Prostatitis is a common urological disease characterized by inflammatory changes in the prostate caused by the influence of harmful factors (infectious, occupational and others). The standard treatment regimen for prostatitis depends on the form, course and causative agent of the disease.
Therapy of prostatitis depending on the type
The disease is polyetiological in nature, but the main factor of occurrence is infectious. The task of urology is therefore the search for rational methods of etiotropic therapy and infection control.
Treatment of bacterial prostatitis includes antibiotic therapy. The drug is prescribed after laboratory diagnostics to determine the causative agent and sensitivity to antibiotics.
According to the results of statistical studies on the treatment of the disease, drugs from the group of fluoroquinolones, cephalosporins and tetracyclines have proven to be the most effective.
Antiviral drugs are used in the treatment of prostatitis caused by herpes, HPV or cytomegalovirus. Prostatitis of fungal etiology is treated with antifungal drugs.
Since many factors influence the occurrence of prostatitis, therapy is usually complex and generally includes lifestyle adjustments aimed at strengthening immunity and improving blood flow to the pelvic organs.
The list of events includes:
- dietary nutrition (to prevent constipation);
- regular physical and sexual activity;
- vitamin therapy;
- proper sleeping and waking patterns.
If prostatitis is caused by a violation of pelvic blood circulation, regular physical activity, massage and physiotherapy exercises (squats, lunges, walking, running) are shown to eliminate congestion. In the presence of latent sources of infection (caries, sinusitis, tonsillitis), sanitation of pathological foci is required.
therapy regimens
The symptoms of chronic and acute forms of prostatitis are similar, but the drug exposure schemes are different. This is because the treatment in the acute form is aimed at fighting the infection and stopping unpleasant symptoms, and the chronic form of the disease requires methods of exposure to physiotherapy.
List of drugs in the acute stage of prostatitis:
- NSAIDs - eliminate discomfort and inhibit the development of the inflammatory process in the gland.
- antibiotics. Affect the causative agent of the disease. The most commonly used are protected penicillins, macrolides, cephalosporins, fluoroquinolones.
- antispasmodics. They are used to eliminate pain in the gland, improve the outflow of secretions, relax the walls of vessels and improve microcirculation.
- alpha blockers. Improve outflow in acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. Ease inflammation of the body and reduce swelling.
- phytotherapeutics. They are a healing aid of natural origin. Gently affect the prostate and reduce the swelling of the organ.
Important!In the acute stage of prostatitis, physiotherapeutic measures are contraindicated.
Physical therapy helps spread the infection and worsen the inflammation.
The chronic form of prostatitis, on the other hand, is treated mainly with physiotherapeutic methods:
- laser therapy.
- Phonophoresis (a combination of ultrasound and a drug).
- electrophoresis.
- exposure to microwaves.
Apply one or more treatment methods at the same time. Surgical intervention (endoscopic method) is used only in the chronic form, which is complicated by the sclerotic process and congestion in the gland. The operation can significantly improve the patient's quality of life, restore lost functions.
Treatment principles of acute prostatitis
Urogenital infections are almost always the cause of acute prostatitis. It can be both non-specific (caused by conditionally pathogenic microorganisms) and sexual infections (gardnerellosis, chlamydia, gonorrhea, trichomoniasis, etc. ).
In the first case, the pathogenic microflora penetrates the prostate gland from the intestine or urinary tract by the lymphatic or hematogenous route, causing inflammation there.
In the second case, the pathogen is transmitted from an infected sexual partner.
The treatment of acute prostatitis depends on the type of pathogen and always includes antibiotics. After a thorough examination, the doctor identifies the pathogen and prescribes the appropriate remedy.
In the case of an infection with protozoa (trichomoniasis), a drug from the group of nitroimidazoles is usually prescribed. Intracellular chlamydia infection is treated with macrolide antibiotics.
Alternative agents include some other macrolides, fluoroquinolones, and a tetracycline antibiotic.
Treatment of gonorrhea lesions includes antibiotics of the penicillin and cephalosporin group and vaccine therapy. Inflammation of the gland caused by Gardnerella requires the use of antibiotics (macrolide, lincosamide, as well as a drug from the group of nitroimidazoles and its analogues are prescribed).
When treating acute prostatitis caused by nonspecific microbial flora, a standard drug regimen, which also includes antibiotics, is used.
The standard treatment regimen for prostatitis includes the following actions:
- Bed rest in acute form, massage and exercise therapy in the chronic stage of the disease.
- Diet food.
- Antibiotics to suppress the microbial flora that caused the inflammation in the prostate.
- NSAIDs are used as a symptomatic remedy for pain and to fight inflammation.
- bioregulatory peptides. These are products from the prostate gland of cattle. Stimulate the regenerative processes in the gland.
- antispasmodics.
- Muscle relaxants are used to relax the bladder, urethra, and perineal muscles.
- Means that improve blood circulation and rheological properties of blood that eliminate constipation (for example, a drug that improves microcirculation in the gland by blocking receptors located in the wall of blood vessels).
- Hormonal agents.
Depending on the course and severity of the prostatitis, further measures (ultrasound, autologous blood transfusion, rectal administration of medication) can be added.
To quickly stop the symptoms of prostatitis, intravenous infusions are used.
Such treatment is carried out in a hospital. To stimulate the immune system, tissue preparations, anabolic steroids are prescribed.
Treatment of acute bacterial prostatitis
Antibacterial treatment is indicated in the acute form of the disease caused by infection. However, in some cases it is also prescribed for chronic prostatitis of nonbacterial etiology - as an additional measure to influence possible latent infections. Agents with a broad antibacterial spectrum are preferred.
The duration of treatment is from 2 weeks to a month. With good dynamics of improvement of the condition, treatment can be extended up to 2 months.
The most commonly used groups of antibiotics to treat bacterial prostatitis are:
- proprietary penicillins. Medicines are prescribed orally 1 g twice a day. It is important to take the drug regularly at the same time, 12 hours apart. The course of drug exposure ranges from one week to 10 days. Penicillins are usually used pending laboratory test results.
- 2nd generation fluoroquinolones, 200 mg 2 times daily for 1-2 weeks.
- Fluoroquinolones 3 generations 0. 5 g 1 time / day for 5 days.
- 3rd generation cephalosporins. Assign the drug in / m or / in 1 g 2 times or 2 g 1 time per day for 7-10 days.
- 4th generation cephalosporins 2 g per day intravenously or intramuscularly for 5-7 days.
- aminoglycosides. Enter 1. 0 g/m 1 time/day for 5-7 days.
- macrolides. Non-toxic, do not affect the intestinal flora. Assign orally 500 mg 1-2 times a day. The remedy must be taken for at least 5-14 days.
When taking antibiotics for prostatitis, patients are not recommended to independently reduce the dosage and duration of treatment. The entire course lasts at least two weeks.
Allergic patients should inform the doctor before starting treatment about the existing intolerance to certain drugs. It is possible that in the event of a violation of liver or kidney functions, the specialist will have to adjust the treatment regimen or dosage of drugs, so it is important to warn him in advance.
The treatment regimen of viral acute prostatitis
Virological diagnostic methods are not part of the examination protocol, so the diagnosis "viral prostatitis" is usually rarely made by urologists. Herpes infection and HPV are sexually transmitted.
The genital herpes virus enters the body of a man and multiplies, after which it reaches the lymph nodes, from where it spreads through the internal organs through the hematogenous and lymphogenous pathways.
After drug exposure, the virus persists in the spinal or cranial ganglia and recurs periodically. Usually an exacerbation occurs after hypothermia or a decrease in immunity.
The culprits of this type of prostatitis are the herpes virus, cytomegalovirus, HPV and influenza. The pathogen can invade not only the prostate, but also other nearby organs, e. g. B. Bladder, urethra, testicles, rectum, and cause severe damage with reduced immunity.
The causative agent of viral prostatitis can be identified by laboratory analysis. In men, genital herpes has the appearance of vesicles and sores located in the groin, scrotum, perineum, or urethra. Basically, the disease progresses with severe itching and burning, but there is also an asymptomatic course.
Treatment for viral inflammation of the prostate includes:
- Taking antiviral drugs. They are effective in treating herpes and HPV. The mechanism of their action is based on suppressing the emergence of new generations of viruses. The specific treatment is carried out for 5 days with the maximum therapeutic dose on the first day.
- Reception of immunomodulators.
- To normalize urination, alpha-blockers are prescribed, which relieve tension in smooth muscles and facilitate the outflow of urine.
With the defeat of HPV or warts, sometimes it becomes necessary to remove growths with electrocoagulation, laser or liquid nitrogen. The procedure is performed in a hospital.
The treatment regimen of acute fungal prostatitis
Prolonged use of antibiotics leads to the emergence of new types of microorganisms that are resistant to many antibacterial agents. The increase in the number of patients with fungal prostatitis is caused by the uncontrolled use of antibiotics and gradual dependence on them.
With a decrease in immunity, the fungus of the genus Candida begins to actively multiply in the body, causing candidiasis.
When treating Candida prostatitis, the following apply:
- antifungals. Drugs are sometimes combined in different proportions.
- Probiotics with bifido and lactobacilli. They inhibit the growth of pathogenic flora.
- Immunomodulating agents that strengthen the body's defences.
Important!The diet of patients with a yeast infection of the prostate should include foods with probiotics.
These are kefir, yogurt, acidophilus milk. In addition, it is necessary to limit the use of sweets, pastries, fresh milk, fruits and juices.
Conclusion
It should be remembered that only a specialized urologist can choose a course of medicines for prostatitis. Self-medication slows down the healing process and, in the worst case, can harm the body, provoke severe allergic reactions and help the body adapt to certain antibiotics, as a result of which these drugs no longer have a therapeutic effect.