The relevance of studying the mechanism of development of chronic prostatitis increases proportionally with the increase in the number of cases diagnosed with the disease.It is known that chronic prostatitis (CP) occupies a leading position among urinary diseases and is the result of the influence of many indispensable factors in modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
Because the disease not only affects an increasing proportion of men but is also diagnosed at younger and younger ages, there is often a rather dismissive attitude toward the problem among doctors, who resort to formulaic treatment regimens that fail to lead to recovery.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a series of pathological processes in the prostate, manifested as a chronic inflammatory process of tissues.However, we cannot talk about CP solely as a result of the penetration of pathogenic microorganisms into the prostate, since such a view justifies attempts to treat prostatitis only with the help of antibiotics, which almost never gives long-term positive results.
The main factors underlying the development of pathology can be considered complex changes in tissues and, accordingly, the functional capacity of the gland, which is the main reason for the development of infectious microflora.Chronic prostatitis is, to a certain extent, a collective diagnosis that combines many factors:
- Reduced immunity.
- Stagnant processes in the pelvic organs.
- Urinary disorders.
- Degenerative process in prostate parenchyma.
- Booty disturbance.
- Inflammatory processes.
Development mechanism
The penetration of pathogenic microflora into a healthy prostate can practically not cause an inflammatory process, since the prostate microflora has a certain resistance to pathogens present in the urethra.However, the presence of one or more of the above-mentioned irritants leads to the development of persistent inflammation, accompanied by the appearance of scars (fibrosis) or necrotic area.
The proliferation of connective tissue during scar formation causes stagnation in the acini (secretory tubes), exacerbating the course of the disease.Necrosis of tissue leads to the formation of a cavernous cavity in which, in addition to dead epithelium, prostatic secretions accumulate.
Therefore, the main cause of the development of CP is not infection, but various physiological disorders that cause the inflammatory process to turn into a chronic form.
Another feature of the disease that makes diagnosis difficult isflow frequency.As a rule, under the influence of external factors or the internal state of the body, periodic changes in the intensity of pathology occur, during which acute conditions are replaced by periods of remission.
Often not only are there complete absence of symptoms, but there are also no laboratory parameters that indicate the presence of infection (e.g., white blood cells).Despite the positive results, this condition cannot be considered a recovery because all the physiological disorders in the gland remain unchanged.
Reason
The main causes of circulatory disorders in the pelvic organs and stagnation of venous blood in the prostate are:
- Regularly sit in a sitting position.
- Hypothermia of the whole body or directly in the pelvic area.
- Systemic constipation.
- Abstain from prolonged sexual activity or excessive sexual activity.
- The presence in the body of a chronic infection of any location (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest, causes immunosuppression.
- History of urogenital infection (gonorrhea, trichomoniasis).
- Toxic effects on the body due to systematic consumption of alcoholic beverages.
The presence of any of these causes leads to the emergence of stagnant processes, impaired secretory function of the gland and reduced resistance of cells to diseases, contributing to the creation of optimal conditions for the development of pathogenic microorganisms in the prostate.
Can chronic prostatitis be cured?
Although a large amount of systematic information is available on the developmental mechanisms of CP,Treating it is extremely difficultand is one of the leading problems in modern urological practice.
Since the disease occurs in each patient according to an individual pattern, the treatment approach must also be individual, taking into account all the physiological changes that occur in the prostate.
The anatomical features of the prostate, which can be accessed transurethral or transrectal, significantly reduce the effectiveness of the treatment used.In this regard, to achieve relatively stable results, a long course of treatment (usually several months) is required, during which the patient must strictly comply with all the doctor's orders.
Unfortunately, only a complete cure can be achievedin 30 cases out of 100.This is mainly due to late seeking medical help, due to not having serious symptoms for a long time or consciously avoiding unpleasant diagnostic and treatment procedures.As a rule, at the time of treatment, atrophic processes in the prostate are irreversible, and even with long-term treatment, it is possible only to completely eliminate symptoms and achieve stable remission, the duration of treatment depends on the patient's compliance with the doctor's recommendations.
Treatment
The combination of measures used in the treatment of CP includes:
Antibacterial therapy
Suppression of the activity of bacterial microflora should be carried out only after a series of laboratory tests, based on the results of which the most effective drug is prescribed.
As a rule, the duration of antibiotics is determined by the severity of the disease and is at least 30 days.Interruption of treatment is unacceptable, since the remaining microorganisms will become resistant to this group of drugs and then they will need to be replaced and an even longer course.When treating prostatitis, priority should be given to using antibiotics with bactericidal effects:
- Fluoroquinolone;
- Azalid;
- Aminoglycosides;
- Tetracycline.
If laboratory tests reveal a specific nature of the infection, for example, trichomoniasis or viral origin of prostatitis, then nitroimidazole or antiviral drugs are prescribed in parallel with antibiotics.
The use of antispasmodics and α-blockers
The main purpose of using the medication in this series is to relieve spasms in the pelvic floor, help increase blood supply, improve urine flow and relieve pain.
Laxative
To avoid excessive strain on the pelvic muscles that occurs during defecation, laxatives should be used because straining during constipation can worsen the patient's condition.
Physical therapy
One of the most popular physical therapy methods is rectal prostatic massage.The therapeutic effect of the finger on the prostate, performed through the anus, is to squeeze out the infected secretions, which are then excreted through the urethra.
In addition, during massage, blood supply to tissues increases, which has a positive effect in antibacterial therapy.To perform rectal prostate massage, the following physiotherapy methods are also used:
- Simulate electric current.
- High frequency thermotherapy.
- Infrared laser therapy.
prevent
After stabilization of the condition, the patient must follow the rules that impose some restrictions on the usual lifestyle:
- Avoid water procedures in open reservoirs and swimming pools.
- Check with your doctor regularly.
- Completely stop drinking alcohol.
- Have a regular sex life with a partner.
Compliance with the rules will allow you to maintain remission for as long as possible and avoid worsening the disease.