Treatment of chronic prostatitis

Treatment of chronic prostatitis is a complex of therapeutic measures aimed at eliminating inflammation of the prostate gland.

According to static information, this disease has significantly "rejuvenated" over the past half century. It affects about 40% of the stronger sex between the ages of 30 and 40. In men older than 40-45 years, the inflammatory process of the prostate occurs much more often - up to 55-60% of all cases of treatment with urogenital complaints.

Prostatitis is the inflammation of the prostate gland, located in men immediately under the bladder. Depending on what causes contributed to the onset of the disease, prostatitis may appear suddenly or exist in the body of a man for a long time, having long been transformed into a chronic form. Treatment of chronic prostatitis is appointed individually by the urologist andrologist.

The prostate, which has been attacked by bacterial infection or hypothermia, initially resists with the resources of the immune system. If immunity is weak, a person continues to rely on self-healing and does not go to the urologist in a timely manner, prostatitis does not give up, he simply passes into a heavier, more latent form. Unfortunately, only when really acute symptoms are manifested - painful sensations when urinating, problems with intimate life, only then the patient starts to sound the alarm and turns to the doctor. At a minimum, this is a long, stubborn treatment for chronic prostatitis, sometimes lasting for years, as a negative result - the overgrowth of the disease into an oncological process.

Prostatitis can be caused by various causes, and it is classified in this way: 

• Acute bacterial form; 
• Chronic bacterial form; 
• Chronic non-bacterial form (chlamydia, staphylococcus, Trichomonas); 
• Asymptomatic (asymptomatic).

The chronic form of the disease, as a rule, is caused by bacterial infection, which can signal itself, fade and come back - to recur. Most often, the acute phase is skipped, the symptoms are healed, and the treatment of chronic prostatitis usually happens on its own, without the appointment of a doctor. The erased symptomatology and the attenuation of pain do not at all mean that the prostatitis is cured. He simply "hides" his manifestations, and the infection remains in the body.

The reasons why a chronic process of inflammation in the prostate gland can develop: 

• Regular hypothermia of the whole body, especially the legs and lower back; 
• Inadequate nutrition, leading to constipation; 
• Lack of motor activity - sitting work; 
• Indiscriminate intimate life, lack of protective equipment for sexual intercourse; 
• Chronic infectious diseases of organs and systems; 
• Venereal diseases, including those not treated or hidden; 
• Insufficient activity of immunity.

Symptoms that can give a signal that you need to start treatment for chronic prostatitis:

• Chronic weak pain in the lower back;
• Periodic aching pain in the groin area;
• Periodic weak pain signals in the testicles or genitals;
• Subfebrile temperature;
• Chronic pain in the joints of the legs;
• Episodic manifestations similar to cystitis;
• Atypical rare discharge from the urethral canal.

In a word, any malaise from the back and below, which, of course, can be a sign of a completely different disease, still requires treatment to the doctor. After the collection of anamnesis, visual examination, biochemical analyzes are assigned, as well as the main analytical marker - bacterial culture. As a material for culture, a portion of urine and excretion from the gland is taken.

Treatment of chronic prostatitis is more thorough and component, in contrast to the treatment of acute disease. Often, relieving a patient of prostatitis is not so easy and fast, as it may seem at first glance. The effectiveness of therapy depends on the availability of the medical institution in which the patient is observed, and on the price that the patient is willing to pay for the use of medical services.

What measures include the treatment of chronic prostatitis?

Treatment of chronic prostatitis has the following objectives: 

• Neutralization of bacterial infection - a course of antibiotics (at least one month); 
• Activation of the immune system - the appointment of immunomodulators; 
• Prophylaxis of dysbacteriosis - probiotics are prescribed; 
• Prevention of allergic manifestations - antihistamines may be prescribed; 
• Thermal physiotherapy procedures; 
• Appointment of drugs to relax the muscles of the gland - alpha-blockers; 
• Prostate massage; 
• Reflexotherapy course; 
• Drafting a diet, a special diet, which excludes the use of spicy foods, alcohol-containing beverages; 
• Possible surgical intervention to remove the affected areas of the prostate gland.

Activation of the immune system

Activation of the immune system - the appointment of immunomodulators. Prostatitis in chronic form is characterized by a decrease in the protective functions of the immune system, which must be maintained and activated. Immunomodulators are designed to normalize the humoral links of immunity and stimulate the local response of the immune system to inflammation. By bioavailability, levamisole, thymalin, prodigiozan, methyluracil have proved to be well established. These drugs stimulate the active action of macrophages (their phagocytic, absorbing function), activate the protective mechanism at the level of all cells of the body. The course of treatment depends on the choice of the drug, so, levamisole has a strong effect on the T-link of immunity, and can cause an allergic reaction. He is appointed for a period of up to 3 days, then a break is made and the course is repeated. Metiluratsil is safer, besides it has an anabolic property and significantly accelerates all regenerative processes, it can be applied up to 2 weeks. 

[1], [2], [3], [4], [5], [6], [7], [8]

Prevention of dysbiosis

Prevention of dysbacteriosis - probiotics are prescribed for the restoration of microflora and the normalization of the ratio of specific conditionally pathogenic bacteria. It is recommended to use a complex of probiotic drugs, since each of them stimulates their group of bacteria. Bifidumbacterin, lactose-containing gastropharm or lactobacterin, colibacterin, linex and bifiform were well proven. 

Prevention of allergic manifestations

Prevention of allergic manifestations - can be prescribed antihistamines. An intensive course of antibiotics can lead not only to dysbiosis, but also aggressive autoimmune response in the form of allergic reactions. The appointment of antihistamines is not mandatory in the therapeutic regimen. Treatment of chronic prostatitis with the use of additional antihistamine therapy is carried out only with the manifestation of clinical signs of allergy. As a rule, preparations of the third generation are prescribed - cetirizine and fexofenadine group, that is, drugs that go well with other drugs and do not cause drowsiness.

Treatment of chronic prostatitis with antibiotics

One of the most common ways of treating the disease are antibiotics. The purpose of these or other medications is made on the basis of the causes that caused the appearance of the disease. Most often this type of medicine is prescribed for people suffering from bacterial chronic prostatitis.

Patients with symptoms such as severe pain or fever may need intravenous antibiotics. treatment of chronic prostatitis with antibiotics is prescribed for at least a month and a half, but often courses are longer or more painful, and several courses of therapy are prescribed with breaks to rest from medications.

Take medication should be strictly in accordance with the norms and frequency prescribed by the attending physician. The patient should not refuse further treatment, even if his state of health has significantly improved - this impression can be deceiving, and as soon as the body stops receiving medication, the disease may appear again. If suddenly after the passed medical course the condition has not improved, it is necessary to inform the doctor about it. Most likely, the patient does not have a bacterial, but some other form of the disease.

 Appointed drugs of the macrolide group are effective antibiotics obtained from treated Streptomyces fungi. Macrolides are effective against many bacteria and microorganisms, such as coccal infections, legionella, chlamydia and mycoplasma. In addition, this group of drugs can be retained for a long time in the prostate gland and practically does not cause a toxic effect. The most popular drugs of this group include roxithromycin, vilprafen, macropen, azithromycin. Also, tetracycline (doxycycline) and cephaloporine (ceftriaxone) drugs are prescribed, which effectively neutralize anaerobic microorganisms and are active against chlamydia. Penicillin group in the modern clinical practice is used less often, mainly on laboratory-proven indications. Usually, amoxicillin, amoxiclav is used. Effective and fluoroquinolones due to its property to penetrate into the deep layers of tissue. A wide spectrum of action is rendered by norfloxacin, ofloxacin, ciprofloxacin. The choice of a group of antibiotics directly depends on the inflammatory stage of the process, the individual tolerability or intolerance of the drugs. Antibiotic therapy can be performed with the help of injections or given in tableted form. Often a set of therapeutic measures includes the introduction of antibacterial solutions, gels or ointments directly into the source of inflammation or anal antibacterial suppositories.

Treatment of chronic prostatitis with other medications

Treatment of chronic prostatitis can consist in taking nonsteroidal and analgesic anti-inflammatory drugs. To facilitate the course of the disease are known to everyone Ibuprofen and aspirin. The dosage of the drugs is necessarily prescribed by the urologist-andrologist, since the misuse of these medications can not only exacerbate the patient's condition, but also provoke a host of other ailments. Occasionally, chronic prostatitis treatment is administered with analgesics.

Treatment of chronic prostatitis with alpha blockers

Treatment of chronic prostatitis can be treated with alpha blockers - drugs that have the ability to relax the muscle fibers and the neck of the bladder in the same place where the prostate is attached to the bladder. The use of alpha-blockers allows the patient to run much less frequently to the toilet, and also reduces the pain present during urination.

Appointment of drugs to relax the muscles of the gland - alpha-blockers . The use of these drugs improves the tone of the muscles of the urethral canal, the epithelium of the seminal vesicles and the capsule of the prostate itself. Alpha-adrenoblockers significantly increase the duration of the remission period, especially in combination with NSAIDs - non-steroidal anti-inflammatory drugs. Appointed Omnik, Sonizin, Cardura. All these drugs belong to the same group, but the right of their choice belongs to the urologist, who determines the appropriateness of the drug, the dosage and the regimen for its administration.

Treatment of chronic prostatitis with massage

Finally, there is an unpleasant but very effective procedure for men, which is often prescribed to patients with prostatitis. This procedure is called prostate massage.

Massage is carried out with the help of a doctor's hand: the doctor puts a glove on his hand, lubricates the index finger with a special lubricant, then inserts a finger into the rectum of the man and conducts a study of the parameters, the symmetry of both parts of the prostate gland, as well as the state of the mucous membrane of the intestine and the degree of the man's pain syndrome. After this, the doctor decides on the intensity and time length of the massage. Usually, first one gland is massaged, then the other.

Physiotherapy for chronic prostatitis

Thermal physiotherapy procedures are designed to tidy the tone of the musculature of the prostate and restore the disturbed circulation of blood flow in places where pathological scars have formed. Also, physiotherapy significantly enhances the effect of antibacterial therapy by better sucking the drugs into the prepared tissues. Physiotherapeutic procedures include ultrasonic heating, thermal action directly on the prostate through the anus, possible irrigation with enemas (solution enriched with antibiotics).

Reflexotherapy for chronic prostatitis

The reflexotherapy course is also aimed at strengthening and improving blood circulation in the prostate, the condition of the muscles of the entire pelvis is normalized, and painful sensations decrease. Among well-proven methods, one can mention magnetotherapy conducted on biologically active points.

Treatment of chronic prostatitis by surgical methods

Possible surgical intervention to remove the affected areas of the prostate gland. Indications for surgical procedure are sclerotic degeneration of tissues, then sparing electroresection (removal of dying tissues) is carried out. Also, the cause for surgery may be a violation of trophism, the state of the gland tissues due to the accumulation of calcinates (calculous chronic prostatitis). TUR - transurethral resection is an operation that is performed under epidural or intravenous barbiturate anesthesia. Postoperative recovery period lasts no more than a week.

Methods, which involves the treatment of chronic prostatitis, is determined by a urologist on the basis of diagnostic information and his clinical practical experience. In addition to the use of medication and other therapy from the patient, a responsible attitude to treatment and a certain level of patience are required.

Diet with chronic prostatitis

Drafting a diet, a special diet, which excludes the use of spicy foods, alcohol-containing beverages. The diet is needed to strengthen the protective properties of the body, as well as to perform the main task - detoxification and washing (urine removal). Chronic prostatitis dictates the observance of a gentle diet throughout life. During the reception of antibiotics and the passage of general medical measures, a classic diet No. 7 is appointed, which is designed to remove excess fluid, nitrogenous compounds from the body and to remove puffiness. Also effective is diet No. 5, which is prescribed, as a rule, in hepatopathologies and diseases of the bile ducts. 

Treatment of chronic prostatitis is also the observance of the rules of a healthy, rational way of life, in which motor activity is feasible, rest and sleep, and, if possible, rejection of bad habits.

[9], [10], [11], [12], [13], [14]