Chronic prostatitis is an inflammatory disease characterized by lesions of the prostate gland and severe urodynamic disorders. One of the causes of chronic inflammation of the prostate is improper or premature treatment in the acute phase, when the desquamation and proliferation of the glandular epithelium is reversible and successfully corrected with medication within 2-3 weeks.
Treatment of chronic prostatitis includes massive antibiotic therapy aimed at eradicating the infectious pathogen, a set of measures to increase the body's immunity, physiotherapeutic methods, thermotherapy. Psychocorrection can also be included in the therapy regimen, as in men with long-term and recurrent prostatitis, neurasthenic and neurosis-like conditions are often observed.
Why does inflammation become chronic?
Knowing the causes of chronic prostate inflammation is necessary to prevent exacerbations and improve the quality of life of patients. There are a large number of factors that can affect the functional state of the glandular (glandular) tissue of the prostate gland and cause inflammation, which is based on the desquamation and proliferation of epithelial cells.
The main cause of chronic prostatitis in men is widespread contamination of the mucous membranes of the genitourinary system by pathogenic microorganisms. In the vast majority of cases (more than 80%) of infectious prostatitis, gram-negative and gram-positive bacteria become the causative agent of the infection: enterobacteriaceae (in particular, Escherichia coli), gonococci, staphylococci. Less often, the infectious and inflammatory process continues against the background of infection with viruses, fungi and protozoa, but such forms of prostatitis are treated quite successfully during the acute period and rarely give recurrence, subject to correct and timely therapy.
It should also be borne in mind that for the development of chronic aseptic prostatitis, a single acute urinary tract infection is sufficient, therefore personal hygiene, use of condoms during sexual intercourse and timely treatment of urinary tract diseases have aof great importance in the prevention of this disease in men. Medicine recognizes cases of hematogenous infection (through systemic circulation) of the prostate in chronic sinusitis, tonsillitis and other diseases that contribute to the active growth of pathogenic flora, therefore, rehabilitation of foci of chronic infection is an important stage in the complex treatment of inflammation ofelongated or elongated prostate.
Negative factors that can cause prostate worsening (including non-infectious course) are:
- urinary tract injuries and surgery on the organs of the genitourinary system;
- regular or severe hypothermia of the pelvic organs (swimming in open water during periods when the water is not warm enough or the weather is cool outside, working in refrigerators and freezers, etc. );
- hypodynamics caused by sedentary work and insufficient physical activity of a man (a sedentary lifestyle is one of the main factors in the development of chronic cognitive prostatitis);
- bad habits, in which the absorption of the most important macro and micronutrients that determine the chemical composition and rheological properties of prostate secretions (zinc, chromium, selenium, manganese) is slowed down or impaired;
- disorders in the intimate sphere (frequent masturbation, irregular sexual intercourse, long periods of abstinence, frequent arousal that does not end with sexual intercourse);
- overweight;
- eating disorder (increased consumption of spicy, highly salty, smoked and fatty foods).
Pay attention! Urologists note that the main pathogenetic factor in the development of chronic inflammation of the prostate gland is posterior urethritis. It has also been observed that inflammatory changes in the prostate in men appear during the first months after suffering a gonorrhea infection.
Treatment of chronic prostatitis with medication
Treatment of chronic prostatitis with medication is aimed only at suppressing acute symptoms during an exacerbation and destruction of the infection, but medication can not be used as the only remedy (the effectiveness of such treatment will not exceed 36%, according to Dr. . Pechersky).
A complete treatment regimen for prolonged or recurrent prostate inflammation, which is used today as the standard for uncomplicated disease, is presented in the table below.
Table. Preparations for the complex treatment of chronic prostatitis.
| Pharmacological group | Purpose | Extinction (destruction) of pathogenic bacteria - causative agents of infectious prostatitis, urethritis, cystitis and other urinary tract infections. |
|---|---|
| Antimicrobial and antiprotozoal agents. | Treatment of infections caused by pathogenic microbes and protozoa. |
| Non-steroidal anti-inflammatory drugs (preferably in the form of rectal suppositories). | Reducing inflammation in prostate tissue, relieving pain in the perineum, intergluteal space, sacrum and groin. |
| Antiseptics in the form of rectal suppositories. | Rehabilitation of rectal mucosa and prevention of its infection with prolonged prostate. |
| Alpha blockers. | Normalize urination, restore daily urine output. |
| Microcirculation correctors. | Elimination of congestion in the pelvic vessels, restoring normal blood and lymph flow. |
| Urodynamic correctors (agents that affect metabolism in prostate tissue). | Improving metabolic and metabolic processes in prostate gland tissue and its nutrition. |
| Power regulators. | Complex treatment of erectile dysfunction, improvement of chemical composition, viscosity and fluidity of seminal fluid, increase of sperm activity (the use of drugs of this group is indicated for patients whose prostate is complicated by autoimmune infertility). |
The duration of antibiotic treatment is at least 4-6 weeks. Under no circumstances should you take over-the-counter antibacterial drugs, as the main factor in choosing therapy are the results of microscopic examination of prostate secretions and spontaneously released fluids as a result of prostate massage. Some antibiotics, for example, penicillin (a combination of amoxicillin with clavulanic acid) are spare drugs and their incorrect use can lead not only to a lack of a clinically significant effect and the progression of pathology, but also to the development of superinfection.
Important! In some cases, men with chronic prostatitis need psychological correction, especially if pain syndrome is combined with behavioral changes, increased anxiety, irritability, and neurasthenia. Antidepressants with selective serotonin reuptake inhibition are used to suppress these symptoms.
Physiotherapy
Heat therapy is the main method of treating chronic prostatitis outside of periods of exacerbation (after regression of acute symptoms). Heat therapy refers to physiotherapy methods and is a dosed effect of heat on the affected area. The benefits of thermal procedures are in the normalization of blood circulation, alleviation of inflammatory processes, reduction of chronic pelvic pain, which is one of the main clinical manifestations of chronic prostatitis, which reduces the quality of life for men. Heat also improves the penetration of medicinal substances into the prostate tissue, therefore, in some cases, physiotherapy is used to increase the effectiveness of drug therapy (for example, antibiotic electrophoresis). For men at a high risk of thrombus formation, warming is prescribed for prophylaxis, as heat has a moderate resorption effect.
There are a large number of methods of thermal effects on the body, and the choice of a specific method of treatment should be performed by a physician, taking into account the clinical appearance, form and stage of the disease, the age of the man and his toleranceindividual. The following methods of thermotherapy are most effective for prostatitis:
- thermal applications with minerals (ozokerite, paraffin, bischofite), salt or sand;
- electric heating pads;
- deep heating of tissues with high strength for direct action on blood vessels and nerve endings (diathermy);
- exposure to high-frequency alternating magnetic fields to eliminate pain, relieve inflammation, and eliminate neurosis-like manifestations (inductothermia);
- ultrasound therapy (promotes resorption of abscesses and healing of formed scars);
- electrophoresis with insertion of electrodes into the rectum;
- exposure to prostate tissue by high-frequency pulsed currents (darsonvalization).
In some physiotherapy rooms, chronic inflammation of the prostate is treated with hot mud applications ("mud pants"). Such procedures have a positive effect not only on blood and lymph circulation, but also on the production of prostate secretion, as well as nourishment of inflamed organ tissues. In some cases, the clay is injected directly into the rectum in the form of tampons, as with this method of administration it is possible to quickly achieve a therapeutic effect and a positive response to therapy.
Other treatments
The complex treatment scheme, in addition to drug and thermal therapy, is complemented by various procedures prescribed by the doctor, taking into account the specifics of the pathology in each case.
Prostate massage
This is one of the main methods of treating chronic inflammation of the prostate gland, which is advised to be used in almost 90% of cases (in the absence of contraindications). Massage is a finger effect on the prostate to stimulate the release of secretory fluid. The duration of the procedure is usually about 1-2 minutes. The criterion for a sufficient effect is the complete emptying of the prostate glands, which the patient feels as relief (for which he must inform the doctor).
The benefits of massage are determined by the therapeutic effect that can be achieved after undergoing a course of treatment (8-12 procedures). With an uncomplicated course, these are:
- normalize muscle tone;
- improving blood circulation to the prostate vessels (because of this, the transport of medicinal substances to the tissues of the affected organ is accelerated and the effectiveness of therapy is increased);
- restoring the ability to secrete;
- normalization of blood and lymph outflow from the prostate gland (especially important in cognitive prostatitis).
The procedure is contraindicated during the acute period due to the high risk of spreading the infection to surrounding tissues and organs (hematogenous infection), with other infectious diseases of the genitourinary system, the presence of cysts or stones in the prostate. Prostate massage is not prescribed for patients who have been diagnosed with tuberculous organ damage, adenoma or other neoplastic diseases (including cancerous lesions of the prostate gland). In the presence of diseases of the rectum (hemorrhoids, anal fissures, proctitis, paraproctitis), massage can cause complications and provoke recurrence of the underlying disease.
Important! Studies show that almost 42% of men refuse prostate massage due to increased psychological distress associated with the peculiarities of this procedure. The physician's work with such patients should include detailed information on the consequences of refusing treatment and possible complications, in particular, infertility and persistent sexual dysfunction. In some cases, it may be advisable to prescribe a mild sedative a few days before starting treatment.
Hot enemas
Hot enemas are home remedies for chronic prostatitis, but urologists recognize their effectiveness and recommend them for faster and more effective prostate treatment. The water temperature for these enemas should be around 42 ° C. Before the procedure, it is necessary to clean the intestines with a regular enema or laxative. The volume of an enema is from 150 to 300 ml. It is recommended to empty the intestines 30-50 minutes after administration of the solution.
Recipes for chronic prostate inflammation are listed below.
- Dissolve 10 drops of iodine and about 20 ml of chlorhexidine in 200 ml of water. Apply at bedtime for 15 days.
- A decoction of chamomile, grapes or calendula should be inserted into the rectum (about 250 ml), and then hold it for 1 hour. The procedure is repeated once a day for 2 weeks.
- Sea oil (40-50 ml) is heated to 40 ° C and inserted into the rectum for 20-30 minutes. The course of treatment is 10-15 days. The procedure is best done at bedtime.
- In case of severe pain syndrome, significantly limiting the patient's mobility and impairing his quality of life, novocaine microclysters can be used. Dissolve 2 ampoules of a 2% solution of novocaine in 180 ml of a steep chamomile decoction. Hold for at least 50 minutes. Repeat daily for 1 week.
Anti-inflammatory drugs, antiseptics, antibiotics can also be used by medicines for microclinics. The use of these drugs is permissible with the permission of a physician strictly at the indicated dose.
Treatment of chronic prostatitis: step-by-step instructions
Using different treatment methods is not enough to completely get rid of chronic prostatitis. If a man does not monitor his diet and does not change his lifestyle, deteriorations will occur regularly, leading to irreversible changes in the structure and functional activity of the prostate glands and persistent diurnal and sexual disorders. In order for the effectiveness of treatment and the duration of remission to be higher, you should adhere to the recommendations set out in the guidelines below for patients with chronic prostatitis.
- Step 1. If a man is diagnosed with chronic prostatitis, he should start correcting his diet. It is necessary to exclude foods with a large amount of fat, salt and spices from the menu. Fats increase blood cholesterol levels, and salt promotes fluid retention and edema in prostate tissue. Spices (as various chemical additives) irritate the mucous membranes of the urinary tract, provoking a worsening of existing symptoms.
- Step 2. It is also necessary to completely eliminate alcoholic beverages, as they slow down the absorption of nutrients, disrupt blood and lymph circulation, and adversely affect prostate metabolism. If a man suffers from smoking addiction, measures should be taken to get rid of this habit (toxic substances in tobacco smoke disrupt the viscosity and fluidity of prostate secretions and change its chemical composition).
- Step 3. Overweight men should consult an endocrinologist and nutritionist for a comprehensive diagnosis and correction of body weight, taking into account the identified deviations. Obesity is the most important factor in the development of chronic prostatitis and an important stage in complex therapy is weight loss in patients with high BMI.
- Step 4. To eliminate stagnant phenomena associated with hypodynamic disorders, it is necessary to ensure an adequate level of physical activity, corresponding to age and physical fitness. Swimming, physiotherapy exercises, stretching exercises, walking are beneficial for prostatitis.
- Step 5. For normal prostate function, it is necessary to monitor the quality of sexual life. It is advisable to have a permanent sexual partner, avoid episodes of sexual arousal if there is no possibility of further intercourse, and be checked regularly for genital infections, which can also provoke a worsening of chronic prostatitis.
Men with recurrent prostate should monitor emotional stress, avoid stressful situations, and prolonged exposure to cold or drafts.
Chronic prostatitis is a disease that is difficult to treat, especially if the patient does not follow the prescription of the attending physician and does not take a responsible approach to nutrition and regimen issues. Inflammation of the prostate is dangerous with serious complications, so you need to approach the problem comprehensively. Men with this diagnosis should understand that pills alone are not enough to fully restore all prostate gland functions, so you should not abandon the basic therapy methods for chronic prostatitis suggested by your doctor, even if they causeprimary psychological or physical concerns.