Rehabilitation treatment of patients with chronic prostatitis in a resort

Chronic prostatitis tends to a continuously-recurring type of flow, which emphasizes the importance of the final, rehabilitative stage of complex therapy, which is optimal for conducting in the sanatorium-resort conditions. In the same place, it is advisable to regularly repeat antirecessionary courses. The resort stage of rehabilitation treatment and rehabilitation is most favorable in the general system of health improvement of the population, including reproductive health. The effect of natural healing factors is aimed at increasing the resistance of the organism, and has a general therapeutic effect.

Rehabilitation of patients with chronic prostatitis is carried out in the conditions of the resort with nitric-siliceous thermal waters. Numerous experimental studies indicate that the mechanism of their effect is realized at the cellular level. As a result, the activity of mitochondria increases, the number of cytoplasmic microvesicles increases. Mineral water stimulates connective tissue, epithelial and parenchymal cells, affects the function of the hypothalamic-pituitary-andrenal and sympathetic-adrenal systems, stimulates hemodynamics and metabolism of biologically active substances, affects the immune system. Balneotherapy affects the course of the inflammatory process, in particular, delays the development of sclerosing.

Rehabilitation period is the most important stage of patients' cure for chronic prostatitis. Its necessity is due to several points. First, the absence or disappearance of clinical signs of chronic prostatitis after treatment does not yet mean restoration of the secretory and barrier functions of the prostate. By the end of treatment, the content of leukocytes, lecithin grains, zinc, prostatic y-globulin, acid phosphatase in the secretion of the gland often does not have time to normalize.

Secondly, after treatment of urethrogenic chronic prostatitis, there are usually signs of local immune deficiency, manifested, in particular, by insufficient functional activity of urethral neutrophil granulocytes, low level of antibacterial antibodies protecting the epithelium from bacteria and having the ability to adhere to the epithelium of the urinary tract.

Third, the course of antibiotic therapy disrupts the natural microflora of the urethra, which along with other factors of local resistance prevents the development of a superficial or invasive infection of the urethra and prostate. It has been proved that "bacterial antagonism" plays a key role in the natural protection of the male urethra from pathogens that are sexually transmitted. Antibiotics (especially a wide spectrum of action) suppress not only the pathogenic, but also the protective microflora of the urethra. In these conditions, pathogenic or conditionally pathogenic microorganisms caught on its surface during sexual intercourse cause inflammation of not only the urethra, but also does not restore its barrier function of the prostate gland. In this case, if the infectious agent enters the gland from the urethra by the lymphogenous route, the primary symptoms of chronic prostatitis (pain, dysuria, etc.) may occur within a few hours after infection.

The long-lasting allergic and autoimmune effects of chronic prostatitis are manifested, in particular, by antibacterial IgA (revealed in the secretion of the prostate gland for 2 years after treatment) and IgG, the content of which is secreted only 6 months after the end of treatment. According to Shortliffe LMD et al. (1981), antibacterial secretory IgA in the secretion of the gland is determined even a year after the end of treatment. According to J.E. Fowler (1988), similar to "subclinical infections" of male genital organs, in which antibacterial IgA in the secretion of the gland and seminal plasma are detected, can be one of the main causes of infertility. For example, IgA antibodies to Escherichia coli have never been found in semen in men who have had infertility but have not had a urinary tract infection.

After antibiotic treatment, testicular insufficiency, estrogenation of the hormonal background, disruption of testosterone biosynthesis in the testes and its metabolites in the liver and prostate are preserved. The high level of blood progesterone associated with these disorders, the change in pituitary regulation of the gonads, can also cause spermatogenesis and fertility disorders that persist after treatment of chronic prostatitis.

In the rehabilitation period, sanatorium and spa treatment is the most promising, with mud therapy, ozokeritotherapy, balneotherapy, various types of climatic treatment (aerotherapy, direct and diffused solar radiation, bathing in open and closed water bodies) along with traditional methods.

[1], [2], [3], [4]