Prostatitis is a common urological disease characterized by the presence of inflammatory changes in the prostate as a result of the influence of damaging factors (infectious, professional and others). The standard treatment regimen for prostatitis depends on the form, course and pathogen of the disease.
Prostatitis therapy by type
The disease has a polyetiological character, but the main factor of occurrence 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 were found to be the most effective.
In the treatment of prostatitis caused by herpes, HPV or cytomegalovirus, antiviral drugs are used. Prostatitis of fungal etiology is treated with antimycotic agents.
Since many factors influence the onset of prostatitis, treatment is usually complex and includes general lifestyle adjustments 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;
- proper sleeping and waking habits.
If prostatitis is caused by a violation of the pelvic blood supply, regular physical activity, massage and physiotherapy exercises (squats, lunges, walking, running) are shown to eliminate congestion. In the presence of latent sources of infection (caries, sinusitis, tonsillitis), sanitization of pathological foci is necessary.
Therapeutic regimens
Symptoms of chronic and acute forms of prostatitis are similar, but drug exposure patterns are different. This is due to the fact that in the acute form, treatment is aimed at fighting infection and stopping 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. Influencing 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. Improve outflow during acute urinary retention by relaxing smooth muscles in the urethra and bladder neck. Relieve body inflammation and reduce swelling.
- Phytotherapeutic agents. They are an auxiliary healing agent of natural origin. Gently affect the prostate, reducing the swelling of the organ.
Important! In the acute stage of prostatitis, physiotherapeutic measures are contraindicated.
Physiotherapy will help spread the infection and make the inflammation worse.
The chronic form of prostatitis, on the contrary, is treated mainly by physiotherapeutic methods:
- Laser therapy.
- Phonophoresis (a combination of ultrasound and a drug).
- Electrophoresis.
- Exposure to microwaves.
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 of 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 enters lymphogenously or hematogenously from the intestines or urinary tract into the prostate and causes inflammation there.
In the second case, the pathogen is transmitted by an infected sexual partner.
The method of treating 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 infection with protozoa (trichomoniasis), a drug from the group of nitroimidazoles is usually prescribed. Treatment of intracellular Chlamydial infection is based on macrolide antibiotics.
Alternative agents are certain 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, as well as a drug from the group of nitroimidazoles and its analogues are prescribed).
In the treatment of acute prostatitis caused by nonspecific microbial flora, a standard treatment regimen is used, which also includes antibiotics.
The standard treatment regimen for prostatitis involves the following measures:
- Bed rest in acute form, massage and exercise therapy in the chronic stage of the disease.
- Diet food.
- Antibiotics to suppress the microbial flora responsible for prostate inflammation.
- NSAIDs are used as a symptomatic remedy for pain and to fight inflammation.
- bioregulatory peptides. These are bovine prostate products. Stimulates regenerative 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 receptors located in the wall of blood vessels).
- Hormonal agents.
Depending on the course and characteristics of prostatitis, other measures (ultrasound, autohemotransfusion, rectal administration of drugs) can be added to the scheme.
To quickly stop the symptoms of prostatitis, intravenous infusions are used.
Such treatment is carried out in a hospital setting. To stimulate the immune system, tissue preparations, anabolics are prescribed.
Treatment of acute bacterial prostatitis
Antibacterial treatment is indicated in the acute form of the disease caused by infection. But in some cases it is also prescribed for chronic prostatitis of abacterial etiology - as an additional measure of 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 improving the condition, treatment can be extended for up to 2 months.
The most commonly used groups of antibiotics 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 drug exposure varies from a week to 10 days. Penicillins are generally used until the results of laboratory tests are obtained.
- 2nd generation fluoroquinolones, 200 mg 2 times daily for 1-2 weeks.
- Fluoroquinolones 3 generations 0. 5 g once/day for 5 days.
- 3rd 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, does not harm the intestinal microflora. Orally assign 500 mg 1-2 times a day. The remedy should be taken for at least 5-14 days.
When taking antibiotics for prostatitis, patients are not recommended to independently reduce the dosage and duration of treatment. The full course lasts at least two weeks.
Allergic patients should inform the doctor about the existing intolerance to certain drugs before starting treatment. It is possible that in the event of a violation of the functions of the liver or kidneys, the specialist will have to make adjustments to the treatment regimen or dosage of drugs, so it is important to warn him in advance.
The treatment scheme for acute viral prostatitis
Virological diagnostic methods are not included in the examination protocol, so the diagnosis of "viral prostatitis" is usually rarely made by urologists. Herpes 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 by the hematogenous and lymphogenous route.
After exposure to the drug, the virus persists in the spinal or cranial lymph nodes and periodically reappears. Usually an exacerbation occurs after hypothermia or a decrease in immunity.
The culprits of this type of prostatitis are the herpes virus, cytomegalovirus, HPV and influenza. The causative agent is able to penetrate not only into the prostate, but also into other organs located near it, for example, the bladder, urethra, testicles, rectum, causing their severe damage when immunity is reduced.
The causative agent of viral prostatitis can be identified using laboratory tests. In men, genital herpes appears in the form of vesicles and localized sores in the groin, scrotum, perineum or urethra. Basically, the disease is manifested by severe itching and burning, but there is also an asymptomatic course.
Treatment for viral inflammation of the prostate includes:
- Take antiviral drugs. They are effective in treating herpes and HPV. The mechanism of their action is based on suppressing 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 tension of smooth muscles and facilitate the outflow of urine.
With the defeat of HPV or warts, sometimes it becomes necessary to remove the growths with the help of electrocoagulation, laser or liquid nitrogen. The procedure is performed in a hospital.
The treatment scheme for 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 their progressive addiction.
With a decrease in immunity, the fungus of the genus Candida begins to actively multiply in the body, causing candidiasis.
In the treatment of candidal prostatitis apply:
- Antimycotics. Medicines are sometimes combined in different proportions.
- Probiotics containing bifido- and lactobacilli. They inhibit the growth of pathogenic flora.
- Immunomodulating agents that increase the body's defenses.
Important!The nutrition of patients with fungal infection of the prostate should include foods containing probiotics.
These are kefir, yogurts, 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 drug treatment 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 do notwill have more therapeutic effect.