Prostatitis is a common urological disease characterized by the presence of inflammatory changes in the prostate gland resulting from the influence of damaging factors (infectious, vocational, and others). The standard treatment regimen for prostatitis depends on the form, course and pathogen of the disease.
Therapy of prostatitis depending on the type
The disease has a polyetiological nature, 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 are 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 occurrence of prostatitis, therapy is usually 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;
- proper sleep and wake patterns.
If prostatitis is caused by a violation of the pelvic blood supply, then regular physical activity, massage and physiotherapy exercises (squats, lunges, walking, running) are shown to eliminate congestion. In the presence of sources of latent infection (caries, sinusitis, tonsillitis), sanitation of pathological foci is necessary.
Therapy regimens
The symptoms of chronic and acute forms of prostatitis are similar, but the schemes of drug exposure are different. This is due to the fact that in the acute form, treatment is aimed at fighting the infection and stopping unpleasant symptoms, and the chronic form of the disease needs 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. Influence 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 enhance microcirculation.
- Alpha blockers. Improve outflow during acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. Relieve inflammation of the body and reduce swelling.
- Phytotherapeutic agents. They are an auxiliary healing agent of natural origin. Gently affect the prostate gland, reducing 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 contrary, is treated mainly by physiotherapeutic methods:
- Laser therapy.
- Phonophoresis (a combination of ultrasound and a drug).
- Electrophoresis.
- Exposure to microwaves.
Apply one or several methods of treatment 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 quality of life of the patient, restore lost functions.
Principles of treatment of acute prostatitis
Urogenital infections are almost always the cause of acute prostatitis. It can be both non-specific (caused by conditionally pathogenic microorganisms) and venereal (gardnerellosis, chlamydia, gonorrhea, trichomoniasis, etc. ) infections.
In the first case, the pathogenic microflora penetrates the lymphogenous or hematogenous route from the intestines 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 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 with macrolide antibiotics.
Alternative agents are some other macrolides, fluoroquinolones, and a tetracycline antibiotic.
Treatment of gonorrheal lesions includes antibiotics of 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 drug 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 that caused inflammation in the prostate gland.
- NSAIDs are used as a symptomatic remedy for pain and to combat inflammation.
- bioregulatory peptides. These are products from the prostate gland of cattle. Stimulate the processes of regeneration in the gland.
- Antispasmodics.
- Muscle relaxants are used to relax the bladder, urethra, and perineal muscles.
- Means that improve blood circulation and 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 of a wide antibacterial spectrum.
The course of treatment is from 2 weeks to a month. If there is a good dynamics of improvement in the condition, then the treatment can be extended up to 2 months.
The most 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 ranges from a week to 10 days. Penicillins are usually used until the result of laboratory tests is obtained.
- Fluoroquinolones of the 2nd generation, 200 mg 2 times a day for 1-2 weeks.
- Fluoroquinolones 3 generations 0. 5 g 1 time / 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, do 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.
Allergy sufferers should inform the doctor about the existing intolerance to specific drugs even before the start of treatment. It is possible that in case of violation of the functions of the liver or kidneys, the specialist will need to make adjustments to the treatment regimen or dosage of medications, so it is important to warn him in advance.
The scheme of treatment of viral acute prostatitis
Virological diagnostic methods are not included in the examination protocol, therefore, 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 through the hematogenous and lymphogenous route.
After drug exposure, the virus persists in the spinal or cranial ganglia and periodically recurs. 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 nearby, for example, the bladder, urethra, testes, rectum, causing their severe damage when immunity is reduced.
The causative agent of viral prostatitis can be identified using laboratory analysis. In men, genital herpes has the appearance of vesicles and sores localized 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 tension of smooth muscles and facilitate the outflow of urine.
With the defeat of HPV or warts, sometimes it becomes necessary to remove growths using electrocoagulation, laser or liquid nitrogen. The procedure is carried out in a hospital.
The scheme of treatment of acute fungal prostatitis
Prolonged use of antibiotics leads to the emergence of new varieties of microorganisms that are resistant to many antibacterial agents. The increase in the number of patients with fungal prostatitis is caused by uncontrolled use of antibiotics and 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 candidal prostatitis apply:
- Antimycotics. Drugs 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 with 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 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.