Prostatitis is a common urological disease characterized by the presence of inflammatory changes in the prostate resulting from the influence of harmful factors (infectious, vocational 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 occurrence is infectious. Therefore, the task of urology is the search for rational methods of etiotropic therapy and the fight against infection.
Treatment of bacterial prostatitis includes antibiotic therapy. The drug is prescribed after laboratory diagnosis to determine the pathogen and antibiotic sensitivity.
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.
In the treatment of prostatitis caused by herpes, HPV or cytomegalovirus, antiviral drugs are used. Fungal prostatitis is treated with antimycotic agents.
As many factors influence the occurrence of prostatitis, therapy is often complex and includes general lifestyle adjustments aimed at boosting immunity and improving blood circulation to the pelvic organs.
The event list includes:
- dietary nutrition (for the prevention of constipation);
- regular physical and sexual activity;
- vitamin therapy;
- adequate patterns of sleep and wakefulness.
If prostatitis is caused by a violation of the pelvic blood supply, then regular physical activity, massage and physical therapy exercises (squat, lunge, walk, run) are shown to eliminate congestion. In the presence of sources of latent infection (caries, sinusitis, tonsillitis), it is necessary to clean up the pathological foci.
therapy regimens
Symptoms of chronic and acute forms of prostatitis are similar, but drug exposure schedules are different. This is due to the fact that, in the acute form, the treatment aims to fight the infection and stop the unpleasant symptoms, and the chronic form of the disease requires physiotherapeutic methods of exposure.
List of drugs in the acute phase 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 used are protected penicillins, macrolides, cephalosporins, fluoroquinolones.
- Antispasmodics. They are used to eliminate pain in the gland, improve the output of secretions, relax vascular walls and improve microcirculation.
- Alpha blockers. Improve flow during acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. Relieve body inflammation and reduce swelling.
- Herbal agents. They are an auxiliary healing agent of natural origin. It gently affects the prostate, reducing organ swelling.
Important!In the acute phase of prostatitis, physical therapy measures are contraindicated.
Physical therapy will help spread the infection and worsen the inflammation.
The chronic form of prostatitis, on the contrary, is treated mainly by physiotherapeutic methods:
- Lasertherapy.
- Phonophoresis (a combination of ultrasound and a medication).
- Electrophoresis.
- Microwave exposure.
Apply one or several 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. These can be non-specific (caused by conditionally pathogenic microorganisms) and venereal (gardnerellosis, chlamydia, gonorrhea, trichomoniasis, etc. ) infections.
In the first case, the pathogenic microflora penetrates the lymphogenic or hematogenous pathway from the intestine or urinary tract to 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 gonorrhoeal 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 their 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 the acute form, massage and exercise therapy in the chronic phase of the disease.
- Diet food.
- Antibiotics to suppress the microbial flora that causes inflammation in the prostate.
- NSAIDs are used as a symptomatic remedy for pain and to fight inflammation.
- Bioregulatory peptides. These are bovine prostate products. Stimulate 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 receptors located in the wall of blood vessels).
- Hormonal agents.
Depending on the course and characteristics of prostatitis, other measures (ultrasound, autohemotransfusion, rectal drug administration) can be added to the regimen.
To quickly stop the symptoms of prostatitis, intravenous infusions are used.
Such treatment is performed in a hospital environment. To stimulate the immune system, tissue preparations, anabolic steroids 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 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 commonly used for the treatment of bacterial prostatitis are:
- protected penicillins. Medications are prescribed orally 1 g 2 times a day. It is important to take the medicine 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 often used until laboratory test results are obtained.
- 2nd generation fluoroquinolones, 200 mg twice 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 a day for 7-10 days.
- 4th generation cephalosporins 2 g daily 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 adversely affect the intestinal microflora. Assign 500 mg orally 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 doctor about existing intolerance to specific drugs before starting treatment. It is possible that in case of violation of liver or kidney functions, the specialist will need to make adjustments to the treatment regimen or dosage of drugs, so it is important to notify him in advance.
The treatment regimen for acute viral prostatitis
Virological diagnostic methods are not included in the examination protocol, therefore, the diagnosis of "viral prostatitis" is usually rarely made by urologists. Herpes infection and HPV are sexually transmitted.
The genital herpes virus enters a man's body and multiplies, after which it reaches the lymph nodes, from where it spreads to the internal organs via the hematogenous and lymphogenic route.
After exposure to the drug, the virus persists in the spinal or cranial ganglia and recurs periodically. Generally, an exacerbation occurs after hypothermia or decreased 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 the prostate, but also other organs located nearby, for example, bladder, urethra, testes, rectum, causing severe damage when immunity is reduced.
The causative agent of viral prostatitis can be identified through laboratory analysis. In men, genital herpes looks like blisters and sores located in the groin, scrotum, perineum, or urethra. Basically, the disease proceeds with intense itching and burning, but there is also an asymptomatic course.
Treatment for viral inflammation of the prostate includes:
- Take antiviral medications. They are effective in treating herpes and HPV. The mechanism of its 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 smooth muscle tension and make it easier to pass 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 regimen for acute fungal prostatitis
Prolonged use of antibiotics leads to the emergence of new strains 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 dependence on them.
With a decrease in immunity, the fungus of the Candida genus begins to actively multiply in the body, causing candidiasis.
In the treatment of Candida prostatitis apply:
- Antimycotics. Drugs are sometimes combined in different proportions.
- Probiotics containing bifido and lactobacilli. They inhibit the growth of pathogenic flora.
- Immunomodulatory 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, cakes, 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 at worst can harm the body, cause severe allergic reactions and help the body adapt to certain antibiotics, causing these drugs to no longer have a therapeutic effect.