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 prominent place among urological diseases and is the result of the influence of several factors that are 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 formulated treatment regimens that are incapable of leading 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 tissue process.However, we cannot talk about CP only as a result of the penetration of pathogenic microorganisms into the prostate, as 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 tissues and, consequently, in the functional abilities of the gland, which are the main reason for the development of infectious microflora.Chronic prostatitis, to some extent, is a collective diagnosis that combines several factors:
- Decreased immunity.
- Stagnant processes in the pelvic organs.
- Violation of urodynamics.
- Degenerative processes in the prostate parenchyma.
- Trophic disturbance.
- Inflammatory processes.
Development mechanism
The penetration of pathogenic microflora into a healthy prostate 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 of the acini (ducts that supply secretion), worsening the course of the disease.Tissue necrotization leads to the formation of a cavernous cavity, in which, in addition to the dead epithelium, prostatic secretions accumulate.
Thus, the main cause of the development of CP is not infection, but rather various physiological disorders that allow the inflammatory process to acquire a chronic form.
Another distinctive 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 an 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, since all physiological disorders of 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 entire body or directly in the pelvic region.
- 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.
- History of urogenital infections (gonorrhea, trichomoniasis).
- Toxic effects on the body due to the systematic consumption of alcoholic beverages.
The presence of any of these causes leads to the appearance of stagnation processes, deterioration of the excretory function of the glands and a decrease in cellular resistance to diseases, which contributes to the creation of ideal 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 on the mechanism of CP development,its treatment is extremely difficultand is one of the main problems in modern urological practice.
Due to the fact that the disease occurs in each patient according to an individual pattern, therefore, the treatment approach must also be individual, taking into account all physiological changes occurring in the prostate.
The anatomical characteristics of the prostate, which can be accessed through the urethra or rectum, significantly reduce the effectiveness of the therapeutic effect used.In this regard, to achieve a relatively stable result, a long course of therapy (usually several months) is required, during which the patient is obliged 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, the long absence of serious symptoms or the conscious avoidance of unpleasant diagnostic and therapeutic procedures.As a rule, at the time of treatment, atrophic processes in the prostate are irreversible, and even with prolonged treatment, it is only possible to completely eliminate the symptoms and achieve a 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 with 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 antibiotic use is determined by the severity of the disease and is at least 30 days.It is unacceptable to interrupt treatment, as the remaining microorganisms will become resistant to this group of drugs and will subsequently need to be replaced and for an even longer course.When treating prostatitis, preference is given to antibiotics with a bactericidal effect:
- Fluoroquinolones;
- Azalides;
- Aminoglycosides;
- Tetracyclines.
If laboratory tests reveal a specific nature of the 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, as pushing during constipation can worsen the patient's condition.
Physiotherapy
One of the most common methods of physical therapy is rectal prostate massage.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 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 the condition has stabilized, the patient is obliged to follow the rules that impose some restrictions on the usual way of life:
- Avoid water procedures in open reservoirs and swimming pools.
- Check with your doctor regularly.
- Completely stop drinking alcohol.
- Have regular sex with a partner.
Compliance with the rules will allow you to stay in remission for as long as possible and avoid exacerbations of the disease.