Prostatitis is a common urological disease characterized by the presence of inflammatory changes in the prostate gland as a result of the influence of harmful factors (infectious, occupational, etc. ). The standard treatment regimen for prostatitis depends on the form, course and pathogen of the disease.
Treatment of prostatitis depending on the type
The disease is polyetiological in nature, but the main factor of its occurrence is infectious. Therefore, the task of urology is to search for rational methods of etiotropic therapy and fight against infection.
Treatment of bacterial prostatitis includes antibiotic therapy. The drug is prescribed after laboratory diagnostics to determine the pathogen and sensitivity to antibiotics.
According to the results of statistical studies in the treatment of the disease, drugs from the group of fluoroquinolones, cephalosporins and tetracyclines are considered the most effective.
Antiviral drugs are used to treat prostatitis caused by herpes, HPV or cytomegalovirus. Prostatitis of fungal etiology is treated with antimycotic agents.
Since many factors affect the development of prostatitis, therapy is usually complex and usually includes lifestyle changes aimed at increasing immunity and improving blood circulation in the pelvic organs.
The list of events includes:
- diet food (to prevent constipation);
- regular physical and sexual activity;
- vitamin therapy;
- proper sleeping and waking patterns.
If prostatitis is caused by a violation of the pelvic blood supply, regular physical activity, massage and physiotherapy exercises (squatting, lunging, walking, running) are indicated to eliminate the blockage. In the presence of hidden sources of infection (caries, sinusitis, tonsillitis), pathological centers must be sanitized.
Therapy regimens
The symptoms of chronic and acute forms of prostatitis are similar, but the drug exposure patterns are different. This is due to the fact that the treatment in the acute form is aimed at fighting the infection and stopping unpleasant symptoms, and the chronic form of the disease needs physiotherapeutic exposure methods.
List of drugs in the acute phase of prostatitis:
- NSAIDs - relieve anxiety and prevent the development of the inflammatory process in the gland.
- Antibiotics. The causative agent of the disease affects. The most commonly used are protected penicillins, macrolides, cephalosporins, fluoroquinolones.
- Antispasmodics. They are used to relieve pain in the gland, improve the flow of secretions, relax the vessel walls and increase microcirculation.
- Alpha blockers. Improve flow during acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. Eliminate body inflammation and reduce swelling.
- Phytotherapy agents. They are adjuvant healing agents of natural origin. By gently affecting the prostate gland, it reduces the swelling of the organ.
It is important!In the acute stage of prostatitis, physiotherapeutic measures are contraindicated.
Physiotherapy will help spread the infection and aggravate the inflammation.
The chronic form of prostatitis, on the other hand, is mainly treated with physiotherapeutic methods:
- Laser therapy.
- Phonophoresis (combination of ultrasound and medicine).
- Electrophoresis.
- Exposure to microwave ovens.
Apply one or more treatment methods at the same time. Surgical intervention (endoscopic method) is used only in the chronic form, complicated by the sclerotic process and blockage in the gland. The operation can significantly improve the patient's quality of life and restore lost functions.
Principles of treatment 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 venereal (gardnerellosis, chlamydia, gonorrhea, trichomonosis, etc. ) infections.
In the first case, the pathogenic microflora penetrates from the intestines or urinary tract into the prostate by a lymphogenous or hematogenous route and causes inflammation there.
In the second case, the pathogen is transmitted from an infected sexual partner.
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 case of infection with protozoa (trichomoniasis), a drug from the group of nitroimidazoles is usually prescribed. Intracellular chlamydia infection is treated with macrolide antibiotics.
Alternative agents are some other macrolides, fluoroquinolones, and tetracycline antibiotics.
Treatment of gonorrheal lesions includes penicillin and cephalosporin antibiotics and vaccine therapy. Inflammation of the gland caused by Gardnerella requires the use of antibiotics (a macrolide, lincosamide, as well as a drug from the group of nitroimidazoles and its analogues are prescribed).
In the treatment of acute prostatitis caused by non-specific microbial flora, a standard drug regimen including antibiotics is used.
The standard treatment regimen for prostatitis includes the following measures:
- Bed rest in the acute form, massage and exercise therapy in the chronic stage of the disease.
- Diet food.
- Antibiotics to suppress the microbial flora that cause inflammation in the prostate gland.
- NSAIDs are used symptomatically to treat pain and inflammation.
- bioregulatory peptides. These are products obtained from the prostate gland of cattle. Stimulate regeneration 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, remove congestion (for example, a drug that improves microcirculation in the gland by blocking receptors located on the wall of blood vessels).
- Hormonal agents.
Depending on the course and characteristics of prostatitis, other measures (ultrasound, autohemotransfusion, rectal administration of drugs) can be added to the scheme.
Intravenous infusions are used to quickly stop the symptoms of prostatitis.
Such treatment is carried out in hospital conditions. To stimulate the immune system, tissue preparations, anabolics are prescribed.
Treatment of acute bacterial prostatitis
In the acute form of the disease caused by infection, antibacterial treatment is indicated. But in some cases, it is also prescribed for chronic prostatitis of abacterial etiology - as an additional measure of the effect on possible hidden infections. Broad spectrum antibacterial agents are preferred.
The course of treatment is from 2 weeks to a month. If there is an improvement in the condition, the treatment can be extended up to 2 months.
The most commonly used groups of antibiotics in the treatment of bacterial prostatitis are:
- protected penicillins. Medicines are prescribed 1 g orally 2 times a day. It is important to take the medicine regularly at the same time with a 12-hour break. The course of exposure to the drug is from one week to 10 days. Penicillins are usually used until laboratory test results are available.
- 2nd generation fluoroquinolones, 200 mg 2 times a day for 1-2 weeks.
- Fluoroquinolones 3 generations 0. 5 g once a day for 5 days.
- 3rd generation cephalosporins. Prescribe the drug / m or / 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 once a day for 5-7 days.
- Macrolides. It is not toxic, does not have a negative effect on the intestinal microflora. Assign 500 mg orally 1-2 times a day. The remedy should be taken for at least 5-14 days.
When taking antibiotics for prostatitis, patients are not recommended to independently reduce the dose and duration of treatment. The full course is at least two weeks.
Allergic patients should inform the doctor about existing intolerance to specific drugs before starting treatment. It is possible that the specialist will have to make adjustments to the treatment regimen or the dosage of drugs in case of liver or kidney dysfunction, so it is important to notify him in advance.
The scheme of treatment of acute viral prostatitis
Virological diagnostic methods are not included in the examination protocol, so the diagnosis of "viral prostatitis" is rarely made by urologists. Herpes infection and HPV are sexually transmitted.
The genital herpes virus enters the male body and multiplies, then reaches the lymph nodes, from where it spreads to the internal organs by hematogenous and lymphogenous ways.
After exposure to the drug, the virus remains in the spinal or cranial ganglia and periodically replicates. Usually, an exacerbation occurs after hypothermia or a decrease in immunity.
The culprits of this type of prostatitis are herpes virus, cytomegalovirus, HPV and influenza. The agent can penetrate not only the prostate, but also other nearby organs, such as the bladder, urethra, testicles, and rectum, causing serious damage to them when immunity is reduced.
The causative agent of viral prostatitis can be determined using laboratory analysis. Genital herpes in men has the appearance of localized vesicles and sores in the groin, scrotum, perineum or urethra. Basically, the disease continues with severe itching and burning, but there is also an asymptomatic course.
Treatment of viral inflammation of the prostate includes:
- Taking antiviral drugs. They are effective in the treatment of herpes and HPV. Their mechanism of action is based on preventing the creation of new generations of the virus. Special treatment is carried out for 5 days with the maximum therapeutic dose on the first day.
- Reception of immunomodulators.
- To normalize urine output, alpha-blockers are prescribed, which relieve smooth muscle tension and facilitate urination.
With the defeat of HPV or warts, it is sometimes necessary to remove growths using electrocoagulation, laser or liquid nitrogen. The procedure is performed in a hospital.
Acute fungal prostatitis treatment scheme
Long-term 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 due to the uncontrolled use of antibiotics and their gradual addiction.
With a decrease in immunity, the fungus of the genus Candida begins to multiply actively in the body and causes candidiasis.
It is used in the treatment of candidal prostatitis:
- Antimycotics. Medicines are sometimes combined in different proportions.
- Probiotics containing bifido- and lactobacilli. They inhibit the growth of pathogenic flora.
- Immunomodulators that increase the body's defenses.
It is important!Foods containing probiotics should be included in the diet of patients with fungal infection of the prostate.
These are kefir, yogurt, acidophilus milk. In addition, it is necessary to limit the use of sweets, cakes, fresh milk, fruits and juices.
The result
It should be remembered that only a specialist urologist can choose a course of medication for prostatitis. Self-medication slows down the healing process, and in the worst case, it can harm the body, cause severe allergic reactions and help the body adapt to certain antibiotics, as a result of which these drugs will no longer have a therapeutic effect.