The relevance of studying the mechanism of development of chronic prostatitis increases in direct proportion with 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 integral part of modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
Since the disease not only affects an increasing percentage of the male population, but is also diagnosed at an increasingly younger age, doctors who use classical treatment regimens, incapable of leading to cure, often adopt a rather dismissive attitude towards the problem.
What is chronic prostatitis
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes of the prostate, manifested in the form of a chronic inflammatory process of tissues.However, one cannot talk about CP only due to the penetration of pathogenic microorganisms into the prostate, since such a view justifies attempts to treat prostatitis exclusively with the help of antibiotics, which almost never bring lasting positive results.
The main factors underlying the development of pathology can be considered complex changes in tissues and, accordingly, the functional capabilities of the gland, which are the main reason for the development of infectious microflora.Chronic prostatitis, to a certain extent, is a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in the pelvic organs.
- Disturbance of urodynamics.
- Degenerative processes in the prostate parenchyma.
- Trophic disturbance.
- Inflammatory processes.
Development mechanism
The penetration of pathogenic microflora into a healthy prostate is practically impossible to provoke 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 provoking factors mentioned above leads to the development of persistent inflammation, accompanied by the appearance of scar formations (fibrotization) or areas of necrosis.
The proliferation of connective tissue during scar formation causes stagnation of the acini (channels which ensure secretion), worsening the progression of the disease.Tissue necrosis leads to the formation of a cavernous cavity in which, in addition to the dead epithelium, prostatic secretions accumulate.
Thus, 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 distinctive feature of the disease that makes diagnosis difficult isflow frequency.As a rule, under the influence of external factors or the internal state of the body, a periodic change in the intensity of the pathology occurs, during which acute states are replaced by periods of remission.
Often, there is not only a complete absence of symptoms, but also an absence of laboratory parameters indicating the presence of infection (eg, white blood cells).Despite the positive results, this condition cannot be considered a cure, since all physiological disorders of the gland remained unchanged.
Reasons
The main causes of circulatory disorders in the pelvic organs and stagnation of venous blood in the prostate are:
- Constantly sitting 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.
- The presence in the body of a chronic infection of any location (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest, causing immunosuppression.
- A 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 stagnant processes, deterioration of the excretory function of the glands and a decrease in cellular resistance to diseases, which contribute to the creation of optimal conditions for the proliferation of pathogenic microorganisms in the prostate.
Is it possible to cure chronic prostatitis?
Despite the availability of a large amount of systematic information on the mechanism of development of CP,its treatment is extremely difficultand constitutes one of the main problems of modern urological practice.
Since the disease occurs in each patient according to an individual pattern, the therapeutic approach should also be individual, taking into account all physiological changes occurring in the prostate.
The anatomical features of the prostate, accessible either through the urethra or through the rectum, significantly reduce the effectiveness of the therapeutic effect used.In this regard, to achieve a relatively stable result, a long course of treatment is required (usually several months), during which the patient must strictly comply with all the doctor's requirements.
Unfortunately, a complete cure cannot be achievedin 30 cases out of 100.This is mainly due to a late medical consultation, a long absence of serious symptoms or a conscious avoidance of unpleasant diagnostic and then 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 stable remission, the duration of which depends on the patient's compliance with the doctor's recommendations.
Treatment
The set 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 series of laboratory tests, on the basis 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 treatment, since the remaining microorganisms will become resistant to this group of drugs and will then have to be replaced and undergo even longer treatment.When treating prostatitis, preference is given to antibiotics with a bactericidal effect:
- Fluoroquinolones;
- Azalides;
- Aminoglycosides;
- Tetracyclines.
If laboratory tests reveal a particular nature of the infection, for example trichomoniasis or a viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed in parallel with antibiotics.
The use of antispasmodics and α-blockers
The main goal 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
To avoid excessive stress on the pelvic muscles that occurs during defecation, it is advisable to use laxatives, since pushing during constipation can worsen the patient's condition.
Physiotherapy
One of the most common physiotherapy methods is rectal prostate massage.The therapeutic effect of a finger on the prostate, carried out through the anus, is to remove the infected secretion, which is subsequently excreted through the urethra.
In addition, during massage, blood supply to the tissues increases, which has a positive effect on antibacterial therapy.To perform rectal prostate massage, the following physiotherapeutic methods are also used:
- Electric current simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After stabilization of the condition, the patient is required to follow the rules that impose certain restrictions on the usual lifestyle:
- Avoid water procedures in open tanks and pools.
- Consult your doctor regularly.
- Stop drinking alcohol completely.
- Have a regular sex life with just one partner.
Compliance with the rules will allow you to stay in remission as long as possible and avoid exacerbations of the disease.