Prostatitis is a common urological disease characterized by the presence of inflammatory changes in the prostate due to the influence of harmful factors (infectious, professional 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 is polyetiological in nature, but the main factor in its 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 diagnostics to determine the pathogen and sensitivity to antibiotics.
According to the results of statistical research in the treatment of diseases, the most effective drugs are from the group of fluoroquinolones, cephalosporins and tetracyclines.
In the treatment of prostatitis caused by herpes, HPV or cytomegalovirus, antiviral drugs are used. Prostatitis of fungal etiology is treated with antifungals.
Since the occurrence of prostatitis is influenced by many factors, therapy is usually complex and includes adjusting the way of life in general, with the aim of increasing immunity and improving blood circulation in the pelvic organs.
The list of events includes:
- dietary nutrition (for prevention of constipation);
- regular physical and sexual activity;
- vitamin therapy;
- regular sleeping and waking patterns.
If prostatitis is caused by a violation of the blood supply to the pelvis, regular physical activity, massage and physiotherapy exercises (squats, lunges, walking, running) are indicated to eliminate congestion. In the presence of a source of latent infection (caries, sinusitis, tonsillitis), it is necessary to rehabilitate pathological foci.
Therapy regimens
The symptoms of chronic and acute forms of prostatitis are similar, but the drug exposure schemes are different. This is due to the fact that in the acute form, the treatment is aimed at fighting the infection and stopping unpleasant symptoms, while the chronic form of the disease requires physiotherapeutic exposure methods.
List of drugs in the acute phase of prostatitis:
- NSAIDs - remove discomfort and inhibit the development of the inflammatory process in the gland.
- Antibiotics. It affects the causative agent of the disease. Protected penicillins, macrolides, cephalosporins, fluoroquinolones are most often used.
- Antispasmodics. They are used to relieve pain in the gland, improve secretion outflow, relax vascular walls and improve microcirculation.
- Alpha blockers. Improve outflow during acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. Relieve body inflammation and reduce swelling.
- Phytotherapeutic agents. They are auxiliary medicinal means of natural origin. They have a gentle effect on the prostate, reducing the swelling of the organ.
Important!Physiotherapy measures are contraindicated in the acute phase of prostatitis.
Physiotherapy will help spread the infection and worsen the inflammation.
The chronic form of prostatitis, on the contrary, is treated mainly with 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 the chronic form, complicated by the sclerotic process and blockage 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 lymphogenous or hematogenous way from the intestine 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 treatment of acute prostatitis depends on the type of pathogen and always includes antibiotics. After a detailed examination, the doctor identifies the pathogen and prescribes the appropriate medicine.
In the case of protozoan infection (trichomoniasis), a drug from the nitroimidazole group is usually prescribed. Intracellular chlamydial infection is treated with macrolide antibiotics.
Alternative agents are some other macrolides, fluoroquinolones and tetracycline antibiotics.
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 nitroimidazole group and its analogues are prescribed).
In the treatment of acute prostatitis caused by non-specific microbial flora, a standard drug regimen is used, which also includes antibiotics.
The standard treatment regimen for prostatitis includes the following measures:
- Bed rest in the acute form, massage and physical therapy in the chronic phase of the disease.
- Diet food.
- Antibiotics to suppress the microbial flora that caused inflammation in the prostate.
- NSAIDs are used as a symptomatic medicine for pain and to fight inflammation.
- bioregulatory peptides. These are products from the prostate of cattle. 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 rheological properties of blood that eliminate blockage (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 a hospital environment. 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 of influence on 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 dynamic of improving the condition, then the treatment can be extended up to 2 months.
The groups of antibiotics most commonly used to treat bacterial prostatitis are:
- protected penicillins. Medicines are prescribed orally at 1 g twice 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 ranges from one week to 10 days. Penicillins are usually used until laboratory test results are available.
- 2nd generation fluoroquinolones, 200 mg twice a day for 1-2 weeks.
- Fluoroquinolones 3 generations 0. 5 g once a 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 negatively affect the intestinal microflora. Assign orally 500 mg 1-2 times a day. The medicine must 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 lasts at least two weeks.
Allergic patients should inform their doctor about existing intolerance to certain drugs before starting treatment. It is possible that in the case of liver or kidney function disorders, the specialist will have to adjust the treatment regimen or the dosage of drugs, so it is important to warn him in advance.
Scheme of treatment of viral acute prostatitis
Virological diagnostic methods are not included in the examination protocol, so the diagnosis of "viral prostatitis" is 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 through the internal organs via hematogenous and lymphogenous routes.
After exposure to the drug, the virus persists in spinal or cranial ganglia and periodically recurs. Usually aggravation occurs after hypothermia or reduced immunity.
The culprits of this type of prostatitis are herpes virus, cytomegalovirus, HPV and influenza. The causative agent can penetrate not only the prostate, but also other organs located nearby, for example, the bladder, urethra, testicles, rectum, causing their serious damage when immunity is reduced.
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. Basically, the disease proceeds with severe itching and burning, but there is also an asymptomatic course.
Treatment for viral prostatitis includes:
- Taking antiviral drugs. They are effective in the treatment of herpes and HPV. The mechanism of their action is based on suppressing the emergence of new generations of viruses. 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 the tension of smooth muscles and facilitate the outflow of urine.
With the defeat of HPV or warts, it is sometimes necessary to remove growths with electrocoagulation, laser or liquid nitrogen. The procedure is performed in a hospital.
Scheme of treatment of acute fungal prostatitis
Long-term use of antibiotics leads to the emergence of new types 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 Candida fungus begins to multiply actively in the body, causing candidiasis.
In the treatment of candidal prostatitis, the following are used:
- 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!Food with probiotics should be included in the diet of patients with a yeast infection of the prostate.
These are kefir, yogurts, 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 it can harm the body, cause severe allergic reactions and help the body to adapt to certain antibiotics, as a result of which these drugs will no longer have a therapeutic effect.