Prostatitis is an inflammatory process in the prostate gland (prostate). This disease causes a lot of problems, and has several forms. More details about the causes, symptoms and treatment of chronic bacterial abstatitis are given below.
Prevalence of the disease
It is considered the most common urological disease in men under the age of 50 and the third most common urological diagnosis in the stronger sex over 50, after benign hyperplasia and prostate cancer. The prevalence of prostatitis according to various sources ranges from 35–40 to 70–90% of cases. The frequency of the disease increases with age: there is a point of view that after 30 years this disease is diagnosed in 30% of men, after 40 years - 40%, at 50 years - 50%, etc.
Although he is more representatives of the stronger sex are exposed, chronic abacterial prostatitis is not always safe for women. Despite the fact that the girls have no prostate, there is its anatomical and physical resemblance - Skin’s gland, located on the back wall of the urethra and producing a secret that is very similar in structure to the secretion of the prostate gland. Its selection takes place during an orgasm, and from the point of view of scientists, it contains almost no multifunctional load, as a result of which biologists and physiologists believe the Skin glands to be a rudiment, which in the future will completely disappear. But as long as there is iron, there is, unfortunately, a disease that affects it. One of them is skeinitis - an infectious and inflammatory disease, which is essentially its female abacterial prostatitis.
The main factors
Prostatitis is called bacterial, which did not occur due to infections, and while flowing into a chronic form. This disease is also called chronic pelvic pain syndrome. Causes of abacterial prostatitis:
- The inflammatory process of tendons and ligaments located in the pelvic floor, which occurs when infectious sources of inflammation are located nearby (with cystitis, urethritis, intestinal infections). Ligaments and tendons are strained, which is why there is quite a strong pain in the lower abdomen, groin, perineum.
- An increase in the volume of the ligaments of the pelvic floor. With inflammation, they pinch the nerve endings located near. There is severe pain radiating to the genitals, legs, lower back, tailbone.
- Constant stress and fatigue.
- Circulatory disturbance in the prostate.
- Injuries to the spine.
The main symptoms of abacterial prostatitis:
- pain in the pelvic area (pains have a uniform look);
- acute pain in the perineum and external genitalia, lower abdomen;
- impaired urination;
- pathology of the reproductive system;
- poor physiological state;
- continuous feeling nervous tension, breakdowns.
Diagnosis with abacterial prostatitis begins from history taking. The doctor must be as careful as possible to the patient, so as not to miss any of the signs of the disease. He certainly performs anal finger examination prostate gland. General blood tests, urine tests, microbiological studies of urine, prostate secretion, and sperm are under way to prove the deficiency of the causative agent of the disease.
The patient is required to undergo a course of urinary line tests. A method such as uroflowmetry is used - determining the characteristics of the flow of urine. This is necessary in order to detect pathology of the urinary tract. A sound examination is used for the examination.
If the microbiological examination is negative, no pathogenic bacteria have been identified, the doctor will record abacterial prostatitis and determine the appropriate treatment. But first of all, the expert is obliged to understand the mental state of his patient, to find an opportunity to explain the occurrence of pain to him and eliminate the use of unnecessary medications.
Therapy of abacterial prostatitis is in the competence of the urologist (andrologist). Attitude to treatment should be comprehensive, it is necessary to solve the problems facing the patient and the doctor.
The style of a man’s existence, his lifestyle, and characteristic features of thinking are subject to correction. It is important to free oneself from the passion for alcohol, move more, play sports, restore sexual life, eat right. Of course, that without a course of basic therapy, getting rid of the disease will not work. Therefore, the use of pharmaceuticals is considered an integral factor in absolute cure.
Indications for hospitalization
Therapy of this disease is carried out more often on an outpatient basis. But in the event that the disease can not be corrected for a long time, has a severe course and a tendency to relapse, placing the patient in a hospital is highly desirable. This will make it possible to successfully deal with the existing disease.
The treatment of chronic prostatitis should be aimed at preventing new foci, and reducing existing infection, normalizing blood circulation, improving drainage of the prostate lobes, correction of hormonal levels and immunity. For this reason, doctors are advised to take immunomodulators, anticholinergics, anti-inflammatory and vasodilators against the background of conventional drugs. The use of angioprotectors is acceptable. In addition, it is also recommended to apply prostate massage, if there are no contraindications.
What to take?
The drugs for the treatment of prostatitis abacterial and bacterial will be as follows:
- Finasteride (diphenylamine 5-a-reductase).
- Terazosin (alpha-blockers).
- Cyclosporine (immunosuppressant).
- "Allopurinol" (a drug that normalizes the exchange of urates).
- Inhibitors of cytokines.
Prescribe "Cefotaxime" with abacterial prostate based on enterobacteria nogo sowing prostate secretion, which provides an opportunity not only to identify the pathogen, but also to establish its susceptibility to this or other medicines. If the therapy model is compiled correctly and in accordance with all the rules, then its effectiveness will reach 90% and more.
If, according to the results of the diagnosis, it was found that chronic prostatitis is of an abacterial nature, then a short-term course of drugs is acceptable. If the scheme gives a positive result, then it should be continued. As a rule, the effectiveness of such therapy is 40%. This indicates that the microbial representative was simply not identified or was not diagnosed (for example, the disease is provoked by chlamydia, ureaplasmas, trichomonads, mycotic organisms, or microbes).
In addition, pathogenic agents, which are not detected by typical methods of study, can be detected by more correct methods, for example, by means of histological examination of prostate biopsy specimens.
As for the use of antibacterial substances in case of constant pelvic pain, This result is still under discussion. Nevertheless, experts are of the opinion that if medication is still taken, then the course should not be longer than a month. If positive dynamics can be traced, then therapy should be extended for another 4-6 weeks. If there is no result, then the doctor must change the medication to another, which will be more effective.
Antibacterial agents from the category of fluoroquinolones are considered the leading drugs for relieving the patient from chronic prostatitis. They have great bioavailability, are able to accumulate in the tissues of the prostate gland, and are functional in interaction with many gram-negative microorganisms.
Typically, the following drugs are prescribed for the treatment of the disease:
- Norfloxacin. The course of treatment is not more than 2 weeks, a dose of 800 mg per day.
- "Ciprofloxacin". The duration of treatment is up to 28 days, the dose is from 250 to 500 mg.
- "Pefloxacin". The course of therapy is up to 2 weeks, a dose of 800 mg per day
If therapy with fluoroquinolones does not give the expected result, it is permissible to prescribe penicillin substances - Amoxiclav in combination with Clindamycin. And also, in some cases, tetracyclines are prescribed, namely, “Doxycycline.” This drug gives excellent results in prostate damage with chlamydia.
Antibacterial agents can be used for prophylactic purposes. Their low effectiveness can be determined by a number of conditions, among which the wrong choice of pharmaceutical agent, chemoresistance of microorganisms to the product.
Already after antibiotic therapy is over, treatment with a-blockers should be started, since Intraprostatic reflux is considered one of the likely factors in the formation of the disease. Such a treatment strategy is important for those patients in whom irrigative and obstructive signs are saved. Substances of this category of drugs reduce intraurethral pressure. They also have a calming effect on the neck of the bladder.
A similar result is determined by the fact that almost fifty percent of intraurethral pressure directly depends on the stimulation of a1-adrenergic receptors, and subsequent substances effectively block this stimulation. These drugs include:
Effective in the treatment of chronic prostatitis, a drug such as Finasteride. Experts became interested in its impact on the development of this ailment at the end of the 20th century. Once in the body, the therapeutic substance blocks the dynamics of the 5-a-reductase enzyme, which transforms testosterone into a prostatic configuration - 5-a-dihydrotestosterone. This adrogen itself has high initiative and stimulates the proliferation of epithelial and stromal gland tissue. As a result, it grows in volume and gives rise to proper signs.
When using Finasteride, hematrophy of overgrown stromal tissue is performed already after 90 days, and part of the glandular matter is reduced by half half a year after the start of therapy. In accordance with this, their secretory function is suppressed. As a result, the patient ceases to suffer from pain, dysuric disorders disappear due to a decrease in the volume of the prostate gland, and there is a decrease in edema and organ pressure on the capsule.
A course of NSAIDs is prescribed to save the patient from uncomfortable sensations. More often in this capacity, Diclofenac is used at a dose of 50 to 100 mg per day.
Along with taking medications, patients are recommended to undergo non-drug treatment courses. Such procedures alleviate the condition, reduce the size of the gland, and also increase the amount of antibacterial substances in the tissues of the organ.
Non-drug therapy include:
- Laser therapy.
- Microwave hyperpyrexia used transrectally.
To implement the latter method, the temperature is selected in a personal mode. If the device is exposed in the temperature spectrum from 39 to 40 degrees, then it turns out not only to increase the concentration of the pharmaceutical agent in the organ, but also to stimulate immunity at the cellular level, remove congestion, and free itself from microorganisms. If the thermal spectrum rises to 40-45 degrees, then it will be possible to achieve anesthetic and sclerosing effect.
Magnetic and laser therapy for chronic abacterial prostatitis is used in combination. The result is similar to the effect of microwave hyperthermia at 39–40 degrees, however, it has a biostimulating effect due to the laser effect on the organ. In addition, this method can help with vesiculitis and epididymo-orchitis.
Transrectal massage is a very useful treatment method. But it is used only if the man has no contraindications for this.
The right therapy with an experienced urologist will help overcome the disease. The main thing is not to lose heart and clearly follow all the appointments and instructions of the doctor.
In order to prevent the development of chronic abacterial prostatitis, you must:
- Have a sex life with a constant partner.
- Adhere to a healthy lifestyle, move more, walk more often and go in for sports.
- Eat right, avoiding greasy and spicy, smoked foods.
- Avoid hypothermia, due to which immunity is reduced.
- Visit a urologist regularly.
And last, do not self-medicate, and at the first signs of the disease visit a doctor. Only a specialist will be able to understand how to treat abacterial prostatitis in each case. Therefore, do not risk your health and do not self-medicate.