Treatment of chronic prostatitis applied in a spa setting

Mud therapy

The therapeutic effect of rectal mud tampons consists of two phases. The first phase, reflex, is a response to the effect of the thermal factor and is manifested by a significant increase in the blood filling of arterioles, precapillaries and capillaries, which leads to improved trophism of the tissues of the rectum and prostate. The second phase - neurohumoral - is based on an increase in the content of biologically active substances (histamine, etc.) in the mucous membrane of the rectum, which increases the permeability of tissue structures for ionized inorganic and organic biologically active components of the mud.

The temperature of mud applications (rectal tampons), the duration of exposure and the number of procedures are of significant importance in the therapeutic effect of this factor and its effectiveness. Under the influence of mud therapy, the general condition of patients improves, tissue blood supply increases, and a neurohumoral response of the body is formed with the participation of the endocrine and other systems. The beneficial effect of heat when using rectal tampons is supplemented by slight mechanical pressure, as well as the effect of biologically active substances contained in the therapeutic mud. These substances penetrate the rectal mucosa into the blood, where they have an effect. Mud therapy reduces pain and inflammation in the prostate gland, improves its function, as well as spermatogenesis. Under the influence of a relatively high temperature (40-42 °C) of mud applications and rectal tampons, the permeability of the rectal mucosa for the chemical ingredients of the therapeutic mud increases, due to which the anti-inflammatory effect is largely realized. Therapeutic mud is used in the form of applications ("panties") and rectal tampons (200 g of therapeutic mud per tampon). The mud temperature is 40-42 °C, the duration of the procedures is 20-30 minutes, they are carried out daily, the course of treatment is 10-12 procedures. In patients with chronic prostatitis, hypertension stage I, as well as in elderly people, mud therapy is carried out in the form of applications and rectal tampons with a temperature of 37-38 °C. The duration of the procedure is 10-15 minutes, every other day, the course of treatment is 8-10 procedures.

Paraffin therapy

Paraffin is a white, dense, odorless mass. It is obtained by distilling oil. The melting point of paraffin is 50-57 °C. It has low thermal conductivity and high heat capacity. These properties of paraffin are used in the treatment of chronic prostatitis. Paraffin cakes are used for treatment, which are applied to the sacrum or perineum. The procedures are carried out daily or every other day, depending on the individual sensitivity of the patient. The temperature of the cakes is 38-40 °C. The course of treatment is 10-12 procedures.

Ozocerite therapy

Ozokerite is a waxy mass of dark brown or black color of petroleum origin. Contains paraffin, mineral oils and resins. For the treatment of patients with chronic prostatitis, ozokerite is used in the form of cakes with a temperature of 38-40 ° C on the sacrum or perineum, daily, for a course of treatment - 10-12 procedures. Ozokerite has not only a thermal effect. It contains enough organic and mineral substances with anti-inflammatory properties.

Clay therapy

Clays are finely dispersed mineral sedimentary deposits of water bodies, varied in mineral composition. In terms of physical properties, they are close to silt mud and peat, have high plasticity, viscosity, low thermal conductivity, high heat capacity, as a result of which they retain heat well. Fatty plastic clays (yellow, gray, green) without admixture of sand with water are most suitable for therapeutic use.

For the treatment of chronic prostatitis, clay is used, previously cleaned of foreign inclusions and diluted with a 10% solution of sodium chloride. The clay is heated in a water bath to a temperature of 40-42 ° C, after which it is applied to the "panties" area. The duration of the procedures is 20-30 minutes, they are carried out daily or every other day, the course of treatment is 10-12 procedures.

Sand therapy

River or sea sand, cleaned of foreign impurities, heated to a temperature of 40-42 °C, dry or slightly moistened, is used. Specially adapted boxes are used for local procedures. The area of action is the perineum. The duration of the procedure is 15-20 minutes, daily or every other day, the course of treatment is 12-15 procedures.

Naftalan treatment

Naphthalan oil has an anti-inflammatory, analgesic effect, increases the overall reactivity of the body, stimulates metabolic and trophic processes in the body. It finds therapeutic use in the form of general and local baths, naphthalan applications, vaginal and rectal tampons. Refined (dehydrated) naphthalan, as well as naphthalan ointments and pastes are used for applications. In the treatment of chronic prostatitis, naphthalan is applied with a brush to the "panties" area. The temperature of the naphthalan is 37-38 ° C. The lubricated areas of the skin are irradiated with a Sollux lamp for 15-20 minutes (procedure time). After the procedure, rest for 30-40 minutes is recommended. The course of treatment consists of 10-15 procedures, which are carried out for 2 days in a row with a 3-day break. In parallel, it is recommended to prescribe naphthalan rectal tampons with a temperature of 36-37 °C, which can be left for 5-6 hours.

Treatment with hydrogen sulphide waters

It is successfully used for many diseases, these waters have anti-inflammatory, desensitizing effect, improve blood circulation, have a beneficial effect on the functional state of the nervous system. B.G. Alperovich in 1936 was the first to report on the successful use of natural hydrogen sulfide (Matsesta) water in the treatment of patients with non-specific chronic prostatitis. A.A. Buyuklyan in 1970 suggested using Matsesta water in the form of microclysters with a hydrogen sulfide concentration of 150 mg / l, a temperature of 38-40 ° C, in an amount of 100-200 ml. The water must be retained in the rectum for 20-25 minutes. The procedures are carried out every other day, the course of treatment - 12-15 procedures. However, the author did not scientifically substantiate the use of such dosages. I.I. In 1976, Nesterov used artificially prepared hydrogen sulphide water in the form of half-baths and microclysters to treat patients with chronic prostatitis. For microclysters, water with a hydrogen sulphide concentration of 50-100 mg/l and a temperature of 36-37 °C is used. The amount of water administered at one time is 50 ml, the duration of its presence in the rectum is 10 minutes. The procedures are carried out daily or every other day. The course of treatment is 10-12 procedures. Patients with non-specific chronic prostatitis tolerated treatment with hydrogen sulphide waters well. Only a few patients had a reaction to the procedure that slightly exceeded the physiological one, manifested by increased pain in the lower abdomen, in the sacrum, perineum, dysuria, general weakness. A similar reaction began in the first hours after the bath and continued for up to 24 hours; it was especially pronounced during treatment with microclysters of hydrogen sulphide water, which is apparently associated with the rapid absorption of sulphides by the rectal mucosa.

To reduce the irritating effect of hydrogen sulphide water on the rectal mucosa, slow down the absorption of sulphides and, consequently, eliminate the reaction to the procedure, a procaine-hydrogen sulphide mixture was proposed for microclysters with preliminary introduction of vaseline oil into the rectum. At the same time, the number of patients who had a reaction to the procedure decreased from 25.3 to 3.8%. Procaine provided a pronounced analgesic effect. Under the influence of hydrogen sulphide therapy in patients with chronic prostatitis, according to rheovasography, an increase in the tone and elasticity of the vascular wall, an increase in the number of functioning capillaries, an increase in the blood flow rate, a decrease in venous congestion were observed, which led to a decrease in prostate edema and contributed to the anti-inflammatory effect. This made it possible to recommend hydrogen sulphide waters to patients with chronic prostatitis.

Climatic factors

Climatic factors serve as natural biostimulants of the body. They have a thermal, chemical and biological effect, which is carried out through the extensive neuroreceptor apparatus of the skin and respiratory tract. The impact of climatic factors on the human body mobilizes adaptation mechanisms, affects tissue trophism, changes immunobiological reactivity, metabolic processes, stimulates sexual function. When prescribing climatotherapy, it is necessary to take into account the season, climatic features of the area, individual reactivity of the body, the age of the patient, the degree of activity of the inflammatory process and the clinical course of the disease. For andrological patients, various types of aerotherapy can be used: long stay in the open air, walks in the forest, by the sea, air baths with partial or complete nudity. General and local sunbathing with direct and diffuse radiation, swimming in the sea, estuary, lake, river, and in the cool season - in closed artificial reservoirs are also effective. During a stay in the open air, especially by the sea, in parks, in the forest, the course of the main physiological processes in the body improves, which helps to normalize sexual function. Air baths are simple, accessible and very effective procedures. Unlike general aerotherapy, air baths include a dosed effect of fresh air on a naked or partially naked person. During an air bath, the body is affected by a whole range of meteorological elements: temperature, humidity, pressure, air ionization, diffuse solar radiation. For andrological patients, indifferent (air temperature 21-23 °C) or warm (over 23 °C) air baths are indicated in most cases. In some cases of sexual dysfunction, after taking warm and indifferent air baths, you can gradually move on to moderately cold (9-16 °C) baths, strictly monitoring the individual capabilities of the body.

Sunbathing is a procedure with an active photochemical and thermal effect. It helps to activate the functional systems of the body, primarily the nervous and humoral systems, through which the activity of the sex glands is regulated. Sunbathing should be prescribed with some caution, in small doses according to the gentle (low) load regimen, starting with 20.9 J, bringing the maximum dose to 104.5-125.4 J, adding 20.9 J every 2 days. The procedures should be carried out under comfortable environmental conditions: air temperature of 20-25 °C, wind speed from 0.8 to 3.2 m/s, in the morning (8.00-10.00) or pre-evening (17.00-19.00) hours. Sunbathing is recommended to be taken on special loungers with a protected headboard. The course of treatment is prescribed 20-25 procedures.

In all types of climatic and balneological treatment, andrological patients are prescribed morning hygienic gymnastics, therapeutic physical training, sports games, terrain cure, etc. Heat therapy, radon procedures and this combined interaction causes a certain wave process of a high information level, which leads to stimulation of cell division, cellular and intracellular regeneration, activation of functions.

It has been shown that during radon procedures, when the level of radon radiation is several times lower than the natural radioactive background, a person experiences significant stimulation of mast cell degranulation and the amount of heparin can increase by 1.5-2 times. Analysis of a large clinical material, study of remote treatment results helped to make a number of discoveries, one of which was later called radiation hormesis in the literature. The term "radiation hormesis" refers to the phenomenon that atomic radiation can, depending on the dose, cause a diametrically opposite effect on living organisms. In sufficiently large doses, it inhibits vital processes, up to the death of the organism, with a decrease in the dose it reduces the damaging effect, and at ultra-low doses it stimulates vital processes, having a beneficial effect on cells.

Research on clinical and experimental radon therapy allows for a deeper understanding of the mechanisms of radiation hormesis. The results of studying the mechanisms of the therapeutic effect of radon procedures allow us to state that the stimulation of the protective and restorative forces of the body is carried out by irradiating primarily the receptor cells of barrier organs, i.e. not directly, but indirectly, by stimulating the centers of immune and neuroendocrine regulation. Balneotherapy, including radon therapy, in conditions adequate for the body and doses that exceed natural background irritants several times, replaces the tonic effect of natural stimulants that the sick body lacks. Balneotherapy acts with active irritants on the same receptors of barrier organs and awakens the protective and adaptive forces of the body. This allows the patient's body to a certain extent to cope with the disease or to compensate for its pathological effect for a time.

The local action of the balneotherapy procedure also reduces pathological impulses from the affected organ. Of course, the neurohumoral centers receive a tonic effect not only from the receptors of the skin and mucous membranes, but also through vision, hearing, muscle proprioceptors and other endoreceptors of various organs. This effect also weakens when a person is ill and the active connection of his body with external stimuli is limited. Radon procedures artificially increase impulses from the barrier organs, which determines their stimulating effect on the body's defenses, and hence the therapeutic effect of their use.

Thus, radon therapy (irradiation in near-background doses) is one of the methods of stimulating weakened protective and adaptive forces of a sick organism, used when the action of other natural stimulating factors is impossible or insufficient. Moreover, it has been found that radon, as one of the main natural factors of radiation hormesis, stimulates the resistance of living organisms to oncological and infectious diseases, increases life expectancy, and serves as one of the necessary conditions for maintaining normal life and health.

Research has shown that the therapeutic effect of radon directly depends on the presence of microelements in water. The impact of alpha particles leads to the emission of very weak beams of short ultraviolet radiation, which carry biological information. According to I.I. Gusarov (2002), two effects take place in the beneficial action of therapeutic factors:

• preventive (hormesis) - due to the action of radon waters;
• therapeutic - mainly due to the action of other natural and medical factors.

It was found that irradiation of living organisms or freshly isolated tissues with small doses of radiation causes secondary radiation in the latter, which in turn has a stimulating effect on bioobjects. These secondary biogenic radiations are constantly produced in a living organism under the influence of natural radioactive background, and their intensity depends on its level. Natural radiation background continuously excites biopolymers of a living organism, and excited electrons form vortex clots of energy and information (polaritons). Slowly disintegrating, they produce coherent secondary biogenic radiation in the ultraviolet range. Filling the internal space of a living organism, secondary biogenic radiation apparently constitutes the electromagnetic physical basis of the biofield. Diseases and conditions in which radon therapy has a beneficial effect are associated with a violation of the coordination of various vital processes realized with the participation of VBI.

However, it should be noted that the role of radon radiation and its daughter products, as well as nitrogen-siliceous waters, in the formation of secondary biogenic radiation has not yet been established. As is known, the action of general and local balneological procedures is based on a complex of various factors: mechanical, temperature, chemical and ionizing.

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Hydrostatic effects

The mechanical effect is determined by the hydrostatic pressure of the water mass and gas bubbles. It is noted that the pressure creates a favorable environment for eliminating inflammatory changes and restoring impaired functions, and affects venous blood flow. In the mechanism of action of nitrogen-silicon baths, a large role is played by the peculiar physical effect of the gas (nitrogen) itself, since the nitrogen bubbles are small and slightly mobile. They densely cover the entire body, accumulate on hairy areas and cause very slight tactile irritation of the skin receptors. In addition to the mechanical effect, there is also a thermal effect, caused by the difference in temperature of the water in the bath (36-37 °C) and the bubbles of gaseous nitrogen (20-22 °C).

Nitrogen-siliceous baths are easily tolerated by patients, in 69% of patients they cause a feeling of calm and a tendency to sleep, i.e. they have a sedative effect on the central nervous system. They can be classified as weak irritants, which have the ability to increase inhibition and weaken excitation.

The temperature factor determines a number of features of the physiological effect of mineral waters. Its effect is greater, the greater the difference between the body and water temperatures. The aquatic environment dramatically changes the conditions of heat transfer due to the large difference in the heat capacity and thermal conductivity of air and water. In response to the action of a thermal stimulus (balneotherapy with a water temperature of more than 37 °C), complex thermoregulatory reactions develop, which contribute to increased heat transfer and a decrease in heat production. The lumen and number of blood vessels increase, blood flow increases, the activity of the cardiovascular and respiratory systems changes, and the intensity of metabolism increases.

Chemical elements included in mineral water determine specific features of the action of balneological procedures with different salt content and gas saturation. Gases, mineral substances, active ions penetrating the body through the skin and mucous membranes change the ionic composition in the cells of the skin and internal organs, act humorally on the interoreceptors of the vessels. Chemical ingredients of mineral waters affect the energy and metabolic processes occurring in the body. Irritation of exteroceptors and penetration of various substances into the body change the course of many physiological processes, lead to increased function of the adrenal glands, which causes an indirect anti-inflammatory effect.

Numerous publications have reported increased resistance to external regressive factors, mobilization of the body's reserve capacities, increased nonspecific reactivity, and normalization of the immune status after exposure to nitrogen-siliceous thermal waters. According to V. S. Dergachev (1995), in patients with chronic decomposed tonsillitis, under the influence of balneological procedures, the indices of the quantity and differentiation of T-cells approach the norm by the end of treatment. Under the influence of this water, the indices of protein-synthetic processes in the studied cells increase or are maintained, as indicated by the quantitative and volumetric density of ribosomes, rough endoplasmic reticulum, and Golgi complex. The energy potentials of the cell are maintained or even increase, as indicated by the increase in the number of mitochondria, the total area of the inner mitochondrial membrane, and the surface-volume ratios of the length of the section profile of the inner mitochondrial membrane to the volume of mitochondria. Transendothelial transport is maintained or increases, as evidenced by an increase in the total number of microvesicles.

Long-term clinical observations of the course of neuroendocrine syndromes in gynecological patients under the influence of balneological procedures indicate their favorable course against the background of treatment. When studying the mechanism of action of nitrogen-siliceous thermal waters, their favorable effect on the course of the inflammatory process was proven, in particular in the form of delaying the development of the sclerosis process.

V.I. Ryazanov et al. (1976), studying the effect of mineral waters on the transformation of lymphoid cells, determined that balneotherapy does not disrupt the immune structural homeostasis of the body. E.A. Skal'skaya et al. (1976) revealed an increase in the phagocytic activity of leukocytes in the treatment of patients with rheumatism with a minimal degree of activity. In a series of experiments (at the Belokurikha resort), bathing animals in nitrogen-siliceous water caused a decrease in the level of humoral antibodies in the precipitation reaction up to their disappearance after 2.5 months. A decrease in antibody titers, anti-O-streptolysin, incomplete antibodies in the Coombs reaction, autohemagglutinins and y-globulin fractions of protein after treatment indicates a desensitizing effect.

E.F. Fedko et al. (1978), Yu.I. Borodin et al. (1990) studied the effect of nitrogen-siliceous waters on the early stages of chronic inflammatory phenomena in an experiment on animals. They found that nitrogen-siliceous waters restore the structure of lymph nodes, their functional capacity and prevent sclerosis. V.N. Gorchakov et al. (1978, 1988) studied the effect of mineral waters on microcirculation in the focus of chronic inflammation. The scientists noted an increase in the capillary network and improved blood circulation in the pathological focus. A positive effect of balneotherapy in an experiment on some forms of ischemic heart disease was revealed. A positive effect of balneotherapy on the microcirculation of peripheral vessels was established. The basis for the therapeutic use of such waters was their pronounced analgesic, desensitizing effects, as well as the enhancement of the body's adaptive capabilities. The mechanism of action of nitrogen-siliceous thermal waters is realized both through the normalization of the hypothalamus function, blocking the transmission of pain impulses, and through the improvement of blood circulation in the myometrium, endometrium, ovaries due to the reserve capillaries of the tissues. Improvement of metabolic processes, increase in general and regional hemodynamics, normalization of the function of the ovaries and the hypothalamic-pituitary-adrenal system have a positive effect on the body in a number of gynecological diseases. The possibility of stimulating anabolic processes, as well as regulating the content of sex hormones under the influence of balneotherapy has been proven. It has been shown that taking nitrogen-siliceous water after a standard fat load causes clarification of the blood serum from chylomicrons.