Antibacterial therapy for prostatitis is not the only treatment method.Antibacterial drugs are prescribed only if there are appropriate indications, especially for periodic exacerbations and increased severity of disease manifestations.
The effectiveness of drugs 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 gland, and therefore their effectiveness in the treatment of prostatitis, is different.Therefore, from the drugs to which the greatest sensitivity of the flora has been established, those with the maximum ability to penetrate the prostate are selected.The same approach to the treatment of prostate adenoma can significantly speed up recovery.
A broad-spectrum drug for the treatment of prostatitis
Another condition for the effectiveness of the drug used to treat prostatitis is that it has a broad spectrum of antibacterial action.This is due to the fact that it is quite difficult to determine with certainty the flora that lives in the prostate.Those with a broad spectrum of antibacterial activity include mainly drugs of 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 significant advantages over others are drugs from the fluoroquinolone group.These drugs have a wider spectrum of antimicrobial action and the ability to accumulate in the prostate in high concentrations when taken orally.In addition to direct antibacterial effects, fluoroquinolones almost never cause immune deficiency in patients and, most importantly, microorganisms do not develop resistance to them.
Tetracycline drugs are also widely used as antibacterial therapy.
Young patients who are given a course of antibacterial therapy should be aware that the drugs used may have a spermotoxic effect.Therefore, between the use of these drugs and the intended conception, it is necessary to have a gap of at least 4 months, exceeding the full cycle of spermatogenesis.
Antibacterial drugs are prescribed, as a rule, for chronic bacterial prostatitis or chronic infectious prostatitis.For non-infectious chronic prostatitis, treatment tactics remain controversial and controversial.Antibacterial drugs are prescribed to such patients in the hope of curing the latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not from the first visit.As a rule, in no more than a few days, the doctor examines the patient to detect the 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 have anti-edematous and analgesic effects.
After determining the type of bacteria and its sensitivity, antibacterial drugs are prescribed, of which fluoroquinolones are the most effective.Treatment is carried out for 4 weeks or more (minimum 28 days) under clinical and bacteriological control.
If the effect is positive in patients with recurrent chronic prostatitis, the use of antibacterial drugs is recommended to be extended to 6-8 weeks.Sometimes antibiotic therapy is extended to 16 weeks with a practical cure thereafter.If there is no positive result, the antibacterial drug used is abandoned, but not earlier than after 2 weeks of treatment.The ideal antibacterial drug should be fat-soluble, not binding to serum proteins, and weakly alkaline, so that it is maximally concentrated in the prostate gland itself, and not in the plasma.The best in terms of this need are fluoroquinolones, which have the best pharmacological properties in the treatment of chronic prostatitis;they create a sufficient concentration in the prostate gland, in secretions and sperm, and are active against most of the bacteria found in chronic prostatitis.
So, 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 drug that does not cause side effects;
- determination of the effective dose, method 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;
- the combination of antibacterial drugs, both with each other and with drugs and procedures that increase the antimicrobial effect, reduce the incidence of complications, and improve microcirculation in the prostate;
- carry out complex therapy taking into account the general health characteristics of the patient.
Sometimes, with long-term or overactive antibacterial therapy, intestinal dysbiosis develops (a decrease in the number and activity of normal intestinal microflora).In this case, it is recommended to use drugs that promote its recovery.
Results of treatment of prostatitis with drugs
Strategies and tactics of antibacterial therapy are complex and diverse, but their use can increase the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, a longer period of well-being may occur.But, as a rule, sooner or later the painful sensations that cause anxiety return.Therefore, the use of antibacterial drugs alone is not considered sufficient.Good results are achieved with a therapeutic program aimed at increasing local and general resistance.In this case, you can count on the success of antibacterial therapy or long-term remission.
Improves microcirculation in the prostate
In all forms of chronic prostatitis, in addition to affecting the microflora, they try to restore microcirculation in the prostate, improve the outflow of secretions from the ducts of the gland, increase the intensity of metabolic processes in the source of inflammation and local and general resistance.
Nonsteroidal anti-inflammatory drugs are considered an important step in the treatment of chronic prostatitis.Their positive effect on microcirculation has been proven.
Anticongestive treatment includes measures aimed at reducing venous stagnation in the pelvis: stopping disturbed sexual intercourse, inactive lifestyle, frequent alcohol consumption, etc. For varicose veins on the lower legs and hemorrhoidal veins, which can also cause prostatitis, surgical treatment of this disease is carried out.For congestive non-infectious prostatitis, only decongestant therapy is carried out.
The treatment complex for chronic prostatitis includes special drugs with a very effective effect.In some cases of exacerbation of chronic prostatitis with 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.
Pain relief due to prostatitis
Since the presence and severity of pain in prostatitis serves as the main indicator of the patient, which determines his attitude to the disease and affects the manifestation of depression, analgesic therapy in the treatment of chronic prostatitis is one of the most important components in the general treatment of this disease.The pain syndrome observed in chronic prostatitis is very diverse in its localization, duration and degree of intensity.In this regard, the method of using analgesic drugs is very important.
Oral administration (through the mouth) is quite effective and temporarily relieves pain.Rectal use of painkillers in suppositories and microenemas is more effective, because it uses the combined effects of analgesics and anti-inflammatory drugs, as well as the effect of temperature.To change the tone of the glands, belladonna extract can be added to suppositories.
Strengthens 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 overcome any disease.With chronic prostatitis, the body's defenses are reduced.In this regard, without using general immunological treatment for chronic prostatitis, it is very difficult to achieve success.
Sometimes drugs are used to treat chronic prostatitis that increase the reactivity of the body.Having a pyrogenic effect (increasing body temperature), the drug aggravates chronic inflammation in the prostate gland and turns it into an acute one, which promotes recovery, because it is easier to treat inflammatory diseases in the acute stage.This medicine works when it quickly enters the bloodstream.Therefore, it is given intravenously, starting with a small dose, every day, gradually and carefully increasing the dose.Using this method of intravenous administration, patients with chronic prostatitis must be treated as inpatients so that they are under observation.This medicine is given every day for 9-10 days in a row.At the elevation caused by artificially aggravated chronic inflammation in the prostate gland, from about the 4th day, the introduction of 1-2 antibiotics and sulfonamides or other drugs in relatively high doses began.To increase the blood supply to the prostate gland, physiotherapy is performed simultaneously, and to improve the outflow of prostate secretions, daily massage is performed.The therapeutic effect in the form of improvement or recovery is obtained to varying degrees in almost every patient.
Hormone therapy
It is necessary to use sex hormone preparations for prostatitis with caution.In patients suffering from chronic prostatitis for years and decades, such a need may arise.However, it is better to use it after determining the content of sex hormones in the blood serum (testosterone, estradiol, prolactin, FSH, LH).Simpler tests can also be performed, for example, a cytological study of a scraping from the scaphoid fossa of the urethra.If there is an imbalance of sex hormones, hormonal drugs can be included in the treatment regimen.
Enzymes may also be prescribed to help resolve scar tissue in the prostate gland during long-term disease.
Men who suffer from chronic prostatitis for a long time, as we all know, experience sexual dysfunction.The latter is divided into intercourse, reproduction and hormones.In the majority of patients with prostatitis, fortunately, hormone levels do not suffer significantly.
If the function of intercourse, or the ability to have sexual intercourse, is impaired, there is a decrease in erection, "fading" of orgasm and ejaculation is impaired.The elimination of these symptoms and the normalization of sexual life largely depends on the underlying disease - prostatitis.The more successful the treatment, the faster the symptoms of sexual disorders disappear or decrease.
Treatment of sexual disorders due to arising neurosis includes psychotherapy, tranquilizers (sedatives) and other drug prescriptions depending on the symptoms of the sexual disorder.This therapy shows how prostatitis symptoms can affect a person's quality of life.
In the 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.Due to the negative pressure created, the cracks in the cavernous body of the penis widen, and blood flows into it.The penis grows and an erection occurs.
Repeated procedures lead to an increase in the gap in the cavernous body, to a more stable blood supply to the organs and, finally, to an increase in erectile function.A positive effect in chronic prostatitis is also shown by increased sexual activity, which has a strong psychotherapeutic effect.
The phallodecompression (PLD) method for prostatitis is performed daily or every other day.The course of treatment is 10-15 procedures.It is useful to combine phallodecompression with prostate instillation massage, as this increases the level of drug absorption after the procedure is completed.
Instillation
This type of therapy includes techniques that allow direct and direct delivery of drugs to their intended destination.During instillation therapy with this method, drugs are administered through the external opening of the urethra using a conventional disposable syringe with a conical disposable cannula (soft hollow tube) or syringe.The optimal amount of the drug mixture given is 5 ml.Before the procedure, you need to urinate to make sure your bladder is empty.
At the time of administration, it is recommended to imitate urination, that is, rest, then the excess medicine will enter the bladder and be removed 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 flowing back after removing the cannula or syringe.And in order for the solution to reach the prostate faster, it is recommended that, when introducing it, you carefully caress the filled urethra with the fingers of your free hand towards the perineum.
After the procedure, you must resist the urge to urinate, otherwise, the given medicinal mixture will immediately flow out.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 nature of the disease, as well as the compatibility of the given drugs.Oil mixtures should not be given because of the risk of fat embolism (blockage of blood vessels);you can not make the mixture yourself, because 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 therapy (suppository) 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 clear psychotherapeutic effect.Patients usually tend to 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 has an anti-inflammatory effect and stimulates complex membranes.In addition to medicated suppositories, magnetic suppositories are also used in the treatment of prostatitis.
Microclyster
Usually, microenemas are used to treat prostatitis, which is often called traditional treatment for prostatitis.The basis of its use is the simultaneous temperature and medicinal effect.Microenemas are usually used before going to bed.
As medicinal ingredients, they use aqueous infusions of chamomile, calendula, sage or motherwort, mixed with boiling water before giving a microenema.After the infusion has been cooled to a temperature of 40°C, the drug is administered into the rectum.A small amount is injected - no more than 100 ml of liquid.The medicine must be absorbed in the rectum, that is, feces immediately after microenema administration is undesirable.
Herbal water infusion can be replaced with 1 teaspoon of alcohol infusion (calendula, motherwort or chamomile), which is 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 require proof.Microclysters are usually used simultaneously with antibacterial agents as the final stage of a more active local procedure or as an independent therapeutic effect for mild pain symptoms.
The very important thing is that the use of drugs alone does not lead to good and long-lasting effects.It is necessary to perform the prostate drainage procedure in combination with drug therapy - only then the effect can be guaranteed/