Prostate treatment in men: what medications to take

ProstatitisIt is an inflammatory disease of the prostate gland.It manifests itself as 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 digital rectal examination.In addition, an ultrasound of the prostate and culture of prostate secretions and urine are performed.Treatment is conservative: antibiotic therapy, immunotherapy, prostate massage, lifestyle correction.

General information

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

Pathology develops with the penetration of an infectious agent that enters the prostate 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 specific infections, and conditions accompanied by congestion in the prostate tissue.The following predisposing factors are identified:

• General hypothermia (single or permanent, associated with working conditions).
• Sedentary lifestyle, profession that requires the person to sit 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 "usual" sexual relations without emotional connotations).
• The presence of chronic diseases (cholecystitis, bronchitis) or chronic infectious foci in the body (chronic osteomyelitis, untreated cavities, tonsillitis, etc.).
• Past 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).

Congestion in the prostate tissue plays a decisive role in the appearance 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.

Prostatitis symptoms

acute prostatitis

There are three stages of acute prostatitis, which are 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 intensifying during defecation.It is difficult to urinate, urine comes out in a thin stream.In some cases, urinary retention is observed.Low fever or moderate hyperthermia is typical.
• acute parenchymal.Severe general intoxication, hyperthermia up to 38-40°C, chills.Dysuric disorders, often acute urinary retention.Sharp, stabbing pain in the perineum.Difficulty defecating.

chronic prostatitis

In rare cases, chronic prostatitis becomes the result of an acute process;However, as a rule, a mainly chronic course is observed.The temperature occasionally rises to subfebrile levels.The patient notices mild pain in the perineum, discomfort when urinating and defecating.The most characteristic symptom is poor secretion from the urethra during defecation.The mainly 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 specific infection (chlamydia, trichomonas, ureaplasma, gonococcus).The symptoms of a specific inflammatory process in many cases mask the manifestations of damage to the prostate.There may be a slight increase in pain when urinating, mild pain in the perineum, poor discharge from the urethra during defecation.A small change in the clinical picture often goes unnoticed by the patient.

Chronic inflammation of the prostate 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 usually mental depression, anxiety and irritability.The clinical picture does not always include all of the listed groups of symptoms;varies between different patients and changes over time.There are three main syndromes characteristic of chronic prostatitis: pain, dysuria and sexual disorders.

There are no pain receptors in the 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 sleep to intense, disturbing sleep.There is a change in the nature of the pain (increasing or weakening) 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 experiences frequent urges 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 muscular layer of the bladder and ureters then develops.Symptoms of dysuria weaken during this period and then increase again with decompensation of adaptive mechanisms.

In the initial stages, dyspotence may develop, which manifests itself differently in different patients.Patients may complain of frequent nocturnal erections, loss of orgasm, or deterioration of the erection.Accelerated ejaculation is associated with a decrease in the threshold level of excitation of the orgasmic center.Pain during ejaculation can cause rejection 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.Loss of potency and dysuria can be due to both changes in the prostate and the suggestibility of the patient, who, if diagnosed with chronic prostatitis, expects the inevitable development of sexual and urinary disorders.Psychogenic dyspotence and dysuria develop especially frequently in suggestible and anxious patients.

Impotence, and sometimes the very threat of possible sexual disorders, is difficult for patients to tolerate.Often there is a change in character, irritability, bad mood, excessive concern for one's own 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 represents more than 50% of cases of the disease in people no older than 30 to 35 years.
• Chronic option.It is considered an ageless category.It does not manifest itself for a long time;the impetus for its development is a cold or an infection.

For the reason that caused the pathology:

• Bacterial inflammation of the prostate gland predominates in men under 40 years of age, occurs against 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.

Depending on the nature of the structural changes in the prostate gland:

• 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 occurs due to the formation of stones inside the prostate.Considered an omen 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:

• Urination disorder with the appearance of a weak and intermittent stream of urine, unusually short, causing splashing, difficulty and pain before urinating.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 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 he may become agitated.Periods of fever alternate with intense chills.Acute pain in the perineum makes urination difficult and defecation impossible.

Increased inflammation of the prostate causes acute urinary retention.In rare cases, the abscess spontaneously ruptures 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 in the rectum.

Chronic prostatitis is characterized by an undulating course with periods of prolonged remissions, during which inflammation of the prostate is latent or manifests itself with extremely few symptoms.Patients who are not bothered by anything often stop treatment and recur only if complications arise.

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 (epdidymoorchitis) and inflammation of the seminal vesicles (vesiculitis).The result of these diseases is usually infertility.

Diagnosis

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

Prostatitis treatment

Treatment of acute prostatitis

Patients with an acute uncomplicated process are treated by a urologist on an outpatient basis.In case of severe poisoning or suspicion of a purulent process, hospitalization is indicated.Antibacterial therapy is carried out.Medicines 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, they resort to installing a cystostomy 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 and include etiotropic therapy, physiotherapy and correction of immunity:

• Antibiotic therapy.The patient is prescribed long courses of antibacterial medications (for 4 to 8 weeks).The selection of the type and dosage of antibacterial drugs, as well as the determination of the duration of treatment, is carried out on an individual basis.The drug is selected based on the sensitivity of 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 the massage, the inflammatory secretion accumulated in the prostate is compressed into the ducts, then enters the urethra and is removed from the body.The procedure improves blood circulation in the prostate, which minimizes congestion and ensures better penetration of antibacterial drugs into the tissue of the affected organ.
• Physiotherapy.To improve blood circulation, exposure to laser, ultrasonic waves and electromagnetic waves is used.If it is impossible to carry out physiotherapeutic procedures, the patient is prescribed hot medicinal microenemas.

In case of chronic and prolonged inflammation, consultation with an immunologist is indicated to choose the tactics of immunocorrective therapy.The patient receives recommendations for lifestyle changes.Making certain 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 treatment with antimicrobial agents, which relieve the manifestations of inflammation.
• Pain syndrome is relieved by analgesics, antispasmodics, rectal suppositories and microenemas with warm solutions of analgesics.NSAIDs can be used.
• Immunostimulants, immunomodulators, enzymes, vitamin complexes and a combination of microelements have proven effective.
• Physiotherapeutic methods are possible only in the subacute stage of the disease.They improve microcirculation and increase immunity: UHF, microwaves, electrophoresis, laser, magnetotherapy.
• Massage is another effective method of influencing 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.
• Psychologist consultations.

Treatment methods for prostatitis

Antibacterial therapy is most effective in treating prostatitis.Herbal medications, immunocorrectors, and hormonal medications may also be used as prescribed by a doctor.

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

Drug treatment

Treatment of prostatitis using antibacterial therapy should begin with a bacterial culture, the objective of which is to evaluate the sensitivity of the organism to this type of antibiotics.If there are problems with urination, the use of anti-inflammatory drugs gives a good result.

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

Anticoagulants and anti-inflammatories 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 must be made by a doctor.To correctly select the most effective drugs, you will need 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 to be effective in the treatment of chronic prostatitis.Its action aims to suppress bacterial infections and strengthen the body's own immunity.Additionally, 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 down the spread of the infection.

The duration of taking antibacterial drugs is 2-4 weeks.In case of positive dynamics, the course may be extended.

Physiotherapy

Physiotherapeutic techniques in the treatment of prostatitis aim to activate blood circulation in the pelvic area, improve metabolic processes in the prostate and cleanse 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;
• heating;
• ultrasound;
• mud therapy;
• high frequency irradiation;
• physiotherapy.

One of the oldest methods, transrectal prostate massage, according to modern research, has not proven its effectiveness.

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 talk to your doctor about all non-traditional methods of treating prostatitis.

Surgical treatment

Surgical methods are used in complex and emergency cases:

• for drainage of purulent abscesses, which are removed by laparoscopic methods using 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 by endoscopic methods.In case of a large affected area or multiple stones, prostate resection is used.

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

Folk remedies

Home remedies for the treatment of prostatitis are unlikely to be effective on their own, but in combination with medications and physiotherapy methods they may be applicable.These include: beekeeping products, decoctions of herbs and seeds, tinctures of garlic, ginger, castor, 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 pills, 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. Analgesics are used for symptomatic treatment;They relieve pain well.
3. Immunostimulants help improve blood circulation, relieve swelling and are used in complex therapies.
4. Herbal medicines have a mild effect.They, like candles from bee products, are used as a complement to the main treatment.
5. Compositions based on ichthyol promote blood flow in the intestinal mucosa, which accelerates the attenuation of inflammatory processes and slightly improves immunity.
6. Enzyme-based products prevent the formation of scar tissue.It is recommended to take it as part of a complex therapy with antibiotics, anti-inflammatories and analgesics.

Auxiliary medications

For the symptomatic treatment of prostatitis in men, for example, to relieve pain when urinating, antispasmodics can also be taken, which relax smooth muscles and thus quickly relieve pain.

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

Diet and lifestyle

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

Foods should contain enough fiber to prevent constipation.The protein content should be reduced.It is advisable 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, it is necessary to undergo regular examination by a urologist.Not completely cured prostatitis may be accompanied by the formation of calcifications, which will then have to be removed along with the gland.Experts are confident that there are no other ways to remove or dissolve stones.

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

Prognosis and prevention

Acute prostatitis is a disease that has a marked tendency to become chronic.Even with adequate and timely treatment, chronic prostatitis becomes the result of more than half of patients.Recovery 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 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.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 in the development of prostatitis.If symptoms of a urological or sexually transmitted disease appear, a doctor should be consulted as soon as possible.