The relevance of studying 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 place among urological diseases and is the result of many factors that are an integral part of modern life (social environment, ecology, increased resistance of pathogens to antibacterial drugs).
As the disease not only affects an increasing percentage of the male population, but is also diagnosed at a younger age, physicians who are treated with inappropriate pattern regimens often face the problem as opposed to recovery.
What is chronic prostatitis
The diagnosis of chronic prostatitis (CP) combines a fairly wide range of pathological processes in the prostate, manifested in the form of a chronic inflammatory process of tissues. However, one cannot speak of CP only because of the penetration of pathogens into the prostate, since such a view justifies trying to treat prostatitis exclusively with antibiotics, which almost never brings lasting positive results.
The main factors underlying the development of pathology can be considered complex tissue changes and, accordingly, the functional abilities of the gland, which are the main cause of the development of infectious microflora. To a certain extent, chronic prostatitis is a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in the pelvic organs.
- urodynamic disorder.
- Degenerative processes in the prostate parenchyma.
- trophic disorder.
- inflammatory processes.
development mechanism
Penetration of pathogenic microflora into a healthy prostate gland is practically not able to provoke the 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 provoking factors leads to the development of persistent inflammation, accompanied by the appearance of scarring (fibrosis) or areas of necrosis.
The proliferation of connective tissue in the course of scarring leads to congestion processes in the acini (secretory excretion ducts), which aggravate the course of the disease. The necrosis of tissues leads to the formation of a cavernous cavity, in which, in addition to dead epithelium, a secret prostate gland accumulates.
So, the main cause of the development of CP is not an infection, but various physiological disorders that cause the inflammatory process to become chronic.
Another distinctive feature of the disease that complicates diagnosis isperiodicity of the flow. As a rule, under the influence of external factors or the internal state of the body, the intensity of the pathology periodically changes, while acute states are replaced by periods of remission.
Often not only symptoms are absent, but also laboratory indicators that indicate infection (e. g. leukocytes). Despite the positive results, this condition cannot be considered recovery, since all physiological disorders in the gland remained unchanged.
The reasons
The main causes of circulatory disorders in the pelvic organs and venous congestion in the prostate are:
- Staying in a sitting position for a long time.
- 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 a chronic infection of any localization (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest leads to suppression of the immune system.
- A history of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effects on the body from systematic consumption of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnant processes, a deterioration in the excretory function of the glands, a decrease in cellular resistance to diseases, which contribute to the creation of optimal conditions for the reproduction of pathogenic microorganisms in the prostate .
Can chronic prostatitis be cured?
Despite the availability of a large amount of systematized information about the mechanism of development of CP,its treatment is extremely difficultand is one of the leading problems in modern urological practice.
Due to the fact that the disease proceeds according to an individual scheme in each patient, the treatment approach should also be individual and take into account all the physiological changes that have occurred in the prostate.
The anatomical peculiarities of the prostate, which can be accessed either through the urethra or through the rectum, significantly reduce the effectiveness of the applied therapeutic effect. In this regard, to achieve a relatively stable result, a long course of therapy (usually several months) is required, during which the patient must strictly comply with all the requirements of the doctor.
Unfortunately, only a complete cure can be achievedin 30 out of 100 cases. This is mainly due to the premature seeking of medical help, the absence of severe symptoms for a long time or the conscious avoidance of unpleasant diagnostic and subsequent therapeutic measures. Atrophic processes in the prostate, as a rule, are irreversible at the time of treatment, and even with long-term treatment, only complete elimination of symptoms and stable remission are possible, the duration of which depends on the patient's compliance with the doctor's recommendations.
treatment
The complex of measures for 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 will be prescribed.
As a rule, the duration of antibiotic administration depends on 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 subsequently they will have to be replaced and have an even longer course. In the treatment of prostatitis, preference is given to antibiotics that have a bactericidal effect:
- fluoroquinolones;
- azalides;
- aminoglycosides;
- tetracyclines.
If laboratory tests reveal a specific type of infection, for example, trichomoniasis or the viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed in parallel with antibiotics.
The use of antispasmodics and α-blockers
The main purpose of using drugs of this series is to relieve spasms in the pelvic floor, which helps increase blood supply, improve urine outflow and reduce pain.
laxative
In order to avoid excessive strain on the pelvic muscles during defecation, it is advisable to use laxatives, since attempts during constipation can aggravate the patient's condition.
physical therapy
One of the most common methods of physiotherapy is rectal massage of the prostate. The therapeutic effect of the impact of a finger on the prostate, performed through the anus, is to push out the infected secret, which is subsequently excreted through the urethra.
In addition, during the massage, blood circulation in the tissues increases, which has a positive effect on antibiotic therapy. To carry out 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 must follow the rules that impose some restrictions on the usual way of life:
- Avoid water treatments in open reservoirs and pools.
- Get checked by a doctor regularly.
- Avoid 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 exacerbation of the disease.