The relevance of studying the mechanisms 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) occupies a leading place among urological diseases and is the result of the influence of many factors that are an important part of modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
Since this disease not only affects an increasing percentage of the male population, but is also diagnosed at a younger age, there is often a rather disappointing attitude towards the problem on the part of doctors who use formulaic treatment regimens that cannot lead to recovery.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a wide range of pathological processes in the prostate gland, which is manifested in the form of a chronic inflammatory process of the tissue.However, we cannot talk about CP only as a result of the penetration of pathogenic microorganisms into the prostate, because such a view allows attempts to treat prostatitis exclusively with the help of antibiotics, which almost never bring lasting positive results.
The main factor underlying the development of pathology can be considered a complex change in the tissue and, thus, the functional abilities of the gland, which is the main reason for the development of infectious microflora.Chronic prostatitis, to some extent, is a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant process in the pelvic organs.
- Urodynamic disorders.
- Degenerative processes in the prostate parenchyma.
- Trophic disorder.
- Inflammatory process.
Mechanism of development
The penetration of pathogenic microflora into a healthy prostate gland is impossible to cause an inflammatory process, because the prostate microflora has a certain resistance to pathogens found in the urethra.However, the presence of one or more of the provoking factors mentioned above leads to the development of persistent inflammation, accompanied by the appearance of scar formation (fibrotization) or areas of necrosis.
The proliferation of connective tissue during scar formation causes stagnation in the acini (channels that provide secretion), worsening the course of the disease.Necrotization of tissue leads to the formation of cavernous cavities, where, 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 allow the inflammatory process to acquire a chronic form.
Another characteristic of the disease that makes diagnosis difficult isflow frequency.As a rule, under the influence of external factors or internal conditions of the body, periodic changes in the intensity of the pathology occur, in which the acute state is replaced by a period of remission.
Often there is not only a complete absence of symptoms, but also the absence of laboratory parameters that indicate the presence of infection (for example, white blood cells).Despite the positive results, this condition cannot be considered a recovery, because all physiological disorders in the gland remain unchanged.
Reason
The main causes of blood circulation disorders in the pelvic organs and venous blood stagnation in the prostate gland are:
- Always sit 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.
- The presence in the body of chronic infections of any localization (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest, causes immune suppression.
- History of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to systematic consumption of alcoholic beverages.
The presence of any of these causes leads to the appearance of a stagnant process, deterioration of the excretory function of the gland, and a decrease in cellular resistance to disease, 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?
Although there is a large amount of systematic information on the mechanism of CP development,the treatment is very difficultand is one of the main problems in modern urological practice.
Due to the fact that the disease occurs in each individual patient according to an individual pattern, therefore, the treatment approach must also be individual, taking into account all the physiological changes that have occurred in the prostate gland.
The anatomical features of the prostate, which can be accessed either through the urethra or through the rectum, significantly reduce the effectiveness of the therapeutic effect used.In this case, to achieve relatively stable results, a long course of therapy is required (usually several months), during which the patient is required to strictly comply with all the doctor's requirements.
Unfortunately, a complete cure is only within reachin 30 cases out of 100.This is mainly due to the delay in seeking medical help, due to the long absence of severe symptoms or consciously avoiding unpleasant diagnostic and then therapeutic procedures.As a rule, at the time of treatment, the atrophic process in the prostate cannot be restored, 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 compliance with 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 using antibiotics should be carried out only after a set of laboratory tests, based on 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 unacceptable to interrupt the treatment, because the remaining microorganisms will become resistant to this group of drugs, and subsequently they will have to be replaced and a longer course.When treating prostatitis, preference is given to antibiotics that have a bactericidal effect:
- Fluoroquinolones;
- Azalide;
- Aminoglycosides;
- Tetracycline.
If laboratory tests reveal the nature of a specific infection, for example, trichomoniasis or prostatitis of viral origin, nitroimidazoles or antiviral drugs are prescribed in parallel with antibiotics.
Use of antispasmodics and α-blockers
The main purpose of using drugs in this series is to relieve spasms in the pelvic floor, which helps increase blood supply, increase urine flow and reduce pain.
laxative
To avoid excessive pressure on the pelvic muscles that occurs during defecation, it is advisable to use laxatives, as pushing during constipation can worsen the patient's condition.
Physiotherapy
One of the most common physiotherapy methods is rectal massage of the prostate gland.The therapeutic effect of fingers on the prostate, carried out through the anus, is to squeeze infected secretions, which are then expelled through the urethra.
In addition, during massage, the blood supply to the tissue increases, which has a positive effect on antibacterial therapy.To perform rectal prostate massage, the following physiotherapeutic methods are also used:
- Simulation of electric current.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the stabilization of the condition, the patient is required to follow the rules that impose some restrictions on the normal way of life:
- Avoid water procedures in reservoirs and open pools.
- Check with your doctor regularly.
- Stop drinking alcohol completely.
- Have a normal sex life with one partner.
Compliance with the rules will allow you to remain in remission as long as possible and avoid exacerbation of the disease.