Chronic prostatitis treatment: magnetic therapy

Magnetotherapy - a therapeutic method based on the use of permanent (PMP) or variable (PMP) low-frequency magnetic fields (MP). In the opinion of Yu.M. Raygorodsky and co-authors. (2000), this method has a number of advantages over other methods of physiotherapy. They are as follows:

• MP is the only field that penetrates without loosening through the tissues of the body, which makes it possible to realize a direct effect on the pathological focus;
• MP, along with ultrasound, has the greatest number of operating factors, however, unlike ultrasound, it does not require contact exposure techniques;
• magnetotherapy is the most physiological kind of therapy, since since the phase of intrauterine development a person is constantly surrounded by the lines of force of the Earth's magnetic field. Therefore, magnetotherapy is easily tolerated by most people;
• Magnetotherapy has a minimum number of contraindications, in particular such as neoplasms, and an easy hypotensive effect allows it to be well tolerated by patients with hypertensive disease;
• MP allows the most technically simple to implement the above principles of optimality of physiotherapy and especially the principle of dynamic impact at maximum biotropic saturation.

All this gives grounds for more widely applying the effect of MP on the body in various diseases, including chronic prostatitis.

At present it can be considered an established fact that the effect of MP on the animal and human organism is determined by the set of biotropic parameters of this field. The main of them are intensity (tension), gradient, vector, exposure, frequency, pulse shape, localization.

PMP is most often characterized by only the first four parameters, although sometimes localization is of fundamental importance in the nature of its impact. PeMP is also characterized by frequency. The shape of the pulse is added to the characteristic of the pulsed magnetic field (IMP). The largest set of biotropic parameters is the traveling pulsed magnetic field (BIMP), the localization of which can vary according to a given law. Moreover, in accordance with the prescribed law, when using the BIMP, it is possible to change the localization of both PMP, and PMP, and UTI. Any of the modes is not difficult to realize if the BIMP is realized by a set of fixed radiators of the MP, which are connected in series one after another. In this case, the frequency that is addressed to the whole organism is called the modulation frequency of the BIMP. It is defined as the number of switches in I s divided by the number of emitters. If each radiator in the set operates in a pulsed mode with a frequency higher than the modulation frequency, then the frequency of such an BIMP becomes an additional (eighth) biotropic parameter.

Thus, the BIMP, having a wider impact zone compared to other fields, is the most promising in increasing the number of biotropic parameters. Let's note in passing that in favor of any pulse therapy the rhythmic nature of the processes taking place in organs and tissues testifies. Therefore, rhythmic (impulse) effects are closer to natural conditions and are more easily absorbed by one or another body systems. In addition, to the impulse actions (in contrast to the continuous ones) adaptation is much less developed; there is an opportunity to substantially increase the dosage of the physical factor in the pulse and the variety of its physical characteristics. This helps to increase the individuality of physiotherapy treatment. It is important that the parameters of impulse action correspond to the rhythmic activity of the object characterized by chronaxy, lability, accommodation, etc.

Experiments on animals (rats, rabbits, dogs) were carried out in order to study the reactions of the organism in normal and with some types of experimentally caused pathology to general and local effects of PMP, UTI with a strength of 3 to 100 mTl and an exposure of 10 to 60 min. General and local effects (on the limbs) were performed once and repeatedly (7-15 days). The general and local action of MP with induction of 35-50 mTl for 20-30 min caused the appearance of functional morphological effects, the development of which can be conditionally divided into three periods: primary reactions, stabilization and resolution.

In the first period immediately after the cessation of the effect of the MP, an increase in ESR and the number of leukocytes, an increase in the platelet adherence index, coagulation properties of blood, its viscosity, the tone of blood vessels, and their bioelectrical resistance were noted. Within 5 minutes there was a slowing of capillary blood flow and formation of aggregates of blood elements. Further, gradually the phenomenon of aggregation was replaced by disaggregation, blood flow and vascular blood flow increased, vascular tone and bioelectrical resistance of tissues, blood viscosity and coagulation indexes decreased. By the end of the first day, even signs of hypocoagulation appeared.

The second period (2-4 days) was characterized by the stability of the reactions that developed by the end of 1 day. During the resolution period, the severity of these reactions rarely decreased. In a part of the animals, they disappeared by the end of the second week, and some of them were registered for another 1 month. With increasing magnetic field induction from 60 to 100 mTl and exposure from 30 to 60 minutes, more pronounced changes appeared. In these cases, a third of the animals observed had arterial and venous hypotension, electrocardiography recorded a slight decrease in the voltage of the QR complex, prolonged intraventricular conduction, a decrease or increase in the 7 tooth, and hypercoagulable phenomena prevailed in the peripheral blood. In all animals of this group, the alignment of functional-morphological shifts occurred 2-3 weeks later than under the influence of MP with induction up to 50 mT for 20 min.

Influence of MP with induction from 3 to 10 mT at an exposure of 10-20 min caused in the first period an improvement in peripheral circulation, an increase in the blood filling of the vessels, a decrease in their tone, bioelectrical resistance, a decrease in the viscosity and coagulation function of the blood. However, the second and third periods in these animals were short-lived. By the end of the 2-3 days, the studied indicators returned to their original state. The effect on the finiteness of the MP with induction to 50 mT and exposure of 20-30 min daily for 7-15 days also caused the development of individual reversible and favorable reactions. The action of the SMS, induced by the apparatus and elastic magnets, had the same effect. PeMP and UTI contributed to the appearance of more pronounced magnetobiological effects than PMP. In young specimens, the character of the indices studied was more deformed than in adults.

With repeated short-term exposures, as in long-term daily, the effect of summation was noted. As the intensity of M P and the course of its influence increased, positive and then negative physiological effects first developed. This can be explained by the development of the reaction of training, activation and stress. Multiple short-term effects of MP with induction up to 50 mT caused a wave-like change in the reactions of training and activation.

The best therapeutic effect for the treatment of traumatic limb injuries was obtained with the use of MP with an induction of 5-10 mTl and an exposure of 10 min for 2-3 days, which first caused the training reaction, and then, with increasing tension and exposure to 20-30 min, the activation reaction . This led to an increase in the resistance of the organism and acceleration of the processes of reparative regeneration of injured tissues.

The combination of small doses of PMP with PeMP or UTI enhanced the positive effect of these MPs. On the basis of the data given, it can be concluded that in order to obtain the necessary effectiveness of the therapeutic effect, the MP should be limited to a strength of 50 mT. The therapeutic effect is achieved by stimulating the reactions of training and activation through short-term and repeated exposures with a permanent increase in magnetic induction from 5 to 50 mTl and exposure from 10 to 30 min, or by simultaneous or sequential effects of PMP, PEMP, and UTI of small intensities.

In the body, the most sensitive to the MP are blood systems - vascular, endocrine and central. In recent years, interesting data on the sensitivity to MP of various parts of the immune system of humans and animals have been obtained.

Estimating the results of numerous studies, we can conclude that the most characteristic for blood under the influence of MP changes in the erythroid system. Regardless of the intensity of the field and the duration of the action, reticulocytosis was observed. The change in the number of reticulocytes serves as an indicator of the intensity of regenerative processes in the red blood system.

Under the influence of MP changes occur in the blood coagulation system, the nature of some is determined by the initial state of this system and most often leads to the normalization of the coagulation process. Favorable effect of MP on microcirculation and vascular reactivity is also expressed in their normalizing effect on the tone and parameters of microcirculation. Thus, in the MP there was a change in the blood flow velocity in arterioles, precapillaries and capillaries, an increase in the capacity of the vascular system, an increase in the diameter of the capillaries and the density of the capillary loops, and the acceleration of the formation of the collateral channel.

The reaction of the endocrine system is expressed in an increase in the activity of the hormonal and mediator links of the sympathoadrenal system (SAS), while the leading role in the formation of the reaction of the endocrine system belongs to the hypothalamic centers. The normalizing effect of MP on SAS was revealed. This or that shift in it is associated with the formation of one of the three reactions of the body to the MP as an irritant - adaptation, activation or stress. When studying the effect of MP on the reproductive system, sensitivity of the testis tissue to it has been proved.

The course of infectious processes in MP appears to be more favorable, especially in the presence of bacteriostatics or biogenic stimulants, which is explained by the stimulation of immunological reactivity or its normalization under the influence of MP. To explain the easier course of infectious processes under the influence of MP, its effect on microorganisms has not yet been possible, since information on the magnetostatic characteristics of bacteria in the nutrient medium and in the presence of drugs is very fragmentary and contradictory. While it can only be asserted that the MP has an effect on the metabolism and growth of microorganism cells.

The basis of modern ideas about the effect of MP on a living organism is the concept of its action as an irritant. To this irritation the body responds with the adaptive reaction of training, activation, or stress. The formation of a particular reaction is determined by a set of biotropic parameters of the MP and individual susceptibility to the organism. Among

Different types of MP with the greatest number of biotropic parameters and the greatest biological activity is possessed by BIMP. It is promising from the point of view of resonance effects on organs and tissues, taking into account the rhythmic nature of the processes taking place in them. At the same time, the least development of adaptation to BIMP is observed in comparison with PMP or PeMP.

The question of the mechanism of the effect of MP at the cellular level has not yet been fully studied. However, there is already quite convincing evidence of the participation in this mechanism of membrane processes, as well as calcium and magnesium ions. In particular, MP affects the electrochemical potential and the protein-lipid component of the membrane, on the course of intracellular metabolic processes.

Modern ideas about the medical properties of MP are based not only on the development under its influence of adaptive reactions. It is also important to strengthen the effect of drugs in tissues that are in the MP. It can be a vasodilator, analgesic, decongestant, sedative, neurotropic and, very importantly, phoretic effects. The effect of combined magnetolaser treatment on 24 patients aged 52 to 70 years, suffering from BPH stage I with concomitant chronic prostatitis, was studied. The installation "Uzor-2K" with a wavelength of 0.89 microns and a repetition rate of 3000 Hz was used. One emitter with a magnetic attachment at induction up to 63 mT was installed on the perineum in the projection of the prostate gland, the second - rectally in the projection of the prostate. Previously, all patients underwent intravenous laser irradiation of the blood (BLOCK) for 25 minutes with a He-Ne laser with a wavelength of 0.63 μm at a power of 1.5 mW with the aid of the ALOK-1 apparatus, which provides for repeated passage of blood through the irradiation zone. The effectiveness of such a preventive measure for immunostimulation of the body before transurethral resection of the prostate has been reported in the work of G.V. Uchvatkina et al. (1997). For 2-3 days, magnetolaser therapy sessions with the above applications were performed for 3 minutes. Then this course was repeated 2-3 times. In all patients, dysuria significantly decreased or completely disappeared, prostate gland volume decreased, urodynamics normalized, and pain symptomatology disappeared.

Among the other urological diseases, in the treatment of which magnetolaser therapy was applied, the following conditions can be noted:

• inflammatory and post-traumatic damages of the genitourinary system;
• urolithiasis disease;
• hydronephrosis;
• chronic pyelonephritis;
• tuberculosis of the genitourinary system;
• sexual dysfunction in men and women.

The optimal effect of the Ulan-Urat laser device on restoring the passage of urine, the concentration and filtration functions of the kidneys, on stimulating the escape of small stones was demonstrated.

The mechanism of combined magnetolaser therapy is associated with the effect of magnetophoresis, in particular on the protein-lipid cell membranes of a pathologically altered organ.

NI Tarasov et al. (1998) revealed a correction of LPO shifts in the treatment of chronic prostatitis with tocopherol or ceruloplasmin in combination with rectal magnetotherapy and laser irradiation. According to VA. Golubchikova et al. (2001), as well as M.Ya.Alekseev and V.A. Golubchikova (2002), the use in the complex treatment of chronic prostatitis magnetotherapy in combination with laser irradiation and electrostimulation leads to a summation of the effect of these factors. As a result, the secretory function of the prostate is normalized, the activity of the inflammatory process is reduced and the pain syndrome is stopped. At the same time, the remission period lasts up to 2 years in 60.5% of patients.

Magnetotherapy was used to stimulate the body's immune system in patients with chronic prostatitis. For this purpose, the thyroid and thymus glands were irradiated with the Volna-2 apparatus, the power of the action was 30-40 W, the frequency was 460 MHz, the wavelength was 630 nm, the duration of the exposure was 10-15 min daily, 15-20 procedures per course treatment. Treatment was conducted in 57 patients with HP. As a result of the treatment, 75.5% of patients disappeared or significantly reduced pain, dysuria and other symptoms. Improved the secret of the prostate, increased the number of lecithin grains. In 71.4% of patients, an antibacterial effect was noted. Increased the content of T-lymphocytes and decreased the number of B-lymphocytes.

The data obtained indicated a stimulating effect of magnetotherapy on the T-cell link of the immune system when exposed to the thyroid and thymus glands. As a result, there was a pronounced anti-inflammatory effect, which led to the elimination of inflammation in the prostate.

According to VA. Mokhort et al. (2002), the use of magnetotherapy in the complex treatment of chronic prostatitis contributed to the complete disappearance of complaints in 83.7% of patients, a decrease in the severity of symptoms in 16.2% and had no effect in 3.2% of patients. N.V. Bychkova et al. (2002) used magnetolaser therapy in the treatment of chronic prostatitis. They observed a positive clinical effect in 89% of patients, a decrease in dysuric phenomena in 86%, improvement in sexual function in 54%.

According to Ya. L. Dunaevsky et al. (2000), magnetotherapy contributed to the regression of inflammatory changes in the secretion of the prostate in 82.4% of patients for chronic prostatitis, their complete disappearance in 58.9% of patients. N.F. Sergienko and A.I. Goncharuk (2002), proved that local magnetic therapy in combination with drug treatment after only 2-3 procedures contributed to the disappearance of pain syndrome in 82% of patients, while 14% noted a significant decrease. The authors recommend the use of magnetotherapy in the treatment of chronic prostatitis, especially calculous, when the use of microwave therapy is contraindicated.

Summarizing the above and relying on the literary data of recent years on magnetotherapy, we can conclude that the therapeutic effect of the action of MP is due to the vasodilator,

Anti-edematous, immunostimulating and sedative actions. Finally, there is another property of MP in local exposure thus providing magnetophoresis in the tissue of the drug. To optimize the physiotherapeutic effect, in particular in urology in the treatment of urethroprostatitis in men, it is necessary:

• increase the biotropic saturation of the physical field (for example, magnetic field);
• To ensure a combined effect of the main field with additional ones (for example, magnetic with laser and electric);
• to warm up the mucous membrane of the urethra and prostate, as this not only accelerates the processes of ion transport, but also creates the effect of partial sanation in bacterial forms of urethroprostatitis;
• to ensure access of the drug to the mucous membrane of the urethra and the prostate for the realization of the pirotic properties of MP and local drug therapy;
• conduct micromassage of the urethra as a result of the force interaction of the external field with magnetically sensitive elements inserted inside the urethra (through the catheter); - ensure the possibility of affecting the gland from the side of both the urethra and the rectum. An example of the successful use at the same time of all the factors affecting the MP with the realization of the physiotherapeutic effect is the Intramag apparatus for magnetotherapy in urology. The device is intended for the treatment of inflammatory diseases of the genitourinary tract in men and women, including urogenital infection. It contains a BMP radiator for men, made in the form of a gutter, a set of urethral catheters-irrigators, made in the form of elastic (polyethylene) tubes with holes on the lateral surface, and a set of catheter-heaters. Inside the elastic tube of catheters-irrigators there is a metal spiral made of magnetic stainless steel and an electric heater.

During treatment, a catheter-irrigator is inserted into the urethra, which is filled with a drug and then placed in the radiator channel. After switching on the device, the MP begins to move along the urethra along a zigzag, swinging the spiral. Thus, the force action of the MP is realized, which is accompanied by a micro-massage of the mucous membrane of the urethra due to the oscillations of the catheter. There is also an improvement in the irrigation of the mucous membrane with a drug solution. The information effect of the field is due to the choice of its frequency near 1 Hz or 10 Hz, which contributes to better absorption by the body of this physical factor and a more complete realization of the anti-inflammatory effect. The phoretic effect of the field is provided by magnetophoresis, for the enhancement of which in the apparatus it is possible to combine it with the electrophoresis of the drug in the mucous membrane of the urethra. For this purpose, the spiral inside the catheter has an external contact to connect it to the active electrode of any standard galvanizing apparatus (Potok device).

The possibility of electrophoresis dramatically increases the number of ions in the drug solution due to its dissociation, making it easier for the MP to insert them into the tissue. Yu.A. Kobzev et al. (1996) conducted a study on the effect on the perineal region of electromagnetic radiation in the millimeter range (the Intramag apparatus). This radiation allows, along with magnetotherapy, to perform electrophoresis of medicinal products, micromassage in BMP and to introduce magnetically controlled suspensions. After 4-5 procedures, patients had a loss of pain in the prostate, a significant decrease in the number of white blood cells in its secretion, restoration of sexual function. Parallel to the disappearance of clinical signs of prostatitis, positive changes occurred in all links of the homeostasis system (procoagulant, anticoagulant, fibrinolytic). In the peripheral blood, the activity of proteases was normalized, the ratio and quantity of T and B lymphocytes, the content of immunoglobulins, the level of circulating immune complexes, and the bactericidal activity of serum were approaching the norm. According to SA. Suvorova (1998), magnetotherapy in patients with chronic prostatitis was accompanied by the restoration of fibrinolytic activity of peripheral blood (increase in total fibrinolytic, plasminogen activity and activity of plasminogen activators, decrease in antiplasmin activity), disappearance of pain in the gland, normalization of its surface. There was a decrease in the number of leukocytes and an increase in the content of lecithin grains in the secretion of the prostate.