The importance of studying the mechanism of the 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 the influence 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 affects an increasing proportion of the male population, but is also diagnosed at an increasingly young age, doctors who are unable to cure and use formulaic treatment are often quite dismissive of the problem.
What is chronic prostatitis
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate gland, which is manifested in the chronic inflammatory process of the tissues.However, we cannot talk about CP only as a result of the penetration of pathogenic microorganisms into the prostate, since this view justifies attempts to treat prostatitis exclusively with antibiotics, which almost never bring lasting positive results.
The main factors behind the development of the pathology are the complex changes in the tissues and, accordingly, the functional abilities of the gland, which are the main causes of the development of the infectious microflora.Chronic prostatitis is to some extent a collective diagnosis that combines several factors:
- Reduced immunity.
- Stagnant processes in the pelvic organs.
- Disorder of urodynamics.
- Degenerative processes in the prostate parenchyma.
- Trophic disturbance.
- Inflammatory processes.
Development mechanism
The penetration of pathogenic microflora into a healthy prostate gland is practically impossible to 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 provoking factors leads to the development of permanent inflammation, which is accompanied by the appearance of scar formations.fibrotization) or necrotic areas.
The proliferation of connective tissue during scar formation causes stagnation in the acini (secretion channels), worsening the course of the disease.The death of the tissues leads to the formation of a cavernous cavity, in which, in addition to the dead epithelium, secretions from the prostate accumulate.
Thus, the main reason for the development of CP is not infection, but various physiological disorders that allow the chronic form of the inflammatory process.
Another distinguishing feature of the disease that makes diagnosis difficultfrequency of flow.Usually, due to external factors or the internal state of the body, the intensity of the pathology changes periodically, during which acute conditions are replaced by periods of remission.
Often, not only the complete absence of symptoms, but also the absence of laboratory parameters indicating the presence of infection (for example, white blood cells).Despite the positive results, this condition cannot be considered a cure, as all the physiological abnormalities of the gland have remained unchanged.
Reasons
The main causes of circulatory disorders of the pelvic organs and stagnation of venous blood in the prostate gland:
- Constantly sitting in a sitting position.
- Hypothermia of the whole body or directly in the pelvic area.
- Systematic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- Presence of chronic infection of any localization (sinusitis, bronchitis) in the body.
- Excessive physical activity with lack of sleep or rest, which causes immunosuppression.
- History of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to the systematic consumption of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnant processes, the deterioration of the excretory function of the glands and a decrease in the resistance of cells to diseases, which contributes to the creation of optimal conditions for the proliferation of pathogenic microorganisms in the prostate gland.
Is it possible to cure chronic prostatitis?
Despite the large amount of systematic information available on the mechanism of CP development,treatment is extremely difficultand one of the leading problems of modern urological practice.
Given that the disease manifests itself according to a unique pattern in each patient, the approach to treatment must be individual, taking into account all the physiological changes that have occurred in the prostate gland.
The anatomical characteristics of the prostate, which can be reached either through the urethra or the rectum, significantly reduce the effectiveness of the applied therapeutic effect.In this regard, to achieve a relatively stable result, a long (usually several months) therapy is required, during which the patient must strictly comply with all the requirements of the doctor.
Unfortunately, only complete recovery is possible30 out of 100 cases.This is mainly due to late medical help, the long-term absence of serious symptoms or the conscious avoidance of unpleasant diagnostic and then therapeutic procedures.As a general rule, during treatment, the atrophic processes of the prostate are irreversible, and even with long-term treatment, only the complete elimination of symptoms and the achievement of stable remission are possible, the duration of which depends on whether the patient complies with the doctor's recommendations.
Treatment
The complex of measures used in the treatment of CP includes the following:
Antibacterial therapy
The suppression of the activity of the bacterial microflora with antibiotics should be carried out only after a series of laboratory tests, based on the results of which the most effective drug is prescribed.
In general, the duration of taking antibiotics is determined by the severity of the disease and is at least 30 days.Interruption of treatment is unacceptable, as the remaining microorganisms become resistant to this group of drugs, and then replacement and even longer treatment is required.In the treatment of prostatitis, antibiotics with a bactericidal effect are preferred:
- Fluoroquinolones;
- Azalides;
- aminoglycosides;
- Tetracyclines.
If the laboratory tests reveal the specific nature of the infection, for example, trichomoniasis or viral prostatitis, then nitroimidazoles or antiviral drugs are prescribed in parallel with antibiotics.
Use of anticonvulsants and α-blockers
The main purpose of using drugs in this series is to relieve pelvic floor spasms, which helps to increase blood supply, improve urine flow, and reduce pain.
Laxatives
In order to avoid excessive use of the pelvic muscles during defecation, it is advisable to use laxatives, as the pressure during constipation can worsen the patient's condition.
Physiotherapy
One of the most common methods of physiotherapy is prostate rectal massage.The therapeutic effect of the finger on the prostate through the anus is to push out the infected discharge, which is then discharged through the urethra.
In addition, the blood supply to the tissues increases during the massage, which has a positive effect on the antibacterial therapy.The following physiotherapy methods are also used to perform rectal prostate massage:
- Electric current simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the stabilization of the condition, the patient must follow the rules that impose certain restrictions on the usual lifestyle:
- Avoid water treatment in open reservoirs and pools.
- Consult your doctor regularly.
- Stop drinking alcohol completely.
- Have a regular sex life with a partner.
Adherence to the rules will allow you to remain in remission as long as possible and avoid the aggravation of the disease.