Antibacterial therapy for prostatitis is not the only treatment method.Antibacterial drugs are prescribed only in case of appropriate indications, mainly for periodic exacerbations of the disease and increased severity of the manifestations of the disease.
The effectiveness of drugs for the treatment of prostatitis
It is known that different antibiotics are able to overcome the prostate barrier to different degrees, therefore their concentration in the prostate gland and thus their effectiveness in the treatment of prostatitis also differs.Therefore, among the drugs to which the greatest sensitivity of the flora has been established, those that are able to penetrate the prostate maximally 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 the drug used to treat prostatitis is that it has a broad-spectrum antibacterial effect.This is due to the fact that it is quite difficult to reliably determine the flora living in the prostate.Medicines belonging to the penicillin group primarily include broad-spectrum antibacterial agents.Tetracycline drugs have valuable properties in terms of penetration through the prostate barrier and breadth of antibacterial action.
Modern drugs of the fluoroquinol group
New antibacterial agents that have a significant advantage over others are drugs belonging to the group of fluoroquinolones.These drugs have a wider spectrum of antimicrobial activity and can 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 what is particularly important, microorganisms do not develop resistance to them.
Tetracycline drugs are also widely used as antibacterial therapy.
A young patient prescribed antibacterial treatment should be aware that the drugs used have a spermotoxic effect.Therefore, between the use of these drugs and the planned conception, there should be a break of at least 4 months, which exceeds the entire cycle of spermatogenesis.
Antibacterial drugs are usually prescribed for chronic bacterial prostatitis or infectious chronic prostatitis.Treatment tactics for non-infectious chronic prostatitis remain controversial and contradictory.Such patients are prescribed antibacterial drugs in the hope of curing the latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not from the first visit.Usually, within a few days, the doctor will examine the patient for infection.During this period, symptomatic therapy is recommended, usually with an anti-inflammatory effect in the form of 50 mg diclofenac or 100 mg suppository, which has an edema and pain-relieving effect.
After determining the type and sensitivity of the bacteria, 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 recurrent chronic prostatitis, it is recommended to extend the use of the antibacterial drug for 6-8 weeks.Sometimes the antibiotic therapy is extended to 16 weeks, after which practical recovery.If there is no positive result, the used antibacterial drug is abandoned, but no earlier than after 2 weeks of treatment.The ideal antibacterial drug should be fat-soluble, non-binding to serum proteins, and weakly alkaline, so that it is maximally concentrated in the prostate itself and not in the plasma.In terms of these requirements, the best 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 sperm, and are active against most bacteria found 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 determination of its sensitivity to antimicrobial agents;
- selection of 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 sufficiently long antimicrobial therapy to ensure the greatest possible effect;
- a combination of antibacterial drugs, both with each other and with drugs and procedures that enhance the antimicrobial effect, reduce the occurrence of complications and improve the microcirculation of the prostate;
- carrying out complex therapy, taking into account the characteristics of the patient's general state of 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 recommended to use drugs that promote healing.
Results of medical treatment of prostatitis
The strategy and tactics of antibacterial therapy are complex and varied, but their application can improve the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, a more or less long-lasting feeling of well-being may occur.But usually, sooner or later, the painful feelings that cause anxiety return.Therefore, the use of antibacterial drugs alone is not considered sufficient.The therapeutic program aimed at increasing local and general resistance achieves good results.In this case, you can count on the success of antibacterial therapy or long-term remission.
Improving microcirculation of the prostate
In the case of all forms of chronic prostatitis, in addition to influencing the microflora, efforts are made to restore the microcirculation of the prostate, improve the outflow of secretions from the glandular ducts, increase the intensity of the metabolic processes taking place at the source of the 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 has been proven.
Anti-congestion treatment includes measures aimed at reducing venous congestion in the pelvis: stopping interrupted sexual intercourse, a sedentary lifestyle, frequent alcohol consumption, etc.In the case of varicose veins of the lower limbs and hemorrhoidal veins, which can also cause prostatitis, surgical treatment of these diseases is carried out.In congestive, non-infectious prostatitis, only decongestant therapy is performed.
The treatment complex for chronic prostatitis contains special, highly effective drugs.In some cases of chronic prostatitis, in the presence of dysuric phenomena caused by venous congestion, drugs that reduce the tone of the smooth muscles of the prostate are used to reduce the urge to urinate.But only a doctor can recommend them.
Relieving pain caused by prostatitis
Since the presence and severity of pain in prostatitis is the main indicator of the patient, which determines his attitude to the disease and affects the manifestation of depression, in the treatment of chronic prostatitis, pain-relieving therapy is one of the most important components of the general treatment of the disease.The pain syndromes observed in chronic prostatitis are very diverse in their localization, duration and intensity.In this regard, the use of pain-relieving drugs is of great importance.
Oral administration is quite effective and temporarily relieves pain.The rectal application of painkillers in suppositories and microenemas is even more effective, as they use the combined effect of painkillers and anti-inflammatories, as well as the effect of temperature.Belladonna extract can be added to suppositories to change the tone of the gland.
Strengthening the immune system
In the treatment of chronic prostatitis, it is very important to increase the body's reactivity and defense, which usually helps to cope with any disease.In the case of chronic prostatitis, the body's defense capacity decreases.In this regard, it is very difficult to achieve success without the use of general immunological treatment of chronic prostatitis.
Sometimes a drug is used to treat chronic prostatitis that increases the body's ability to react.The drug with a pyrogenic (body temperature-increasing) effect aggravates chronic inflammation of the prostate and turns it into an acute one, which promotes healing, since inflammatory diseases are easier to treat in the acute stage.The drug works when it enters the bloodstream quickly.Therefore, it is administered intravenously, starting with small doses, gradually and carefully increasing the dose daily.With this method of intravenous administration, patients with chronic prostatitis must be treated as inpatients for observation.The drug is administered daily for 9-10 consecutive days.At the peak of the artificially induced aggravation of chronic inflammation of the prostate gland, from about the 4th day, the introduction of 1-2 antibiotics and sulfonamides or other drugs in fairly high doses.In order to improve the blood supply to the prostate, physiotherapy is performed at the same time, and daily massage is performed to improve the outflow of prostate secretions.The therapeutic effect in the form of improvement or healing can be achieved to varying degrees in almost all patients.
Hormone therapy
Sex hormone preparations for prostatitis should be used very carefully.Patients suffering from chronic prostatitis for years or decades may have such a need.However, it is better if the content of sex hormones (testosterone, estradiol, prolactin, FSH, LH) in the blood serum is determined.Simpler tests can also be performed, such as a cytological examination of a scraping from the urethral scaphu cavity.If the balance of sex hormones is upset, hormonal drugs can be included in the treatment regimen.
Enzymes may also be prescribed to dissolve prostate scar tissue for 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.Fortunately, for the vast majority of patients with prostatitis, hormone levels do not suffer significantly.
If the copulatory function or the ability to have sex is impaired, the erection is reduced, the orgasm "fades" and the ejaculation is impaired.The elimination of these symptoms and the normalization of sexual life largely depend on the underlying disease - prostatitis.The more successful the treatment, the faster the symptoms of sexual dysfunction disappear or decrease.
Treatment of sexual disorders due to developing neurosis includes psychotherapy, sedatives (tranquilizers), and the prescription of other drugs depending on the symptoms of the sexual disorder.This therapy shows how symptoms of prostatitis can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, you can use the LOD therapy, which consists of creating a vacuum in the vessel into which the penis is placed.As a result of the resulting negative pressure, the cracks in the cavernous bodies of the penis widen and blood flows into them.The penis enlarges and an erection occurs.
Repeated procedures lead to an increase in the gaps in the hollow bodies, a more stable blood supply to the organ and, ultimately, an improvement in erectile function.The positive effect of chronic prostatitis is also manifested in increased sexual activity, which has a powerful psychotherapeutic effect.
Phallodecompression method (PLD) for prostatitis is performed daily or every other day.The duration of the treatment is 10-15 procedures.It is useful to combine phallodecompression with instillation prostate massage, as this increases the rate of absorption of drugs after the procedure is completed.
Instillations
This type of therapy includes techniques that allow the drug to be delivered directly and directly to its destination.During instillation therapy using this method, drugs are administered through the external opening of the urethra using a conventional disposable syringe, a conical disposable cannula (a soft hollow tube), or a syringe.The optimal volume of the administered drug mixture is 5 ml.Before the procedure, you will need to urinate to make sure your bladder is empty.
During administration, it is recommended to imitate urination, i.e. relax, then the excess medicine enters the bladder and is excreted with the first dose of urine;the head of the penis should be pressed with your fingers or a special clamp - this prevents 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 to carefully smooth the filled urethra with the fingers of your free hand towards the perineum during insertion.
After the intervention, you must tolerate the urge to urinate, otherwise the administered medicinal mixture will flow back immediately.This mixture consists of the same drugs as for oral administration: antibiotics, pain relievers, antispasmodics, anti-inflammatories.
Instillation therapy for prostatitis allows the use of various drugs, the choice of which depends on the nature of the disease and the compatibility of the administered drugs.Oil mixtures should not be administered due to the risk of fat embolism (occlusion of blood vessels);in no case do not prepare the mixture yourself, as you can make a mistake in the dosage, which will lead to unpleasant and even dangerous consequences.
Cones (candles)
Suppository therapy (suppositories) is widely used in the treatment of prostatitis.The effect of the medicinal products in the suppository occurs primarily through the general blood stream, not through the mucous membrane of the intestinal wall.
The use of candles has a pronounced psychotherapeutic effect.In general, patients tend to use any suppositories for self-treatment of prostatitis, regardless of their composition.Patients especially often use propolis suppositories and thiotriazoline (0.5 g/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.
Microclysters
Typically, microenemas are used to treat prostatitis, often referred to as conventional treatment for prostatitis.Their use is based on the simultaneous temperature and healing effect.Microenema is usually used before going to bed.
Aqueous infusion of chamomile, calendula, sage or motherwort is used as a medicinal substance, which is boiled with boiling water before the microenema is administered.After the infusion has cooled down to 40°C, the medicine must be injected into the rectum.A small amount is injected - no more than 100 ml of liquid.Medicines must be absorbed in the rectum, that is, stool is not desirable immediately after microenema administration.
The aqueous infusion of herbs can be replaced with 1 teaspoon of alcoholic infusion (calendula, motherwort or chamomile), which is diluted with 100 ml of warm water before administration.You can add 1.0 g of antipyrine or 10 drops of tincture of iodine to the infusion.The effectiveness of microenema is well known and does not require proof.Microclysters are usually used simultaneously with antibacterial agents as the last stage of more active local procedures or as an independent therapeutic effect in case of mild pain symptoms.
It is a very important aspect that the use of drugs alone does not lead to a good and long-lasting effect.Prostate drainage procedures must be performed in combination with drug therapy - only then can the effect be guaranteed/