Prostate treatment in men: what drugs should be used

Prostatitisis an inflammatory disease of the prostate.It manifests itself as frequent urination, pain in the penis, scrotum, rectum, sexual dysfunction (erectile dysfunction, premature ejaculation, etc.), sometimes urinary retention and hematuria.Diagnosis of prostatitis is determined by a urologist or internist based on the typical clinical picture and results of rectal examination.In addition, prostate ultrasound and cultures of prostate secretions and urine were performed.Treatment is conservative - antibacterial therapy, immunotherapy, prostate massage, lifestyle modification.

General information

Prostatitis is an inflammation of the seminal gland (prostate) – the prostate.This is the most common disease of the genitourinary system in men.Usually it affects patients aged 25-50 years.According to various data, prostatitis affects 30-85% of men over 30 years old.Prostatic abscesses, inflammation of the testicles and appendages can form, threatening infertility.Ascending infection leads to inflammation of the upper part of the genitourinary system (cystitis, pyelonephritis).

Pathology develops with the penetration of an infectious agent into the prostate tissue from the organs of the genitourinary system (urethra, bladder) or from a remote inflammatory focus (pneumonia, influenza, sore throat, boils).

Causes of prostatitis

Staphylococcus yellow, Enterococcus, Enterobacter, Pseudomonas, Proteus, Klebsiella and E. Coli can act as infectious agents in acute cases.Most microorganisms belonging to the flora are conditionally pathogenic and cause prostatitis only in the presence of other risk factors.Chronic inflammation is often caused by an association of many bacteria.

The risk of developing the disease increases with hypothermia, a history of infection, and specific conditions accompanied by blockages in prostate tissue.The following influencing factors were identified:

• Whole body hypothermia (one-time or permanent, related to working conditions).
• Sedentary lifestyle, an occupation that forces a person to sit for long periods of time (operating a computer, driving, etc.).
• Continuous constipation.
• Disorders of the normal rhythm of sexual activity (excessive sexual activity, prolonged abstinence, incomplete ejaculation during "habitual" sexual intercourse without emotional overtones).
• The presence of chronic diseases (cholecystitis, bronchitis) or chronic foci of infection in the body (chronic osteomyelitis, untreated caries, tonsillitis, etc.).
• Previous urinary diseases (urethritis, cystitis, etc.) and sexually transmitted diseases (chlamydia, trichomonas, gonorrhea).
• Conditions that suppress the immune system (chronic stress, irregular and poor nutrition, chronic lack of sleep, overtraining in athletes).

A decisive role in the occurrence of prostatitis is played by blockages in the prostate tissue.Disruption of capillary blood flow causes an increase in lipid peroxidation, swelling, and secretion of prostate tissue and facilitates the development of infection.

Symptoms of prostatitis

Acute prostatitis

There are three stages of acute prostatitis, characterized by the presence of a certain clinical picture and morphological changes:

• Acute Catarrhal.Patients complain of frequent, painful urination, pain in the sacrum and perineum.
• acute cyst.The pain becomes more intense, sometimes spreading to the anus and intensifies when defecating.Difficulty urinating, urine flows out in a thin stream.In some cases, urinary retention is observed.Typically mild fever or moderate hyperthermia.
• Acute parenchyma.Severe systemic poisoning, increased body temperature up to 38-40°C, chills.Dyspepsia, often acute urinary retention.Sharp, stabbing pain in the perineum.Difficulty in defecation.

Chronic prostatitis

In rare cases, chronic prostatitis becomes the result of an acute process, however, as a rule, a predominantly chronic course is observed.The temperature sometimes rises to levels below fever.The patient feels mild pain in the perineum and discomfort when urinating and defecating.The most characteristic symptom is little discharge from the urethra during defecation.The chronic form of the disease mainly develops over a significant period of time.Before that, there was prostatitis (blood stagnation in the capillaries), which gradually turned into bacterial prostatitis.

Chronic prostatitis is often a complication of the inflammatory process caused by the causative agent of a specific infection (chlamydia, trichomonas, ureaplasma, gonococcus).Symptoms of a specific inflammatory process in many cases mask the manifestations of prostate damage.There may be slight increased pain when urinating, mild pain in the perineum, and little secretion from the urethra during defecation.A small change in the clinical picture often goes unnoticed by the patient.

Chronic prostatitis can be manifested by a burning sensation in the urethra and perineum, difficulty urinating, sexual dysfunction, and general fatigue.The consequences of potential disorders (or fear of these disorders) are often depression, anxiety and irritability.The clinical picture does not always include all of the symptom groups listed;it differs between different patients and changes over time.There are three main syndromes characteristic of chronic prostatitis: pain, difficulty urinating, and sexual dysfunction.

There are no pain receptors in prostate tissue.The cause of pain in chronic prostatitis is the almost inevitable participation of nerve pathways in the inflammatory process due to the abundant distribution of the pelvic organs.Patients complain of pain of varying intensity - from mild, aching to severe, making it difficult to sleep.There is a change in the nature of the pain (increase or decrease) during ejaculation, excessive sexual activity or abstinence from sexual intercourse.The pain radiates to the scrotum, sacrum, perineum and sometimes to the lumbar region.

Due to inflammation in chronic prostatitis, the volume of the prostate increases, compressing the urethra.The luminosity of the ureter decreases.The patient frequently wants to urinate and feels the bladder is not completely emptied.As a rule, the phenomenon of indigestion is manifested in the early stages.Compensatory hypertrophy of the bladder muscle layer and ureter then develops.Dysuria symptoms weaken during this period and then increase again due to decompensation of adaptive mechanisms.

In the early stages, dysfunction can develop, which manifests itself differently in different patients.Patients may complain of frequent nighttime erections, loss of orgasm, or poor erection ability.Rapid ejaculation is associated with a decrease in the stimulation threshold of the orgasm center.Pain during ejaculation can cause refusal of sexual activity.After that, sexual dysfunction becomes more pronounced.In advanced stages, impotence develops.

The degree of sexual dysfunction is determined by many factors, including the patient's sexual constitution and mood.Impaired potency and difficulty urinating can be caused by changes in the prostate and by the suggestibility of the patient, who, if diagnosed with chronic prostatitis, will inevitably develop sexual and urinary disorders.Psychogenic dyspepsia and dysuria develop especially frequently in anxious, suggestive patients.

It is difficult for the patient to endure impotence and sometimes there is a risk of sexual dysfunction.There are often changes in personality, irritability, grumpiness, excessive concern for one's health and even "sickness".

Classify

In modern urology there is no unified classification of diseases.However, practicing doctors prefer this option for classifying the inflammatory process in the prostate:

According to the progression of the disease:

• Acute prostatitis.It accounts for more than 50% of cases in people no older than 30-35 years old.
• Chronic options.It is considered an ageless genre.It does not manifest for a long time;The impetus for its development is a cold or infection.

Regarding the cause of the disease:

• Bacterial prostatitis, which prevails in men under 40 years old, occurs against the background of ultrasound and does not extend beyond the boundaries of the organ.
• Non-bacterial pathological changes in the gland, mainly chronic.
• Viral prostatitis is characterized by an acute course affecting the entire genital area.

According to the nature of structural changes in the prostate:

• Fibrous prostatitis is characterized by rapid growth of the gland and requires radical intervention.Clinically similar to prostate adenoma.
• Calculating prostatitis occurs due to the formation of stones inside the prostate.Considered a harbinger of cancer.
• Congestive prostatitis, a result of a sedentary lifestyle, is diagnosed in every second patient.

Signs of disease

If a man discovers at least two of the following symptoms of prostatitis, he should immediately contact a qualified specialist:

• Urinary disorders with intermittent urine, weak and abnormally short urine stream, causing urine splashing, difficulty and pain before urinating.The frequent urge to empty the bladder occurs mainly at night.
• Pain is localized in the lower abdomen, spreading to the scrotum, perineum and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in sperm (concentration, quantity).

complications

In the absence of timely treatment of acute prostatitis, the risk of developing a prostatic abscess is very high.As pus collections form, the patient's body temperature rises to 39-40°C and may become irritable.Episodes of fever alternate with intense chills.Sharp pain in the perineum makes it difficult to urinate and impossible to defecate.

Increasing swelling of the prostate leads to acute urinary retention.In rare cases, the abscess ruptures spontaneously into the urethra or rectum.When opened, cloudy, pus-filled urine with a pungent, unpleasant odor appears in the urethra;When opened, stool containing pus and mucus enters the rectum.

Chronic prostatitis is characterized by a wave-like course with prolonged periods of remission, in which the inflammation in the prostate is latent or manifests with extremely few symptoms.Patients who are not bothered by anything often stop treatment and only return if complications develop.

The spread of infection along the urinary tract causes pyelonephritis and cystitis.The most common complications of the chronic process are inflammation of the testicles and epididymis (epdidymo-orchitis) and inflammation of the seminal vesicles (semulitis).The consequence of these diseases is often infertility.

Diagnose

Characteristic clinical pictures help simplify the process of diagnosing acute and chronic prostatitis.Required:

Treatment of prostatitis

Treatment of acute prostatitis

Patients with an uncomplicated acute course were treated on an outpatient basis by a urologist.In case of severe intoxication or suspicion of a purulent process, hospitalization is indicated.Antibacterial therapy is performed.The drug is selected taking into account the sensitivity of the infectious agent.Widely used antibiotics can penetrate well into prostate tissue and act on it.

With the development of acute urinary retention due to prostatitis, they must use bladder catheterization instead of urethral catheterization, because there is a risk of prostatic abscess formation.When an abscess develops, transrectal or transurethral debridement is performed.

Treatment of chronic prostatitis

Treatment of chronic prostatitis must be comprehensive, including etiotropic therapy, physiotherapy, immunomodulation:

• Antibiotic therapy.The patient is prescribed long-term antibacterial drugs (for 4-8 weeks).The choice of type and dosage of antibacterial drug, as well as determining the duration of treatment is carried out individually.The drug is selected based on the sensitivity of the microflora based on the results of urine and prostatic secretion cultures.
• Prostate massage.Gland massage has a complex effect on the affected organ.During massage, inflammatory substances accumulated in the prostate will be forced into the ducts, then enter the urethra and be eliminated from the body.This procedure improves blood circulation in the prostate, helps minimize congestion and ensures better penetration of antibacterial drugs into the tissues of the affected organ.
• Physical therapy.To improve blood circulation, people use lasers, ultrasound waves and electromagnetic waves.If it is not possible to carry out physiotherapeutic procedures, the patient will be prescribed warm probiotics.

In case of chronic, long-term inflammation, it is necessary to consult an immunologist to choose an immunotherapy strategy.Patients are given recommendations for lifestyle changes.Making certain changes in the lifestyle of patients with chronic prostatitis is both a treatment and a preventative measure.Patients should normalize sleep and alertness, adjust their diet, and engage in moderate physical activity.

Treatment of acute prostatitis

Acute prostatitis requires bed rest, a special, salt-free diet, and sexual rest.

Course treatments:

• The most effective treatment for prostatitis is etiotropic therapy.If the cause of prostatitis is infection, then the use of antibacterial drugs is the top priority, which helps reduce inflammatory manifestations.
• Pain syndrome is alleviated by analgesics, antispasmodics, rectal suppositories, microenemas with warm analgesic solutions.NSAIDs may be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and combinations of trace elements have proven their effectiveness.
• Physiotherapy can only be performed in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
• Massage is another effective method of affecting the prostate.It opens the ducts, normalizing blood circulation in the scrotum and pelvis.
• Acute hydronephrosis can be corrected with urinary catheterization and trocar cystostomy.
• The purulent process involves surgical intervention.
• Consulting by a psychologist.

Treatment methods for prostatitis

Antibacterial therapy is most effective for treating prostatitis.Herbal medicines, immunomodulators and hormonal medicines can also be used as prescribed by your doctor.

In the absence of acute symptoms, prostatitis can be treated with physical therapy.In cases of abscesses and suppuration, surgical intervention is recommended.

Drug treatment

Treatment of prostatitis with antibacterial therapy must begin with bacterial culture, the purpose of which is to assess the sensitivity of the body to this antibiotic.If urination is impaired, the use of anti-inflammatory drugs will bring good results.

The drug is administered in tablet form, in acute cases - in the form of drops or intramuscular injections.Rectal suppositories are effective in the treatment of chronic forms of prostatitis: with their help, the drug reaches its goal faster and has minimal effect on other organs.

Blood thinners and anti-inflammatories have also been shown to be effective.

Antibacterial therapy

Antibiotics are an effective remedy in the fight against bacterial prostatitis.To achieve the desired effect and not harm the body, the choice of medication, dosage and treatment regimen must be made by a doctor.To correctly select the most effective drugs, he will have to find out which pathogen causes prostatitis, and also check the tolerance of a particular group of patients to antibiotics.

Antibiotics in the fluoroquinolone group have been shown to be effective in treating chronic prostatitis.Their action is aimed at preventing bacterial infection and strengthening the body's immunity.In addition, the bacteriostatic antibiotic trimethoprim is recommended for the prevention and treatment of concomitant diseases of the genitourinary system.

To treat prostatitis caused by mycoplasma and chlamydia, you can take additional drugs from the macrolide and tetracycline groups to slow the spread of infection.

The duration of antibacterial use is from 2 to 4 weeks.In case of positive motivation, the course can be extended.

Physical therapy

Physiotherapeutic techniques in the treatment of prostatitis are aimed at activating blood circulation in the pelvic area, improving metabolic processes in the prostate and cleaning the ducts.If physical therapy is combined with antibiotics, the effects of the latter will be enhanced.

Main methods include:

• magnetic therapy;
• laser therapy;
• electrophoresis;
• start up;
• supersonic;
• mud therapy;
• high frequency irradiation;
• physical therapy.

One of the oldest methods, transrectal prostate massage, according to modern research, has no proven effectiveness.

Treatment is non-specific

Treatments for nonspecific prostatitis include:

• hirudotherapy;
• therapeutic fasting;
• acupuncture;
• diet according to the Ostrovsky method;
• Alkalize the body using the Neumyvakin method.

We strongly recommend that you discuss all non-traditional prostatitis treatments with your doctor.

Surgical treatment

Surgical methods are used in complex and emergency cases:

• for drainage of purulent abscesses, which are removed endoscopically through punctures;
• in case of difficulty urinating due to damage to the urinary tract;
• with a large volume of affected area;
• with a significant number of stones in the body of the gland.

Stones and hardened tissue are removed endoscopically.In cases where the affected area is large or has many stones, prostatectomy is used.

Transurethral resection is also effective for bacterial prostatitis.In this way, the risk of recurrence can be reduced.

Folk remedies

Folk remedies for treating prostatitis are unlikely to be effective, but can be applied in combination with medications and physical therapy methods.These include: beekeeping products, decoctions of herbs and seeds, garlic tincture, ginger, beaver, fresh vegetables, pumpkin seeds.

In cases of acute illness, you must consult a doctor and in no case should you self-medicate!If the abscess ruptures, death can occur.

Suppositories for prostatitis

When treating prostatitis, rectal suppositories are much more effective than pills, if only because the rectum is much closer to the prostate, which means the medicine will act faster.

The composition of drugs for prostatitis can be completely different;they are prescribed to solve a specific problem.

1. The antibacterial agent is especially effective for prostatitis caused by chlamydia.
2. Pain relievers are used to treat symptoms;They relieve pain well.
3. Immune stimulant improves blood circulation, reduces swelling and is used in complex therapy.
4. Herbal medicine has mild effects.They, like candles on bee products, are used as an addition to the main treatment.
5. Preparations based on Ichthyol promote blood flow in the intestinal mucosa, help accelerate the deterioration of inflammatory processes and slightly improve immunity.
6. Products containing enzymes prevent the formation of scar tissue.It is recommended to take it as part of complex therapy with antibiotics, anti-inflammatory drugs and analgesics.

Auxiliary drugs

To treat symptoms of prostatitis in men, such as pain relief when urinating, you can additionally take antispasmodic drugs, which relax smooth muscles and thus quickly relieve pain.

Overall health is enhanced by blood thinning and anti-inflammatory dietary supplements based on bee products, pumpkin oil and palm fruit extract.

Diet and lifestyle

To treat prostatitis, a balanced, reasonable diet and healthy lifestyle are very important.Food should not contain spicy, fried, salty or pickled foods.In acute cases, alcohol is strictly prohibited.

Foods should contain enough fiber to prevent constipation.Protein content should be reduced.You should add herbs, ginger, and pumpkin seeds to your diet.

Consequences of untreated prostatitis

Even if prostatitis symptoms do not appear for a long time, it is still necessary to be examined regularly by a urologist.Prostatitis that is not completely cured may be accompanied by the formation of calcifications, which will then have to be removed along with the gland.Experts are confident that there is no other way to remove or dissolve the stone.

In addition, pathogenic microorganisms can move to nearby organs, causing inflammation.Progressive prostatitis can cause the development of adenomas and prostate cancer.

Prognosis and prevention

Acute prostatitis is a disease with a pronounced tendency to become chronic.Even with timely adequate treatment, chronic prostatitis becomes a consequence in more than half of patients.However, achieving recovery with properly tailored therapy and following the doctor's recommendations is not always possible to eliminate unpleasant symptoms and achieve stable, long-term remission in a chronic process.

Prevention includes eliminating risk factors.It is necessary to avoid hypothermia, alternate sedentary work with periods of physical activity and eat regular and nutritious meals.When constipated, use laxatives.One of the preventive measures is to normalize sexual life, since both excessive sexual activity and sexual abstinence are risk factors for developing prostatitis.If symptoms of urinary or sexually transmitted diseases appear, you should consult a doctor promptly.