Antibiotic therapy for prostatitis is not the only treatment method.Antibacterial drugs are prescribed only if there are appropriate indications, mainly for periodic exacerbations and increased severity of disease manifestations.
The effectiveness of medications for the treatment of prostatitis.
It is known that various antibiotics can overcome the prostate barrier to varying degrees and, therefore, their concentration in the prostate, and therefore their effectiveness in the treatment of prostatitis, is different.Therefore, among the medications to which the greatest sensitivity of the flora has been established, those with the maximum ability to penetrate the prostate are selected.A similar approach to the treatment of prostate adenoma can significantly speed up recovery.
Broad spectrum medications for the treatment of prostatitis.
Another condition for the effectiveness of a drug used to treat prostatitis is that it have a broad spectrum of antibacterial action.This is due to the fact that it is quite difficult to reliably determine the flora that lives in the prostate.Those with a broad spectrum of antibacterial activity mainly include drugs from the penicillin group.Tetracycline drugs have valuable properties in terms of penetration through the prostate barrier and breadth of antibacterial action.
Modern drugs from the fluoroquinol group.
New antibacterial agents that have a significant advantage over others are drugs from the fluoroquinolone group.These drugs have a broader spectrum of antimicrobial action and the ability to accumulate in the prostate in high concentrations when taken orally.In addition to the direct antibacterial effect, fluoroquinolones almost never cause immunodeficiency in the patient and, what is especially important, microorganisms do not develop resistance to them.
Tetracycline medications are also widely used as antibacterial therapy.
A young patient who is prescribed antibiotic treatment should take into account that the drugs used can have a spermotoxic effect.Therefore, between the use of these drugs and the planned conception, an interval of at least 4 months is necessary, exceeding the complete cycle of spermatogenesis.
Antibacterial drugs are prescribed, as a rule, for chronic bacterial prostatitis or chronic infectious prostatitis.For chronic non-infectious prostatitis, treatment tactics remain controversial and controversial.These patients are prescribed antibacterial medications in the hopes of curing a latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not from the first visit.As a rule, after a few days, the doctor examines the patient for infection.During this period, symptomatic therapy is recommended, usually with an anti-inflammatory effect in the form of 50 mg of diclofenac or 100 mg in suppositories, which has anti-edematous and analgesic effects.
After establishing the type of bacteria and its sensitivity, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.Treatment is carried out for 4 or more weeks (minimum 28 days) under clinical and bacteriological control.
If the effect is positive in patients with chronic recurrent prostatitis, it is recommended to extend the use of the antibacterial drug to 6-8 weeks.Sometimes antibiotic therapy is prolonged up to 16 weeks and then there is a virtual cure.If there is no positive result, the antibacterial drug used is abandoned, but not earlier than 2 weeks of treatment.An ideal antibacterial drug should be fat-soluble, not bound to serum proteins, and slightly alkaline, so that it is maximally concentrated in the prostate gland and not in the plasma.The best in terms of these requirements are fluoroquinolones, which have the best pharmacological properties in the treatment of chronic prostatitis;They create a sufficient concentration in the prostate gland, in its secretions and in sperm, and are active against most of the bacteria found in chronic prostatitis.
Therefore, a necessary condition for the maximum effectiveness of antibacterial therapy for chronic prostatitis is compliance with the following general principles:
- isolation and determination of the microflora that causes prostatitis and identification of its sensitivity to antimicrobial agents;
- choose the most effective medications that do not cause side effects;
- determination of effective doses, methods and frequency of administration, taking into account the characteristics of the effect of the selected drug;
- timely initiation of treatment and a sufficiently long course of antimicrobial therapy to ensure the maximum possible effect;
- a combination of antibacterial drugs, both with each other and with drugs and procedures that enhance the antimicrobial effect, reduce the incidence of complications and improve microcirculation in the prostate;
- Carrying out complex therapies taking into account the characteristics of the patient's general health.
Sometimes, with prolonged or excessively active antibacterial therapy, intestinal dysbiosis develops (a decrease in the amount and activity of normal intestinal microflora).In these cases, it is recommended to use drugs that promote recovery.
Results of treatment of prostatitis with medications.
The strategy and tactics of antibacterial therapy are complex and varied, but their use can improve the effectiveness of the treatment.
After successful antibiotic therapy for prostatitis, a more or less prolonged period of well-being may occur.But, as a rule, sooner or later the painful sensations that caused anxiety return.Therefore, the use of antibacterial drugs alone is not considered sufficient.Good results are achieved through a therapeutic program aimed at increasing local and general resistance.In this case, one can count on the success of antibacterial therapy or long-term remission.
Improve microcirculation in the prostate.
In all forms of chronic prostatitis, in addition to influencing the microflora, they strive to restore microcirculation in the prostate, improve the outflow of secretions from the glandular ducts, increase the intensity of metabolic processes at the source of inflammation and local and general resistance.
Non-steroidal anti-inflammatory drugs are considered an important step in the treatment of chronic prostatitis.Its positive effect on microcirculation has been demonstrated.
Anticongestive treatment includes measures aimed at reducing venous stagnation in the pelvis: interruption of interrupted sexual relations, sedentary lifestyle, frequent alcohol consumption, etc.For varicose veins of the lower extremities and hemorrhoidal veins, which can also cause prostatitis, surgical treatment of these diseases is carried out.For non-infectious congestive prostatitis, only decongestant therapy is performed.
The treatment complex for chronic prostatitis includes special medications with very effective effects.In some cases of exacerbation of chronic prostatitis in the presence of dysuric phenomena caused by venous stagnation, drugs that reduce the tone of the smooth muscles of the prostate are used to reduce the urge to urinate.But only a doctor can recommend them.
Elimination of pain due to prostatitis.
Since the presence and severity of pain in prostatitis serves as the main indicator for the patient, which determines his attitude towards the disease and affects the manifestation of depression, analgesic therapy in the treatment of chronic prostatitis is one of the most important components of the general treatment of the disease.The pain syndromes observed in chronic prostatitis are very diverse in their location, duration and degree of intensity.In this regard, the method of using painkillers is of great importance.
Oral administration (by mouth) is quite effective and temporarily relieves pain.Rectal use of analgesics in suppositories and microenemas is even more effective, since they take advantage of the combined effect of analgesics and anti-inflammatory drugs, as well as the effects of temperature.To change the tone of the gland, belladonna extract can be added to suppositories.
Strengthening the immune system.
When treating chronic prostatitis, it is very important to increase the reactivity of the body and its defenses, which usually help to cope with any disease.With chronic prostatitis, the body's defenses are reduced.In this sense, without the use of general immunological treatment for chronic prostatitis, it is very difficult to achieve success.
Sometimes a medication is used to treat chronic prostatitis that increases the body's reactivity.By having a pyrogenic effect (increased body temperature), the drug exacerbates chronic inflammation in the prostate gland and transforms it into an acute one, which promotes recovery, since it is easier to treat inflammatory diseases in the acute stage.The medication works when it quickly enters the bloodstream.Therefore, it is administered intravenously, starting with small doses, daily, increasing the dose gradually and carefully.With this method of intravenous administration, patients with chronic prostatitis should be treated as inpatients for observation.The medication is administered daily for 9 to 10 days in a row.At the peak of the exacerbation of artificially caused chronic inflammation in the prostate gland, approximately from the 4th day, the introduction of 1-2 antibiotics and a sulfonamide or other drug in fairly high doses begins.To improve the blood supply to the prostate, physiotherapy is carried out simultaneously, and to improve the outflow of prostate secretions, a daily massage is carried out.The therapeutic effect in the form of improvement or recovery is obtained to varying degrees in almost all patients.
Hormone therapy
It is necessary to use sex hormone preparations for prostatitis very carefully.In patients suffering from chronic prostatitis for years and decades, such a need may arise.However, it is better to use them after determining the content of sex hormones in the blood serum (testosterone, estradiol, prolactin, FSH, LH).Simpler tests can also be performed, for example, cytological studies of scrapings from the scaphoid fossa of the urethra.If there is an imbalance of sex hormones, hormonal medications may be included in the treatment regimen.
Enzymes may also be prescribed to help resolve prostate gland scar tissue during prolonged illness.
Men who suffer from chronic prostatitis for a long time, as we already know, experience sexual dysfunction.The latter is divided into copulative, reproductive and hormonal.In the vast majority of prostatitis patients, fortunately, hormone levels are not significantly affected.
If copulatory function, or the ability to have sexual intercourse, is affected, a decreased erection, a "fading" of the orgasm, and ejaculation problems occur.Elimination of these symptoms and normalization of sexual life largely depend on the underlying disease - prostatitis.The more successful the treatment, the faster the symptoms of the sexual disorder will disappear or decrease.
Treatment of sexual disorders due to emerging neurosis includes psychotherapy, sedatives (sedatives) and the prescription of other medications depending on the symptoms of the sexual disorder.This therapy shows how prostatitis symptoms can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, you can resort to LOD therapy, which consists of creating a vacuum in the vessel in which the penis is placed.Due to the negative pressure created, the cracks in the corpora cavernosa of the penis widen and blood flows into them.The penis enlarges and an erection occurs.
Repeated procedures cause an increase in spaces in the corpora cavernosa, a more stable blood supply to the organ and, ultimately, an improvement in erectile function.A positive effect in chronic prostatitis is also manifested by an increase in sexual activity, which has a powerful psychotherapeutic effect.
The phallodecompression (PLD) method for prostatitis is performed daily or every other day.The course of treatment is 10 to 15 procedures.It is useful to combine phallodecompression with prostate massage by instillation, as this increases the degree of absorption of the drugs once the procedure is completed.
Instillations
This type of therapy includes techniques that allow direct, direct delivery of the drug to its intended destination.During instillation therapy with this method, medications are administered through the external opening of the urethra using a conventional disposable syringe with a cannula or disposable conical syringe (soft hollow tube).The optimal volume of the administered medicinal mixture is 5 ml.Before the procedure, you should urinate to make sure your bladder is empty.
At the time of administration, it is recommended to imitate urination, that is, relax, then the excess medication will enter the bladder and be expelled with the first portion of urine;the head of the penis must be pressed with your fingers or a special clamp;This will prevent the injected solution from returning after removing the cannula or syringe.And so that the solution reaches the prostate faster, it is recommended that, when introducing it, you gently caress the filled urethra towards the perineum with the fingers of your free hand.
After the procedure, it is necessary to endure the urge to urinate;Otherwise, the administered medicinal mixture will come out again immediately.This mixture consists of the same drugs as for oral administration: antibiotics, analgesics, antispasmodics, anti-inflammatories.
Instillation therapy for prostatitis allows the use of a variety of drugs, the choice of which depends on the nature of the disease, as well as the compatibility of the administered drugs.Oil mixtures should not be administered due to the risk of fat embolism (blockage of blood vessels);In no case should you make the mixture yourself, as you can make a mistake in the dosage, which will lead to unpleasant and even dangerous consequences.
Suppositories (candles)
In the treatment of prostatitis, suppository (suppository) therapy is widely used.The action of the drugs included in the suppository is carried out mainly through the general bloodstream, and not through the mucous membrane of the intestinal wall.
The use of candles has a pronounced psychotherapeutic effect.Patients usually use any suppository for self-treatment of prostatitis, regardless of its composition.Patients especially often use suppositories with propolis, as well as with thiotriazoline (0.5 g per suppository), which have a complex anti-inflammatory and membrane-stimulating effect.In addition to medicinal suppositories, magnetic suppositories are also used in the treatment of prostatitis.
Microclysters
Typically, microenemas are used to treat prostatitis, which are often called traditional prostatitis treatment.The basis of its use is the simultaneous temperature and medicinal effects.Microenemas are usually used before bedtime.
As medicinal substances, aqueous infusions of chamomile, calendula, sage or motherwort are used, made with boiling water before administering a microenema.Once the infusion has cooled to a temperature of 40°C, the medication is administered into the rectum.A small volume is injected - no more than 100 ml of liquid.Medicines must be absorbed in the rectum, that is, feces immediately after the introduction of a microenema are undesirable.
Aqueous herbal infusions can be replaced with 1 teaspoon of alcohol infusions (calendula, motherwort or chamomile), which are diluted in 100 ml of warm water before administration.You can add 1.0 g of antipyrine or 10 drops of iodine tincture to the infusion.The effectiveness of microenemas is well known and does not need proof.Microclysters are usually used simultaneously with antibacterial agents as a final stage of more active local procedures or as an independent therapeutic effect for mild pain symptoms.
A very important point is that the use of medicines alone does not give a good and long-lasting effect.It is necessary to perform prostate drainage procedures in combination with drug therapy;Only in this way can the effect be guaranteed.