Prostatitis is a common urological disease characterized by the presence of inflammatory changes in the prostate gland resulting from the influence of harmful factors (infectious, occupational and others). The standard treatment regimen for prostatitis depends on the form, course and pathogen of the disease.
Prostatitis therapy depending on the type
The disease has a polyetiological nature, but the main factor of onset is infectious. Therefore, the task of urology is the search for rational methods of etiotropic therapy and the fight against infection.
Treatment for bacterial prostatitis includes antibiotic therapy. The drug is prescribed after laboratory diagnostics to determine the pathogen and sensitivity to antibiotics.
According to the results of statistical studies in the treatment of the disease, drugs from the group of fluoroquinolones, cephalosporins and tetracyclines are the most effective.
Antiviral drugs are used in the treatment of prostatitis caused by herpes, HPV or cytomegalovirus. Prostatitis of fungal etiology is treated with antifungal agents.
Since many factors influence the onset of prostatitis, therapy is generally complex and includes lifestyle adjustments in general, aimed at increasing immunity and improving blood circulation in the pelvic organs.
The list of events includes:
- dietary nutrition (for the prevention of constipation);
- regular physical and sexual activity;
- vitamin therapy;
- adequate sleep and wakefulness.
If prostatitis is caused by a violation of the pelvic blood supply, it is shown that regular physical activity, massage and physiotherapy exercises (squats, lunges, walking, running) eliminate congestion. In the presence of latent sources of infection (caries, sinusitis, tonsillitis), sanitation of pathological foci is necessary.
Therapeutic regimes
The symptoms of chronic and acute forms of prostatitis are similar, but the drug exposure patterns are different. This is due to the fact that in the acute form the treatment is aimed at fighting the infection and stopping the unpleasant symptoms, and the chronic form of the disease requires physiotherapeutic methods of exposure.
List of drugs in the acute stage of prostatitis:
- NSAIDs - eliminate discomfort and inhibit the development of the inflammatory process in the gland.
- Antibiotics. Affect the causative agent of the disease. The most commonly used are protected penicillins, macrolides, cephalosporins, fluoroquinolones.
- Antispasmodics. They are used to eliminate pain in the gland, improve the outflow of secretions, relax the vascular walls and improve microcirculation.
- Alpha blockers. Improves outflow during acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. Relieves inflammation in the body and reduces swelling.
- Phytotherapeutic agents. I am an auxiliary healing agent of natural origin. Gently hit the prostate gland, reducing the swelling of the organ.
Important! In the acute stage of prostatitis, physiotherapeutic measures are contraindicated.
Physiotherapy will help spread the infection and aggravate the inflammation.
The chronic form of prostatitis, on the other hand, is mainly treated with physiotherapy methods:
- Laser therapy.
- Phonophoresis (a combination of ultrasound and a drug).
- Electrophoresis.
- Microwave exposure.
Apply one or more treatment methods at the same time. Surgical intervention (endoscopic method) is used only in the chronic form, complicated by the sclerotic process and congestion in the gland. The operation can significantly improve the patient's quality of life, restore lost functions.
Principles of treatment of acute prostatitis
Urogenital infections are almost always the cause of acute prostatitis. It can be both nonspecific infections (caused by conditionally pathogenic microorganisms) and venereal (gardnerellosis, chlamydia, gonorrhea, trichomoniasis, etc. ).
In the first case, the pathogenic microflora penetrates lymphatically or hematogenously from the intestine or urinary tract into the prostate and causes inflammation there.
In the second case, the pathogen is transmitted from an infected sexual partner.
The method of treatment of acute prostatitis depends on the type of pathogen and always includes antibiotics. After a thorough examination, the doctor identifies the pathogen and prescribes the appropriate remedy.
In case of protozoal infection (trichomoniasis), a drug from the group of nitroimidazoles is usually prescribed. Treatment of intracellular chlamydia infection is with macrolide antibiotics.
Alternative agents are some other macrolides, fluoroquinolones and a tetracycline antibiotic.
Treatment of gonorrheal lesions includes antibiotics from the penicillin and cephalosporin group and vaccine therapy. Inflammation of the gland caused by gardnerella requires the use of antibiotics (macrolide, lincosamide and a drug from the group of nitroimidazoles and its analogues are prescribed).
In the treatment of acute prostatitis caused by non-specific microbial flora, a standard drug regimen is used, which also includes antibiotics.
The standard treatment regimen for prostatitis includes the following measures:
- Bed rest in acute form, massage and physical therapy in the chronic stage of the disease.
- Diet food.
- Antibiotics to suppress the microbial flora that caused inflammation in the prostate gland.
- NSAIDs are used as a symptomatic remedy for pain and to fight inflammation.
- bioregulatory peptides. These are produced by the prostate gland of cattle. Stimulate the regeneration processes in the gland.
- Antispasmodics.
- Muscle relaxants are used to relax the bladder, urethra and perineal muscles.
- Means that improve blood circulation and the rheological properties of blood that eliminate congestion (for example, a drug that improves microcirculation in the gland by blocking the receptors located in the wall of blood vessels).
- Hormonal agents.
Depending on the course and characteristics of prostatitis, other measures can be added to the scheme (ultrasound, autohemotransfusion, rectal administration of drugs).
To quickly stop the symptoms of prostatitis, intravenous infusions are used.
This treatment is carried out in a hospital setting. To stimulate the immune system, tissue, anabolic preparations are prescribed.
Treatment of acute bacterial prostatitis
Antibacterial treatment is indicated in the acute form of the disease caused by the infection. But in some cases, it is also prescribed for chronic prostatitis of abacterial etiology, as an additional measure of the influence on possible latent infections. Preference is given to means with a broad antibacterial spectrum.
The course of treatment is from 2 weeks to a month. If there is a good dynamic of improvement of the condition, the treatment can be extended up to 2 months.
The groups of antibiotics most used for the treatment of bacterial prostatitis are:
- protected penicillins. Medicines are prescribed orally 1 g 2 times a day. It is important to take the drug regularly at the same time with an interval of 12 hours. The course of exposure to the drug ranges from one week to 10 days. Penicillins are usually used until the laboratory test result is obtained.
- 2nd generation fluoroquinolones, 200 mg 2 times a day for 1-2 weeks.
- Fluoroquinolones 3 generations 0, 5 g 1 time per day for 5 days.
- Third generation cephalosporins. Assign the drug in / m or / in 1 g 2 times or 2 g 1 time per day for 7-10 days.
- 4th generation cephalosporins 2 g per day intravenously or intramuscularly for 5-7 days.
- Aminoglycosides. Enter 1. 0 g / m 1 time / day for 5-7 days.
- Macrolides. Non-toxic, it does not adversely affect the intestinal microflora. Assign orally 500 mg 1-2 times a day. The remedy must be taken for at least 5-14 days.
When taking antibiotics for prostatitis, patients are not recommended to independently reduce the dosage and time of treatment. The full course is at least two weeks.
Allergic patients should inform the physician of existing intolerance to specific medications before starting treatment. It is possible that in case of violation of the functions of the liver or kidneys, the specialist will have to make changes to the treatment regimen or dosage of drugs, so it is important to warn him in advance.
The treatment scheme of acute viral prostatitis
Virological diagnostic methods are not included in the examination protocol, so usually the diagnosis of "viral prostatitis" is rarely made by urologists. Herpes infection and HPV are sexually transmitted.
The genital herpes virus enters the body of a man and multiplies, after which it reaches the lymph nodes, from where it spreads through the internal organs via the hematogenous and lymphogenic pathways.
After exposure to the drug, the virus persists in the spinal or cranial ganglia and recurs periodically. Usually, exacerbation occurs after hypothermia or a decrease in immunity.
The culprits of this type of prostatitis are the herpes virus, cytomegalovirus, HPV and the flu. The causative agent is able to penetrate not only into the prostate, but also into other organs located nearby, for example, bladder, urethra, testicles, rectum, causing their severe damage when immunity is reduced.
The causative agent of viral prostatitis can be identified by laboratory analysis. In men, genital herpes looks like blisters and sores located in the groin, scrotum, perineum, or urethra. Basically, the disease proceeds with severe itching and burning, but there is also an asymptomatic course.
Treatment for viral inflammation of the prostate includes:
- Taking antiviral drugs. They are effective in treating herpes and HPV. The mechanism of their action is based on the suppression of the emergence of new generations of the virus. Specific treatment is carried out for 5 days with the maximum therapeutic dose on the first day.
- Reception of immunomodulators.
- To normalize urination, alpha-blockers are prescribed, which relieve the tension of smooth muscles and facilitate the outflow of urine.
With the defeat of HPV or warts, it sometimes becomes necessary to remove the growths using electrocoagulation, laser or liquid nitrogen. The procedure is performed in a hospital.
The treatment scheme of acute fungal prostatitis
Prolonged use of antibiotics leads to the emergence of new varieties of microorganisms resistant to many antibacterial agents. The increase in the number of patients with fungal prostatitis is caused by the uncontrolled use of antibiotics and the gradual addiction to them.
With a decrease in immunity, the fungus of the genus Candida begins to actively multiply in the body, causing candidiasis.
In the treatment of candida prostatitis apply:
- Antifungals. Medicines are sometimes combined in different proportions.
- Probiotics containing bifidus and lactobacilli. They inhibit the growth of pathogenic flora.
- Immunomodulating agents that increase the body's defenses.
Important!Nutrition of patients with fungal infection of the prostate should include foods with probiotics.
These are kefir, yogurt, acidophilus milk. In addition, it is necessary to limit the use of sweets, pastries, fresh milk, fruits and juices.
Conclusion
It should be remembered that only a specialist urologist can choose a course of drugs for prostatitis. Self-medication will slow down the healing process and, in the worst case, can harm the body, cause severe allergic reactions and help the body adapt to certain antibiotics, as a result of which these drugs will no longer have a therapeutic effect.