Prostatitis is a common urological disease characterized by the presence of inflammatory changes in the prostate gland due to the influence of damaging factors (infectious, occupational, etc. ). The standard treatment regimen for prostatitis depends on the form, course and pathogen of the disease.
Treatment of prostatitis depends on the type
This disease has a polyetiological nature, but the main factor of occurrence is infectious. Therefore, the task of urology is to find rational methods of etiotropic therapy and fight infection.
Treatment for bacterial prostatitis includes antibiotic therapy. This drug is prescribed after laboratory diagnostics to determine the pathogen and sensitivity to antibiotics.
According to the results of statistical studies in the treatment of diseases, drugs from the group of fluoroquinolones, cephalosporins and tetracyclines were found to be the most effective.
In the treatment of prostatitis caused by herpes, HPV or cytomegalovirus, antiviral drugs are used. Prostatitis of fungal etiology is treated with antimycotic agents.
Since many factors affect the occurrence of prostatitis, therapy is usually complex and includes general lifestyle adjustments, aimed at improving immunity and improving blood circulation in the pelvic organs.
The list of events includes:
- dietary nutrition (for the prevention of constipation);
- frequent physical and sexual activity;
- vitamin therapy;
- proper sleeping and waking patterns.
If prostatitis is caused by a violation of the pelvic blood supply, then regular physical activity, massage and physiotherapy exercises (squats, lunges, walking, running) are indicated to eliminate congestion. In the presence of a latent source of infection (caries, sinusitis, tonsillitis), sanitation of the pathological focus is required.
Therapy regimen
The symptoms of chronic and acute forms of prostatitis are similar, but the scheme of drug exposure is different. This is due to the fact that in the acute form, the treatment is aimed at combating the infection and stopping the unpleasant symptoms, and the chronic form of the disease requires physiotherapeutic methods of exposure.
List of drugs in the acute stage of prostatitis:
- NSAIDs - eliminate discomfort and prevent the development of the inflammatory process in the gland.
- Antibiotics. Affect the causative agent of the disease. The most commonly used are protected penicillins, macrolides, cephalosporins, fluoroquinolones.
- Antispasmodic. It is used to eliminate pain in the glands, improve the outflow of secretions, relax the vascular walls and improve microcirculation.
- Alpha blockers. Improves outflow during acute urinary retention by relaxing the smooth muscles of the urethra and bladder neck. Relieves body inflammation and reduces swelling.
- Phytotherapeutic agents. They are additional healing agents of natural origin. Slowly affects the prostate gland, reducing swelling of the organ.
Important!In the acute stage of prostatitis, physiotherapeutic measures are contraindicated.
Physiotherapy will help spread the infection and worsen the inflammation.
The chronic form of prostatitis, on the other hand, is treated mainly by physiotherapeutic methods:
- Laser therapy.
- Phonophoresis (a combination of ultrasound and medication).
- Electrophoresis.
- Exposure to microwaves.
Apply one or more treatment methods at the same time. Surgical intervention (endoscopic method) is used only in chronic forms, complicated by sclerotic processes and congestion in the gland. The operation can significantly improve the patient's quality of life, restoring lost functions.
Principles of acute prostatitis treatment
Urogenital infections are almost always the cause of acute prostatitis. It can be both a non-specific infection (caused by conditionally pathogenic microorganisms) and sexually transmitted (gardnerellosis, chlamydia, gonorrhea, trichomoniasis, etc. ).
In the first case, the pathogenic microflora penetrates the lymphogenous or hematogenous route 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.
Methods of treating acute prostatitis depend on the type of pathogen and always include antibiotics. After a thorough examination, the doctor identifies the pathogen and prescribes the appropriate medication.
In the case of infection with protozoa (trichomoniasis), drugs from the group of nitroimidazoles are usually prescribed. Treatment of intracellular chlamydial infection is with macrolide antibiotics.
Alternative agents are several other macrolides, fluoroquinolones, and tetracycline antibiotics.
Treatment of gonorrheal lesions includes penicillin and cephalosporin group antibiotics and vaccine therapy. Inflammation of the glands caused by gardnerella requires the use of antibiotics (macrolides, lincosamides, as well as drugs from the group of nitroimidazoles and their 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 involves the following steps:
- Bed rest in the acute form, massage and exercise therapy in the chronic stage of the disease.
- Diet food.
- Antibiotics to block the microbial flora that cause inflammation in the prostate gland.
- NSAIDs are used as symptomatic drugs for pain and to combat inflammation.
- bioregulatory peptides. This is a product from the prostate gland of a cow. Stimulates the regeneration process in the gland.
- Antispasmodic.
- Muscle relaxants are used to relax the bladder, urethra, and perineal muscles.
- Means that improve blood circulation and the rheological properties of blood that relieve congestion (for example, drugs that improve microcirculation in the gland by blocking receptors located on the walls of blood vessels).
- Hormonal agents.
Depending on the course and characteristics of prostatitis, other measures (ultrasound, autohemotransfusion, rectal administration of drugs) can be added to the scheme.
To quickly stop the symptoms of prostatitis, intravenous infusion is used.
Such treatment is carried out in a hospital setting. 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 infection. But in some cases, it is also prescribed for chronic prostatitis of abacterial etiology - as an additional measure of influence on the possibility of latent infection. Preference is given to broad spectrum antibacterial means.
The course of treatment is from 2 weeks to a month. If there is a good dynamic improvement in the condition, then the treatment can be extended up to 2 months.
The most widely used group of antibiotics for the treatment of bacterial prostatitis are:
- protected penicillin. 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 is from a week to 10 days. Penicillin is usually used until laboratory test results are obtained.
- 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.
- 3rd generation cephalosporins. Give the medicine in / m or / in 1 g 2 times or 2 g 1 time a day for 7-10 days.
- 4th generation cephalosporin 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 affect the intestinal microflora. Give 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 reduce the dose and treatment time independently. Full course of at least two weeks.
Allergic patients should inform the doctor about existing intolerance to certain drugs before starting treatment. It is possible that in the event of a violation of liver or kidney function, the specialist will need to make adjustments to the treatment regimen or drug dosage, so it is important to warn him in advance.
Acute viral prostatitis treatment scheme
Virological diagnostic methods are not included in the examination protocol, so usually the diagnosis of "viral prostatitis" is rarely made by urologists. Herpes and HPV infections are sexually transmitted.
The genital herpes virus enters the body of a man and multiplies, after which it reaches the lymph nodes, from where it spreads through the internal organs through hematogenous and lymphogenous routes.
After drug exposure, the virus persists in spinal or cranial ganglia and periodically replicates. Usually, exacerbation occurs after hypothermia or decreased immunity.
Causes of this type of prostatitis are herpes virus, cytomegalovirus, HPV and influenza. The causative agent is able to penetrate not only into the prostate, but also into other organs located nearby, for example, the bladder, urethra, testicles, rectum, causing their severe damage when immunity is reduced.
The causative agent of viral prostatitis can be identified using laboratory analysis. In men, genital herpes has the appearance of vesicles and sores located in the groin, scrotum, perineum or urethra. Basically, the disease persists with severe itching and burning, but there are also asymptomatic courses.
Treatment for viral inflammation of the prostate includes:
- Take antiviral drugs. They are effective in treating herpes and HPV. Their mechanism of action is based on the suppression of the emergence of a new generation 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 smooth muscle tension and facilitate the outflow of urine.
With the defeat of HPV or warts, sometimes it becomes necessary to remove the tumor using electrocoagulation, laser or liquid nitrogen. This procedure is carried out in a hospital.
Acute fungal prostatitis treatment scheme
Prolonged use of antibiotics leads to the emergence of new types of microorganisms that are resistant to many antibacterial agents. The increase in the number of patients with fungal prostatitis is due to the uncontrolled use of antibiotics and the gradual addiction to them.
With a decrease in immunity, fungi of the Candida genus begin to actively multiply in the body, causing candidiasis.
In the treatment of candidal prostatitis used:
- Antimycotics. Drugs are sometimes combined in different proportions.
- Probiotics containing bifido- and lactobacilli. They inhibit the growth of pathogenic flora.
- Immunomodulating agents that increase the body's defenses.
Important!The diet of patients with prostate yeast infection should include foods with probiotics.
These are kefir, yogurt, acidophilus 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 urologist can choose a course of medication for prostatitis. Medicines themselves 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 medicines no longer have a therapeutic effect.