Antibacterial therapy for prostatitis is not the only method of treatment.Antibacterial drugs are prescribed only for appropriate indications, primarily with periodic exacerbations and increased severity of the symptoms of the disease.
The effectiveness of drugs for the treatment of prostatitis
It is known that different antibiotics can cross the prostate barrier to different degrees and therefore their concentration in the prostate gland and therefore their effectiveness in treating prostatitis varies.Therefore, from the drugs to which the greatest sensitivity of the flora has been identified, those that have the greatest ability to penetrate the prostate are selected.A similar approach to treating prostate adenoma can significantly speed recovery.
Broad-spectrum drugs for the treatment of prostatitis
Another requirement for the effectiveness of a drug for the treatment of prostatitis is that it has a broad spectrum of antibacterial activity.This is because it is quite difficult to reliably determine the flora living in the prostate.The medicines with a broad spectrum of antibacterial effects primarily include medicines from the penicillin group.Tetracycline drugs have valuable properties in terms of penetration through the prostate barrier and the breadth of antibacterial action.
Modern drugs of the fluoroquinol group
New antibacterial agents that have a clear advantage over others are drugs from the group of fluoroquinolones.These drugs have a broader spectrum of antimicrobial activity and can accumulate in the prostate at high concentrations when taken orally.In addition to the direct antibacterial effect, fluoroquinolones almost never cause immunodeficiency in the patient and, most importantly, microorganisms do not develop resistance to them.
Tetracycline drugs are also commonly used as antibacterial therapy.
A young patient who is prescribed antibacterial therapy should be aware that the drugs used can have a spermotoxic effect.Therefore, there must be an interval of at least 4 months between taking these drugs and the intended conception, which exceeds the entire cycle of spermatogenesis.
Antibacterial drugs are usually prescribed for chronic bacterial prostatitis or infectious chronic prostatitis.In non-infectious chronic prostatitis, treatment tactics remain controversial and controversial.Such patients are prescribed antibacterial drugs in the hope of curing a latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, i.e. not from the first visit.Typically, the doctor will examine the patient within a few days to detect an infection.During this period, symptomatic therapy is recommended, usually with an anti-inflammatory effect in the form of 50 mg diclofenac or 100 mg in suppositories, which has an anti-edematous and pain-relieving effect.
After determining the type of bacteria and their sensitivity, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.Treatment takes place over 4 or more weeks (at least 28 days) under clinical and bacteriological control.
If the effect is positive in patients with recurrent chronic prostatitis, it is recommended to extend the use of the antibacterial drug to 6-8 weeks.Sometimes antibiotic therapy is extended to 16 weeks and after that it is practically cured.If there is no positive result, the antibacterial medication used is discontinued, but not before 2 weeks of treatment.An ideal antibacterial drug should be fat-soluble, non-binding to serum proteins, and weakly alkaline so that it is maximally concentrated in the prostate itself rather than in 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, in its secretions and sperm and are active against most of the bacteria found in chronic prostatitis.
Therefore, compliance with the following general principles is a necessary condition for the maximum effectiveness of antibacterial therapy for chronic prostatitis:
- Isolation and determination of the microflora causing prostatitis and identification of their sensitivity to antimicrobial agents;
- Selection of the most effective drugs that do not cause side effects;
- Determination of effective doses, methods and frequency of administration, taking into account the characteristics of the action of the selected drug;
- timely initiation of treatment and sufficiently long antimicrobial therapy to ensure the greatest possible effect;
- a combination of antibacterial drugs, both with each other and with drugs and procedures that enhance the antimicrobial effect, reduce the occurrence of complications and improve microcirculation in the prostate;
- Conducting complex therapy taking into account the characteristics of the patient's general health condition.
Sometimes with prolonged or overly active antibiotic therapy, intestinal dysbiosis (a decrease in the number and activity of normal intestinal flora) develops.In these cases, it is recommended to use medications that promote recovery.
Results of drug treatment of prostatitis
The strategy and tactics of antibacterial therapy are complex and diverse, but their use can improve the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, there may be a more or less long period of well-being.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 by a therapy program aimed at increasing local and general resistance.In this case, you can count on the success of antibacterial therapy or long-term remission.
Improving 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 gland ducts, increase the intensity of metabolic processes at the source of inflammation, as well as local and general resistance.
Nonsteroidal anti-inflammatory drugs are considered an important step in the treatment of chronic prostatitis.Its positive effect on microcirculation has been proven.
Anticongestive treatment includes measures to reduce venous stagnation in the pelvis: interruption of sexual intercourse, lack of physical activity, 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.In congestive non-infectious prostatitis, only decongestant therapy is carried out.
The treatment complex for chronic prostatitis includes special drugs with a highly effective effect.In some cases of exacerbation of chronic prostatitis in 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 serve as the main indicator for the patient, determining his attitude to the disease and influencing 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 vary greatly in their location, duration and intensity.In this context, the manner in which analgesics are used is of great importance.
Oral (oral) administration is very effective and temporarily relieves pain.The rectal use of painkillers in suppositories and microenemas is even more effective, as they use the combined effects of analgesics and anti-inflammatory drugs as well as temperature effects.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 body's responsiveness and defenses, which usually help to cope with any disease.In chronic prostatitis, the body's defenses are weakened.In this regard, it is very difficult to achieve success without the use of general immunological treatment of chronic prostatitis.
Sometimes to treat chronic prostatitis, a drug is used that increases the body's responsiveness.Due to its pyrogenic effect (increasing body temperature), the drug aggravates chronic inflammation in the prostate and converts it into acute, which promotes recovery, since inflammatory diseases are easier to treat in the acute stage.The drug works when it enters the bloodstream quickly.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 require hospitalization so that they are under observation.The medicine is administered daily for 9-10 days in a row.At the peak of the artificially induced exacerbation of chronic inflammation of the prostate, around the 4th day, the administration of 1-2 antibiotics and a sulfonamide or another medication begins in relatively high doses.To improve the blood supply to the prostate, physiotherapy is carried out at the same time, and to improve the outflow of prostatic secretions, daily massage is carried out.The therapeutic effect in the form of improvement or recovery occurs to varying degrees in almost every patient.
Hormone therapy
It is necessary to use sex hormone preparations for prostatitis very carefully.Such a need may arise in patients who have suffered from chronic prostatitis for years and decades.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 may also be performed, such as cytological examinations of swabs from the scaphoid fossa of the urethra.If there is an imbalance in sex hormones, hormonal drugs can be included in the treatment regimen.
For long-term illness, enzymes may also be prescribed to help dissolve scar tissue in the prostate.
As we already know, men who suffer from chronic prostatitis for a long period of time suffer from sexual dysfunction.The latter is divided into copulatory, reproductive and hormonal.Fortunately, in the vast majority of patients with prostatitis, hormone levels do not suffer significantly.
If the copulatory function or the ability to have sexual intercourse is impaired, there will be a reduced erection, a “fading” of the orgasm 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 symptoms of a sexual disorder disappear or diminish.
Treatment of sexual disorders due to new-onset neurosis includes psychotherapy, sedatives and the prescription of other medications depending on the symptoms of the sexual disorder.This therapy shows how the symptoms of prostatitis can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, you can use LOD therapy, which consists of creating a vacuum in the vessel where the penis is placed.The resulting negative pressure causes the cracks in the erectile tissue of the penis to widen and blood to flow there.The penis enlarges and an erection occurs.
Repeated procedures lead to an increase in the gaps in the erectile tissue, a more stable blood supply to the organ and ultimately an improvement in erectile function.A positive effect in chronic prostatitis is also manifested in increased sexual activity, which has a strong psychotherapeutic effect.
The phallodecompression method (PLD) for prostatitis is performed daily or every other day.The course of treatment includes 10-15 procedures.It is useful to combine phallodecompression with instillation prostate massage, as this increases the degree of absorption of drugs after the procedure is completed.
Instillations
This type of therapy involves techniques that allow direct and direct delivery of the drug to its intended destination.Instillation therapy using this method involves administering medication through the external opening of the urethra using a conventional disposable syringe with a disposable conical cannula (soft hollow tube) or syringe.The optimal volume of the drug mixture administered 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, to relax, then the excess drug enters the bladder and is excreted with the first portion of urine;The head of the penis must be pressed with your fingers or a special clamp.This prevents the injected solution from flowing back after the needle or syringe is removed.And so that the solution reaches the prostate more quickly, it is recommended to carefully stroke the fingers of your free hand over the filled urethra towards the perineum when inserting it.
After the procedure, you must endure the urge to urinate, otherwise the administered medicinal mixture will flow out again immediately.This mixture consists of the same drugs as for oral administration: antibiotics, analgesics, antispasmodics, anti-inflammatory drugs.
Instillation therapy for prostatitis allows the use of various drugs, the choice of which depends on the type of disease, as well as the tolerability of the drugs administered.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, otherwise you can make a mistake in the dosage, which can lead to unpleasant and even dangerous consequences.
Suppositories (candles)
Suppository therapy (suppositories) is often used in the treatment of prostatitis.The action of the medicines contained in the suppository occurs mainly through the general bloodstream and not through the mucous membrane of the intestinal wall.
The use of candles has a pronounced psychotherapeutic effect.For self-treatment of prostatitis, patients usually tend to use suppositories, regardless of their composition.Patients particularly 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 suppositories containing active ingredients, magnetic suppositories are also used to treat prostatitis.
Microclysters
Typically, microenemas are used to treat prostatitis, often referred to as traditional prostatitis treatment.The basis of their application is the simultaneous temperature and healing effect.Microenemas are usually used at bedtime.
As medicine, they use aqueous infusions of chamomile, calendula, sage or feverfew, which are brewed with boiling water before administering a microenema.After the infusion has cooled to a temperature of 40 ° C, the medicine is administered into the rectum.A small amount is injected - no more than 100 ml of liquid.Drugs must be absorbed in the rectum, i.e.h.Bowel movements immediately after administration of a microenema are undesirable.
Water infusions of herbs can be replaced with 1 teaspoon of alcohol infusions (calendula, feverfew or chamomile), 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 requires no proof.Microclysters are usually used simultaneously with antibacterial agents as a final stage of more active local interventions or as an independent therapeutic effect for mild pain symptoms.
A very important point is that taking medication alone does not lead to a good and long-lasting effect.It is necessary to carry out prostate drainage in combination with drug therapy - only then can the effect be guaranteed/