Prostatitis is a common urological disease, which is characterized by the presence of inflammatory changes in the prostate gland as a result of the impact of damaging factors (infectious, occupational and others). The standard treatment regimen for prostatitis depends on the form, course and pathogen of the disease.
Treatment 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 fighting infection.
Treatment of 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, drugs from the group of fluoroquinolones, cephalosporins and tetracyclines are the most effective in the treatment of the disease.
In the treatment of prostatitis caused by herpes, HPV or cytomegalovirus, antiviral drugs are used. Prostatitis with a fungal etiology is treated with antifungal agents.
Since many factors influence the occurrence of prostatitis, therapy is usually complex and includes a general lifestyle adjustment aimed at increasing immunity and improving blood circulation in the pelvic organs.
The list of events includes:
- dietary nutrition (to prevent constipation);
- regular physical and sexual activity;
- vitamin therapy;
- proper sleep and wake patterns.
If prostatitis is caused by a violation of the blood supply to the pelvis, then regular physical activity, massage and physical therapy exercises (squats, lunges, walking, running) are indicated to eliminate congestion. In the presence of sources of latent infection (caries, sinusitis, tonsillitis), it is necessary to clean up pathological foci.
Therapy regimens
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 needs physiotherapeutic methods of exposure.
List of drugs in the acute stage of prostatitis:
- NSAIDs - remove discomfort and inhibit the development of the inflammatory process in the gland.
- antibiotics. Affecting the causative agent of the disease. Protected penicillins, macrolides, cephalosporins, fluoroquinolones are most often used.
- 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 in acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. It relieves body inflammation and reduces swelling.
- Phytotherapeutic agents. They are an auxiliary remedy of natural origin. Gently affects the prostate gland, reducing the swelling of the organ.
important!Physiotherapy measures are contraindicated in the acute stage of prostatitis.
Physical therapy 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 (combination of ultrasound and medicine).
- Electrophoresis.
- Exposure to microwaves.
Apply one or more treatment methods at the same time. Surgical intervention (endoscopic method) is used only in a chronic form, complicated by a 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 non-specific (caused by conditionally pathogenic microorganisms) and venereal (gardnerellosis, chlamydia, gonorrhea, trichomoniasis, etc. ) infections.
In the first case, the pathogenic microflora penetrates by a 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 by 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 treatment.
For protozoan infection (trichomoniasis), a drug from the group of nitroimidazoles is usually prescribed. Intracellular chlamydial infection is treated with macrolide antibiotics.
Alternative agents are some other macrolides, fluoroquinolones, and a tetracycline antibiotic.
Treatment of gonorrheal lesions includes penicillin and cephalosporin antibiotics and vaccine therapy. Inflammation of the gland caused by gardnerella requires the use of antibiotics (a 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 non-specific microbial flora, a standard drug scheme is used, which also includes antibiotics.
The standard treatment regimen for prostatitis includes the following measures:
- Bed rest in the acute form, massage and exercise therapy in the chronic stage of the disease.
- Diet food.
- Antibiotics to suppress the microbial flora that causes inflammation of the prostate gland.
- NSAIDs are used as a symptomatic agent for pain and to fight inflammation.
- bioregulatory peptides. These are products of the prostate gland of cattle. They 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 rheological properties of blood, which remove 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 can be added to the scheme (ultrasound, autohemotransfusion, rectal administration of drugs).
Intravenous infusions are used to quickly stop the symptoms of prostatitis.
Such treatment is carried out in hospital conditions. 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 an infection. But in some cases it is also prescribed for chronic prostatitis of abacterial etiology - as an additional measure to affect possible latent infections. Preference is given to agents with a broad antibacterial spectrum.
The course of treatment is from 2 weeks to a month. If there is a good dynamics of improvement of the condition, then the treatment can be extended up to 2 months.
The most used groups of antibiotics to treat bacterial prostatitis are:
- protected penicillins. Medicines 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 usually used pending the results of laboratory tests.
- 2nd generation fluoroquinolones, 200 mg 2 times a day for 1-2 weeks.
- Fluoroquinolones 3 generations 0. 5 g 1 time / day for 5 days.
- Cephalosporins 3rd generation. Assign the drug in / m or / in 1 g 2 times or 2 g 1 time a day for 7-10 days.
- Cephalosporins of the 4th generation 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 adversely affect the intestinal microflora. Prescribe orally 500 mg 1-2 times a day. The medicine should be taken for at least 5-14 days.
When taking antibiotics for prostatitis, patients are not recommended to independently reduce the dose and duration of treatment. The full course is at least two weeks.
Allergic patients should inform the doctor about the existing intolerance to certain drugs before starting the treatment. It is possible that in the event of a liver or kidney function disorder, the specialist will have to adjust the treatment regimen or the dosage of the drugs, so it is important to warn him in advance.
Scheme for the treatment of viral acute prostatitis
Virological diagnostic methods are not included in the research 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 man's body and multiplies, then reaches the lymph nodes, from where it spreads through the internal organs by hematogenous and lymphogenous routes.
After exposure to the drug, the virus persists in spinal or cranial ganglia and periodically relapses. Usually, exacerbation occurs after hypothermia or a decrease in immunity.
The culprits for 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, the bladder, urethra, testicles, rectum, causing severe damage when immunity decreases.
The causative agent of viral prostatitis can be identified by laboratory analysis. In men, genital herpes has the appearance of vesicles and sores localized in the groin, scrotum, perineum or urethra. In general, the disease proceeds with severe itching and burning, but there is also an asymptomatic course.
Treatment of 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 appearance of new generations of the virus. Specific treatment is carried out for 5 days with a 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, sometimes it becomes necessary to remove growths with the help of electrocoagulation, laser or liquid nitrogen. The procedure is performed in a hospital.
Treatment scheme for acute fungal prostatitis
Long-term 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 due to uncontrolled use of antibiotics and gradual addiction to them.
With a decrease in immunity, fungi of the genus Candida begin 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.
- Immunomodulatory agents that increase the body's defenses.
important!The diet of patients with yeast infection of the prostate should include foods with probiotics.
These are kefir, yogurt, acidophilic 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.