self-treatment of prostatitis, regardless of the composition.Patients especially often use suppositories with propolis, as well as thiotriazoline (0.5 g per suppository), which has a complex anti-inflammatory and membrane-stimulating effect.In addition to medicated suppositories, magnetic suppositories are also used in the treatment of prostatitis.
Microclysters
Typically, microenemas are used to treat prostatitis, which is often called the traditional treatment of prostatitis.The basis for their use is the simultaneous effect of temperature and medicine.Microenemas are usually used at bedtime.
As medicinal substances, they use aqueous infusions of chamomile, calendula, sage, or mother plant, brewed with boiling water before applying microlism.After the infusion cools down to a temperature of 40°C, the drug is injected into the rectum.It is injected in a small volume - no more than 100 ml of liquid.Medicines must be absorbed in the rectum, that is, stools are undesirable immediately after microilism administration.
Water infusions of herbs can be replaced with 1 teaspoon of alcohol infusions (calendula, mother or chamomile) diluted in 100 ml of hot water before application.You can add 1.0 g of antipyrine or 10 drops of iodine tincture to the infusion.The effectiveness of microenemas is well known and does not need 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 drugs alone does not lead to a good and long-term effect.Along with drug therapy, it is necessary to perform prostate drainage procedures - only then the effect can be guaranteed/