Prostate treatment in men: what drugs to take

Prostatitisis an inflammatory disease of the prostate gland.It manifests itself with 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 established by a urologist or andrologist based on a typical clinical picture and the results of a rectal examination.Additionally, an ultrasound of the prostate and a culture of prostatic secretions and urine are performed.Treatment is conservative: antibacterial therapy, immunotherapy, prostate massage, lifestyle correction.

General information

Prostatitis is inflammation of the seminal gland (prostate) - prostate.It is the most common disease of the genitourinary system in men.It most often affects patients between the ages of 25 and 50.According to various data, prostatitis affects 30-85% of men over the age of 30.Possible formation of abscesses of the prostate gland, 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 with the penetration of an infectious agent that enters the prostatic tissue from the organs of the genitourinary system (urethra, bladder) or from a remote inflammatory focus (pneumonia, influenza, 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 the disease increases with hypothermia, a history of infections, and specific conditions accompanied by congestion of prostatic tissue.The following predisposing factors are identified:

• General hypothermia (one-time or permanent, associated with working conditions).
• A sedentary lifestyle, a profession that forces a person to remain in a sitting position 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 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, irregular and poor nutrition, regular lack of sleep, overtraining in athletes).

A decisive role in the onset of prostatitis is played by congestion of the prostatic tissue.Disruption of capillary blood flow causes an increase in lipid peroxidation, swelling, exudation of prostatic 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 radiating to the anus and intensifies during defecation.Urination is difficult, urine comes out in a thin stream.In some cases, urinary retention is observed.Low-grade fever or moderate hyperthermia are typical.
• Acute parenchymal.Severe general intoxication, hyperthermia up to 38-40°C, chills.Dysuric disorders, often acute urinary retention.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 predominantly chronic course is observed.The temperature occasionally rises to subfebrile levels.The patient notes mild pain in the perineum, discomfort during urination and defecation.The most characteristic symptom is scanty secretion from the urethra during defecation.The predominantly 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 transforms into abacterial prostatitis.

Chronic prostatitis is often a complication of the inflammatory process caused by the causative agent of a specific 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, mild pain in the perineum, scanty secretions from the urethra during defecation.A small change in the clinical picture often goes unnoticed by the patient.

Chronic inflammation of the prostate gland can manifest itself as a burning sensation in the urethra and perineum, dysuria, sexual dysfunction, and increased general fatigue.The consequence of potency disorders (or fear of these disorders) is often mental depression, anxiety and irritability.The clinical picture does not always include all the groups of symptoms listed;varies between 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 the nervous 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 and disturbing sleep.There is a change in the nature of pain (increase or decrease) during ejaculation, excessive sexual activity or sexual abstinence.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, compressing the urethra.The lumen of the ureter decreases.The patient feels a frequent need to urinate and a sensation of incomplete emptying of the bladder.As a rule, dysuric phenomena are expressed in the early stages.Then compensatory hypertrophy of the muscle layer of the bladder and ureters develops.The symptoms of dysuria attenuate during this period, and then increase again with the decompensation of the adaptation mechanisms.

Potency may develop in the initial stages, manifesting itself differently in different patients.Patients may complain of frequent nocturnal erections, loss of orgasm, or deterioration of erection.Accelerated ejaculation is associated with a decrease in the threshold level of arousal of the orgasmic center.Pain during ejaculation can cause refusal of sexual activity.Subsequently, sexual dysfunctions become more pronounced.In an advanced stage, impotence develops.

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

Impotence and sometimes the very threat of possible sexual disorders are difficult for patients to tolerate.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:

According to the course of the disease:

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

For the reason that caused the pathology:

• Bacterial inflammation of the prostate gland, predominates in men under the age of 40, occurs on the background of ultrasound 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.

According to the nature of structural changes in the prostate gland:

• Fibrous prostatitis is characterized by rapid irreversible growth of the gland and requires radical intervention.Clinically it resembles prostatic adenoma.
• Calcium inflammation of the prostate gland occurs due to the formation of stones within the prostate.Considered a harbinger of cancer.
• Congestive prostatitis, a consequence of a sedentary lifestyle, is diagnosed in one in two patients.

Signs of the disease

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

• Micturition disorder with the presence of a weak, intermittent, unusually short stream of urine, causing splashing, difficulty and pain before urination.The frequent need to empty the bladder occurs mainly 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 semen (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 forms, the patient's body temperature rises to 39-40°C and can become frenzied in nature.Periods of fever alternate with severe chills.Sharp pain in the perineum makes urination difficult and makes defecation impossible.

Increased swelling of the prostate gland leads to acute urinary retention.In rare cases, the abscess ruptures spontaneously into the urethra or rectum.Once opened, purulent, cloudy urine with an unpleasant, pungent odor appears in the urethra;once opened, the stool contains pus and mucus in the rectum.

Chronic prostatitis is characterized by a wave-like course with periods of long remission, during which the inflammation of the prostate is latent or manifests itself with extremely few symptoms.Patients who are not bothered by anything often stop treatment and seek treatment only if complications develop.

The spread of the infection along the urinary tract causes the appearance of pyelonephritis and cystitis.The most common complication of the chronic process is inflammation of the testicles and epididymis (epdymo-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 diagnosis of acute and chronic prostatitis.It is mandatory:

Treatment of prostatitis

Treatment of acute prostatitis

Patients with an acute process without complications are treated by a urologist on an outpatient basis.In case of severe intoxication or suspicion of purulent process, hospitalization is indicated.Antibacterial therapy is carried out.Drugs are selected taking into account the sensitivity of the infectious agent.Antibiotics are widely used that can penetrate well into the prostate tissue and act on it.

With the development of acute urinary retention due to prostatitis, the installation of a cystostomy is resorted to instead of a urethral catheter, since there is a danger of the formation of a prostatic abscess.When an abscess develops, a transrectal or transurethral endoscopic 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 (for 4-8 weeks).The selection of the type and dosage of antibacterial drugs, as well as the determination of the duration of the treatment course is carried out individually.The drug is selected based on the sensitivity of the microflora based on the results of culture of urine and prostate secretions.
• Prostate massage.Gland massage has a complex effect on the affected organ.During massage, the inflammatory secretion accumulated in the prostate gland is compressed into the ducts, then enters the urethra and is expelled from the body.The procedure improves blood circulation in the prostate, minimizing congestion and ensuring better penetration of antibacterial drugs into the tissue of the affected organ.
• Physiotherapy.To improve blood circulation, laser exposure, ultrasonic waves and electromagnetic waves are used.If it is impossible to carry out physiotherapeutic procedures, the patient is prescribed warm medicinal microenemas.

In case of long-term chronic inflammation, consultation with an immunologist is indicated to choose the tactics of immunocorrective therapy.The patient is given recommendations for lifestyle changes.Making some changes in the lifestyle of a patient with chronic prostatitis is 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.

Course treatment methods:

• The most effective treatment for prostatitis is etiotropic therapy.If the basis of prostatitis is an infection, the priority is a course of antimicrobial agents that relieve the manifestations of inflammation.
• Pain syndrome is relieved with analgesics, antispasmodics, rectal suppositories, microenemas with warm solutions of painkillers.NSAIDs can be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven their effectiveness.
• Physiotherapeutic methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwave, electrophoresis, laser, magnetotherapy.
• Massage is another effective method to influence the prostate.Opens the ducts, 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.
• Psychological consultations.

Treatment methods for prostatitis

Antibacterial therapy is more effective in treating prostatitis.Phytotherapeutic, immunocorrecting and hormonal drugs can also be used upon doctor's prescription.

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

Treatment with drugs

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

Medicines are taken in tablets, in acute cases - as a 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 minimal effect on other organs.

Anticoagulant and anti-inflammatory drugs have also proven effective.

Antibacterial therapy

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

Antibiotics from the fluoroquinolone group have proven effective in the treatment of chronic prostatitis.Their action is aimed at suppressing bacterial infection and strengthening the body's immunity.In addition to this, 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 also take drugs from the group of macrolides and tetracyclines, which slow the spread of the infection.

The duration of taking antibacterial drugs is from 2 to 4 weeks.In case of positive dynamics the course may 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 gland and cleaning the ducts.If physiotherapy is combined with antibiotics, the effect of the latter is enhanced.

The main methods include:

• magnetotherapy;
• laser therapy;
• electrophoresis;
• heating;
• ultrasound;
• mud therapy;
• high frequency irradiation;
• physical therapy.

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

Non-specific treatments

Nonspecific methods for 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 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 a 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 using endoscopic methods.In case of a large affected area or multiple stones, resection of the prostate is used.

Transurethral resection is also effective for bacterial prostatitis.This way the risk of recurrence can be reduced.

Folk remedies

Folk remedies for the treatment of prostatitis are unlikely to be effective on their own, 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 brook, fresh greens, pumpkin seeds.

In acute cases of the disease it is necessary to consult a doctor and in no case 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, which means that the medicine will act faster.

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

1. Antibacterial agents are especially effective for 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 attenuation of inflammatory processes and slightly improves immunity.
6. Enzyme products prevent the formation of scar tissue.It is recommended to take it as part of a complex therapy with antibiotics, anti-inflammatories and painkillers.

Accessory drugs

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

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

Diet and lifestyle

A correct and balanced diet and a healthy lifestyle are very important for the treatment of prostatitis.Food should not contain spicy, fried, salted or pickled foods.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 aromatic 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 regularly undergo examination by a urologist.Prostatitis that is not completely healed may be accompanied by the formation of calcifications, which will then need to be removed together with the gland.Experts are sure that there are no other ways to remove or dissolve stones.

Furthermore, pathogenic microorganisms can migrate to nearby 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 adequate and timely treatment, chronic prostatitis becomes the outcome in more than half of patients.Healing is not always achieved, however, with correct and consistent therapy and following the doctor's recommendations, it is possible to eliminate unpleasant symptoms and achieve stable, long-term 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.For constipation, laxatives should be used.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 appear, you should immediately consult a doctor.