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 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 covers a growing 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 template regimens for treatment 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, one cannot talk about CP only as a result of pathogen penetration into the prostate, because such a view allows attempts to treat prostatitis exclusively with 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 cause of 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 practically cannot 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 above provoking factors leads to the development of persistent inflammation, accompanied by the appearance of scar formation (fibrotization) or areas of necrosis.
The proliferation of connective tissue in the process of scar formation causes a congestive process in the acini (channels that ensure the excretion of secretions), which worsens 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 become chronic.
Another distinguishing feature of this disease, which makes diagnosis difficult, isflow periodicity. As a rule, under the influence of external factors or internal conditions of the body, there are periodic changes in the intensity of the pathology, 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 indicators that indicate the presence of infection (for example, leukocytes). Despite the positive results, this condition cannot be considered a recovery, because all physiological disorders in the gland remain unchanged.
The reasons
The main causes of blood circulation disorders in the pelvic organs and venous blood stagnation in the prostate gland are:
- Remain 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 the systematic use 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, a decrease in cellular resistance to disease, which contributes to the creation of optimal conditions for the reproduction of pathogenic microorganisms in the prostate gland. .
Can chronic prostatitis be cured?
Although there is a large amount of systematic information on the mechanisms 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 persists in each individual patient according to an individual scheme, therefore, the treatment approach should 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 (usually several months) is required, during which the patient must 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 untimely seeking medical help, due to the absence of severe symptoms for a long time 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 a doctor's recommendation.
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 become resistant to this group of drugs, and in turn, they will have to be replaced and a longer course. In the treatment of prostatitis, priority is given to antibiotics that have a bactericidal effect:
- Fluoroquinolones;
- Azalides;
- 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 this series of drugs is to relieve spasms in the pelvic floor, which helps to increase blood supply, improve the flow of urine and reduce pain.
laxative
To avoid excessive pressure on the pelvic muscles that occurs during defecation, it is advisable to use laxatives, as attempts 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 the impact of the finger on the prostate, carried out through the anus, is to squeeze out the infected secret, which is then expelled through the urethra.
In addition, during the massage, the blood supply to the tissue increases, which has a positive effect on antibiotic therapy. To perform rectal prostate massage, the following physiotherapeutic methods are also used:
- Electrical simulation.
- 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.
- Get regular checkups with your doctor.
- Avoid 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.