Treatment of the prostate in men: what medications should be taken?

Prostatitisis an inflammatory disease of the prostate.It is manifested by frequent urination, pain in the penis, scrotum, rectum, sexual disorders (erectile dysfunction, premature ejaculation, etc.), sometimes urinary retention and blood in the urine.The diagnosis of prostatitis is made by a urologist or andrologist based on a typical clinical picture and the results of a rectal examination.In addition, an ultrasound examination of the prostate and a culture of prostate secretion and urine are carried out.Treatment is conservative – antibacterial therapy, immunotherapy, prostate massage, lifestyle correction.

General information

Prostatitis is an inflammation of the seminal gland (prostate).It is the most common disease of the genitourinary system in men.Patients between the ages of 25 and 50 are most commonly affected.According to various data, prostatitis affects 30-85% of men over 30 years old.Possible abscess formation of the prostate, inflammation of the testicles and limbs, threatening infertility.An ascending infection leads to inflammation of the upper parts of the genitourinary system (cystitis, pyelonephritis).

The pathology arises as a result of the penetration of an infectious agent that enters the prostate tissue from the organs of the urogenital system (urethra, bladder) or from a distant focus of inflammation (pneumonia, flu, sore throat, furunculosis).

Causes of Prostatitis

Staphylococcus aureus, Enterococcus, Enterobacter, Pseudomonas, Proteus, Klebsiella and E. Coli can act as infectious agents in acute cases.Most microorganisms belong to the conditionally pathogenic flora and cause prostatitis only in the presence of other predisposing factors.Chronic inflammation is usually due to polymicrobial associations.

The risk of developing this disease increases with hypothermia, a history of specific infections and diseases associated with blockage of prostate tissue.The following predisposing factors are identified:

• General hypothermia (one-time or permanent, related to working conditions).
• A sedentary lifestyle, a profession that forces a person to be sedentary for a long time (computer operator, driver, etc.).
• Constant constipation.
• Disturbances in 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 urological diseases (urethritis, cystitis, etc.) and sexually transmitted diseases (chlamydia, trichomoniasis, gonorrhea).
• Conditions that lead to suppression of the immune system (chronic stress, irregular and poor diet, regular lack of sleep, overtraining in athletes).

Congestion in the prostate tissue plays a crucial role in the development of prostatitis.Disruption of capillary blood flow leads to increased lipid peroxidation, swelling and exudation of prostate tissue, creating conditions for the development of an infectious process.

Symptoms of prostatitis

Acute prostatitis

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

• Acute catarrhal.Patients complain of frequent, often painful urination, pain in the sacrum and perineum.
• Acute follicles.The pain becomes more intense, sometimes radiates into the anus and increases during bowel movements.Urination is difficult, the urine flows out in a thin stream.In some cases, urinary retention is observed.Mild fever or moderate hyperthermia is typical.
• Acute parenchyma.Severe general intoxication, hyperthermia up to 38-40°C, chills.Dysuric disorders, often acute urinary retention.Stinging, throbbing pain in the perineum.Difficulty passing stool.

Chronic prostatitis

In rare cases, chronic prostatitis is the result of an acute process, but usually a primarily chronic course is observed.The temperature occasionally rises to subfebrile levels.The patient notes slight pain in the perineum, discomfort during urination and bowel movements.The most characteristic symptom is scanty discharge from the urethra during bowel movements.The predominantly chronic form of the disease develops over a longer period of time.It is preceded by prostatosis (stagnation of blood in the capillaries), which gradually turns into abacterial prostatitis.

Chronic prostatitis is often a complication of the inflammatory process caused by the causative agent of a particular infection (chlamydia, trichomonas, ureaplasma, gonococci).The symptoms of a specific inflammatory process in many cases mask the manifestations of prostate damage.There may be a slight increase in pain during urination, mild pain in the perineum, and scanty discharge from the urethra during bowel movements.A slight change in the clinical picture often goes unnoticed by the patient.

Chronic inflammation of the prostate can manifest itself as a burning sensation in the urethra and perineum, dysuria, sexual dysfunction and increased general fatigue.The result of erectile dysfunction (or the fear of these disorders) is often psychological depression, anxiety and irritability.The clinical picture does not always include all of the symptom groups listed;it varies depending on the patient and changes over time.There are three main syndromes characteristic of chronic prostatitis: pain, dysuria and sexual dysfunction.

There are no pain receptors in prostate tissue.The cause of pain in chronic prostatitis is the almost inevitable involvement of nerve pathways in the inflammatory process due to the abundant innervation of the pelvic organs.Patients complain of pain of varying intensity - from mild, aching to intense, disturbing sleep.During ejaculation, excessive sexual activity or sexual abstinence, there is a change in the nature of the pain (increasing or weakening).The pain radiates to the scrotum, sacrum, perineum and sometimes to the lumbar region.

As a result of inflammation in chronic prostatitis, the volume of the prostate increases, which compresses the urethra.The lumen of the ureter decreases.The patient experiences frequent urge to urinate and the feeling of incomplete bladder emptying.Dysuric phenomena usually manifest themselves in the early stages.Then compensatory hypertrophy of the muscular layer of the bladder and ureters develops.The symptoms of dysuria weaken during this period and then increase again as the adaptive mechanisms decompensate.

In the initial stages, dyspotence may develop, which manifests itself differently in different patients.Patients may complain of frequent nocturnal erections, lost orgasm, or worsening erections.Accelerated ejaculation is associated with a reduction in the arousal threshold of the orgasm center.Pain during ejaculation can lead to refusal of sexual activity.As a result, sexual dysfunction becomes more pronounced.In the advanced stage, impotence develops.

The degree of sexual disorder is determined by many factors, including the patient's sexual constitution and psychological mood.Erectile dysfunction and dysuria can be caused both by changes in the prostate gland and by the suggestibility of the patient, who, when diagnosed with chronic prostatitis, expects the inevitable development of sexual and urinary tract disorders.Psychogenic dyspotence and dysuria occur particularly frequently in suggestible, anxious patients.

Impotence and sometimes even the impending threat of possible sexual disorders are difficult for patients to endure.Often there is a change in character, irritability, grumpiness, excessive concern for one's health and even "illness".

Classification

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

Depending on the course of the disease:

• Acute prostatitis.It accounts for more than 50% of cases of the disease in people no older than 30-35 years.
• Chronic optionIt is a non-age category.It does not manifest itself for a long time;The trigger for its development is a cold or infection.

For the reason that caused the pathology:

• Bacterial inflammation of the prostate gland, which is prevalent in men under 40 years old, occurs against the background of ultrasound examination and does not extend beyond the boundaries of the organ.
• Non-bacterial pathological changes in the gland, predominantly chronic.
• Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.

Depending on the type of structural changes in the prostate:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention.Clinically similar to a prostate adenoma.
• Calcific inflammation of the prostate occurs due to the formation of stones in the prostate.Considered a harbinger of cancer.
• Every second patient is diagnosed with congestive prostatitis, which is the result of a sedentary lifestyle.

Signs of the disease

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

• Difficulty urinating with the appearance of an intermittent, weak stream of urine that is unusually short and causes splashing, difficulty and pain before urination.The frequent urge to empty the bladder occurs especially at night.
• Pain localized in the lower abdomen radiates to the scrotum, perineum and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in sperm (consistency, quantity).

Complications

Without timely treatment of acute prostatitis, there is a significant risk of developing a prostate abscess.When a purulent focus forms, the patient's body temperature rises to 39-40 ° C and hecticness may occur.Phases of fever alternate with severe chills.Stinging pain in the perineum makes it difficult to urinate and defecation impossible.

Increasing swelling of the prostate leads to acute urinary retention.In rare cases, the abscess ruptures spontaneously into the urethra or rectum.When opened, purulent, cloudy urine with an unpleasant, pungent odor appears in the urethra;When opened, the feces contain pus and mucus and enter the rectum.

Chronic prostatitis is characterized by a wave-like course with long remission phases in which the inflammation of the prostate is latent or manifests itself with extremely minor symptoms.Patients who have nothing bothering them often stop treatment and only turn to treatment when complications arise.

The spread of infection along the urinary tract leads to the appearance of pyelonephritis and cystitis.The most common complication of the chronic process is inflammation of the testicles and epididymis (epdidymo-orchitis) and inflammation of the seminal vesicles (vesiculitis).The result of these diseases is often infertility.

diagnosis

The characteristic clinical picture simplifies the diagnosis of acute and chronic prostatitis.It is mandatory:

Treatment of prostatitis

Treatment of acute prostatitis

Patients with an uncomplicated acute course are treated on an outpatient basis by a urologist.In case of severe poisoning or suspicion of a purulent process, hospitalization is indicated.Antibacterial therapy is carried out.The selection of drugs is carried out taking into account the sensitivity of the infectious agent.Antibiotics that penetrate well into the prostate tissue and can work there are widely used.

With the development of acute urinary retention due to prostatitis, they resort to installing a cystostomy instead of a urethral catheter, since there is a risk of the formation of a prostate abscess.If an abscess develops, endoscopic transrectal or transurethral opening of the abscess is performed.

Treatment of chronic prostatitis

Treatment of chronic prostatitis should be comprehensive and include etiotropic therapy, physiotherapy and correction of immunity:

• Antibiotic therapy.The patient is prescribed long courses of treatment with antibacterial drugs (for 4-8 weeks).The type and dosage of antibacterial medication and the duration of treatment are selected individually.The drug is selected based on the sensitivity of the microflora based on the results of culture of urine and prostatic secretion.
• Prostate massage.Glandular massage has a complex effect on the affected organ.During the massage, the inflammatory secretion accumulated in the prostate is pushed into the ducts, then enters the urethra and is removed from the body.The procedure improves blood flow to the prostate, which minimizes congestion and ensures better penetration of antibacterial drugs into the tissues of the affected organ.
• Physiotherapy.Laser exposure, ultrasound waves and electromagnetic waves are used to improve blood circulation.If physiotherapeutic interventions are not possible, the patient is prescribed warm medical microenemas.

In the case of chronic, long-lasting inflammation, consultation with an immunologist is advisable in order to determine the tactics of immunocorrective therapy.The patient is given recommendations to change his lifestyle.Certain changes in the lifestyle of a patient with chronic prostatitis are both a therapeutic and preventive measure.The patient is recommended to normalize sleep and wakefulness, adjust the diet and engage in moderate physical activity.

Treatment of acute prostatitis

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

Methods of course treatment:

• The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, treatment with antimicrobial agents that relieve the inflammatory symptoms is the priority.
• The pain syndrome is relieved by analgesics, antispasmodics, rectal suppositories and microenemas with warm analgesic solutions.NSAIDs can be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
• Physiotherapeutic methods are only possible in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
• Another effective method of influencing the prostate is massage.It opens the ducts and normalizes blood circulation in the scrotum and pelvis.
• Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
• The purulent process requires surgical intervention.
• Psychologist consultations.

Treatment methods for prostatitis

In the treatment of prostatitis, antibacterial therapy is most effective.Herbal medicines, immune correctors and hormone preparations can also be used as prescribed by a doctor.

If there are no acute symptoms, prostatitis can be treated with physical therapy.Surgical intervention is recommended for abscesses and suppurations.

Treatment with medication

Treatment of prostatitis with antibacterial therapy must begin with a bacterial culture, the purpose of which is to assess the body's sensitivity to this type of antibiotic.If there are problems with urination, the use of anti-inflammatory drugs leads to a good result.

In acute cases, medication is taken in tablet form - as a dropper or intramuscularly.Rectal suppositories are effective in the treatment of chronic forms of prostatitis: with their help, drugs achieve their effect faster and have minimal effects on other organs.

Blood-thinning and anti-inflammatory medications have also proven effective.

Antibacterial therapy

Antibiotics are an effective tool in the fight against bacterial prostatitis.In order to achieve the desired effect and not harm the body, the choice of drug, dosage and treatment regimen should be made by a doctor.In order to correctly select the most effective drugs, he needs to find out what type of pathogen caused prostatitis, and also test the patient for his tolerance to antibiotics of a particular group.

Antibiotics from the group of fluoroquinolones have proven to be effective in the treatment of chronic prostatitis.Their action is aimed at suppressing bacterial infections 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 additionally take drugs from the group of macrolides and tetracyclines, which slow down the spread of the infection.

The duration of taking antibacterial drugs is 2 to 4 weeks.If the dynamics are positive, the course can be extended.

Physiotherapy

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 physiotherapy is combined with taking antibiotics, their effect increases.

The main methods include:

• magnetic field therapy;
• laser therapy;
• electrophoresis;
• warm up;
• Ultrasonic;
• mud therapy;
• radiofrequency irradiation;
• Physiotherapy.

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

Non-specific treatments

Nonspecific methods of treating prostatitis include:

• hirudotherapy;
• therapeutic fasting;
• Acupuncture;
• diet according to the Ostrovsky method;
• Alkalization of the body using the Neumyvakin method.

We strongly recommend that you discuss any non-traditional methods of treating prostatitis with your doctor.

Surgical treatment

In complex and emergency cases, surgical methods are used:

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

Stones and sclerotic tissue are removed using endoscopic methods.If there is a large affected area or several stones, a resection of the prostate is resorted to.

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

Folk remedies

Folk remedies for the treatment of prostatitis alone are unlikely to be effective, but in combination with medications and physiotherapeutic methods they may be applicable.These include: beekeeping products, decoctions of herbs and seeds, tinctures of garlic, ginger, beaver stream, fresh vegetables, pumpkin seeds.

In the event of an acute illness, a doctor must be consulted; under no circumstances should you self-medicate!If a purulent abscess ruptures, death is possible.

Suppositories for prostatitis

In the treatment of prostatitis, rectal suppositories are much more effective than tablets, if only because the rectum is much closer to the prostate and therefore the medicine works faster.

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

1. Antibacterial agents are particularly effective for prostatitis caused by chlamydia.
2. Painkillers are used for symptomatic treatment;They relieve pain well.
3. Immunostimulants improve blood circulation, relieve swelling and are used in complex therapy.
4. Herbal medicines have a mild effect.They, like candles on bee products, are used as an addition to the main treatment.
5. Ichthyol-based compositions promote blood circulation in the intestinal mucosa, which accelerates the weakening of inflammatory processes and slightly improves immunity.
6. Enzyme-based products prevent the formation of scar tissue.It is recommended to be taken as part of complex therapy with antibiotics, anti-inflammatory drugs and painkillers.

Auxiliary medications

For the symptomatic treatment of prostatitis in men, for example to relieve pain when urinating, you can also take antispasmodics that relax the smooth muscles and thereby quickly relieve the pain.

General health is promoted by blood-thinning and anti-inflammatory dietary supplements based on bee products, pumpkin seed oil and palm fruit extracts.

Diet and lifestyle

A proper, balanced diet and a healthy lifestyle are very important for the treatment of prostatitis.The food should not contain spicy, fried, salty or pickled foods.In acute cases, alcohol is strictly prohibited.

To prevent constipation, your diet should contain enough fiber.The protein content should be reduced.It is recommended to supplement the diet with herbs, ginger and pumpkin seeds.

Consequences of untreated prostatitis

Even if the symptoms of prostatitis have not appeared for a long time, regular examination by a urologist is necessary.If prostatitis is incompletely healed, calcifications can form, which then have to be removed along with the gland.Experts are convinced that there is no other way to remove or dissolve stones.

In addition, pathogenic microorganisms can migrate to neighboring organs and cause inflammation there.Advanced prostatitis can lead to the development of adenomas and prostate cancer.

Prognosis and prevention

Acute prostatitis is a disease that has a pronounced tendency to become chronic.Even with timely, adequate treatment, chronic prostatitis occurs in more than half of patients.Recovery is not always possible, however, with correct, consistent therapy and following the doctor's recommendations, it is possible to eliminate unpleasant symptoms and achieve long-term, stable remission in a chronic process.

Prevention consists of eliminating risk factors.It is necessary to avoid hypothermia, alternate sedentary work with periods of physical activity, and eat a regular, nutritious diet.Laxatives should be used if constipation occurs.One of the preventive measures is the normalization of sexual life, since both excessive sexual activity and sexual abstinence are risk factors for the development of prostatitis.If symptoms of a urological or sexually transmitted disease occur, you should consult a doctor immediately.