The urgency of studying the mechanism of development of chronic prostatitis increases in direct proportion to the increase in the number of diagnosed cases of the disease. It is known that chronic prostatitis (CP) takes a leading place among urological diseases and is the result of many factors that are an integral part of modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
Since the disease not only includes a growing percentage of the male population, but is also diagnosed at a younger age, there is often a rather negative attitude towards the problem on the part of doctors who use template regimens for treatment that they cannot guide. before recovery.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) includes a rather wide range of pathological processes in the prostate gland, which is manifested as a chronic inflammatory process of tissues. However, one cannot talk about CP only as a result of the penetration of pathogens into the prostate, because such a view justifies attempts to treat prostatitis exclusively with antibiotics, which almost never bring long-term positive results.
The main factors in the development of pathology can be considered complex tissue changes and, therefore, the functional capabilities of the gland, which are the main reason for the development of infectious microflora. Chronic prostatitis, to some extent, is a collective diagnosis that combines several factors:
- reduced immunity.
- Stagnant processes in the organs of the pelvic cavity.
- Urodynamic disorder.
- Degenerative processes in prostate parenchyma.
- trophic disorder.
- inflammatory processes.
development mechanism
The penetration of pathogenic microflora into a healthy prostate gland practically cannot cause an inflammatory process, since the microflora of the prostate has a certain resistance to the pathogens present in the urethra. However, the presence of one or more of the above-mentioned provoking factors leads to the development of permanent inflammation, which is accompanied by scar formations (fibrotization) or areas of necrosis.
In the process of scar formation, the proliferation of connective tissue causes congestive processes in the acini (ducts that provide secretion), which aggravates the course of the disease. Necrotization of tissues leads to the formation of a cavernous cavity, in which, in addition to the dead epithelium, the secret of the prostate accumulates.
Thus, the main reason for the development of CP is not infection, but various physiological disorders that allow the inflammatory process to become chronic.
Another distinctive feature of the disease, which complicates the diagnosis, isFlow periodicity. As a rule, under the influence of external factors or the internal state of the body, there is a periodic change in the intensity of the pathology, during which acute conditions are replaced by periods of remission.
Often there is not only a complete absence of symptoms, but also the absence of laboratory indicators that indicate the presence of infection (for example, leukocytes). Despite the positive results, this condition cannot be considered a recovery, since all the physiological disorders of the gland remained unchanged.
Reasons
The main causes of blood circulation disorders in the pelvic organs and stagnation of venous blood in the prostate gland are:
- Constant presence in a sitting position.
- Hypothermia in the whole body or directly in the pelvis.
- Systematic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- Presence of chronic infection of any location in the body (sinusitis, bronchitis).
- Excessive physical activity, accompanied by lack of sleep or rest, leads to suppression of immunity.
- History of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effect on the body due to the systematic use of alcoholic beverages.
The presence of any of these reasons leads to stagnation processes, deterioration of the excretory function of the glands, a decrease in the resistance of cells to diseases, which helps to create optimal conditions for the reproduction of pathogenic microorganisms in the prostate gland. .
Can chronic prostatitis be cured?
Although there is a large amount of systematic information about the mechanism of development of CP,Its treatment is extremely difficultand represents one of the leading problems in modern urological practice.
Due to the fact that the disease progresses in each patient according to an individual scheme, therefore, the approach to treatment should be individual, taking into account all the physiological changes occurring in the prostate gland.
Anatomical features of the prostate, which can be accessed both through the urethra and the rectum, significantly reduce the effectiveness of the used therapeutic effect. In this regard, to achieve a relatively stable result, a long course of therapy (usually several months) is required, during which the patient must strictly comply with all the doctor's requirements.
Unfortunately, a complete cure is only possible30 out of 100 cases. This is mainly due to the timely request for medical help, the long absence of severe symptoms or the conscious avoidance of unpleasant diagnostic and then therapeutic procedures. As a rule, atrophic processes of the prostate during treatment are irreversible, and even with long-term treatment it is possible only to completely eliminate the symptoms and achieve a stable remission, the duration of which depends on the patient's compliance. by doctor's recommendation.
treatment
The complex of measures used in the treatment of CP includes:
Antibacterial therapy
Suppression of the activity of bacterial microflora with the help of antibiotics should be carried out only after a complex of laboratory tests, according to the results of which the most effective drug is prescribed.
As a rule, the duration of taking antibiotics is determined by the severity of the disease and is at least 30 days. It is not allowed to stop treatment, because the remaining microorganisms will become resistant to the drugs of this group, and subsequently it will be necessary to change them and take an even longer course. In the treatment of prostatitis, preference is given to antibiotics that have a bactericidal effect:
- fluoroquinolones;
- azalides;
- aminoglycosides;
- Tetracyclines.
If laboratory tests reveal a specific nature of the infection, for example, trichomoniasis or viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed in parallel with antibiotics.
Use of antispasmodic and α-blockers
The main purpose of using drugs of this series is to remove spasm on the pelvic floor, which helps to increase blood supply, improve urine flow and reduce pain.
Laxatives
In order to avoid excessive stress on the pelvic muscles, which occurs during defecation, it is advisable to use laxatives, because trying to constipate can worsen the patient's condition.
Physiotherapy
One of the most common methods of physiotherapy is prostate rectal massage. The therapeutic effect of touching the prostate with a finger, which is carried out through the anus, is to expel the infected secret, which is then excreted through the urethra.
In addition, the blood supply to tissues increases during massage, which has a positive effect on antibiotic therapy. The following physiotherapeutic methods are also used for rectal prostate massage:
- Electrical simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the stabilization of the condition, the patient is required to follow the rules that impose certain restrictions on the usual way of life:
- Avoid water procedures in open reservoirs and pools.
- Check with your doctor regularly.
- Avoid drinking alcohol completely.
- Have a regular sex life with one partner.
Compliance with the rules will allow you to stay in remission as long as possible and prevent exacerbation of the disease.