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) takes a leading place among urological diseases and is the result of the influence of many factors (social environment, ecology, increased resistance of pathogens to antibacterial drugs) that are an integral part of modern life.
Because the disease not only affects a growing percentage of the male population, but is also being diagnosed at an increasingly younger age, the problem is largely neglected by doctors who use formulaic treatment regimens that fail to lead to a cure.
What is chronic prostatitis?
The diagnosis of chronic prostatitis (CP) combines a wide range of pathological processes in the prostate gland, which manifests itself in the form of a chronic inflammatory process of tissues.However, we cannot talk about CP only as a result of the penetration of pathogenic microorganisms into the prostate, because such a view justifies attempts to treat prostatitis only with the help of antibiotics, which almost never gives permanent positive results.
The main factors underlying the development of pathology can be considered complex changes in tissues and, accordingly, the functional abilities of the gland, which is the main reason for the development of infectious microflora.Chronic prostatitis is, to some extent, a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in the pelvic organs.
- Violation of urodynamics.
- Degenerative processes in prostate parenchyma.
- Trophic disorder.
- Inflammatory processes.
Mechanism of development
It is practically impossible for pathogenic microflora to penetrate a healthy prostate gland to cause an inflammatory process, because the prostate microflora has a certain resistance to pathogens present in the urethra.However, the presence of one or more of the above-mentioned provoking factors leads to the development of persistent inflammation accompanied by the formation of scars (fibrotization) or areas of necrosis.
During the formation of scars, the proliferation of connective tissue causes stagnation in the acini (channels that provide secretion), which aggravates the course of the disease.Necrosis 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 reason for the development of CP is not infection, but various physiological disorders that allow the inflammatory process to take a chronic form.
Another distinctive feature of the disease that complicates the diagnosisfrequency of flow.As a rule, under the influence of external factors or the internal state of the body, there is a periodic change in the intensity of the pathology, during which acute conditions are replaced by periods of remission.
Often, not only the complete absence of symptoms, but also the absence of laboratory parameters indicating the presence of infection (for example, white blood cells).Despite the positive results, this condition cannot be considered a cure, because all the physiological disorders in the gland remained unchanged.
Reasons
The main causes of blood circulation disorders in the pelvic organs and stagnation of venous blood in the prostate gland 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.
- Presence of chronic infection of any localization in the body (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest leads to weakening of immunity.
- History of genitourinary infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to the systematic consumption of alcoholic beverages.
The presence of any of these reasons leads to the emergence of stagnant processes, the deterioration of the excretory function of the glands and the reduction of cellular resistance to diseases, which helps to create optimal conditions for the reproduction of pathogenic microorganisms in the prostate gland.
Is it possible to treat chronic prostatitis?
Although there are many systematic data on the mechanism of development of CP,its treatment is quite difficultis one of the leading problems in modern urological practice.
Since the disease occurs according to an individual scheme in each individual patient, the approach to treatment should be individual, taking into account all the physiological changes occurring in the prostate gland.
The anatomical features of the prostate, which can be accessed either through the urethra or the rectum, significantly reduce the effectiveness of the therapeutic effect used.In this regard, a long course of therapy (usually several months) is required to obtain a relatively stable result, during which the patient is required to strictly comply with all the doctor's requirements.
Unfortunately, complete treatment can only be achieved30 out of 100.This is mainly due to a long absence of severe symptoms or a conscious avoidance of unpleasant diagnostic and then therapeutic procedures, due to late seeking medical help.As a rule, atrophic processes in the prostate during treatment are irreversible, and even with long-term treatment, it is only possible to completely eliminate symptoms and achieve 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 series 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 be resistant to this group of drugs, and later their replacement and a longer course will be required.During the treatment of prostatitis, antibiotics with a bactericidal effect are preferred:
- fluoroquinolones;
- Azalides;
- aminoglycosides;
- Tetracyclines.
If laboratory tests reveal the specific nature of the infection, for example, trichomoniasis or viral origin of prostatitis, 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 eliminate spasms in the pelvic floor, which helps to increase blood supply, improve urine flow and reduce pain.
Laxatives
It is recommended to use laxatives to prevent excessive tension in the pelvic muscles during defecation, as pushing during constipation can aggravate the patient's condition.
Physiotherapy
One of the most common methods of physiotherapy is rectal massage of the prostate gland.The therapeutic effect of the finger on the prostate through the anus is to compress the infected secretion, which is then expelled through the urethra.
In addition, blood supply to tissues increases during massage, which has a positive effect on antibacterial therapy.The following physiotherapeutic methods are also used to perform rectal prostate massage:
- Simulation of electric current.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the condition stabilizes, the patient is required to follow the rules that impose some restrictions on the usual lifestyle:
- Avoid water procedures in open reservoirs and swimming pools.
- Check with your doctor regularly.
- Stop drinking alcohol completely.
- Have regular sex with a partner.
Adherence to the rules will allow you to stay in remission as long as possible and prevent the exacerbation of the disease.