The relevance of the study of the mechanism of development of chronic prostatitis increases in direct proportion to the increase in the number of diagnosed cases of the disease. It is known that chronic prostatitis (CP) occupies a leading position among urological diseases and is the result of many factors that are an integral part of modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
Since the disease not only covers an increasing percentage of the male population, but is also diagnosed at an increasingly younger age, there is often a rather dismissive attitude towards the problem on the part of doctors who use standard regimens for treatment that cannot lead to recovery.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate gland, manifested in the form of a chronic inflammatory process of the tissues. However, one cannot talk about CP only as a result of the penetration of pathogens into the prostate, since such a view justifies attempts to treat prostatitis exclusively with antibiotics, which almost never bring permanent positive results.
The main factors governing the development of pathology can be considered complex changes in the tissues and, consequently, the functional abilities of the gland, which are the main cause of the development of infectious microflora. Chronic prostatitis, to some extent, is a collective diagnosis that combines several factors:
- Reduced immunity.
- Stagnant processes in the pelvic organs.
- Urodynamic disorder.
- Degenerative processes in the prostate parenchyma.
- Eating disorder.
- inflammatory processes.
Development mechanism
The penetration of pathogenic microflora into a healthy prostate gland is practically incapable of causing an inflammatory process, since the prostate microflora has some resistance to pathogens present in the urethra. However, the presence of one or more of the above causative factors leads to the development of persistent inflammation, accompanied by the appearance of scar formations (fibrous) or areas of necrosis.
The proliferation of connective tissue during the process of scar formation causes congestive processes in the alveoli (ducts that ensure the excretion of secretions), which worsen the course of the disease. Necrotization of the tissues leads to the formation of a cavernous cavity, in which, in addition to the dead epithelium, a prostatic secret accumulates.
Thus, the main cause of the development of CP is not an infection, but various physiological disorders that allow the inflammatory process to become chronic.
Another distinguishing characteristic of the disease, which makes diagnosis difficult, isflow periodicity. As a rule, under the influence of external factors or the internal state of the body, there is a periodic change in the intensity of the pathology, during which acute conditions are replaced by periods of remission.
Often there is not only a complete absence of symptoms, but also an absence of laboratory markers indicating the presence of infection (for example, leukocytes). Despite the positive results, this situation cannot be considered a recovery, as all the physiological disorders in the gland remained unchanged.
The reasons
The main causes of circulatory disorders in the pelvic organs and stagnation of venous blood in the prostate are:
- Permanent stay in a sitting position.
- Hypothermia of the whole body or directly in the pelvic area.
- Systemic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- The presence in the body of a chronic infection of any localization (sinusitis, bronchitis).
- Excessive physical activity, accompanied by lack of sleep or rest, causes immune suppression.
- History of urogenital infections (gonorrhea, trichomonads).
- Toxic effects on the body due to the systematic use of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnant processes, deterioration of the excretory function of the glands, a decrease in cellular resistance to diseases, which contribute to the creation of optimal conditions for the reproduction of pathogenic microorganisms in the prostate gland.
Can chronic prostatitis be cured?
Despite the availability of a large amount of systematic information on the mechanism of CP development,dealing with it is extremely difficultand is one of the leading problems in modern urological practice.
Due to the fact that the disease progresses in each individual patient according to an individual scheme, therefore, the approach to treatment should also be individual, taking into account all the physiological changes that have occurred in the prostate gland.
The anatomical features of the prostate, which can be accessed either through the urethra or the rectum, significantly reduce the effectiveness of the applied therapeutic effect. In this regard, to achieve a relatively stable result, a long course of treatment (usually several months) is required, during which the patient must strictly comply with all the doctor's requirements.
Unfortunately, a complete cure can only be achievedin 30 cases out of 100. This is mainly due to the untimely seeking of medical help, due to a long absence of serious symptoms or conscious avoidance of unpleasant diagnostic and then therapeutic procedures. As a rule, at the time of treatment, atrophic processes in the prostate are irreversible, and even with long-term treatment, it is only possible to completely eliminate the symptoms and achieve a stable remission, the duration of which depends on the patient's compliance with the recommendationsdoctor's.
Treatment
The set of measures used in the treatment of CP include:
Antibacterial treatment
Suppression of the activity of the bacterial microflora with the help of antibiotics should be carried out only after a set of laboratory tests, according to the results of which the most effective drug is prescribed.
As a rule, the duration of antibiotics is determined by the severity of the disease and is at least 30 days. It is unacceptable to stop treatment, as the remaining microorganisms will become resistant to this group of drugs, and then replacement and an even longer duration will be required. In the treatment of prostatitis, antibiotics that have a bactericidal effect are preferred:
- Fluoroquinolones?
- Azaleas?
- Aminoglycosides?
- Tetracyclines.
If laboratory tests reveal a specific nature of the infection, for example, trichomoniasis or the viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed along with antibiotics.
The use of anticonvulsants and α-blockers
The main purpose of using drugs in this series is to relieve spasm in the pelvic floor, which helps to increase blood supply, improve urine output and reduce pain.
Cataracts
In order to avoid excessive pressure on the pelvic muscles that occurs during the act of defecation, it is recommended to use laxatives, since efforts during constipation can worsen the patient's condition.
Physiotherapy
One of the most common physical therapy methods is prostate rectal massage. The therapeutic effect of probing the prostate with a finger, carried out through the anus, is to dislodge the infected secretion, which is then excreted through the urethra.
In addition, during the massage, the blood supply to the tissues increases, which has a positive effect on the antibiotic treatment. The following physiotherapeutic methods are also used to perform rectal prostate massage:
- Electrical simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After stabilization of the condition, the patient must follow the rules that impose certain restrictions on the usual lifestyle:
- Avoid water procedures in open tanks and swimming pools.
- You are regularly checked by a doctor.
- Avoid drinking alcohol completely.
- Have a regular sex life with a partner.
Compliance with the rules will allow you to remain in remission as long as possible and avoid exacerbations of the disease.