Antibacterial therapy for prostatitis is not the only treatment method.Antibacterial drugs are prescribed only if there are appropriate indications, mainly in cases of periodic exacerbations and increased severity of disease manifestations.
The effectiveness of drugs for the treatment of prostatitis
It is known that various 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 are different.Therefore, among the drugs to which the greatest sensitivity of the flora has been established, those are selected that have the maximum ability to penetrate the prostate.A similar approach to treating prostate adenoma can significantly speed up healing.
Broad-spectrum drugs for the treatment of prostatitis
Another condition for the effectiveness of a 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 living in the prostate.Those that have a wide spectrum of antibacterial activity mainly include drugs from the penicillin group.Tetracycline-based drugs have valuable properties in terms of penetration through the prostate barrier and the extent 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 broader spectrum of antimicrobial action and the ability to 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, which 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 antibacterial treatment should be aware that the drugs used can have a spermotoxic effect.Therefore, between the use of these drugs and the intended conception, it is necessary to maintain an interval of at least 4 months, exceeding the full cycle of spermatogenesis.
Antibacterial medications are usually prescribed for chronic bacterial prostatitis or chronic infectious prostatitis.For chronic non-infectious prostatitis, treatment tactics remain controversial and controversial.Antibacterial medications are prescribed to these patients in hopes of curing a latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not from the first visit.Typically, a few days later, the doctor examines the patient for infection.During this period, symptomatic treatment is recommended, usually with an anti-inflammatory effect in the form of 50 mg of diclofenac or 100 mg in suppositories, which have anti-edematous and analgesic effects.
After establishing the type of bacteria and its sensitivity, antibacterial drugs are prescribed, among which fluoroquinolones are the most effective.The treatment is carried out for 4 weeks or more (minimum 28 days) under clinical and bacteriological control.
If the effect is positive in patients with chronic recurrent prostatitis, it is recommended to extend the use of the antibacterial drug for up to 6-8 weeks.Sometimes antibiotic treatment is extended for up to 16 weeks, followed by convenient recovery thereafter.If there is no positive result, the antibacterial drug used is abandoned, but not earlier than after 2 weeks of treatment.An ideal antibacterial drug should be lipid soluble, not binding 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 of the bacteria present in chronic prostatitis.
Thus, a necessary condition for maximum effectiveness of antibacterial treatment of chronic prostatitis is compliance with the following general principles:
- isolation and determination of the microflora responsible for prostatitis and identification of its sensitivity to antimicrobial agents;
- choose 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 maximum possible effect;
- a combination of antibacterial drugs, both among themselves and with drugs and procedures that enhance the antimicrobial effect, reduce the incidence of complications and improve microcirculation in the prostate;
- carry out complex therapy taking into account the characteristics of the patient's general health.
Sometimes, with prolonged or too active antibacterial treatment, intestinal dysbiosis develops (decrease in the number and activity of normal intestinal microflora).In these cases, it is recommended to use medications to promote healing.
Results of drug treatment of prostatitis
The strategy and tactics of antibacterial therapy are complex and varied, but their use can improve the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, a more or less long period of well-being may occur.But, as a rule, sooner or later the painful sensations that caused anxiety return.Therefore, the use of antibacterial drugs by itself is not considered sufficient.Good results are obtained by a therapeutic program aimed at increasing local and general resistance.In this case, you can count on the success of antibacterial treatment or long-term remission.
Improve microcirculation in the prostate
In all forms of chronic prostatitis, in addition to influencing the microflora, they strive to restore microcirculation in the prostate, improve the outflow of secretions from the glandular ducts, increase the intensity of metabolic processes causing 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 is proven.
Anticongestive treatment includes measures aimed at reducing venous stagnation in the pelvis: stopping interrupted sexual intercourse, 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 non-infectious congestive prostatitis, only decongestant treatment is carried out.
The chronic prostatitis treatment complex includes special drugs with very effective effects.In some cases of exacerbation of chronic prostatitis in the presence of dysuric phenomena caused by venous stagnation, 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.
Elimination of pain due to prostatitis
Since the presence and severity of pain in prostatitis is for the patient the main indicator that determines his attitude to the disease and affects the manifestation of depression, analgesic treatment in the treatment of chronic prostatitis is one of the most important elements of the general treatment of the disease.The pain syndromes observed in chronic prostatitis are very diverse in their location, duration and degree of intensity.In this regard, the method of using analgesic drugs is of great importance.
Oral administration (by mouth) is very effective and provides temporary pain relief.Rectal use of analgesics in suppositories and microenemas is even more effective, since they use the combined effect of analgesics and anti-inflammatories, as well as the effects of temperature.To change the tone of the gland, belladonna extract can be added to suppositories.
Strengthen the immune system
When treating chronic prostatitis, it is very important to increase the body's responsiveness and its defenses, which usually help to cope with any disease.With chronic prostatitis, the body's defenses are reduced.In this regard, without the use of general immunological treatment for chronic prostatitis, it is very difficult to achieve success.
Sometimes a medication is used to treat chronic prostatitis and increases the body's responsiveness.Having a pyrogenic effect (increase in body temperature), the drug exacerbates chronic inflammation of the prostate and transforms it into acute, which promotes recovery, since it is easier to treat inflammatory diseases in the acute stage.The medicine works when it quickly enters the bloodstream.Therefore, it is administered intravenously, starting with small doses, daily, gradually and carefully increasing the dose.Using this method of intravenous administration, patients with chronic prostatitis should be treated as inpatients for observation.The drug is administered daily for 9-10 consecutive days.At the peak of artificial exacerbation of chronic inflammation of the prostate, from about the 4th day, the introduction of 1-2 antibiotics and a sulfonamide or other drug in fairly high doses begins.To improve blood supply to the prostate, physiotherapy is carried out simultaneously, and to improve the outflow of prostate secretions, daily massage is performed.Therapeutic effect in the form of improvement or recovery is achieved to varying degrees in almost all patients.
Hormonal therapy
It is necessary to use sex hormone preparations for prostatitis very carefully.In patients who have suffered from chronic prostatitis for years or even 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.In case of imbalance of sex hormones, hormonal drugs can be included in the treatment regimen.
Enzymes may also be prescribed to help resolve scar tissue in the prostate in cases of long-term disease.
As we already know, men who have suffered from chronic prostatitis for a long time suffer from sexual dysfunction.The latter is divided into copulatory, reproductive and hormonal.Fortunately, in the vast majority of patients with prostatitis, hormonal levels do not suffer significantly.
If copulatory function, or the ability to have sexual intercourse, is impaired, there is a decrease in erection, a "fading" of orgasm, and impaired ejaculation.Elimination of these symptoms and normalization of sex life largely depends on the underlying disease - prostatitis.The more effective its treatment, the more quickly the symptoms of the sexual disorder disappear or diminish.
Treatment of sexual disorders due to emerging neurosis includes psychotherapy, sedatives (sedatives) and the prescription of other medications depending on the symptoms of the sexual disorder.This therapy shows how prostatitis symptoms can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, you can use LOD therapy, which involves creating a vacuum in the vessel in which the penis is placed.Due to the negative pressure created, the cracks in the corpora cavernosa of the penis widen and blood flows into them.The penis enlarges and an erection occurs.
Repeated procedures lead to an increase in gaps in the corpora cavernosa, a more stable blood supply to the organ and, ultimately, to an improvement in erectile function.A positive effect in chronic prostatitis is also manifested by increased sexual activity, which has a powerful psychotherapeutic effect.
The phallodecompression (PLD) method for prostatitis is carried out daily or every other day.The treatment course includes 10-15 procedures.It is useful to combine phallodecompression with instillation prostate massage, as this increases the degree of absorption of drugs after the procedure is completed.
Instillation
This type of therapy includes techniques that allow direct, direct delivery of the drug to its intended destination.During instillation treatment with this method, drugs are administered through the external opening of the urethra using a conventional disposable syringe with a conical disposable cannula (soft hollow tube) or syringe.The optimal volume of the administered medicinal mixture is 5 ml.Before the procedure, you must urinate to make sure your bladder is empty.
At the time of administration, it is recommended to imitate urination, that is, relax, then the excess drug will enter the bladder and be expelled with the first portion of urine;the head of the penis should be pressed with your fingers or special forceps - 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, when introducing it, it is recommended to carefully stroke the filled urethra with the fingers of the free hand towards the perineum.
After the procedure, you must endure 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, analgesics, antispasmodics, anti-inflammatories.
Instillation treatment of prostatitis allows the use of a variety of drugs, the choice of which depends on the nature of the disease, as well as the compatibility of the drugs administered.Oil blends should not be administered due to the risk of fat embolism (blockage of blood vessels);under no circumstances should you make the mixture yourself, as you could make a mistake in the dosage, which would lead to unpleasant or even dangerous consequences.
Suppositories (candles)
In the treatment of prostatitis, suppository therapy (suppositories) is widely used.The action of the drugs contained in the suppository is carried out mainly through the general blood circulation and not through the mucous membrane of the intestinal wall.
The use of candles has a pronounced psychotherapeutic effect.Patients usually tend to use suppositories for self-treatment of prostatitis, regardless of their composition.Patients especially often use propolis suppositories, as well as thiotriazoline (0.5 g per 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 traditional prostatitis treatment.The basis of their use is simultaneous temperature and medicinal effects.Microenemas are typically used before bed.
As medicinal substances, they use aqueous infusions of chamomile, calendula, sage or motherwort, brewed with boiling water before administering a microenema.Once the infusion has cooled to a temperature of 40°C, the drug is administered into the rectum.A small volume is injected - no more than 100 ml of liquid.Medicines should be absorbed through the rectum, that is, stools immediately after administering a microenema are undesirable.
Aqueous herbal infusions can be replaced with 1 teaspoon of alcoholic infusions (calendula, motherwort or chamomile), which are diluted in 100 ml of warm water before administration.You can add 1.0 g of antipyrine or 10 drops of iodine tincture to the infusion.The effectiveness of microenemas is well known and does not need to be proven.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 painful symptoms.
A very important point is that the use of drugs alone does not lead to a positive and lasting effect.It is necessary to carry out prostate drainage procedures in combination with drug treatment - only then can the effect be guaranteed/