The relevance 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. Chronic prostatitis (CP) is known to occupy a prominent 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).
As the disease not only affects an increasing percentage of the male population, but is also diagnosed at an increasingly early age, there is often a dismissive attitude towards the problem on the part of physicians who use model regimens for treatment that fail to lead. The recovery.
What is chronic prostatitis
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate, manifested in the form of a chronic inflammatory process of the tissues. However, one cannot speak of CP only as a result of the penetration of pathogens into the prostate, as such a view justifies attempts to treat prostatitis exclusively with antibiotics, which almost never bring lasting positive results.
The main factors underlying the development of pathology can be considered complex changes in the tissues and, consequently, the functional abilities of the gland, which are the main cause of the development of infectious microflora. Chronic prostatitis, to some extent, is a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in Organs pelvic organs.
- urodynamic disorder.
- Degenerative processes in the prostatic parenchyma.
- Trophic disorder.
- inflammatory processes.
development mechanism
The penetration of pathogenic microflora into a healthy prostate is practically incapable of causing an inflammatory process, as the prostate microflora has a certain resistance to pathogens present in the urethra. However, the presence of one or more of the above triggering factors leads to the development of persistent inflammation, accompanied by the appearance of scar formations.fibrotization) or areas of necrosis.
The proliferation of connective tissue in the process of scar formation causes congestive processes in the acini (ducts that ensure the excretion of secretions), which worsen the course of the disease. Tissue necrotization leads to the formation of a cavernous cavity, in which, in addition to the dead epithelium, a prostatic secret accumulates.
Thus, the main cause of the development of CP is not an infection, but various physiological disorders that allow the inflammatory process to become chronic.
Another distinctive feature of the disease, which makes diagnosis difficult, 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 (eg, leukocytes). Despite the positive results, this condition cannot be considered a recovery, as all the physiological disorders in the gland remained unchanged.
The reasons
The main causes of circulatory disorders in Organs pelvic organs and stagnation of venous blood in the prostate are:
- Permanent stay in the sitting position.
- Hypothermia of the whole body or directly in the pelvic region.
- Systematic constipation.
- Prolonged abstinence from 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 infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to the systematic use of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnant processes, deterioration of the excretory function of the glands, a decrease in cellular resistance to diseases, which contribute to the creation of ideal conditions for the reproduction of pathogenic microorganisms in the prostate .
Can chronic prostatitis be cured?
Despite the availability of a large amount of systematized information about the CP development mechanism,your treatment is extremely difficultand is one of the main problems in modern urological practice.
Due to the fact that the disease proceeds in each patient according to an individual scheme, the treatment approach must also be individual, taking into account all the physiological changes that have occurred in the prostate.
The anatomical features of the prostate, which can be accessed through the urethra or the rectum, significantly reduce the effectiveness of the therapeutic effect applied. In this regard, in order to obtain 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 can only be achievedin 30 cases out of 100. This is mainly due to the untimely search for medical help, due to the long absence of severe symptoms or the conscious avoidance of unpleasant diagnostic and therapeutic procedures. As a rule, at the time of treatment, atrophic processes in the prostate are irreversible, and even with long-term treatment, it is only possible to completely eliminate the symptoms and achieve a stable remission, the duration of which depends on the patient's adherence to the doctor's recommendations.
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 antibiotics is determined by the severity of the disease and is at least 30 days. It is unacceptable to discontinue treatment as the remaining microorganisms will become resistant to this group of drugs and will later need to be replaced and an even longer course. In the treatment of prostatitis, antibiotics with a bactericidal effect are preferred:
- Fluoroquinolones;
- Azalides;
- Aminoglycosides;
- Tetracyclines.
If laboratory tests reveal a specific nature of the infection, for example trichomoniasis or the viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed in parallel with antibiotics.
The use of antispasmodics and α-blockers
The main purpose of using medications in this series is to relieve pelvic floor spasm, which helps to increase blood supply, improve urine flow, and reduce pain.
laxatives
To avoid excessive stress on the pelvic muscles that occurs during the act of defecating, it is advisable to use laxatives, as attempts during constipation can worsen the condition of the patient.
Physiotherapy
One of the most common methods of physical therapy is prostate rectal massage. The therapeutic effect of the impact of a finger on the prostate, carried out through the anus, is to squeeze out the infected secret, which is later excreted through the urethra.
In addition, during massage, the blood supply to the tissues increases, which has a positive effect on antibiotic therapy. To perform rectal massage of the prostate, the following physiotherapeutic methods are also used:
- Electrical simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After stabilization of the condition, the patient is obliged to follow the rules that impose some restrictions on the usual way of life:
- Avoid water procedures in open reservoirs and swimming pools.
- Get checked out by a doctor regularly.
- Completely abstain from drinking alcohol.
- Having regular sex with a partner.
Compliance with the rules will allow you to stay in remission as long as possible and avoid exacerbations of the disease.