The relevance of studying the mechanism of development of chronic prostatitis grows 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 young age, there is often a rather dismissive attitude towards the problem by doctors who use formulaic treatment regimens 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, which manifest in the form of a chronic inflammatory tissue process.However, we cannot talk about CP only as a result of the penetration of pathogenic microorganisms into the prostate, because such a point of view justifies attempts to treat prostatitis exclusively with the help of antibiotics, which almost never brings permanent positive results.
The main factors underlying the development of pathology can be considered complex changes in tissues and, accordingly, the functional capabilities of the gland, which are the main reason for the development of infectious microflora.Chronic prostatitis is to some extent a collective diagnosis that combines several factors:
- Reduced immunity.
- Stagnant processes in the pelvic organs.
- Urodynamic disorder.
- Degenerative processes in the prostate parenchyma.
- Trophic disorder.
- Inflammatory processes.
Development mechanism
The penetration of pathogenic microflora into a healthy prostate is practically impossible to cause an inflammatory process, because the microflora of the prostate 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 permanent inflammation, followed by the appearance of scars (fibrotization) or areas of necrosis.
Proliferation of connective tissue during the formation of scars causes stagnation in the acini (ducts that provide secretion), which worsens the course of the disease.Necrotization of the tissue leads to the creation of a cavernous cavity, in which, in addition to dead epithelium, prostate secretion accumulates.
Therefore, the main cause of the development of CP is not infection, but various physiological disorders that allow the inflammatory process to take a chronic form.
Another characteristic 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, there is a periodic change in the intensity of the pathology, 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 that indicate the presence of infection (for example, white blood cells).Despite the positive results, this condition cannot be considered a recovery, as 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 are:
- Constantly sitting in a sitting position.
- Hypothermia of the whole body or directly in the pelvic region.
- Systematic imprisonment.
- 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, which causes immune suppression.
- 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 reduction of cellular resistance to diseases, which contributes to the creation of optimal conditions for the proliferation of pathogenic microorganisms in the prostate.
Is it possible to cure chronic prostatitis?
Despite the availability of a large amount of systematic information on the mechanism of CP development,its treatment is extremely difficultand is one of the leading problems in modern urological practice.
Given that the disease occurs in each individual patient according to an individual pattern, accordingly, the approach to treatment must be individual, taking into account all the physiological changes that have occurred in the prostate.
Anatomical characteristics 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 is required to strictly comply with all the doctor's requirements.
Unfortunately, complete healing can only be achievedin 30 cases out of 100.This is mainly due to the late seeking of medical help, the long absence of severe symptoms or the 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 how the patient adheres to 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 with antibiotics should be carried out only after a series of laboratory tests, on the basis 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 become resistant to this group of drugs, and after that they will need to be replaced and 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 the specific nature of the infection, for example, trichomoniasis or viral origin of prostatitis, nitroimidazoles or an antiviral drug are prescribed in parallel with antibiotics.
Use of antispasmodics and α-blockers
The main purpose of using drugs from this series is to relieve spasms in the pelvic floor, which helps to increase blood supply, improve urine flow and reduce pain.
Laxatives
In order to avoid excessive stress on the pelvic muscles that occurs during defecation, it is recommended to use laxatives, as pushing during constipation can worsen the patient's condition.
Physiotherapy
One of the most common methods of physiotherapy is rectal prostate massage.The therapeutic effect of the finger on the prostate, which is carried out through the anus, is to push out the infected secretion, which is then excreted through the urethra.
In addition, the blood flow to the tissues increases during the massage, which has a positive effect on the antibacterial therapy.The following physiotherapeutic methods are also used to perform rectal massage of the prostate:
- Simulation of electric current.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the stabilization of the condition, the patient is obliged to adhere to the rules that impose certain restrictions on the usual way of life:
- Avoid water procedures in open tanks and pools.
- Consult your doctor regularly.
- Stop drinking alcohol completely.
- Have a regular sex life with one partner.
Following the rules will allow you to stay in remission as long as possible and avoid worsening of the disease.