Antimicrobial treatment is not the only way to treat prostatitis.Antimicrobial drugs are prescribed only for appropriate indications and mainly for cyclic exacerbations and increases in severity of disease manifestations.
Effectiveness of Medications for Treating Prostatitis
It is known that various antibiotics can overcome the prostate barrier to varying degrees, so they have different concentrations in the prostate and therefore have different effects in treating prostatitis.Therefore, from among the drugs to which the established flora is most sensitive, the drug with the greatest ability to penetrate the prostate is selected.Similar approaches to treating prostate adenomas can significantly speed recovery.
Broad spectrum drugs to treat prostatitis
Another condition for the effectiveness of a drug used to treat prostatitis is that it has a broad antibacterial effect.This is because it is difficult to reliably determine the flora living in the prostate.Drugs with broad-spectrum antibacterial activity mainly include penicillins.Tetracycline drugs have valuable properties in terms of penetration of the prostate barrier and breadth of antimicrobial action.
Fluoroquinolones Modern Drugs
New antibacterial drugs that have significant advantages over other drugs are the fluoroquinolones.These drugs have a broader antimicrobial effect and are capable of accumulating high concentrations in the prostate when taken orally.In addition to their direct antimicrobial effects, fluoroquinolones rarely cause immunodeficiency in patients and, importantly, microorganisms do not develop resistance to them.
Tetracycline drugs are also widely used as antibacterial treatment.
Young patients receiving antimicrobial therapy should be aware that the drugs used may have spermotoxic effects.Therefore, there needs to be a gap of at least 4 months between the use of these drugs and expected conception, exceeding the full cycle of spermatogenesis.
Typically, antibacterial drugs are used to treat chronic bacterial prostatitis or infectious chronic prostatitis.Treatment strategies for non-infectious chronic prostatitis remain controversial and controversial.Antimicrobial drugs are prescribed to such patients in the hope of curing the latent infection.
If chronic prostatitis is suspected, antimicrobials are not prescribed immediately, that is, not from the first visit.Typically, doctors will examine patients over no more than a few days to detect infection.During this period, symptomatic treatment is recommended, usually with anti-inflammatory effects, taking diclofenac 50 mg or 100 mg suppositories, which have anti-edematous and analgesic effects.
After determining the type of bacteria and its susceptibility, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.Treat under clinical and bacteriological control for 4 weeks or longer (at least 28 days).
If the effect on patients with recurrent chronic prostatitis is significant, it is recommended to extend the use of antibiotics to 6-8 weeks.Sometimes antibiotic treatment is extended to 16 weeks, after which time actual cure is achieved.If there are no positive results, the antimicrobial drugs used are discontinued, but not earlier than 2 weeks after treatment.The ideal antibacterial drug should be fat-soluble, not bound to serum proteins, and slightly alkaline to maximize concentration in the prostate itself rather than in the plasma.For these requirements, the best are fluoroquinolones, which have the best pharmacological properties in the treatment of chronic prostatitis; they produce sufficient concentrations in the prostate, its secretions and sperm and are active against most bacteria found in chronic prostatitis.
Therefore, a necessary condition for maximizing the effectiveness of antimicrobial treatment of chronic prostatitis is to adhere to the following general principles:
- Isolation and determination of prostatitis-causing microbiota and identification of their susceptibility to antimicrobial agents;
- Choose the most effective medication that does not cause side effects;
- Consider the action characteristics of the selected drug to determine the effective dosage, administration method and frequency;
- Start treatment promptly and continue antimicrobial treatment for a long enough course to ensure the greatest possible effect;
- Combinations of antimicrobial agents with each other and with agents and procedures that enhance antimicrobial effects, reduce complication rates, and improve prostate microcirculation;
- Complex treatments are performed taking into account the characteristics of the patient's general health condition.
Sometimes, long-term or overly aggressive antimicrobial treatment can lead to dysbiosis (a reduction in the number and activity of normal intestinal flora).In these cases, it is recommended to use drugs that promote their recovery.
Results of drug treatment for prostatitis
Strategies and strategies for antimicrobial treatment are complex and varied, but their use can improve treatment effectiveness.
After successful treatment of prostatitis with antibiotics, there may be a period of more or less long-term health conditions.Usually, however, the painful feelings that cause anxiety will return sooner or later.Therefore, the use of antimicrobials alone is not sufficient.Good results can be achieved with a treatment plan aimed at increasing local and systemic resistance.In this case, you can count on the success of antimicrobial treatment or long-term relief.
Improve prostate microcirculation
In all forms of chronic prostatitis, in addition to affecting the microflora, they work to restore the microcirculation of the prostate, improve the outflow of glandular secretions, increase the intensity of metabolic processes of inflammatory origin and local and systemic resistance.
Nonsteroidal anti-inflammatory drugs are considered an important step in the treatment of chronic prostatitis.Their positive effect on microcirculation has been demonstrated.
Anticongestive therapy includes measures aimed at reducing stagnant veins in the pelvis: discontinuation of intermittent sexual intercourse, sedentary lifestyle, regular alcohol consumption, etc.For varicose veins and hemorrhoidal veins in the lower limbs that can also cause prostatitis, surgical treatment of these conditions is required.For congestive noninfectious prostatitis, only decongestive treatment is performed.
The treatment combination for chronic prostatitis includes special drugs with highly effective effects.In some cases of exacerbation of chronic prostatitis due to dysuria due to venous stasis, drugs that reduce the tone of the smooth muscle of the prostate may be used to reduce the urge to urinate.But only a doctor can recommend them.
Eliminate pain caused by prostatitis
Since the presence and severity of prostatitis pain are the main patient indicators, determine the patient's attitude towards the disease and influence the expression of depression, analgesic treatment in the treatment of chronic prostatitis is one of the most important components of the general treatment of this disease.The pain syndromes observed in chronic prostatitis are very variable in their location, duration, and intensity.In this regard, the use of analgesics is very important.
Oral administration is very effective and can provide temporary pain relief.Rectally administered suppositories and microenemas analgesics are more effective because they exploit the combined effects of analgesics and anti-inflammatory drugs as well as temperature effects.To change the tone of the glands, belladonna extract can be added to suppositories.
strengthen immune system
When treating chronic prostatitis, it is important to increase the body's reactivity and defenses, which often help cope with any disease.With chronic prostatitis, the body's defense capabilities will be reduced.In this regard, if general immunology is not used to treat chronic prostatitis, it is difficult to achieve success.
Sometimes a drug is used to treat chronic prostatitis, which increases the body's responsiveness.The drug has a thermogenic (increased body temperature) effect that aggravates chronic inflammation of the prostate and converts it into acute inflammation, thereby promoting recovery, since inflammatory diseases in the acute phase are easier to treat.The drug works when it enters the bloodstream quickly.Therefore, it is administered intravenously, starting with a small dose, daily, and gradually and carefully increasing the dose.With this intravenous method, patients with chronic prostatitis must be treated as inpatients for observation.The drug is administered once daily for 9-10 days.At the peak of exacerbation of artificially induced chronic inflammation of the prostate, starting around day 4, start 1-2 antibiotics and sulfonamides or other fairly high doses.To improve the blood supply to the prostate, physical therapy is performed at the same time, and to improve the outflow of prostate secretions, massage is performed daily.Nearly every patient experiences the effects of treatment in the form of improvement or restoration to varying degrees.
hormone therapy
Sex hormone preparations for the treatment of prostatitis need to be used with great caution.This need may arise in patients who have had chronic prostatitis for years or even decades.However, it is best to use it after measuring the serum levels of sex hormones (testosterone, estradiol, prolactin, FSH, LH).Simpler tests may also be performed, such as cytology on urethral navicular scrapings.If sex hormones are imbalanced, hormonal medications may be included in the treatment plan.
Enzymes may also be prescribed to help resolve scar tissue in the prostate during long-term illness.
It is well known that men suffering from chronic prostatitis for a long time will develop sexual dysfunction.The latter are divided into mating, reproductive and hormonal.Fortunately, the vast majority of patients with prostatitis do not have significantly affected hormone levels.
If mating function or the ability to have intercourse is impaired, this can lead to reduced erections, "faded" orgasms, and impaired ejaculation.The elimination of these symptoms and the normalization of sexual life largely depend on the underlying disease - prostatitis.The more successful the treatment, the faster the sexual disorder symptoms disappear or decrease.
Treatment of sexual disorders due to new neuroses includes psychotherapy, sedatives (tranquilizers) and other drugs prescribed according to the symptoms of the sexual disorder.This therapy shows how symptoms of prostatitis can affect a person's quality of life.
If erectile dysfunction occurs, after primary treatment, you can use LOD therapy, which involves creating a vacuum in the blood vessels that hold the penis.Due to the negative pressure generated, the cracks in the corpus cavernosum of the penis widen, and blood flows to the cracks.The penis enlarges and becomes erect.
Repeated surgeries cause the spaces within the corpora cavernosa to increase, allowing a more stable blood supply to the organ and ultimately improving erectile function.The positive effect on chronic prostatitis is also reflected in an increase in sexual activity, which has a strong psychotherapeutic effect.
Penile compression (PLD) for prostatitis is performed daily or every other day.The course of treatment is 10-15 times.It is useful to combine penile compression with infusion prostate massage as this will increase the absorption of the medication after the procedure is completed.
instillation
This type of treatment includes technology that allows drugs to be delivered directly to their intended destination.During instillation therapy with this method, the medication is administered through the external opening of the urethra using a regular disposable syringe or syringe with a tapered disposable cannula (soft hollow tube).The optimal volume of the drug mixture to be administered is 5 ml.Before surgery, you should urinate to make sure your bladder is empty.
When administering the drug, it is recommended to imitate urination, that is, relax, the excess drug will enter the bladder and be excreted with the first part of urine; it is necessary to press the glans penis with fingers or a special clamp - this will prevent the injected solution from flowing back after removing the cannula or syringe.In order for the solution to reach the prostate faster, it is recommended to carefully stroke the filled urethra towards the perineum with the fingers of the free hand when introducing the solution.
Be sure to resist the urge to urinate after surgery, otherwise the injected medicine will flow out immediately.The mixture consists of the same drugs as those administered orally: antibiotics, analgesics, antispasmodics, anti-inflammatory drugs.
Instillation therapy for prostatitis can use a variety of drugs, the choice of which depends on the nature of the disease and the compatibility of the drugs used.Oil mixtures should not be used due to the risk of fat embolism (clogging of blood vessels); under no circumstances should you prepare your own mixture, as the dosage can be wrong, leading to unpleasant or even dangerous consequences.
Suppositories (candles)
In the treatment of prostatitis, suppository therapy (suppositories) is widely used.The effects of drugs contained in suppositories are mainly carried out through the general blood flow and not through the mucosa of the intestinal wall.
The use of candles has significant psychotherapeutic effects.Patients generally tend to use any suppository to self-treat prostatitis, regardless of its ingredients.Patients often use propolis suppositories in particular, as well as thiotriazolines (0.5 g per suppository), which have complex anti-inflammatory and membrane-stimulating effects.In addition to medicinal suppositories, magnetic suppositories are also used to treat prostatitis.
micro grouting
Typically, microenemas are used to treat prostatitis, which is often referred to as the traditional treatment for prostatitis.The basis of their use is that they have both temperature and medicinal effects.Microenemas are usually given before bed.
As medicinal substances, they use aqueous infusions of chamomile, calendula, sage or motherwort, brewed with boiling water before performing microenemas.After the infusion is cooled to 40°C, the drug is injected into the rectum.Inject a small amount of liquid - no more than 100 ml.The drug must be absorbed in the rectum, that is, defecation immediately after a microenema is not advisable.
Herbal infusions can be replaced with 1 teaspoon of an alcohol-based infusion (calendula, motherwort or chamomile), diluted with 100ml of warm water before taking.1.0 g of antipyrine or 10 drops of iodine tincture can be added to the infusion.The effectiveness of microenemas is well known and requires no proof.Microenemas are often used concurrently with antimicrobials, as a final stage in more aggressive local surgery or as a stand-alone treatment for mild pain symptoms.
It is very important to note that medications alone do not produce good and long-lasting results.Prostate drainage surgery must be combined with medical treatment to ensure effectiveness/