Chronic prostatitis is an inflammatory disease characterized by prostate damage and severe urodynamic disorders. One of the causes of chronic inflammation of the prostate is inappropriate or early treatment in the acute stage, when the exfoliation and proliferation of the glandular epithelium is reversible and successfully corrected with medication within 2-3 weeks.
The treatment of chronic prostatitis includes massive antibiotic therapy aimed at eliminating the infectious pathogen, a set of measures to increase the body's immunity, physiotherapy methods, heat therapy. Psycho-correction can also be included in treatment, as neuroasthenic and neurosynthetic conditions are common in men with long-term and recurrent prostatitis.
Why does inflammation last for years?
Knowledge of the causes of chronic prostate inflammation is essential to prevent exacerbations and improve patients' quality of life. There are a large number of factors that can affect the functional state of the glandular (glandular) tissue of the prostate and cause its inflammation, which is based on the exfoliation and proliferation of epithelial cells.The main cause of chronic prostatitis in men is the extensive infection of the mucous membranes of the urogenital system with pathogenic microorganisms. In the vast majority of cases (over 80%) of infectious prostatitis, gram-negative and gram-positive bacteria become the causative agent of the infection: enterobacteria (specifically, Escherichia coli), gonococci, staphylococci. Less often, the infectious and inflammatory process proceeds in the context of infection by viruses, fungi and protozoa, but such forms of prostatitis are successfully treated during the acute period and rarely give recurrences, provided proper and timely treatment.
It should also be borne in mind that for the development of chronic aseptic prostatitis, a single acute urinary tract infection is sufficient, therefore, personal hygiene, the use of condoms during sexual intercourse and the timely treatment of urinary tract diseasesare of great importance for the prevention of this disease in men. Medicine knows cases of hematogenous (through systemic circulation) prostate infection in chronic sinusitis, tonsillitis and other diseases that contribute to the active development of pathogenic flora, therefore, the restoration of foci of chronic infection is an important stage of complex treatment for prolonged or prolongedprostate.
Negative factors that can make prostatitis worse (including non-infectious) are:
- urinary tract injuries and surgery on urinary tract organs.
- regular or severe hypothermia of the pelvic organs (swimming in open tanks at times when the water is not hot enough or the weather is cool outside, work in refrigerators and freezers, etc. ).
- weakness caused by sedentary work and insufficient physical activity of a man (sedentary lifestyle is one of the main factors in the development of chronic cognitive prostatitis).
- bad habits, in which the absorption of the most important macro- and micronutrients that determine the chemical composition and rheological properties of prostate secretions (zinc, chromium, selenium, manganese) is slowed down or reduced.
- disorders in the intimate sphere (frequent masturbation, irregular sexual intercourse, long periods of abstinence, frequent arousal that does not end with sexual intercourse).
- overweight?
- eating disorder (increased consumption of spicy, very salty, smoked and fatty foods).
Pay attention! Urologists note that the main pathogenic factor in the development of chronic prostate inflammation is posterior urethritis. It has also been noted that inflammatory changes in the prostate in men occur in the first months after suffering from a gonorrhea infection.
Treatment of chronic prostatitis with drugs
Treatment of chronic prostatitis with drugs is aimed only at suppressing the acute symptoms of exacerbation and destruction of the infection, but drugs can not be used as the only means (the effectiveness of such treatment will not exceed 36%, according to Dr. Pechersky).
A complete treatment regimen for prolonged or recurrent prostate inflammation currently used as a model in simple disease is presented in the table below.Table. Preparations for the complex treatment of chronic prostatitis.
| Pharmacological group | Purpose | Elimination (destruction) of pathogenic bacteria - causative agents of infectious prostatitis, urethritis, cystitis and other urinary tract infections. |
|---|---|
| Antimicrobial and antiprotozoal agents. | Treatment of infections caused by pathogenic microbes and protozoa. |
| Non-steroidal anti-inflammatory drugs (preferably in the form of anal suppositories). | Reduction of inflammation in the prostate tissues, relief of perineal pain, aggregated space, sanctuary and groin. |
| Antiseptics in the form of rectal suppositories. | Restoration of rectal mucosa and prevention of prolonged prostatitis infection. |
| Alpha blockers. | Normalization of urination, restoration of daily urine production. |
| Microcirculation correctors. | Elimination of congestion in the vessels of the small pelvis, restoration of normal blood and lymph flow. |
| Correctors of urodynamics (factors that affect metabolism in prostate tissues). | Improvement of metabolic and metabolic processes in prostate tissues and nutrition. |
| Power controllers. | Complex treatment of erectile dysfunction, improvement of chemical composition, viscosity and fluidity of semen, increase of sperm activity (the use of drugs of this group is indicated for patients whose prostatitis is complicated by autoimmune infertility). |
The duration of antibiotic treatment is at least 4-6 weeks. Under no circumstances should you take antibacterial drugs without a prescription, as the main factor in choosing treatment is the results of the microscopic examination of the prostate secretion and the spontaneously released fluids as a result of the prostate breast. Some antibiotics, for example, penicillins (a combination of amoxicillin with clavulanic acid) are back-up drugs and their misuse can lead not only to the absence of a clinically significant effect and the development of pathology, but also to the development of hyperinfection.
Important! In some cases, men with chronic prostatitis need psycho-correction, especially if the pain syndrome is combined with behavioral changes, increased stress, irritability and neurosis. Antidepressants with selective inhibition of serotonin reuptake are used to suppress these symptoms.
Physiotherapy
Heat treatment is the main method of treating chronic prostatitis outside periods of exacerbation (after the onset of acute symptoms). Heat treatment refers to physiotherapy methods and is a dose of heat to the affected area. The benefits of thermal procedures are the normalization of blood circulation, the relief of inflammatory processes, the reduction of chronic pelvic pain, which is one of the main clinical manifestations of chronic prostatitis, which reduces the quality of life of men. Heat also improves the penetration of drugs into the prostate tissue, so in some cases physiotherapy is used to increase the effectiveness of drug therapy (for example, electrophoresis with antibiotics). For men at high risk of thrombosis, heating is recommended for prevention, as heat has a moderate absorption effect.
There are a large number of methods of thermal effect on the body and the choice of a particular method of treatment should be made by a physician, taking into account the clinical picture, form and stage of the disease, the age of the man and his individual tolerance. The most effective methods of heat treatment for prostatitis are:
- thermal applications with minerals (ozokerite, paraffin, disophyte), salt or sand
- electric pads
- deep heating of high-strength tissues for direct effect on blood vessels and nerve endings (diathermy).
- exposure to high-frequency alternating magnetic fields to eliminate pain, relieve inflammation, and eliminate nerve-like manifestations (induction heat).
- ultrasound treatment (promotes the absorption of abscesses and the healing of formed scars).
- electrophoresis by inserting electrodes into the rectum.
- effect on prostate tissue with high frequency pulses (darsonvalization).
In some physiotherapy rooms, chronic inflammation of the prostate is treated with hot mud applications ("mud pants"). Such procedures have a positive effect not only on blood and lymph circulation, but also on the production of prostate secretion, as well as on the nutrition of the tissues of the inflammatory organ. In some cases, the mud is injected directly into the rectum in the form of a tampon, as with this method of administration it is possible to quickly achieve a therapeutic effect and a positive response to treatment.
Other treatments
The complex treatment regimen, in addition to medication and heat treatment, is complemented by various procedures that the doctor prescribes, taking into account the specifics of the pathology in each case.
Prostate massage
This is one of the main methods of treatment of chronic prostate inflammation, which is recommended to be used in almost 90% of cases (in the absence of contraindications). Massage is a finger effect on the prostate in order to stimulate the outflow of secretory fluid. The duration of the procedure is usually about 1-2 minutes. The criterion for a sufficient effect is the complete emptying of the prostate glands, which the patient feels relief (for which he must inform the doctor).
The benefits of massage are determined by the therapeutic effect that can be achieved after a course of treatment (8-12 procedures). In a simple way, these are:
- normalization of muscle tone?
- improve blood circulation to the prostate vessels (as a result, the transport of drugs to the tissues of the affected organ is accelerated and the effectiveness of treatment is increased).
- privacy restoration
- normalization of blood and lymph outflow from the prostate gland (especially important in cognitive prostatitis).
The procedure is contraindicated during the acute period due to the high risk of infection spreading to surrounding tissues and organs (hematogenous infection), other infectious diseases of the urogenital system, the presence of cysts or stones in the prostate. Prostate massage is not prescribed to patients diagnosed with tuberculous organ damage, adenoma or other neoplastic diseases (including prostate cancer). In the presence of diseases of the rectum (hemorrhoids, anal fissure, proctitis, paraproctitis), massage can cause complications and cause recurrence of the underlying disease.
Important! Studies show that almost 42% of men refuse prostate massage due to the increased psychological discomfort associated with the peculiarities of this procedure. The physician's work with such patients should include detailed information about the consequences of refusing treatment and possible complications, in particular infertility and persistent sexual dysfunction. In some cases, it may be advisable to prescribe a mild sedative a few days before starting treatment.
Hot enemas
Hot enemas are home remedies for chronic prostatitis, but urologists recognize their effectiveness and recommend them for faster and more effective treatment of prostatitis. The water temperature for these enemas should be around 42 ° C. Before the procedure, it is necessary to clean the intestines with a regular enema or laxative. The volume of an enema is from 150 to 300 ml. It is recommended to empty the bowel one hour 30-50 minutes after administration of the solution.
Below are recipes for chronic prostate inflammation.
Dissolve 10 drops of iodine and about 20 ml of chlorhexidine in 200 ml of water. Apply at bedtime for 15 days.Anti-inflammatory drugs, antiseptics, antibiotics can also be used by microclimate drugs. The use of these drugs is allowed with the permission of a doctor strictly in the indicated dosage.
Treatment of chronic prostatitis: detailed instructions
Using different treatments is not enough to get rid of chronic prostatitis completely. If a man does not monitor his diet and does not change his lifestyle, the symptoms will occur regularly, leading to irreversible changes in the structure and functional activity of the prostate glands and persistent dysuric and sexual disorders. To increase the effectiveness of treatment and the duration of remission, you should follow the recommendations given in the following instructions for patients with chronic prostatitis.
- Step 1. If a man is diagnosed with chronic prostatitis, he should start by correcting his diet. It is necessary to exclude foods with a large amount of fat, salt and spices from the menu. Fats increase blood cholesterol levels and salt promotes fluid retention and swelling in prostate tissue. Spices (like various chemical additives) irritate the mucous membranes of the urinary tract, causing worsening of existing symptoms.
- Step 2. It is also necessary to completely eliminate alcoholic beverages, as they slow down the absorption of nutrients, disrupt blood and lymph circulation and adversely affect the metabolism in the prostate. If a man suffers from tobacco addiction, measures must be taken to get rid of this habit (toxic substances in tobacco smoke violate the viscosity and fluidity of prostate secretions and change its chemical composition).
- Step 3. Overweight men should consult an endocrinologist and nutritionist for a complete diagnosis and correction of body weight, taking into account the localized discrepancies. Obesity is the most important factor in the development of chronic prostatitis and an important step in combination therapy is weight loss in patients with high BMI.
- Step 4. In order to eliminate the stagnant phenomena associated with hypodynamic disorder, it is necessary to provide an adequate level of physical activity, corresponding to age and physical condition. Swimming, physiotherapy exercises, stretching, walking are useful for prostatitis.
- Step 5. For the proper functioning of the prostate, it is necessary to monitor the quality of sexual life. It is recommended to have a regular sexual partner, to avoid episodes of sexual arousal if there is no possibility of further sexual intercourse and to check regularly for genital infections, which can also cause worsening of chronic prostatitis.
Men with recurrent prostatitis should monitor emotional stress, avoid stressful situations, and prolonged exposure to cold or flare-ups.
Chronic prostatitis is a disease that is difficult to treat, especially if the patient does not comply with the prescription of the treating physician and does not follow a responsible approach to nutrition and treatment. Inflammation of the prostate is dangerous with serious complications, so you need to approach the problem as a whole. Men with this diagnosis should understand that the pills alone are not enough to fully restore all prostate gland functions, so you should not abandon the basic treatments for chronic prostatitis recommended by your doctor, even if they causeprimary psychological or physical discomfort.