Prostate treatment in men: which drugs to take

Prostatitisis an inflammatory disease of the prostate.It is manifested by frequent urination, pain in the penis, scrotum, rectum, sexual disorders (erectile dysfunction, early 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, ultrasound of the prostate and cultures of prostate secretions and urine are performed.Treatment is conservative - antibacterial therapy, immunotherapy, prostate massage, lifestyle correction.

General information

Prostatitis is an inflammation of the seminal (prostate) gland - the prostate.It is the most common disease of the genitourinary system in men.It most often affects patients aged 25-50.According to various data, prostatitis affects 30-85% of men over the age of 30.Possible formation of prostate abscess, inflammation of the testicles and appendages, which threatens infertility.Ascending infection leads to inflammation of the upper parts of the genitourinary system (cystitis, pyelonephritis).

The pathology develops through the penetration of an infectious agent that enters the prostate tissue from the organs of the genitourinary 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 conditionally pathogenic flora and cause prostatitis only in the presence of other predisposing factors.Chronic inflammation is usually the result of polymicrobial associations.

The risk of developing the disease increases with hypothermia, a history of specific infections and conditions accompanied by congestion in the prostate tissue.The following predisposing factors are identified:

• General hypothermia (single or permanent, related to working conditions).
• Sedentary lifestyle, a profession that forces a person to be in a sitting position for a long time (computer operator, driver, etc.).
• Constant constipation.
• Disturbances of the normal rhythm of sexual activity (excessive sexual activity, prolonged abstinence, incomplete ejaculation during "usual" sexual intercourse devoid of emotional overtones).
• The presence of chronic diseases (cholecystitis, bronchitis) or chronic infectious foci in the body (chronic osteomyelitis, untreated caries, tonsillitis, etc.).
• Previous urological diseases (urethritis, cystitis, etc.) and sexually transmitted diseases (chlamydia, trichomoniasis, gonorrhea).
• Conditions that cause suppression of the immune system (chronic stress, improper and poor diet, regular lack of sleep, overtraining of athletes).

Congestion of the prostate tissue plays a decisive role in the development of prostatitis.Disruption of capillary blood flow causes increased lipid peroxidation, swelling, exudation of prostate tissue and creates 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 certain clinical picture and morphological changes:

• Acute catarrhal.Patients complain of frequent, often painful urination, pain in the sacrum and perineum.
• Acute follicular.The pain becomes more intense, sometimes spreads to the anus, and intensifies during defecation.Urination is difficult, urine flows in a thin stream.In some cases, urine retention is observed.A low temperature or moderate hyperthermia is typical.
• Acute parenchyma.Severe general intoxication, hyperthermia up to 38-40°C, chills.Dysuric disorders, often acute retention of urine.Sharp, throbbing pain in the perineum.Difficulty in defecation.

Chronic prostatitis

In rare cases, chronic prostatitis becomes the result of an acute process, however, as a rule, a primarily chronic course is observed.The temperature occasionally rises to subfebrile levels.The patient notices slight pain in the perineum, discomfort during urination and defecation.The most characteristic symptom is scanty discharge from the urethra during defecation.Primarily the chronic form of the disease develops over a significant 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 certain infection (chlamydia, trichomonas, ureaplasma, gonococcus).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, slight pain in the perineum, scanty discharge from the urethra during defecation.A minor change in the clinical picture often goes unnoticed by the patient.

Chronic prostatitis can be manifested by a burning sensation in the urethra and perineum, dysuria, sexual dysfunction and increased general fatigue.The consequence of potency disorders (or the fear of these disorders) is often mental depression, anxiety and irritability.The clinical picture does not always include all the listed groups of symptoms;it varies in different patients and changes over time.There are three main syndromes characteristic of chronic prostatitis: pain, dysuria, sexual disorders.

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, painful to intense, disturbing sleep.There is a change in the nature of pain (intensification or weakening) during ejaculation, excessive sexual activity or sexual abstinence.The pain spreads 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, compressing the urethra.The lumen of the ureter decreases.The patient has a frequent need to urinate and a feeling of incomplete emptying of the bladder.As a rule, dysuric phenomena are expressed in the early stages.Compensatory hypertrophy of the muscle layer of the bladder and ureter then develops.Symptoms of dysuria during this period weaken, and then increase again with the decompensation of adaptation mechanisms.

In the initial stages, dyspotency may develop, which manifests itself differently in different patients.Patients may complain of frequent nocturnal erections, loss of orgasm or worsening erection.Accelerated ejaculation is associated with a decrease in the threshold level of orgasmic center excitation.Pain during ejaculation can cause rejection of sexual activity.After that, sexual dysfunctions become more pronounced.In the advanced stage, impotence develops.

The degree of sexual disorder is determined by many factors, including the sexual constitution and psychological state of the patient.Impairment of potency and dysuria can be caused both by changes in the prostate and by the suggestibility of the patient, who, if he is diagnosed with chronic prostatitis, expects the inevitable development of sexual disorders and urination disorders.Psychogenic dyspotency and dysuria especially often develop in suggestible, anxious patients.

Impotence, and sometimes the very danger of possible sexual disorders, is hard for patients to bear.Often there is a change in character, irritability, grumpiness, excessive concern for one's own health, and even "sickness".

Classification

In modern urology, there is no single classification of diseases.However, practitioners prefer this option to classify the inflammatory process in the prostate:

According to the course of the disease:

• Acute prostatitis.This accounts for more than 50% of cases of the disease in people not older than 30-35 years.
• Chronic option.It is considered a non-age category.It does not manifest for a long time;the stimulus for its development is a cold or an infection.

For the reason that caused the pathology:

• Bacterial inflammation of the prostate, prevalent in men under 40 years of age, appears against the background of ultrasound and does not cross the boundaries of the organ.
• Non-bacterial pathological changes in the gland, mostly chronic.
• Viral inflammation of the prostate is characterized by an acute course that affects the entire genital area.

According to the nature of structural changes in the prostate:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention.Clinically, it resembles prostate adenoma.
• Calculous inflammation of the prostate is caused by the formation of stones inside the prostate.It is considered a sign of cancer.
• Congestive prostatitis, the result of a sedentary lifestyle, is diagnosed in every second patient.

Signs of illness

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

• Urinary disorder with intermittent, weak stream of urine, unusually short, causing splashing, difficulty and pain before urination.The frequent urge to empty the bladder occurs mostly at night.
• The pain, which is localized in the lower abdomen, radiates to the scrotum, perineum and rectum.
• Sexual dysfunction.
• Problems with ejaculation, changes in sperm (consistency, quantity).

Complications

In the absence of timely treatment of acute prostatitis, there is a significant risk of developing a prostate abscess.When a purulent focus is formed, the patient's body temperature rises to 39-40°C and may become hectic in nature.Periods of fever alternate with severe chills.Sharp pain in the perineum makes it difficult to urinate and prevents defecation.

Increased swelling of the prostate leads to acute retention of urine.In rare cases, the abscess spontaneously bursts into the urethra or rectum.When it opens, purulent, cloudy urine with an unpleasant, pungent odor appears in the urethra;when opened, the stool contains pus and mucus into the rectum.

Chronic prostatitis is characterized by an undulating course with periods of long remissions, during which the inflammation in the prostate is latent or manifests itself with extremely few symptoms.Patients who do not mind often stop treatment and only return if complications arise.

The spread of infection along the urinary tract causes 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 outcome of these diseases is often infertility.

Diagnostics

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

Treatment of prostatitis

Treatment of acute prostatitis

Patients with an uncomplicated acute process are treated by a urologist on an outpatient basis.In case of severe intoxication or suspected purulent process, hospitalization is indicated.Antibacterial therapy is administered.Medicines are selected taking into account the sensitivity of the infectious agent.Antibiotics are widely used, which can penetrate well into the prostate tissue and act on it.

With the development of acute urinary retention due to prostatitis, they resort to the installation of a cystostomy rather than a urethral catheter, because there is a risk of prostate abscess formation.When an abscess develops, endoscopic transrectal or transurethral opening of the abscess is performed.

Treatment of chronic prostatitis

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

• Antibiotic therapy.The patient is prescribed long courses of antibacterial drugs (4-8 weeks).The selection of the type and dose of antibacterial drugs, as well as the determination of the duration of the course of treatment, is carried out individually.The drug is selected based on the sensitivity of the microflora based on the results of the culture of urine and prostate secretions.
• Prostate massage.Gland massage has a complex effect on the affected organ.During the massage, the inflammatory secretion accumulated in the prostate is squeezed into the channels, then enters the urethra and is removed from the body.The procedure improves blood circulation in the prostate, which minimizes clogging and ensures better penetration of antibacterial drugs into the tissue of the affected organ.
• Physiotherapy.Laser exposure, ultrasound and electromagnetic waves are used to improve blood circulation.If it is impossible to carry out physiotherapeutic procedures, the patient is prescribed warm medicinal microenemas.

In the case of chronic, long-term inflammation, a consultation with an immunologist is indicated for choosing immunocorrective therapy tactics.The patient is given recommendations for lifestyle changes.Certain changes in the lifestyle of patients with chronic prostatitis is both a therapeutic and preventive measure.Normalization of sleep and wakefulness, adjustment of diet and moderate physical activity are recommended to the patient.

Treatment of acute prostatitis

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

Treatment course methods:

• The most effective treatment for prostatitis is etiotropic therapy.If the underlying cause of prostatitis is an infection, the priority is a course of antimicrobial agents that alleviate the manifestations of inflammation.
• The pain syndrome is alleviated with analgesics, antispasmodics, rectal suppositories, microenemas and warm solutions of painkillers.NSAIDs may be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
• Physiotherapy methods are possible only in the subacute phase of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetic therapy.
• Massage is another effective method of influencing the prostate.It opens channels, normalizes blood circulation in the scrotum and pelvis.
• Acute renal filtrate retention can be corrected by catheterization and trocar cystostomy.
• The purulent process involves surgical intervention.
• Psychologist consultations.

Methods of treatment of prostatitis

Antibacterial therapy is the most effective in the treatment of prostatitis.Herbal medicines, immunocorrectors and hormonal medicines can also be used according to the doctor's recommendation.

In the absence of acute symptoms, prostatitis can be treated with physiotherapy.In case of abscesses and suppurations, surgical intervention is recommended.

Drug treatment

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

Medicines are taken in tablets, in acute cases - by dropper or intramuscularly.Rectal suppositories are effective in the treatment of chronic forms of prostatitis: with their help, drugs reach their goals faster and have a minimal effect on other organs.

Blood thinners and anti-inflammatory drugs have also been shown to be effective.

Antibacterial therapy

Antibiotics are an effective drug 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 choose the most effective drugs, he will have to find out what kind of pathogen caused prostatitis, and also test the patient for tolerance to antibiotics of a certain group.

Antibiotics from the fluoroquinolone group have proven to be effective in the treatment of chronic prostatitis.Their action is aimed at suppressing bacterial infection and strengthening the body's own immunity.In addition, the bacteriostatic antibiotic trimethoprim is recommended for the prevention and treatment of accompanying diseases of the genitourinary system.

For the treatment of 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 from 2 to 4 weeks.In case of positive dynamics, the course can be extended.

Physiotherapy

Physiotherapy 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, the effect of the latter is enhanced.

The main methods include:

• magnetic therapy;
• laser therapy;
• electrophoresis;
• warming up;
• ultrasound;
• mud therapy;
• high frequency irradiation;
• physical therapy.

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

Non-specific treatments

Non-specific methods of treatment of prostatitis include:

• hirudotherapy;
• therapeutic fasting;
• acupuncture;
• diet according to the Ostrovsky method;
• alkalization of the organism by the Neumyvakin method.

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

Surgical treatment

Surgical methods are used in complex and emergency cases:

• for drainage of purulent abscesses, which are removed by laparoscopic methods through puncture;
• in case of 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 body of the gland.

Stones and sclerotic tissue are removed by endoscopic methods.In the case of a larger affected area or multiple stones, resection of the prostate is resorted to.

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

Folk remedies

It is unlikely that folk remedies for the treatment of prostatitis will be effective by themselves, but in combination with drugs and physiotherapeutic methods they may be applicable.These include: beekeeping products, decoctions of herbs and seeds, tinctures of garlic, ginger, beaver creek, fresh vegetables, pumpkin seeds.

In acute cases of illness, it is necessary to consult a doctor, and under no circumstances should you self-medicate!If the purulent abscess bursts, 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, which means that the medicine will work 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 in prostatitis caused by chlamydia.
2. Painkillers are used for symptomatic treatment;they relieve pain well.
3. Immunostimulants help 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. Compositions based on ichthyol promote blood flow in the area of 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 drugs

For the symptomatic treatment of prostatitis in men, for example, relieving pain during urination, you can additionally take antispasmodics, which relax smooth muscles and thereby quickly relieve pain.

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

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 sour food.In acute cases, alcohol is strictly prohibited.

Food should contain enough fiber to prevent constipation.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 do not appear for a long time, it is necessary to undergo a regular examination by a urologist.Incompletely cured prostatitis can be accompanied by the formation of calcifications, which will then have to be removed together with the gland.Experts are convinced that there are no other ways to remove or dissolve stones.

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

Prognosis and prevention

Acute prostatitis is a disease that has a pronounced tendency to become chronic.Even with timely and adequate treatment, chronic prostatitis becomes the outcome in more than half of patients.Recovery is not always achieved, however, with proper consistent therapy and adherence to 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 regularly and nutritiously.Laxatives should be used for constipation.One of the preventive measures is the normalization of sexual life, because both excessive sexual activity and sexual abstinence are risk factors for the development of prostatitis.If symptoms of a urological or sexually transmitted disease appear, consult a doctor immediately.