The relevance of the study of 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) occupies a leading position 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, there is often a rather dismissive attitude towards the problem on the part of doctors who use treatment preparations that cannot lead to recovery.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate gland, manifested in the form of a 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 such a view justifies attempts to treat prostatitis exclusively with the help of antibiotics, which almost never bring permanent positive results.
The main factors governing the development of pathology can be considered complex changes in tissues and, consequently, the functional abilities of the gland, which are the main reason for the development of infectious microflora.Chronic prostatitis, to some extent, is a collective diagnosis that combines several factors:
- Reduced immunity.
- Stagnation processes in the pelvic organs.
- Disorder of urodynamics.
- Degenerative processes in the prostate parenchyma.
- Eating disorder.
- 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 some resistance to pathogens present in the urethra.However, the presence of one or more of the aforementioned causative factors leads to the development of persistent inflammation, accompanied by the appearance of scar formations (fibrous) or areas of necrosis.
The proliferation of connective tissue during scar formation causes stagnation in the alveoli (ducts that provide secretion), worsening the course of the disease.Necrotization of the tissue 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 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 conditions 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 (for example, white blood cells).Despite the positive results, this situation cannot be considered a recovery, since all the physiological disorders in 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 sits in a sitting position.
- Hypothermia of the whole body or directly in the pelvic area.
- Systemic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- The presence in the body of a chronic infection of any localization (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest, causing immune suppression.
- History of urogenital infections (gonorrhea, trichomonads).
- 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 gland.
Is it possible to cure chronic prostatitis?
Despite the availability of a large amount of systematic information on the mechanism of CP development,dealing with it is extremely difficultand is one of the leading problems in modern urological practice.
Due to the fact that the disease appears in each individual patient according to an individual pattern, therefore, the approach to treatment 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 are 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 (usually several months) is required, during which the patient must strictly comply with all the doctor's requirements.
Unfortunately, a complete cure can only be achievedin 30 cases out of 100.This is mainly due to the delayed seeking of medical help, due to a long absence of serious symptoms or 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 a 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 include:
Antibacterial treatment
Suppression of the activity of the bacterial microflora with the use of 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 stop treatment, as the remaining microorganisms will become resistant to this group of drugs, and then an even longer course will have to be replaced.In the treatment of prostatitis, antibiotics that have a bactericidal effect are preferred:
- Fluoroquinolones?
- Azaleas?
- Aminoglycosides?
- Tetracyclines.
If laboratory tests reveal a specific nature of infection, for example, trichomoniasis or viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed along with antibiotics.
The use of anticonvulsants and α-blockers
The main purpose of using drugs of this series is to relieve spasms in the pelvic floor, which helps to increase blood supply, improve urine flow and reduce pain.
Cataracts
To avoid excessive pressure on the pelvic muscles that occurs during defecation, the use of laxatives is recommended, as pushing during constipation can worsen the patient's condition.
Physiotherapy
One of the most common physical therapy methods is prostate rectal massage.The therapeutic effect of a finger on the prostate, carried out through the anus, is to compress the infected secretion, which is then excreted through the urethra.
In addition, during the massage, the blood supply to the tissues increases, which has a positive effect on the antibacterial treatment.The following physiotherapeutic methods are also used to perform rectal prostate massage:
- Simulation of electricity.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After stabilization of the condition, the patient must follow the rules that impose certain restrictions on the usual way of life:
- Avoid water procedures in open tanks and swimming pools.
- Check with your doctor regularly.
- Stop drinking alcohol completely.
- Have a regular sex life with a partner.
Compliance with the rules will allow you to remain in remission for as long as possible and avoid exacerbations of the disease.