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 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 formulaic treatment regimens that are unable to 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 tissues.However, we cannot talk about CP only as a result of 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 brings lasting positive results.
The main factors underlying the development of pathology can be considered complex changes in the tissues and, accordingly, the functional abilities 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
Penetration of pathogenic microflora into a healthy prostate gland is practically impossible to cause 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 above-mentioned provoking factors 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 in the acini (ducts that provide secretion), aggravating the course of the disease.Necrotization of tissue leads to the formation of a cavernous cavity, in which, in addition to 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 isfrequency of flow.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 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 recovery, since all 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 gland are:
- Constantly sitting 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 a chronic infection of any localization (sinusitis, bronchitis).
- Excessive physical activity accompanied by lack of sleep or rest, causing immune suppression.
- 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 gland.
Is it possible to cure chronic prostatitis?
Despite the availability of a large amount of systematic 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 occurs in each individual patient according to an individual pattern, accordingly, 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 can be accessed 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 therapy is required (usually several months), during which the patient is required to 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 late seeking medical help, due to a long absence of severe 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 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 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 interrupt treatment, since the remaining microorganisms will become resistant to this group of drugs, and subsequently they will need to be replaced and an even longer course.When treating prostatitis, preference is given to antibiotics that have a bactericidal effect:
- Fluoroquinolones;
- Azalids;
- 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 in parallel with antibiotics.
The use of antispasmodics and α-blockers
The main purpose of using drugs in this series is to relieve spasms in the pelvic floor, 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 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 a finger on the prostate, carried out through the anus, is to squeeze out the infected secretion, which is subsequently excreted through the urethra.
In addition, during the massage, blood supply to 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 some restrictions on the usual way of life:
- Avoid water procedures in open reservoirs and pools.
- Check with your doctor regularly.
- Completely stop drinking alcohol.
- Have regular sex life with one partner.
Compliance with the rules will allow you to remain in remission for as long as possible and avoid exacerbations of the disease.