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. It is known that chronic prostatitis (CP) takes a leading place among urological diseases and is the result of many factors (social environment, ecology, increased resistance of pathogens to antibacterial drugs) that are an integral part of modern life.
Since the disease not only affects an increasing percentage of the male population, but also is diagnosed at a younger age, there is often a rather indifferent attitude to the problem by doctors who use standard regimens for treatment. to recover.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a wide range of pathological processes in the prostate gland, which manifests itself in the form of 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 only with antibiotics, which almost never give permanent positive results.
The main factors underlying the development of pathology can be considered complex changes in tissues and, accordingly, the functional abilities of the gland, which is the main reason for the development of infectious microflora. Chronic prostatitis is, to some extent, a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in the pelvic organs.
- Urodynamic disorder.
- Degenerative processes in prostate parenchyma.
- Trophic disorder.
- inflammatory processes.
Mechanism of development
The penetration of pathogenic microflora into a healthy prostate gland practically cannot cause an inflammatory process, because the microflora of the prostate has a certain resistance to pathogens present in the urethra. However, the presence of one or more of the above-mentioned provoking factors leads to the development of persistent inflammation accompanied by the formation of scars (fibrotization) or areas of necrosis.
In the process of scar formation, the proliferation of connective tissue causes congestive processes in the acini (channels that ensure the secretion of secretion), which aggravates the course of the disease. Necrosis of the tissues leads to the formation of a cavernous cavity, where, in addition to the dead epithelium, prostatic secretion 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.
This is another distinguishing feature of the disease that makes diagnosis difficultflow 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 (for example, leukocytes) that indicate the presence of infection. Despite the positive results, this condition cannot be considered a cure, because all the physiological disorders in the gland remained unchanged.
The reasons
The main causes of blood circulation disorders in the pelvic organs and stagnation of venous blood in the prostate gland are:
- Remaining in a sitting position.
- Hypothermia of the whole body or directly in the pelvic region.
- Systematic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- Chronic infection of any localization in the body (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest leads to weakening of immunity.
- History of genitourinary infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to the systematic use of alcoholic beverages.
The presence of any of these reasons leads to the emergence of stagnant processes, the deterioration of the excretory function of the glands, the reduction of cell resistance to diseases, which helps to create optimal conditions for the reproduction of pathogenic microorganisms in the prostate gland. .
Can chronic prostatitis be treated?
Despite the availability of much systematic information on the mechanism of development of CP,its treatment is quite difficultis one of the leading problems in modern urological practice.
Since the disease proceeds according to an individual scheme in each individual patient, the approach to treatment should be individual, taking into account all the physiological changes occurring in the prostate gland.
The anatomical features of the prostate, which can be accessed either through the urethra or the rectum, significantly reduce the effectiveness of the applied therapeutic effect. In this regard, 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 requirements of the doctor.
Unfortunately, complete treatment can only be achieved30 out of 100. This is mainly due to the long absence of severe symptoms or the conscious avoidance of unpleasant diagnostic and then therapeutic procedures, not seeking medical help in time. As a rule, atrophic processes in the prostate during treatment are irreversible, and even with long-term treatment, it is only possible to completely eliminate symptoms and achieve stable remission, the duration of which depends on the patient's compliance. with 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 interrupt the treatment, because the remaining microorganisms will be resistant to this group of drugs, and later their replacement and a longer course will be required. In the treatment of prostatitis, antibiotics with a bactericidal effect are preferred:
- fluoroquinolones;
- Azalides;
- aminoglycosides;
- Tetracyclines.
If laboratory tests reveal the specific nature of the infection, for example, trichomoniasis or viral origin of prostatitis, nitroimidazoles or antiviral drugs are prescribed in parallel with antibiotics.
Use of antispasmodics and α-blockers
The main purpose of using drugs of this series is to eliminate spasm in the pelvic floor, which helps to increase blood supply, improve urine flow and reduce pain.
Laxatives
To prevent excessive stress on the pelvic muscles during defecation, it is recommended to use laxatives, as attempts during constipation can aggravate the patient's condition.
Physiotherapy
One of the most common methods of physiotherapy is rectal massage of the prostate gland. The therapeutic effect of the impact of a finger on the prostate through the anus is to compress the infected secretion, which is then expelled 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 to perform rectal prostate massage:
- Electrical simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the condition stabilizes, the patient is required to follow the rules that impose some restrictions on the usual lifestyle:
- Avoid water procedures in open reservoirs and swimming pools.
- Get regular medical checkups.
- Avoid alcohol completely.
- Have regular sex with a partner.
Adherence to the rules will allow you to stay in remission as long as possible and prevent exacerbation of the disease.