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).
Because the disease not only affects an ever-increasing proportion of the male population but is also being diagnosed at younger and younger ages, there is often a dismissive attitude towards the problem among 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 themselves in the form of a chronic inflammatory process of the tissue.However, one cannot speak of CP alone as a result of the penetration of pathogenic microorganisms into the prostate, since such a point of view justifies attempts to treat prostatitis exclusively with the help of antibiotics, which almost never brings long-term positive results.
The main factors in the development of pathology can be considered complex changes in the tissue and, accordingly, the functionality of the gland, which are the main reason for the development of infectious microflora.Chronic prostatitis is, to a certain extent, 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 disorder.
- Inflammatory processes.
Development mechanism
The penetration of pathogenic microflora into a healthy prostate is practically unable to trigger 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 provoking factors leads to the development of persistent inflammation, accompanied by the formation of scarring (Fibrotization) or areas of necrosis.
The proliferation of connective tissue during scar formation leads to stagnation of the acini (secretory ducts), which worsens the course of the disease.The necrotization of the tissue creates a cavernous cavity in which, in addition to dead epithelium, prostate secretions also accumulate.
Thus, 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 complicates diagnosis isFrequency 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 states are replaced by periods of remission.
Often there is not only a complete absence of symptoms, but also a lack of laboratory parameters that indicate the presence of an infection (e.g. 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 are:
- Constant sitting while sitting.
- Hypothermia of the entire body or directly in the pelvic area.
- Systematic constipation.
- Prolonged abstinence from sexual activity or excessive sexual activity.
- The presence of a chronic infection of any localization (sinusitis, bronchitis) in the body.
- Excessive physical activity, accompanied by lack of sleep or rest, leads to a weakened immune system.
- A history of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effect on the body due to 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 and a decrease in cellular resistance to diseases, which contributes to the creation of optimal conditions for the reproduction of pathogenic microorganisms in the prostate.
Is it possible to cure chronic prostatitis?
Despite the availability of a large amount of systematic information about the mechanism of formation of CP,its treatment is extremely difficultand is one of the main problems in modern urological practice.
Due to the fact that the disease progresses according to an individual pattern in each individual patient, the treatment approach must also be individual and take into account all physiological changes that have occurred in the prostate.
The anatomical features of the prostate, which is accessible either via the urethra or via the rectum, significantly reduce the effectiveness of the therapeutic effect used.In this regard, to achieve a relatively stable result, a long duration of therapy (usually several months) is required, during which the patient must strictly comply with all the doctor's requirements.
Unfortunately, complete healing can only be achievedin 30 out of 100 cases.This is primarily due to the delayed seeking of medical help, the long absence of serious symptoms or the conscious avoidance of unpleasant diagnostic and subsequent therapeutic interventions.As a rule, atrophic processes in the prostate at the time of treatment are irreversible and even with long-term treatment, only complete elimination of symptoms and stable remission is 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 by antibiotics should occur only after a series of laboratory tests, on the basis of which the most effective drug is prescribed.
The duration of antibiotic intake usually depends on the severity of the disease and is at least 30 days.Interruption of treatment is unacceptable, since the remaining microorganisms become resistant to this group of drugs and subsequently need to be replaced, and an even longer duration of treatment is required.In the treatment of prostatitis, preference is given to antibiotics with bactericidal effects:
- fluoroquinolones;
- azalids;
- aminoglycosides;
- Tetracyclines.
If laboratory tests reveal a certain type 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 relieve pain.
laxative
To avoid excessive strain on the pelvic muscles during bowel movements, it is recommended to use laxatives, as straining during constipation can worsen the patient's condition.
Physiotherapy
One of the most common methods of physical therapy is rectal massage of the prostate.The therapeutic effect of a finger passed through the anus on the prostate is to push out the infected secretion, which is subsequently excreted through the urethra.
In addition, during the massage, blood circulation in the tissues increases, which has a positive effect on antibacterial therapy.The following physiotherapeutic methods are also used to carry out a rectal prostate massage:
- Electrical current simulation.
- High frequency thermotherapy.
- Infrared laser therapy.
Prevention
After the condition has stabilized, the patient must follow the rules that entail some restrictions on the usual way of life:
- Avoid water treatments in open reservoirs and pools.
- Consult your doctor regularly.
- Stop drinking alcohol completely.
- Have a regular sex life with a partner.
By following the rules, you can stay in remission as long as possible and avoid exacerbation of the disease.