Antibacterial therapy for prostatitis is not the only method of treatment.Antibacterial drugs are prescribed only if there are appropriate indications, mainly for periodic irritations and increased severity of disease manifestations.
The effectiveness of drugs for the treatment of prostatitis
It is known that different antibiotics can cross the prostate barrier to different degrees, and therefore their concentration in the prostate gland and therefore their effectiveness in the treatment of prostatitis is different.Therefore, from the drugs to which the greatest sensitivity of the flora has been established, those with the maximum ability to penetrate the prostate are chosen.A similar approach to the treatment of prostate adenoma can significantly accelerate recovery.
Broad-spectrum drugs for the treatment of prostatitis
Another condition for the effectiveness of a drug used to treat prostatitis is that it has a broad spectrum of antibacterial action.This is due to the fact that it is quite difficult to reliably determine the flora that lives in the prostate.Those with a broad spectrum of antibacterial activity mainly include drugs of the penicillin group.Tetracycline drugs have valuable properties in terms of penetration through the prostatic barrier and the breadth of antibacterial action.
Modern drugs of the fluoroquinol group
New antibacterial agents that have a significant advantage over others are drugs from the fluoroquinolone group.These drugs have a wider spectrum of antimicrobial action and the ability to accumulate in the prostate in high concentrations when taken orally.In addition to the direct antibacterial effect, fluoroquinolones almost never cause immunodeficiency in the patient and, what is particularly important, microorganisms do not develop resistance to them.
Tetracycline drugs are also widely used as antibacterial therapy.
A young patient who has been prescribed a course of antibacterial therapy should be aware that the drugs used can have a spermotoxic effect.Therefore, between the use of these drugs and the intended conception, it is necessary to have a gap of at least 4 months, exceeding the complete cycle of spermatogenesis.
Antibacterial drugs are usually prescribed for chronic bacterial prostatitis or chronic infectious prostatitis.For chronic non-infectious prostatitis, treatment tactics remain controversial and controversial.Antibacterial drugs are prescribed to such patients in the hope of curing a latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not from the first visit.As a rule, within no more than a few days, the doctor examines the patient to detect the infection.During this period, symptomatic therapy is recommended, usually with an anti-inflammatory effect in the form of 50 mg of diclofenac or 100 mg in suppositories, which has anti-edematous and analgesic effects.
After determining the type of bacteria and their sensitivity, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.Treatment is carried out for 4 or more weeks (minimum 28 days) under clinical and bacteriological control.
If the effect is positive in patients with recurrent chronic prostatitis, the use of the antibacterial drug is recommended to be extended to 6-8 weeks.Sometimes antibiotic therapy is extended to 16 weeks with practical recovery after that.If there is no positive result, the antibacterial drug used is abandoned, but not earlier than after 2 weeks of treatment.An ideal antibacterial drug should be fat-soluble, not bound to serum proteins, and slightly alkaline, so that it is maximally concentrated in the prostate gland itself and not in the plasma.The best in terms of these requirements are fluoroquinolones, which have the best pharmacological properties in the treatment of chronic prostatitis;they create a sufficient concentration in the prostate gland, in its secretions and sperm and are active against most of the bacteria found in chronic prostatitis.
So, a necessary condition for the maximum effectiveness of antibacterial therapy for chronic prostatitis is compliance with the following general principles:
- isolation and determination of the microflora that causes prostatitis and identification of its sensitivity to antimicrobial agents;
- choosing the most effective drugs that do not cause side effects;
- determination of effective doses, methods and frequency of administration, taking into account the characteristics of the effect of the selected drug;
- timely initiation of treatment and a sufficiently long course of antimicrobial therapy to ensure the maximum possible effect;
- a combination of antibacterial drugs, both with each other and with drugs and procedures that increase the antimicrobial effect, reduce the incidence of complications and improve microcirculation in the prostate;
- carrying out complex therapy taking into account the characteristics of the patient's general health.
Sometimes, with long-term or excessively active antibacterial therapy, intestinal dysbiosis (reduction in the number and activity of normal intestinal microflora) develops.In these cases, it is recommended to use drugs that promote its recovery.
Results of drug treatment of prostatitis
The strategy and tactics of antibacterial therapy are complex and varied, but its use can improve the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, a more or less long period of well-being may occur.But, as a rule, sooner or later the painful sensations that caused anxiety return.Therefore, the use of antibacterial drugs in itself is not considered sufficient.Good results are achieved by a therapeutic program aimed at increasing local and general resistance.In this case, you can rely on the success of antibacterial therapy or long-term remission.
Improvement of microcirculation in the prostate
In all forms of chronic prostatitis, in addition to influencing the microflora, they try to restore microcirculation in the prostate, improve the output of secretions from the ducts of the glands, increase the intensity of metabolic processes at the source of inflammation and local and general resistance.
Nonsteroidal anti-inflammatory drugs are considered an important step in the treatment of chronic prostatitis.Their positive effect on microcirculation has been proven.
Anticongestive treatment includes measures aimed at reducing venous stagnation in the pelvis: stopping interrupted sexual intercourse, a sedentary lifestyle, frequent alcohol consumption, etc.For varicose veins of the lower extremities and hemorrhoidal veins, which can also cause prostatitis, surgical treatment of these diseases is carried out.For non-infectious congestive prostatitis, only decongestive therapy is performed.
The treatment complex for chronic prostatitis includes special drugs with very effective effects.In some cases of exacerbation of chronic prostatitis in the presence of dysuric phenomena caused by venous stagnation, drugs that reduce the tone of the smooth muscles of the prostate are used to reduce the urge to urinate.But only a doctor can recommend them.
Elimination of pain due to prostatitis
Since the presence and severity of pain in the prostate serves as the main indicator for the patient, which determines his attitude to the disease and affects the occurrence of depression, analgesic therapy in the treatment of chronic prostatitis is one of the most important components of the general treatment of the disease.Pain syndromes observed in chronic prostatitis are very different in their localization, duration and degree of intensity.In this regard, the method of using analgesic drugs is of great importance.
Oral administration (by mouth) is quite effective and temporarily relieves pain.The rectal use of sedatives in suppositories and microclyzes is even more effective, as they use the combined effect of analgesics and anti-inflammatory drugs, as well as the effects of temperature.To change the tone of the gland, belladonna extract can be added to suppositories.
Strengthening the immune system
When treating chronic prostatitis, it is very important to increase the reactivity of the body and its defenses, which usually help to cope with any disease.With chronic prostatitis, the body's defenses decrease.In this regard, without the use of general immunological treatment for chronic prostatitis, it is very difficult to achieve success.
Sometimes a drug is used to treat chronic prostatitis that increases the reactivity of the body.Having a pyrogenic effect (increase in body temperature), the drug aggravates chronic inflammation in the prostate gland and turns it into an acute one, which promotes healing, as it is easier to treat inflammatory diseases in the acute phase.The drug works when it enters the bloodstream quickly.Therefore, it is administered intravenously, starting with small, daily doses, gradually and carefully increasing the dose.Using this method of intravenous administration, patients with chronic prostatitis should be treated as inpatients in order to be under observation.The drug is administered daily for 9-10 consecutive days.At the peak of the artificially induced aggravation of chronic inflammation in the prostate gland, around the 4th day, the introduction of 1-2 antibiotics and a sulfonamide or other drug in fairly high doses begins.In order to improve the blood supply to the prostate gland, physiotherapy is performed at the same time, and to improve the flow of prostate secretions, daily massage is performed.The therapeutic effect in the form of improvement or recovery is achieved to varying degrees in almost every patient.
Hormonal therapy
It is necessary to use sex hormone preparations for prostatitis very carefully.In patients suffering from chronic prostatitis for years and decades, such a need may arise.However, it is better to use them after determining the content of sex hormones in the blood serum (testosterone, estradiol, prolactin, FSH, LH).Simpler tests can also be performed, for example, cytological studies of scrapings from the scaphoid fossa of the urethra.If there is an imbalance of sex hormones, hormonal medications can be included in the treatment regimen.
Enzymes may also be prescribed to help dissolve scar tissue in the prostate gland during long-term disease.
Men who suffer from chronic prostatitis for a long time, as we already know, experience sexual dysfunction.The latter is divided into copulatory, reproductive and hormonal.In the vast majority of prostate patients, fortunately, hormone levels do not suffer significantly.
If copulatory function, or the ability to have sexual intercourse, is impaired, there is a decrease in erection, a "withering" of orgasm and impaired ejaculation.Eliminating these symptoms and normalizing sex life largely depends on the underlying disease - prostatitis.The more successful its treatment, the faster the symptoms of sexual disorder disappear or decrease.
Treatment of sexual disorders due to emerging neurosis includes psychotherapy, tranquilizers (sedatives) and the prescription of other drugs depending on the symptoms of the sexual disorder.This therapy shows how the symptoms of prostatitis can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, you can use LOD therapy, which consists in creating a vacuum in the vessel in which the penis is placed.Due to the negative pressure created, the cracks in the cavernous bodies of the penis expand, and blood flows into them.The penis enlarges and an erection occurs.
Repeated procedures lead to an increase in the gaps in the corpora cavernosa, to a more stable blood supply to the organ and, ultimately, to an improvement in erectile function.A positive effect on chronic prostatitis is also manifested by increased sexual activity, which has a powerful psychotherapeutic effect.
The phallus decompression method (PLD) for prostatitis is performed daily or every other day.The course of treatment is 10-15 procedures.It is useful to combine phallus decompression with instillation massage of the prostate, as this increases the rate of absorption of drugs after the procedure is completed.
instillations
This type of therapy includes techniques that allow direct and direct delivery of the drug to the intended destination.During instillation therapy with this method, drugs are administered through the external opening of the urethra using a conventional disposable syringe with a disposable conical cannula (soft hollow tube) or syringe.The optimal volume of the medicinal mixture administered is 5 ml.Before the procedure, you must urinate to make sure your bladder is empty.
At the time of administration, it is recommended to imitate urination, that is, to relax, then the excess medicine will enter the bladder and be excreted with the first part of urine;the head of the penis must be pressed with fingers or a special clamp - this will prevent the injected solution from flowing back after removing the cannula or syringe.And in order for the solution to reach the prostate faster, it is recommended that during its introduction you carefully hit the filled urethra with the fingers of your free hand towards the perineum.
After the procedure, you must endure the urge to urinate, otherwise the administered medicinal mixture will flow immediately.This mixture consists of the same drugs as for oral administration: antibiotics, analgesics, antispasmodics, anti-inflammatory drugs.
Instillation therapy for prostatitis allows the use of a variety of drugs, the choice of which depends on the nature of the disease, as well as on the compatibility of the administered drugs.Oil mixtures should not be administered because of the risk of fat embolism (blockage of blood vessels);In no case should you make the mixture yourself, as you can make a mistake in the dosage, which will lead to unpleasant and even dangerous consequences.
Suppositories (candles)
Suppository therapy (suppositories) is widely used in the treatment of prostatitis.The action of medicinal drugs included in the suppository is carried out mainly through the general blood circulation, and not through the mucosa of the intestinal wall.
The use of candles has a pronounced psychotherapeutic effect.Patients usually tend to use any suppository for self-treatment of prostatitis, regardless of their composition.Patients especially often use suppositories with propolis, as well as with thiotriazoline (0.5 g per suppository), which have a complex anti-inflammatory and membrane-stimulating effect.In addition to medicinal suppositories, magnetic suppositories are also used in the treatment of prostatitis.
Microclysters
Typically, micro enemas are used to treat prostatitis, which are often referred to as traditional treatment for prostatitis.The basis of their use is the simultaneous temperature and medicinal effects.Micro enemas are usually used before bedtime.
As medicinal substances, they use aqueous infusions of chamomile, calendula, sage, or mushrooms, made with boiling water before administering a microenema.After the infusion has cooled to a temperature of 40°C, the medicine is introduced into the rectum.A small volume is injected - no more than 100 ml of liquid.Medicines must be absorbed in the rectum, that is, stool immediately after the administration of the micro-enema is undesirable.
Water infusions of plants can be replaced with 1 teaspoon of alcohol infusions (calendula, native or chamomile), which are diluted in 100 ml of warm water before administration.You can add 1.0 g of antipyrine or 10 drops of iodine tincture to the infusion.The effectiveness of micro enemas is well known and does not need proof.Microclysters are usually used simultaneously with antibacterial agents as the final stage of more active local procedures or as an independent therapeutic effect for mild pain symptoms.
A very important point is that the use of medications alone does not bring a good and long-term effect.It is necessary to perform prostate drainage procedures in combination with drug therapy - only then the effect can be guaranteed/