Prostatitis is an infectious and inflammatory disease and is considered one of the most common diseases, but at the same time, the pathology of severe urodynamic disorders is rarely studied and conservative correction is difficult.In recent decades, the incidence of prostatitis has been higher among men who are in the active reproductive stage (age group 20 to 45 years) and who are sexually active, although until recently it was thought that the greatest risk of prostatic inflammatory processes existed only in older men.
In most cases, acute inflammation of the prostate occurs against the background of massive contamination of the prostatic mucosa with pathogenic and opportunistic microorganisms (gonococci, staphylococci, Escherichia coli, etc.).
In addition to antibiotics used in the acute phase of the disease and in the treatment of recurrent infectious prostatitis (including CPPS - chronic pelvic pain syndrome), comprehensive therapy targeting inflammatory changes in the glandular stroma and parenchymal tissue includes the use of modern methods such as laser therapy, cryodestruction or pulsed microcurrent.For treatment to be effective and achieve stable remission, patients must also make adjustments to their treatment regimen, diet, and lifestyle.
Basic treatment of infectious inflammation
The main goals of treating any form of prostatitis are to stop inflammation, eliminate inflammatory changes, and relieve pain, whose prevalence ranges from 35% to 67% according to various sources (roughly every two men with prostatitis complain of pain as a primary symptom).In acute cases, heavy antimicrobial therapy can allow you to quickly achieve clinically significant results within 4-5 days.Despite the rapid remission of infectious inflammation of the prostate, it is impossible to discontinue antibiotic therapy, since most typical pathogens of genitourinary infections quickly become resistant to such drugs, and discontinuation of treatment will lead to chronicity of the disease.
Some of the main pathogens of prostatitis - faecal Staphylococcus aureus and Escherichia coli - are able to form a thick film capsule around the membrane, even if the conditions for administration and continuous use of antibiotics are met, thus reducing the bioavailability of the used drugs and increasing bacterial resistance to the selected antibiotic group.Therefore, even if a positive result is obtained quickly, it is recommended to continue antibiotic treatment for at least 4 weeks.
Why you can't choose your own antibiotics
Antibiotics are the basis of treatment of acute infectious prostatitis, but must be prescribed by the attending physician after laboratory examination of prostate secretions and taking into account several factors: the type of pathogen identified, the degree of mucosal contamination and the resistance of specific microorganisms to certain groups of antibiotics.Experts in the field of practical urology also point out that mixed urogenital infections have been increasing in recent years, so a combination of several antibacterial drugs is often used to treat acute prostatitis.
Self-medication for acute prostatitis leads to the infection becoming chronic in almost 60-70% of cases, which is a very high rate and confirms that independent selection of medications and neglect of medical prescriptions is unacceptable.The importance of laboratory and physical diagnosis and consultation with specialists before using antibiotics lies in the following points.
- Bioavailability indicators.Some antibacterial drugs (eg, the most commonly used and prescribed antibiotics - penicillins) penetrate prostate tissue to a low degree, making their use in the treatment of prostatitis ineffective and impractical.Almost all aminoglycosides also have poor bioavailability.
- degree of bactericidal effect.If the prostate is acutely damaged, antibiotics with bactericidal effects should be used to kill the infectious pathogens.In chronic cases, it is more recommended to take drugs with antibacterial effects to stop the growth of pathogenic flora and prevent their reproduction.
- Patient's general condition.Patients with severe immunosuppression and severe fever and toxic syndrome manifestations should be treated in the hospital.Intravenous antibiotics are given to such patients (oral dosage forms are ineffective in severe clinical cases).
Notice!The lack of positive effects during the use of antimicrobial therapy may indicate the development of a prostate abscess.This is an acute pathology that requires emergency hospitalization of the man and surgical incision of the abscess, followed by drainage and disinfection of the cavity.
Modern approaches to treating chronic inflammation
Physiotherapy is a branch of medicine that studies and applies various natural factors (including artificially created factors) that have a positive effect on the human body for therapeutic purposes.In the complex treatment of genitourinary pathologies, physiotherapy is used in the recovery phase after relief of acute symptoms.
The main goal of physical therapy is to eliminate residual inflammatory effects and stimulate the recovery of damaged tissue.Physical therapy sessions typically consist of 5-10 sessions lasting 10-15 minutes.In order to obtain positive results (reducing the frequency and intensity of chronic pelvic pain, normalizing urination, improving the rheological properties of prostate secretion, etc.), several courses of treatment may be required.
low intensity laser therapy
Laser therapy is one of the most effective and popular methods for treating chronic inflammation of the prostate in men, and is most commonly used as an adjuvant treatment after initial medical correction.The basis of laser therapy is the use of an optical range emitted by a special device (laser).The laser can operate in pulsed and continuous pulse modes with wavelengths up to 904 nm.The method of intravenous laser irradiation of blood is rarely used in urology, and many experts consider it the most effective and common method of complex treatment of many urological diseases.
The main advantages of laser treatment are that it is quite efficient, painless and stimulates not only damaged tissue but also nearby tissue.This method of physical therapy is particularly useful in congestive (stagnant) prostatitis, since laser radiation has a positive effect on the microcirculation of the pelvic vessels and normalizes the outflow of prostate secretions.
electrical stimulation
Galvanic electrical stimulation is indicated for the treatment of any form of prostatitis associated with erectile dysfunction and a general decrease in potency.Stimulation is performed using the intraurethral method, which involves inserting a catheter with electrodes directly into the back of the urethra where the prostate is located.In some cases, rectal electrodes may be used therapeutically, which provide electrical stimulation at the point where the prostate borders the prerectal ampulla.In both cases, it is important to empty the bowel and bladder.
Galvanic therapy has complex positive effects on the prostate, namely:
- Eliminate fluid (blood and lymph) stagnation in the pelvic organs;
- Ensure normal outflow of prostate secretions;
- Increase the permeability of gland parenchymal tissue and its interstitial cell membrane, promoting faster absorption of drugs into inflamed prostate tissue;
- Reduce swelling;
- Normalization of pelvic muscle tone;
- Increases cell regeneration and local immunity (especially in chronic bacterial prostatitis).
The therapeutic effects of electrical stimulation of the prostate will appear after 2-3 surgeries, but it is important not to stop treatment to minimize the risk of possible recurrence.A complete course usually consists of 5-7 programs.
Notice!Electrical stimulation of the prostate is particularly effective in prostatitis associated with severe erectile dysfunction.
Hyperthermia
Hyperthermia is also a type of physical therapy and can be used for self-treatment of prostatitis or in specialized physical therapy rooms.Heat sources for heating the prostate can be:
- Mineral applications (hydrochite, paraffin, ozokerite);
- special electric lamps;
- Heating pad (water, electricity);
- Device for infrared irradiation.
In day hospitals and physiotherapy rooms, a reflector is often used to heat the prostate, which is an incandescent ("blue light") lamp with a focused lampshade.The procedure has certain contraindications, such as autonomic nervous system disorders, malignant tumors, acute infectious inflammatory and purulent infectious processes, active tuberculosis.The use of heat therapy during the acute phase of the disease is unacceptable, as this may lead to hematogenous infection of adjacent organs and tissues (due to a sharp increase in blood circulation) and the development of serious complications, including septic blood poisoning.
Important!If a man is receiving hormonal or immunomodulatory therapy, it is worth consulting his doctor about the use of heat therapy (especially if the patient is receiving treatment at home).Thermal treatment with cytostatic and hemostatic drugs is unacceptable.
Ozone therapy
This is a fairly effective modern method of treating prostatitis and is mainly practiced in paid medical centers.Medical ozone is produced by special medical equipment called ozone generators.The pure gas is highly toxic and can cause acute chemical poisoning and death if inhaled.To introduce ozone into the patient's blood, the gas is mixed with blood or saline (salt concentration 0.9%).
The main indication for using ozone to treat prostatic inflammation is chronic infectious prostatitis that recurs frequently (more than 2-3 times per year).Ozone has powerful antiseptic and bactericidal properties and is therefore often used to disinfect sites, including industrial sites.It destroys almost all pathogenic and opportunistic bacteria that most commonly cause prostate inflammation and are highly resistant to antimicrobial drugs.The feasibility of using this approach was considered reasonable if the patient did not experience stable positive dynamics after changing three antibiotics.
An ozone solution is injected into the prostate part of the urethra or rectum using a special catheter.The course consists of 5-10 programs.
Device to treat prostatitis
Hardware treatment of prostatitis can be performed either in the physiotherapy room or at home (strictly after consultation with the attending physician).Many of these are devices for rectal use, so it is important to consider local limitations in addition to the main contraindications directly related to the disease: acute phase of hemorrhoids, unexplained anal bleeding, violation of the integrity of the rectal epithelial lining, proctitis and pararectitis.
For conditions such as rectal prolapse, pelvic abscess, hemorrhoidal vein thrombosis, and congenital immaturity of the innervation device of the large intestine, no foreign objects (electrodes, sensors) can be introduced into the rectum.
Important!You should consult your doctor before using any device to treat prostatitis and prostate adenoma, as some of these devices may not only be useless but also cause serious damage to your health.The impact of hardware on prostate tissue is unacceptable during the acute phase of the disease and in the presence of any possible contraindications (listed above).
Prostatitis is a serious condition that requires a comprehensive treatment approach.In addition to drugs and physical therapy, in the treatment of prostatitis, some cases also require psychological correction, as well as correction of lifestyle, eating habits, and work and rest patterns.Basic treatment in the recovery and recovery phase should be supplemented by auxiliary treatments: leech therapy (leech therapy), balneotherapy (mineral water therapy), mud therapy, exercise therapy.Men should also exercise more, quit bad habits, and monitor their mental and emotional state.Outside of periods of exacerbation, perform yearly resort treatments to consolidate the gains achieved.