Prostatitis is an infectious and inflammatory disease, considered one of the most common, but at the same time little studied and poorly treated conservatively, pathologies with severe urinary disorders.The incidence of prostatitis in recent decades has been higher in men in the active reproductive period (age group 20 to 45 years) and those who are sexually active, although until recently it was believed that the maximum risk of the inflammatory process in the prostate exists only in older and elderly men.
In most cases, acute prostatitis develops against the background of massive contamination of the mucous membrane of the prostate 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 infectious forms of prostatitis (including CPPS - chronic pelvic pain syndrome), complex therapy of inflammatory changes in the interstitial and parenchymal tissues of the gland also includes the use of modern methods, for example, laser therapy, cryoablation or pulsed microcurrent.For the treatment to be effective and to achieve stable remission, the man will also have to adjust his regime, diet and lifestyle.
Basic treatment of inflammatory diseases
The main goal of therapy in the treatment of any form of prostatitis is to suppress inflammation and eliminate inflammatory changes, as well as relieve pain, the incidence of which, according to various sources, ranges from 35% to 67% (about every second a man with prostatitis complains of pain as a predominant symptom).In acute cases, the use of broad-spectrum antibacterial therapy allows you to quickly achieve a clinically significant effect, which occurs within 4-5 days.Although prostatic inflammation rapidly subsides, antibiotic treatment cannot be discontinued, since most typical pathogens of genital tract infections very quickly develop resistance to this group of drugs, and discontinuation of treatment leads to chronic disease.
Some of the main agents of prostatitis - fecal staphylococcus and Escherichia coli (Escherichia coli) - even if the conditions of use and continuous use of antibiotics are met, they are still able to create a thick film surrounding the membrane membrane, reducing the bioavailability of the drugs used and increasing the resistance of bacteria to the selected group of antibiotics.For this reason, antibiotic treatment should be continued even if a rapid positive result is achieved for at least 4 weeks.
Why can't you choose antibiotics yourself?
Antibiotics are the basis for the treatment of acute infectious prostatitis, but they must be prescribed by a doctor after examining prostatic secretions in the laboratory, taking into account a number of factors: the type of pathogen identified, the degree of contamination of the mucous membrane and the resistance of a particular microorganism to certain groups of antibiotics.Specialists in the field of practicing urology also note that in recent years the incidence of mixed genital tract infections has been steadily increasing, therefore, the combination of several antibacterial and antibacterial agents is often used to treat acute prostatitis.
Self-medication to treat acute prostatitis in nearly 60-70% of cases leads to the infection becoming chronic. This rate is very high and confirms that choosing medication on your own and ignoring prescriptions is unacceptable.The importance of undergoing laboratory tests and physical diagnosis as well as consulting a specialist before using antibiotics is due to the following points.
- Bioavailability indexes.Some antibacterial drugs (for example, the most popular and most prescribed antibiotics - drugs of the penicillin group) have a low degree of penetration into prostate tissue, so their use for prostatitis is ineffective and impractical.Almost all aminoglycosides have poor bioavailability.
- Degree of bactericidal effect.In case of acute damage to the prostate, antibiotics should be chosen that have a bactericidal effect, causing death to infectious pathogens.In chronic cases, it is better to prescribe drugs with a bacteriostatic effect, blocking the growth of pathogenic flora and preventing its reproduction.
- General condition of the patient.Patients with severe immunosuppression as well as severe manifestations of febrile and toxic syndromes should be treated in hospital.Antibiotics are given intravenously to these patients (oral formulations are not effective in severe clinical cases).
Pay attention!The absence of a positive effect during the use of antibacterial therapy may indicate the development of a prostatic abscess.This is an acute pathology that requires the man to be urgently hospitalized in the hospital and surgically open the abscess, followed by drainage and antiseptic treatment of the cavity.
Modern methods of treating chronic inflammation
Physiotherapy is a branch of medicine that studies and applies various natural factors (including artificial ones) for therapeutic purposes that have a positive effect on the human body.In the complex treatment of pathologies of the genitourinary system, physiotherapy is used at the recovery stage, after relief of acute symptoms.
The main goal of physiotherapy is to eliminate residual inflammatory effects and stimulate recovery of damaged tissues.A physical therapy treatment typically consists of 5-10 procedures lasting 10-15 minutes.To achieve positive results (reducing the frequency and intensity of chronic pelvic pain, normalizing urination, improving the rheological properties of prostatic secretions, etc.), several courses of treatment may be required.
Low level laser therapy
Laser therapy is one of the most effective and popular methods for treating chronic prostatitis in men, often used as an adjunct after initial medication adjustments.The basis of laser therapy is the use of optical strips emitted from a special device - a laser.The laser can operate in pulsed and continuous pulse modes, the wavelength can reach 904 nm. In urology, intravenous laser irradiation into the blood is rarely used, which is considered by many experts to be the most complex and effective treatment for many urological diseases.
The main advantage of laser therapy is that it is quite effective, painless and stimulates not only damaged tissues, but also neighboring 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 flow of secretions from the prostate.
Electrical stimulation
Electrical stimulation with electric current is indicated for the treatment of any form of prostatitis, accompanied by erectile dysfunction and general decrease in potency.Stimulation is performed endocrineally, meaning that a catheter with electrodes attached is inserted directly into the back of the urethra, where the prostate is located.In some cases, rectal electrodes may be used for treatment, providing electrical stimulation to the prostate at the junction with the anterior ampulla of the rectum.In both cases, it is important that the bowels and bladder are empty.
Treatment with electric current has a complex positive effect on the prostate, namely:
- eliminates fluid stagnation (blood and lymph) in the pelvic organs;
- ensures normal flow of prostatic secretions;
- increases the permeability of the cell membrane of the parenchymal tissue of the gland and its interstitium, which promotes faster absorption of the drug into the tissue of the inflamed prostate;
- reduce swelling;
- normalizes muscle tone of the pelvic muscles;
- Increases cell regeneration 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 to minimize the risk of possible recurrence.A full course usually includes 5-7 procedures.
Pay attention!Electrical stimulation of the prostate is especially effective for prostatitis with severe erectile dysfunction.
Heat therapy
Thermotherapy is also a type of physiotherapy and can be used to self-treat prostatitis or used in specialist physiotherapy clinics.Heat sources to warm the prostate can be:
- mineral applications (bischofite, paraffin, ozokerite);
- special electric lights;
- heating pads (water, electricity);
- infrared irradiation equipment.
In day hospitals and physiotherapy rooms, a reflector is often used to warm the prostate, which is an incandescent lamp with a focusing lampshade (“green light”).This procedure has certain contraindications, for example, disorders of the autonomic nervous system, malignant tumors, acute infectious processes and purulent infections, active forms of tuberculosis.The use of thermal procedures in the acute phase of the disease is unacceptable, as this can lead to sepsis in neighboring organs and tissues (due to a sharp increase in blood flow) and the development of serious complications, including sepsis.
Important!If a man is prescribed hormonal or immunomodulatory therapy, it is necessary to consult a doctor about the possibility of using heat therapies (especially if the patient is being treated at home).Prescribing thermal treatment procedures with cytostatics and hemostatic drugs is unacceptable.
Ozone therapy
This is a fairly effective modern method of treating prostatitis, which is carried out mainly in paid medical centers.Medical ozone is produced by special medical devices 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 saline (0.9% salt concentration).
The main indication for the use of ozone therapy to treat prostatitis is chronic infectious prostatitis with frequent recurrences (more than 2-3 times a year).Ozone has strong antiseptic and bactericidal properties, so it is often used to disinfect facilities, including industrial facilities.It destroys most pathogenic and opportunistic strains of bacteria, which often cause prostatitis and are highly resistant to antibacterial drugs.The feasibility of using this method is considered reasonable if the patient does not obtain a stable positive dynamic after changing three antibiotics.
The ozone solution is injected with a special catheter into the prostate part of the urethra or rectum.The course includes 5-10 procedures.
Equipment for treating prostatitis
Hardware treatment of prostatitis can be carried out both in the physiotherapy room and at home (strictly after consulting with the treating doctor).Many of them are rectal devices, so in addition to the main contraindications directly related to the disease, it is important to take into account local limitations: acute stages of hemorrhoids, anal bleeding of unknown origin, violation of the integrity of the epithelial layer of the rectum, proctitis and paraproctitis.
It is unacceptable to introduce any foreign objects (electrodes, sensors) into the rectum in cases of rectal prolapse, pelvic abscess, thrombosis of hemorrhoidal veins and congenital immaturity of the nervous apparatus of the large intestine.
Important!Before using any device to treat prostatitis and prostate adenoma, you should consult your doctor because some of these devices are not only useless but also cause significant harm to your health.Hardware impact on prostate tissue is unacceptable in the acute phase of the disease, as well as in the presence of any possible contraindications (listed above).
Prostatitis is a serious disease that requires integrated treatment.In addition to medication and physical therapy methods to treat prostatitis, in some cases it is necessary to use psychological adjustment methods, as well as adjusting lifestyle, eating habits, work and rest.Basic therapy during the recovery and rehabilitation phase needs to be supplemented with auxiliary treatments: hirud therapy (leech 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.In addition to periods of exacerbation, annual sanatorium treatment is indicated to consolidate the achieved results.