Antibacterial therapy for prostatitis is not the only method of treatment.Antibacterial drugs are prescribed only if there are appropriate indications, mainly in case of periodic exacerbations and increased severity of manifestations of the disease.
The effectiveness of drugs for the treatment of prostatitis
It is known that different antibiotics can overcome the prostatic barrier to a different extent, and therefore their concentration in the prostate gland, and therefore their effectiveness in the treatment of prostatitis, is different.Therefore, among the drugs to which the greatest sensitivity of the flora has been ascertained, those with the greatest ability to penetrate the prostate are selected.A similar 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 a drug used to treat prostatitis is that it has a broad spectrum of antibacterial action.This is due to the fact that it is rather difficult to reliably determine the flora living in the prostate.Those with a broad spectrum of antibacterial activity mainly include drugs from the penicillin group.Tetracycline drugs have valuable properties in terms of penetration through the prostatic barrier and breadth of antibacterial action.
Modern drugs from the fluoroquinol group
New antibacterial agents that have a significant advantage over others are drugs from the fluoroquinolone group.These drugs have a broader 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, which is especially 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 be aware that the drugs used can have a spermatotoxic effect.Therefore, between the use of these drugs and the intended conception, there must be an interval of at least 4 months, passing the entire cycle of spermatogenesis.
Antibacterial drugs are prescribed, as a rule, for chronic bacterial prostatitis or for chronic infectious prostatitis.For chronic noninfectious 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 for infection.During this period, symptomatic therapy is recommended, usually with anti-inflammatory effect in the form of 50 mg diclofenac or 100 mg in suppositories, which have anti-edematous and analgesic effects.
After establishing the type of bacteria and their sensitivity, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.The 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 chronic recurrent prostatitis, it is recommended to extend the use of the antibacterial drug to 6-8 weeks.Sometimes antibiotic therapy is extended to 16 weeks with subsequent hands-on treatment.If no positive result is obtained, the antibacterial drug used is abandoned, but not earlier 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 gland itself and not in the plasma.The best in terms of these needs 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 of the bacteria present in chronic prostatitis.
Therefore, a necessary condition for the maximum effectiveness of antibacterial therapy for chronic prostatitis is compliance with the following general principles:
- isolation and determination of the microflora causing prostatitis and identification of its sensitivity to antimicrobial agents;
- choose 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 with each other and with drugs and procedures that improve the antimicrobial effect, reduce the incidence of complications and improve microcirculation in the prostate;
- 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 (a decrease in the number and activity of normal intestinal microflora).In these cases it is advisable to use drugs that promote recovery.
Results of treatment of prostatitis with drugs
The strategy and tactics of antibacterial therapy are complex and varied, but its 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 the anxiety return.Therefore, the use of antibacterial drugs per se is not considered sufficient.Good results are obtained with a therapeutic program aimed at increasing local and general resistance.In this case, you can count on successful antibacterial therapy or long-term remission.
Improve microcirculation in the prostate
In all forms of chronic prostatitis, in addition to influencing the microflora, they strive to restore microcirculation in the prostate, improve the outflow of secretions from the glandular ducts, increase the intensity of metabolic processes in the source of inflammation 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 is proven.
Anti-congestive treatment includes measures aimed at reducing venous stagnation in the pelvis: cessation of interrupted sexual intercourse, sedentary lifestyle, frequent alcohol consumption, etc.For varicose veins of the lower extremities and hemorrhoidal veins, which can also cause prostatitis, surgical treatment of these diseases is carried out.For non-infectious congestive prostatitis, only decongestant therapy is performed.
The therapeutic complex for chronic prostatitis includes special drugs with highly effective effects.In some cases of exacerbation of chronic prostatitis in the presence of dysuric phenomena caused by venous stagnation, 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.
Elimination of pain due to prostatitis
Since the presence and severity of pain in prostatitis serves as the main indicator for the patient, which determines his attitude towards the disease and influences 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.The painful syndromes observed in chronic prostatitis are very different in location, duration and degree of intensity.In this regard, the method of using analgesic drugs is of great importance.
Oral (by mouth) administration is quite effective and temporarily relieves pain.The rectal use of painkillers in suppositories and microenemas is even more effective, since they use the combined effect of analgesics and anti-inflammatory drugs, as well as the effects of temperature.To change the tone of the gland, belladonna extract can be added to suppositories.
Strengthen the immune system
When treating chronic prostatitis, it is very important to increase the body's reactivity and its defenses, which usually help to cope with any disease.With chronic prostatitis, the body's defenses are reduced.In this regard, without the use of general immunological treatment for chronic prostatitis, it is very difficult to achieve success.
Sometimes a drug that increases the body's reactivity is used to treat chronic prostatitis.Having a pyrogenic effect (increased body temperature), the drug exacerbates chronic inflammation in the prostate gland and turns it into acute, promoting recovery, since it is easier to treat inflammatory diseases in the acute phase.The drug works when it enters the bloodstream quickly.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 hospitalized patients so that they are under observation.The medicine is administered daily for 9-10 consecutive days.At the height of the artificially caused exacerbation of chronic inflammation in the prostate gland, starting from about the 4th day, the introduction of 1-2 antibiotics and a sulfonamide or other drug in sufficiently high doses begins.To improve the blood supply to the prostate gland, physiotherapy is performed simultaneously, and to improve the outflow of prostatic secretions, daily massage is performed.The therapeutic effect in the form of improvement or recovery is achieved to a different extent in almost all patients.
Hormone therapy
It is necessary to use sex hormone preparations for prostatitis very carefully.In patients who have suffered 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 studies on scrapings of 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 help resolve 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.In the vast majority of patients suffering from prostatitis, fortunately, hormone levels are not significantly affected.
If copulatory function, or the ability to have sexual intercourse, is compromised, there is a decrease in erection, a “fading” of orgasm and impaired ejaculation.The elimination of these symptoms and the normalization of sexual life largely depend on the underlying disease - prostatitis.The more effective the treatment, the faster the symptoms of the sexual disorder disappear or decrease.
Treatment of sexual disorders due to emerging neurosis includes psychotherapy, sedatives (sedatives), and the prescription of other drugs depending on the symptoms of the sexual disorder.This therapy shows how prostatitis symptoms can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, it is possible to use LOD therapy, which consists in creating a vacuum in the vessel into which the penis is inserted.Due to the negative pressure created, the cracks in the corpora cavernosa of the penis widen and blood flows towards them.The penis enlarges and erection occurs.
Repeated procedures lead to an increase in gaps in the corpora cavernosa, a more stable blood supply to the organ and, ultimately, an improvement in erectile function.A positive effect in chronic prostatitis is also manifested by increased sexual activity, which has a powerful psychotherapeutic effect.
The phallodecompression (PLD) method for prostatitis is performed daily or every other day.The course of treatment is 10-15 procedures.It is useful to combine phallodecompression with instillation of prostate massage, as this increases the degree of absorption of drugs after completion of the procedure.
Instillations
This type of therapy includes techniques that allow direct and direct delivery of the drug to its intended 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 should urinate to make sure your bladder is empty.
At the time of administration it is advisable to imitate urination, that is, relax, then the excess drug will enter the bladder and be expelled with the first portion of urine;the head of the penis must be pressed with fingers or a special clamp: this will prevent the injected solution from flowing back after removing the cannula or syringe.And in order for the solution to reach the prostate faster, it is recommended, when introducing it, to carefully stroke the filled urethra with the fingers of the free hand towards the perineum.
After the procedure it is necessary to endure the urge to urinate, otherwise the administered medicinal mixture will immediately flow back out.This mixture is composed of the same drugs as oral administration: antibiotics, analgesics, antispasmodics, anti-inflammatories.
Instillation therapy for prostatitis allows the use of a variety of drugs, the choice of which depends on the nature of the disease, as well as the compatibility of the administered drugs.Oil blends should not be administered due to the risk of fat embolism (blockage of blood vessels);in no case should you prepare the mixture yourself, as you may 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 contained in the suppository is carried out mainly through the general blood flow and not through the mucosa of the intestinal wall.
The use of candles has a pronounced psychotherapeutic effect.Patients usually tend to use any suppositories for self-treatment of prostatitis, regardless of their composition.Patients especially often use suppositories with propolis and thiotriazole (0.5 g per suppository), which have a complex anti-inflammatory and membrane-stimulating effect.In addition to medicated suppositories, magnetic suppositories are also used in the treatment of prostatitis.
Microclyctors
Typically, microenemas are used to treat prostatitis, which are often called traditional prostatitis treatments.The basis for their use is simultaneous temperature and medicinal effects.Microenemas are usually used before going to sleep.
As medicinal substances, they use aqueous infusions of chamomile, calendula, sage or motherwort, prepared with boiling water before administering a microenema.After the infusion has cooled to a temperature of 40°C, the medicine is administered into the rectum.A small volume is injected: no more than 100 ml of liquid.Medicines must be absorbed in the rectum, that is, stool immediately after administration of a microenema is undesirable.
Aqueous herbal infusions can be replaced with 1 teaspoon of alcoholic infusions (calendula, motherwort or chamomile), which are diluted in 100 ml of warm water before administration.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 require proof.Microclypterans are usually used simultaneously with antibacterial agents as the final stage of more active local procedures or as an independent therapeutic effect for mild painful symptoms.
A very important point is that the use of drugs alone does not lead to a good and long-lasting effect.It is necessary to carry out prostate drainage procedures in combination with drug therapy: only then the effect can be guaranteed/