Prostatitis is an acute inflammatory process in the prostate gland (prostate). This disease causes many problems, and has several forms. Learn more about the causes, symptoms, and treatment of chronic abacterial prostatitis next.
Disease prevalence
It is considered the most common urological disease in men under 50 years of age and the third most common urological diagnosis in men over 50 years of age, after benign hyperplasia and prostate cancer. The prevalence of prostatitis according to various sources ranges from 35–40 to 70–90% of cases. The frequency of the disease increases with age: there is a point of view that after 30 years this disease is diagnosed in 30% of men, after 40 years - 40%, at 50 years - 50%, etc.
Although the stronger sex is more exposed to it, chronic abacterial prostatitis is not always safe for women. Despite the fact that girls do not have a prostate, there is its anatomical and physical similarity - Skene's gland,located on the back wall of the urethra and produces a secret, very similar in composition to the secret of the prostate gland. Its release occurs during the period of orgasm, and from the point of view of scientists, it does not contain practically any multifunctional load, as a result of which biologists and physiologists consider Skene's glands to be a rudiment that will completely disappear in the future. But as long as the gland is present, there are, unfortunately, diseases that affect it. One of them is skineitis - an infectious and inflammatory disease, which is essentially female abacterial prostatitis.
Key Factors
Abacterial is called prostatitis, which did not arise due to infections, and at the same time flowed into a chronic form. This disease is also called chronic pelvic pain syndrome. Causes of abacterial prostatitis:
- Inflammatory process of tendons and ligaments located in the pelvic floor, which occurs when infectious sources of inflammation are nearby (with cystitis, urethritis, intestinal infections). The ligaments and tendons are tense, which is why there is quite a strong pain in the lower abdomen, in the groin, in the perineum.
- Increase in the volume of the ligaments of the pelvic floor. When inflamed, they pinch nearby nerve endings. Severe pain appears, radiating to the genitals, legs, lower back, tailbone.
- Constant stress and fatigue.
- Impaired circulation in the prostate.
- Spine injuries.
Symptoms
Main symptomsabacterial prostatitis:
- pain in the pelvic area (pain has a monotonous appearance);
- acute pain in the perineum and external genitalia, lower abdomen;
- impaired urination;
- pathology of the functions of the reproductive system;
- weakness;
- poor physiological condition;
- feeling of continuous nervous tension, breakdowns.
Diagnosis
Diagnosis of abacterial prostatitis begins with anamnesis. The doctor must be as circumspect as possible to the patient, in order not to miss any of the signs of the disease. He certainly performs an anal digital examination of the prostate gland. General blood and urine tests are given, microbiological studies of urine, prostate secretion, and semen are being conducted in order to prove the lack of the causative agent of the disease.
The patient must undergo a course of studies of the urinary lines. A method such as uroflowmetry is used - determining the characteristics of the flow of urine. This is necessary in order to detect the pathology of the urinary tract. Sound examination is used for examination.
If the microbiological examination is negative, pathogenic bacteria were not detected, the doctor will fix the abacterial prostatitis and determine the appropriate treatment. But first of all, the expert must understand the mental state of his patient, find an opportunity to explain to him the occurrence of pain and eliminate the use of unnecessary medications.
Treatment
Therapy of abacterial prostatitis is the responsibility of a urologist (andrologist). The attitude to treatment should be complex, the problems facing the patient and the doctor should be addressed in turn.
Correction is subject to the style of existence of a man, his way of life, the characteristic features of thinking. It is important to get rid of the passion for alcohol, move more, play sports, restore sex life, eat right. Of course, without a course of basic therapy, it will not be possible to get rid of the disease. Therefore, taking pharmaceuticals is considered an integral factor in the absolute cure.
Indications for hospitalization
Therapy of this disease is carried out more often on an outpatient basis. But in the event that the disease cannot be corrected for a long time, has a severe course and a tendency to relapse, placing the patient in a hospital is highly desirable. This will make it possible to more successfully fight the existing disease.
Medicated treatment
Drug treatment of chronic prostatitis should be focused on preventing new foci and reducing existing infection, normalizing blood circulation, improving drainage of prostate lobules, correcting hormonal levels and immunity. For this reason, doctors advise taking immunomodulators, anticholinergics, anti-inflammatory and vasodilators against the background of conventional drugs. The use of angioprotectors is acceptable. In addition, it is also recommended to apply prostate massage, if there is nocontraindications.
What to take?
Drugs for the treatment of abacterial and bacterial prostatitis will be as follows:
- "Finasteride" (diphenylamine 5-a-reductase).
- Terazosin (alpha-blockers).
- "Cyclosporin" (immunosuppressor).
- Citrates.
- "Allopurinol" (a drug that normalizes the interchange of urates).
- Cytokine inhibitors.
Cefotaxime is prescribed for abacterial prostatitis, based on the data of enterobacterial seeding of prostate secretion, which makes it possible not only to identify the pathogen, but also to establish its susceptibility to this or another drug. If the therapy model is compiled correctly and according to all the rules, then its effectiveness will reach 90% or more.
If, according to the results of the diagnosis, it was found that chronic prostatitis is of an abacterial nature, then it is permissible to prescribe a short course of drugs. If the scheme gives a positive result, then it should be continued. As a rule, the effectiveness of such therapy is 40%. This indicates that the microbial representative was simply not identified, or its diagnosis was not carried out (for example, the disease is provoked by chlamydia, ureaplasmas, Trichomonas, mycotic organisms, or microbes).
In addition, disease-causing agents that are not detected by typical methods of examination can be detected in more correct ways, for example, using histological examination of prostate biopsies.
Regarding the applicationantibacterial agents for persistent pelvic pain, then this result is still under discussion. Nevertheless, experts are of the opinion that if medication is still taken, then the duration of the course should not exceed a month. If there is a positive trend, then it is necessary to extend the therapy for another 4-6 weeks. If there is no result, then the doctor is obliged to change the medication to another one that will be more effective.
The leading drugs for getting rid of chronic prostatitis are antibacterial agents from the category of fluoroquinolones. They have high bioavailability, are able to accumulate in the tissues of the prostate gland, and are functional in relation to many gram-negative microorganisms.
As a rule, the following drugs are prescribed for the treatment of the disease:
- "Norfloxacin". The course of treatment is not more than 2 weeks, the dose is 800 mg per day.
- "Ciprofloxacin". Duration of treatment up to 28 days, dose from 250 to 500 mg.
- "Pefloxacin". The course of therapy up to 2 weeks, a dose of 800 mg per day
In the event that fluoroquinolone therapy does not give the expected result, it is permissible to prescribe substances of the penicillin series - Amoxiclav in combination with Clindamycin. And also in some cases tetracyclines are prescribed, namely "Doxycycline" This drug gives excellent results in case of damage to the prostate gland by chlamydia.
Antibacterial agents canbe used for preventive purposes. Their low efficiency can be determined by a number of conditions, including the wrong choice of a pharmaceutical agent, the chemoresistance of microorganisms to the product.
Already after antibiotic therapy is over, treatment with a-blockers should be started, since intraprostatic reflux is considered one of the likely factors in the formation of the disease. Such a treatment strategy is important for those patients in whom irritative and obstructive signs are preserved. Substances in this category of drugs reduce intraurethral pressure. They also have a calming effect on the bladder neck.
This result is determined by the fact that almost fifty percent of intraurethral pressure directly depends on the stimulation of a1-adrenergic receptors, and subsequent substances will effectively block this stimulation. These drugs include:
- Terazosin.
- Tamsulosin.
- Alfuzosin.
Effective in the treatment of chronic prostatitis is a drug such as Finasteride. Experts became interested in its impact on the development of this disease at the end of the 20th century. Once in the body, the therapeutic substance blocks the dynamism of the 5-a-reductase enzyme, which testosterone transforms into a prostatic configuration - into 5-a-dihydrotestosterone. This androgen itself has a high initiative and stimulates the growth of epithelial and stromal tissue of the gland. ATas a result, it increases in volume and generates the proper signs.
When using Finasteride, hemiatrophy of the overgrown stromal tissue occurs already after 90 days, and part of the glandular matter is reduced by half after six months from the start of therapy. Accordingly, their secretory function is suppressed. As a result, the patient ceases to suffer from pain, dysuritic disorders disappear due to a decrease in the volume of the prostate gland, there is a decrease in edema and organ pressure on the capsule.
To save the patient from discomfort, a course of NSAIDs is prescribed. More often, Diclofenac is used in this capacity at a dose of 50 to 100 mg per day.
Non-drug treatment
Along with taking drugs, patients are recommended to take courses of non-drug therapy. Such procedures alleviate the condition, reduce the size of the gland, and also increase the amount of antibacterial substances in the tissues of the organ.
Non-drug therapy includes:
- Laser therapy.
- Phonophoresis.
- Electrophoresis.
- Microwave hyperpyrexia used transrectally.
To implement the last method, the temperature is chosen in personal mode. If the device is exposed in the temperature spectrum from 39 to 40 degrees, then it turns out not only to increase the concentration of the pharmaceutical agent in the organ, but also to stimulate immunity at the cellular level, remove congestion, and get rid of microorganisms. If the thermal spectrum increases to 40-45 degrees, then it will be possible to achieveanalgesic and sclerosing effect.
Magnetic and laser therapy for chronic abacterial prostatitis is used in combination. The result is similar to the effect of microwave hyperthermia at 39–40 degrees, however, it has a biostimulating effect due to the laser effect on the organ. In addition, this method can help with vesiculitis and epididymo-orchitis.
Transrectal massage is a very useful method of treatment. But it is used only if the man has no contraindications for this.
Correctly chosen therapy from an experienced urologist will help to overcome the disease. The main thing is not to lose heart and clearly follow all the appointments and instructions of the doctor.
Recommendations
To prevent the development of chronic abacterial prostatitis, you must:
- Be sexually active with a regular partner.
- Stay he althy, move more, walk more and exercise more.
- Eat properly, avoiding fatty and spicy, smoked foods.
- Avoid hypothermia, which reduces immunity.
- Regular visits to the urologist.
And lastly, do not self-medicate, and at the first sign of illness, you should visit a doctor. Only a specialist will be able to understand how to treat abacterial prostatitis in each case. Therefore, do not risk your he alth and do not self-medicate.
