Antibacterial therapy for prostatitis is not the only method of treatment.Antibacterial drugs are prescribed only if there are appropriate indications, mainly for periodic exacerbations and increased severity of disease manifestations.
The effectiveness of drugs for the treatment of prostatitis
It is known that different antibiotics can overcome the prostate barrier to varying degrees, and therefore their concentration in the prostate, and therefore their effectiveness in the treatment of prostatitis, is different.Therefore, from the drugs to which the highest sensitivity of the flora has been determined, those with the maximum ability to penetrate the prostate are chosen.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 of antibacterial action.This is due to the fact that it is quite difficult to reliably determine the flora that lives in the prostate.Those with a broad spectrum of antibacterial activity include primarily 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 wider spectrum of antimicrobial activity and the ability to accumulate in the prostate in high concentrations when taken orally.In addition to direct antibacterial action, fluoroquinolones almost never cause immunodeficiencies in patients and, what 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 spermotoxic effect.Therefore, an interval of at least 4 months is necessary between the use of these drugs and the planned conception, which exceeds the full cycle of spermatogenesis.
Antibacterial drugs are usually prescribed for chronic bacterial prostatitis or infectious chronic prostatitis.For non-infectious chronic prostatitis, treatment tactics remain controversial and controversial.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.As a rule, within a few days at most, the doctor examines the patient to detect the infection.In that period, symptomatic therapy is recommended, most often with an anti-inflammatory effect in the form of 50 mg of diclofenac or 100 mg in suppositories, which has an anti-edematous and analgesic effect.
After determining the type of bacteria and their sensitivity, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.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 antibiotic therapy is extended to 16 weeks with virtual cure after that.If there is no positive result, the used antibacterial drug 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 itself, and not in the plasma.The best in terms of these requirements are fluoroquinolones, which have the best pharmacological properties in the treatment of chronic prostatitis;they create a sufficient concentration in the prostate, in its secretions and sperm, and are active against most bacteria found in chronic prostatitis.
Therefore, a necessary condition for maximum effectiveness of antibacterial therapy of chronic prostatitis is compliance with the following general principles:
- isolation and determination of the microflora that causes 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 selected drug;
- timely initiation of treatment and sufficiently long course of antimicrobial therapy to ensure the greatest possible effect;
- combination of antibacterial drugs, both with each other and with drugs and procedures that enhance the antimicrobial effect, reduce the frequency of complications and improve microcirculation in the prostate;
- implementation of complex therapy taking into account the characteristics of the patient's general health.
Sometimes, with long-term or excessively active antibacterial therapy, intestinal dysbiosis (reduction in the number and activity of normal intestinal microflora) develops.In these cases, it is recommended to use drugs that promote his recovery.
Results of treatment of prostatitis with drugs
The strategy and tactics of antibacterial therapy is complex and diverse, but its use can improve the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, there may be a more or less long period of well-being.But, as a rule, sooner or later painful feelings that caused anxiety return.Therefore, the use of antibacterial drugs alone is not considered sufficient.Good results are achieved with a therapeutic program aimed at increasing local and general resistance.In that case, you can count on the success of antibacterial therapy or a long-term remission.
Improvement of microcirculation in the prostate
In all forms of chronic prostatitis, in addition to affecting the microflora, they try to restore microcirculation in the prostate, improve the flow of secretions from the glandular ducts, increase the intensity of metabolic processes at 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 has been proven.
Anticongestive treatment includes measures aimed at reducing venous stagnation in the pelvis: stopping interrupted sexual relations, 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 congestive non-infectious prostatitis, only decongestive therapy is carried out.
The complex for the treatment of chronic prostatitis includes special drugs with a highly effective effect.In some cases of exacerbation of chronic prostatitis with the presence of dysuric phenomena caused by venous stagnation, drugs that reduce the tone of smooth muscles of the prostate are used to reduce the urge to urinate.But only a doctor can recommend them.
Pain relief due to prostatitis
Since the presence and intensity of pain in prostatitis serves as the main indicator for the patient, which determines his attitude towards the disease and affects 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.Pain syndromes observed in chronic prostatitis are very diverse in their localization, duration and degree of intensity.In this sense, the method of using analgesics is of great importance.
Oral administration is quite effective and temporarily relieves pain.Rectal administration of painkillers in suppositories and microenemas is even more effective, because they use the combined action of analgesics and anti-inflammatory drugs, as well as temperature action.To change the tone of the gland, belladonna extract can be added to suppositories.
Strengthening the immune system
When treating chronic prostatitis, it is very important to increase the reactivity of the organism and its defense forces, which usually help in dealing with any disease.In chronic prostatitis, the body's defense power is reduced.In this sense, without the application of general immunological treatment of chronic prostatitis, it is very difficult to achieve success.
Sometimes a drug that increases the reactivity of the body is used to treat chronic prostatitis.Having a pyrogenic (increasing body temperature) effect, the drug worsens chronic inflammation of the prostate and turns it into an acute one, which improves recovery, because it is easier to treat inflammatory diseases in the acute phase.The drug works when it quickly enters the bloodstream.Therefore, it is administered intravenously, starting with small doses, daily, gradually and carefully increasing the dose.With this method of intravenous administration, patients with chronic prostatitis must be treated as inpatients in order to be monitored.The medicine is applied daily for 9-10 days in a row.At the peak of the artificially induced exacerbation of chronic inflammation of the prostate, approximately from the 4th day, the introduction of 1-2 antibiotics and sulfonamides or other drugs in fairly high doses begins.To improve blood supply to the prostate, physiotherapy is performed at the same time, and massage is performed daily to improve the outflow of prostate secretions.The therapeutic effect in the form of improvement or recovery is achieved to a varying degree in almost every patient.
Hormonal therapy
Sex hormone preparations for prostatitis should be used very carefully.In patients who have been suffering 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 of scrapings from 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 remove scar tissue in the prostate 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 with prostatitis, fortunately, hormonal levels do not suffer significantly.
If the copulatory function, that is, the ability to have sex, is impaired, there is a decrease in erection, "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 successful its treatment, the faster the symptoms of sexual disorder disappear or decrease.
Treatment of sexual disorders due to nascent neurosis includes psychotherapy, sedatives (sedatives) 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 the case of erectile dysfunction, after the main treatment, you can use LOD therapy, which consists of creating a vacuum in the vessel in which the penis is located.Due to the created negative pressure, the cracks in the cavernous bodies of the penis expand and blood flows into them.The penis enlarges and an erection occurs.
Repeated procedures lead to an increase in the gaps in the cavernous bodies, to a more stable blood flow to the organ and, ultimately, to an improvement in erectile function.A positive effect in chronic prostatitis is manifested by increased sexual activity, which has a strong psychotherapeutic effect.
Phalloid decompression method (PLD) for prostatitis is performed daily or every other day.The course of treatment is 10-15 procedures.It is useful to combine phallus decompression with instillation massage of the prostate, because this increases the degree of drug absorption after the procedure is completed.
Instillations
This type of therapy involves techniques that allow direct and direct delivery of the drug to the desired 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 syringe.The optimal volume of the applied medicinal mixture is 5 ml.You should urinate before the procedure to make sure your bladder is empty.
At the time of administration, it is recommended to imitate urination, i.e. relax, then the excess medicine will enter the bladder and be expelled with the first portion of urine;you must press the head of the penis with your 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 that you carefully stroke the filled urethra towards the perineum with the fingers of your free hand.
After the procedure, you must resist the need to urinate, otherwise the applied medicinal mixture will come out immediately.This mixture consists of the same drugs as for oral administration: antibiotics, analgesics, antispasmodics, anti-inflammatory drugs.
Instillation therapy for prostatitis allows the use of different drugs, the choice of which depends on the nature of the disease, as well as the compatibility of the drugs used.Oil mixtures should not be given because of the risk of fat embolism (clogging of blood vessels);in no case should you make the mixture yourself, because you can make a mistake in the dosage, which will lead to unpleasant and even dangerous consequences.
suppositories (candles)
Therapy with suppositories (suppositories) is widely used in the treatment of prostatitis.The action of medical drugs included in the suppositories is carried out mainly through the general bloodstream, and not through the mucous membrane 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, as well as with thiotriazoline (0.5 g per suppository), which have a complex anti-inflammatory and membrane-stimulating effect.In addition to medical suppositories, magnetic suppositories are also used in the treatment of prostatitis.
microclysters
Micro-enemas are usually used to treat prostatitis, often referred to as traditional prostatitis treatment.The basis of their use is the simultaneous temperature and healing effect.Micro enemas are usually used before going to bed.
Water infusions of chamomile, calendula, sage, or lemon balm, boiled with boiling water before microenema are used as medicinal substances.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, i.e. stool immediately after microenema administration is undesirable.
Water infusions of herbs can be replaced with 1 teaspoon of alcohol infusions (calendula, lemon balm or chamomile), which are diluted in 100 ml of warm water before use.You can add 1.0 g of antipyrine or 10 drops of iodine tincture to the infusion.The effectiveness of microenema is well known and does not need proof.Microclysters are usually used simultaneously with antibacterial agents as the final stage of more active local procedures or as an independent therapeutic effect for mild pain symptoms.
A very important thing is 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/