The importance of studying the mechanism of development of chronic prostatitis increases in direct proportion to the increase in the number of diagnosed cases of the disease. It is known that chronic prostatitis (CP) occupies a leading place among urological diseases and is the result of many factors that are an integral part of modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
Since the disease not only covers an increasing percentage of the male population, but is also diagnosed at an increasingly young age, there is often a rather dismissive attitude to the problem on the part of doctors who use template regimens for treatment that are unable tolead. towards recovery.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate gland, manifested in the form of a chronic inflammatory process of the tissues. However, one cannot talk about CP only as a result of the penetration of pathogens into the prostate, since such a view justifies attempts to treat prostatitis exclusively with antibiotics, which almost never bring lasting positive results.
The main factors underlying the development of pathology can be considered complex changes in the tissue and, accordingly, the functional abilities of the gland, which are the main cause of the development of infectious microflora. Chronic prostatitis, to a certain extent, is a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in the pelvic organs.
- Urodynamic disorder.
- Degenerative processes in the prostate parenchyma.
- Trophic disorder.
- inflammatory processes.
Mechanism of development
The penetration of pathogenic microflora into a healthy prostate gland is practically not able to cause an inflammatory process, since the microflora of the prostate has a certain resistance to pathogens present in the urethra. However, the presence of one or more of the above provocative factors leads to the development of continuous inflammation, accompanied by the appearance of scar formations (fibrotization) or areas of necrosis.
The spread of connective tissue in the process of scar formation causes congestive processes in the acini (channels that ensure the discharge of secretions), which worsen the course of the disease. Tissue necrosis leads to the formation of a cavernous cavity, in which, in addition to dead epithelium, a prostate secret accumulates.
Thus, the main cause of the development of CP is not an infection, but various physiological disorders that allow the inflammatory process to become chronic.
Another distinguishing feature of the disease, which makes diagnosis difficult, isflow periodicity. As a rule, under the influence of external factors or the internal state of the body, there is a periodic change in the intensity of the pathology, during which acute conditions are replaced by periods of remission.
Often there is not only a complete absence of symptoms, but also a lack of laboratory indicators that indicate the presence of infection (for example, leukocytes). Despite the positive results, this condition cannot be considered a recovery, as all physiological disorders in the gland remained unchanged.
reason
The main causes of blood circulation disorders in the pelvic organs and venous blood stagnation in the prostate gland are:
- Permanent standing in a sitting position.
- Hypothermia of the whole body or directly in the pelvic region.
- Systemic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- The presence in the body of a chronic infection of any location (sinusitis, bronchitis).
- Excessive physical activity, accompanied by lack of sleep or rest, causes suppression of immunity.
- A history of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to the systematic use of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnant processes, the deterioration of the excretory function of the glands, the decrease of cellular resistance to diseases, which contribute to the creation of optimal conditions for the reproduction of pathogenic microorganisms in the prostate gland. .
Can chronic prostatitis be cured?
Despite the availability of a large amount of systematic information on the mechanism of CP development,its treatment is extremely difficultand is one of the main problems in modern urological practice.
Due to the fact that the disease proceeds in each individual patient according to an individual scheme, accordingly, the approach to treatment should also be individual, taking into account all the physiological changes that have occurred in the prostate gland.
The anatomical characteristics of the prostate, which can be reached either through the urethra or through the rectum, significantly reduce the effectiveness of the applied therapeutic effect. In this regard, to achieve a relatively stable result, a long course of therapy (usually several months) is required, during which the patient must strictly comply with all the doctor's requirements.
Unfortunately, a complete cure can only be achievedin 30 cases out of 100. This is mainly due to premature seeking of medical help, due to the long absence of severe symptoms or conscious avoidance of unpleasant diagnostic and then therapeutic procedures. As a rule, at the time of treatment, atrophic processes in the prostate are irreversible, even with long-term treatment, it is only possible to completely eliminate the symptoms and achieve a stable remission, the duration of which depends on the patient's compliance. with the doctor's recommendations.
Treatment
The complex of measures used in the treatment of CP includes:
Antibacterial therapy
Suppression of the activity of bacterial microflora with the help of antibiotics should be carried out only after a complex of laboratory tests, according to the results of which the most effective drug is prescribed.
As a rule, the duration of antibiotics is determined by the severity of the disease and is at least 30 days. It is unacceptable to stop the treatment, as the remaining microorganisms will become resistant to this group of drugs and then they will have to be replaced and an even longer course. In the treatment of prostatitis, priority is given to antibiotics that have a bactericidal effect:
- Fluoroquinolones;
- Azalides;
- Aminoglycosides;
- Tetracyclines.
If laboratory tests reveal a specific nature of the infection, for example, trichomoniasis or the viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed in parallel with antibiotics.
Use of antispasmodics and α-blockers
The main purpose of using drugs of this series is to relieve spasm on the pelvic floor, which helps to increase blood supply, improve urine flow and reduce pain.
laxative
To avoid excessive stress on the pelvic muscles that occurs during the act of defecation, it is advisable to use laxatives, as efforts during constipation can worsen the patient's condition.
Physiotherapy
One of the most common methods of physiotherapy is rectal massage of the prostate gland. The therapeutic effect of the impact of the finger on the prostate, carried out through the anus, is the squeezing of the infected secretion, which is then excreted through the urethra.
In addition, during the massage, the blood supply to the tissues increases, which has a positive effect on antibiotic therapy. The following physiotherapeutic methods are also used to perform rectal prostate massage:
- Electrical simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
prevention
After the stabilization of the condition, the patient is asked to follow the rules that impose some restrictions on the usual way of life:
- Avoid water procedures in reservoirs and open pools.
- Get checked by a doctor regularly.
- Refrain from drinking alcohol completely.
- Have a regular sex life with a partner.
Compliance with the rules will allow you to stay in remission as long as possible and avoid exacerbations of the disease.