Antibacterial therapy for prostatitis is not the only method of treatment.Antibacterial drugs are prescribed only if there are adequate indications, especially 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 treating prostatitis, are different.Therefore, among the drugs to which the greatest sensitivity of the flora has been established, those with the greatest 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 treating prostatitis
Another condition for the effectiveness of a medication used to treat prostatitis is that it has a broad spectrum of antibacterial action.This is due to the fact that it is very difficult to reliably determine the flora living 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 across the prostate barrier and breadth of antibacterial action.
Modern medicines from the fluoroquinol group
New antibacterial agents that have a significant advantage over others are drugs from the fluoroquinolone group.These medications 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, which 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 antibacterial therapy should be aware that the medications used may have a spermotoxic effect.Therefore, between the use of these medications and the intended 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.Antibacterial medications are prescribed to these patients in hopes of curing a latent infection.
If chronic prostatitis is suspected, antibacterial drugs are not prescribed immediately, that is, not at the first appointment.As a rule, within a maximum of a few days, the doctor examines the patient for infection.During this period, symptomatic therapy is recommended, generally with an anti-inflammatory effect in the form of 50 mg of diclofenac or 100 mg in suppositories, which have anti-edematous and analgesic effects.
After establishing the type of bacteria and their sensitivity, antibacterial medications 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 that the use of the antibacterial be extended to 6 to 8 weeks.Sometimes antibiotic therapy is extended to 16 weeks, with practical healing thereafter.If there is no positive result, the antibacterial used is abandoned, but not before 2 weeks of treatment.An ideal antibacterial drug should be fat-soluble, not bound to serum proteins, and weakly alkaline so that it is maximally concentrated in the prostate itself rather than 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, its secretions and sperm, and are active against most bacteria found in chronic prostatitis.
Thus, a necessary condition for the maximum effectiveness of antibacterial therapy in chronic prostatitis is compliance with the following general principles:
- isolation and determination of the microflora causing prostatitis and identification of its sensitivity to antimicrobials;
- 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 start 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 therapy taking into account the characteristics of the patient's general health status.
Sometimes, with prolonged or excessively active antibacterial therapy, intestinal dysbiosis develops (a decrease in the number and activity of normal intestinal microflora).In these cases, it is recommended to use medications that promote recovery.
Results of treating prostatitis with medications
The strategy and tactics of antibacterial therapy are complex and varied, but their use can improve the effectiveness of treatment.
After successful antibiotic therapy for prostatitis, a more or less long 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 medications alone is not considered sufficient.Good results are achieved by a therapeutic program that aims to increase local and general resistance.In this case, you can count on successful antibiotic therapy or long-term remission.
Improving microcirculation in the prostate
In all forms of chronic prostatitis, in addition to influencing the microflora, they seek to restore the microcirculation of the prostate, improve the flow of secretions from the glandular ducts, increase the intensity of metabolic processes at the source of inflammation and 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 aimed at reducing venous stagnation in the pelvis: interruption of interrupted sexual intercourse, sedentary lifestyle, frequent consumption of alcohol, etc.In non-infectious congestive prostatitis, only decongestant therapy is performed.
The treatment complex for chronic prostatitis includes special drugs with highly effective effects.In some cases of exacerbation of chronic prostatitis in the presence of dysuric phenomena caused by venous stagnation, medications are used that reduce the tone of the smooth muscles of the prostate to reduce the urge to urinate.But only a doctor can recommend them.
Elimination of pain due to prostatitis
Since the presence and intensity 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 painful syndromes observed in chronic prostatitis are very diverse in their location, duration and degree of intensity.In this sense, the way in which painkillers are used 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, as they use the combined effect of analgesics and anti-inflammatories, as well as temperature effects.To change the tone of the gland, belladonna extract can be added to suppositories.
Strengthening the immune system
In the treatment of chronic prostatitis, it is very important to increase the body's reactivity and its defenses, which usually help in coping with any disease.In chronic prostatitis, the body's defenses are reduced.In this regard, 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.With a pyrogenic effect (increasing body temperature), the medicine aggravates chronic prostate inflammation and transforms it into acute, which promotes recovery, as it is easier to treat inflammatory diseases in the acute phase.The drug works when it quickly enters the bloodstream.Therefore, it is administered intravenously, starting with small doses, daily, gradually and carefully increasing the dose.Using this intravenous administration method, patients with chronic prostatitis should be treated as inpatients for observation.The medicine is administered daily for 9 to 10 consecutive days.At the height of the exacerbation of artificially caused chronic inflammation in the prostate, from the 4th day, the introduction of 1-2 antibiotics and a sulfonamide or other medication in fairly high doses begins.To improve the blood supply to the prostate, physiotherapy is performed simultaneously, and to improve the outflow of secretions from the prostate, daily massage is performed.The therapeutic effect in the form of improvement or recovery is achieved to varying degrees in almost all patients.
Hormone therapy
It is necessary to use sex hormone preparations for prostatitis very carefully.In patients who have suffered from chronic prostatitis for years and decades, this 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 scar tissue in the prostate during long-term illness.
Men who have suffered from chronic prostatitis for a long time, as we already know, experience sexual dysfunction.The latter is divided into copulatory, reproductive and hormonal.Fortunately, in the vast majority of patients with prostatitis, hormonal levels do not suffer significantly.
If the copulatory function, or the ability to have sexual intercourse, is impaired, there is a decrease in erection, a “fading” of 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 sexual disorder symptoms disappear or lessen.
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 the symptoms of prostatitis can affect a person's quality of life.
In case of erectile dysfunction, after the main treatment, LOD therapy can be used, which consists of creating a vacuum in the vessel where the penis is placed.Due to the negative pressure created, the fissures in the corpora cavernosa of the penis enlarge and blood flows into them.The penis enlarges and an erection occurs.
Repeated procedures lead to an increase in gaps 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 increased sexual activity, which has a powerful psychotherapeutic effect.
The phallodecompression method (PLD) 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 it increases the degree of absorption of medications after the procedure is completed.
Instillations
This type of therapy includes techniques that allow direct and direct delivery of the medication 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 disposable conical cannula (soft hollow tube) or syringe.The ideal volume of the administered medicinal mixture is 5 ml.Before the procedure, you must urinate to ensure your bladder is empty.
At the time of administration, it is recommended to imitate urination, that is, to relax, then the excess medication will enter the bladder and be expelled along with the first portion of urine;the head of the penis must be pressed with your fingers or special forceps - this will prevent the injected solution from flowing back after removing the cannula or syringe.And for the solution to reach the prostate more quickly, it is recommended that, when introducing it, you carefully stroke the filled urethra with the fingers of your free hand towards the perineum.
After the procedure, you must endure the urge to urinate, otherwise the administered medicinal mixture will immediately return.This mixture is composed of the same medications as oral administration: antibiotics, analgesics, antispasmodics, anti-inflammatories.
Instillation therapy for prostatitis allows the use of several medications, the choice of which depends on the nature of the disease, as well as the compatibility 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, as you may get the dosage wrong, which will have unpleasant and even dangerous consequences.
Suppositories (candles)
In the treatment of prostatitis, suppository therapy (suppositories) is widely used.The action of the medicines 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 often tend to use any suppositories for self-treatment of prostatitis, regardless of their composition.Mostly patients 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 medicated suppositories, magnetic suppositories are also used to treat prostatitis.
Microclysters
Typically, microenemas are used to treat prostatitis, which is often called the traditional treatment for prostatitis.The basis for its use is the simultaneous temperature and medicinal effects.Microenemas are generally used before bed.
As medicinal substances, they use aqueous infusions of chamomile, calendula, sage or motherwort, prepared 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 volume is injected - no more than 100 ml of liquid.Medicines must be absorbed in the rectum, that is, feces immediately after administering the microenema are undesirable.
Herbal infusions in water 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 require 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 medications alone does not lead to a good and lasting effect.It is necessary to carry out prostate drainage procedures in combination with drug therapy - only in this way can the effect be guaranteed/