Approximately one-third of men of active reproductive age - 20 to 40 years of age - suffer from chronic prostatitis. Due to the disease, the quality of life of many patients is markedly reduced. Chronic prostatitis is difficult to treat, but it is possible to improve well-being, restore impaired functions and eliminate painful symptoms for a long time. The main thing is to choose the right treatment regimen. Of course, this is the task of the doctor, but in any case it is useful to know what drugs can be used in treatment. Let's talk about what drugs exist for prostatitis and how they work.
Groups of drugs for prostatitis.
Any disease, and prostatitis is no exception, has a cause, a mechanism for the development of the pathological process and clinical manifestations. In accordance with this, the treatment directions also differ.
The question may arise: why is it impossible to limit ourselves to etiotropic treatment, because after the elimination of the cause, the development of the disease should stop, and the symptoms will disappear? In the case of chronic diseases, including prostatitis, not everything is so simple. First of all, it is not always possible to find and eliminate the cause. Secondly, when the pathological mechanism is already working, it sustains itself, and even the elimination of the etiological factor does not guarantee recovery. Therefore, a universal cure for prostatitis has not yet been developed - today all links in therapy are important.
Etiotropic drugs
The etiology of chronic prostatitis is not well understood. On the one hand, infection is considered the cause of the development of the inflammatory process. No microbes are found in the tissues of a healthy prostate. On the other hand, the proportion of bacterial prostatitis is only about 10% in the general structure of the incidence, the remaining 90% of cases are abacterial forms. Probably, the infection plays a role only at an early stage of the development of the disease, being the trigger of the pathological process in the prostate gland. In the future, the importance of the microbial flora decreases and pathological changes in the prostate tissues (congestion, microcirculation disturbance, autoimmune mechanisms, etc. ) become more important factors. What drugs for prostatitis are used?
Etiotropic therapy of bacterial prostatitis involves the appointment of antibiotics. With their selection, not everything is as simple as it might seem. First of all, the spectrum of microorganisms is changing: if until recently E. coli prevailed among the causative agents of chronic prostatitis, now more and more chlamydiae, mycoplasmas, ureaplasmas, gardnerella, trichomonas are found. They are not sensitive to previously used antibiotics. Second, the resistance of microbes to the effects of antibacterial agents is increasing. Therefore, etiotropic drugs for the treatment of prostatitis should be prescribed only after determining the type of pathogen and its sensitivity to antibiotics.
They are considered effective antibacterial drugs against prostatitis.fluoroquinolones. They penetrate well into the tissues of the prostate gland and form concentrations in them high enough to destroy microbes. Another advantage of fluoroquinolones is their broad spectrum of action: many types of pathogenic bacteria are sensitive to them. This group of drugs against prostatitis includes active substances such as ciprofloxacin, levofloxacin, lomefloxacin and others.
When chlamydiae and other intracellular microorganisms are detected,macrolidesYtetracyclines. They are active against specific flora, but have a negative effect on typical pathogens of chronic prostatitis: Escherichia coli, staphylococci. The advantage of macrolides is their low toxicity.
Pathogenic therapy preparations.
Against the background of chronic inflammation in the tissues of the prostate, a complex of changes occurs. There is a stagnation of secretion, venous outflow worsens, the trophism of the gland is disturbed, fibrosis (replacement of healthy connective tissue) gradually develops, immunity suffers. These interrelated pathologic changes support the inflammatory process and reduce the efficacy of etiotropic therapy. Restoration of the structure and functions of the gland with the help of pathogenetic therapy helps to break the vicious circle. Since many factors are involved in the pathogenesis of chronic prostatitis, the drugs in this group are diverse.
- Immunomodulators. In a chronic inflammatory process, the work of all parts of the immune system is disrupted. Immunomodulators regulate defense mechanisms, helping to cope with inflammation and infection. This is a large group of drugs with different mechanisms of action.
- antioxidants. One of the pathological mechanisms that accompany inflammation is oxidative stress. Prostate cells are damaged by free radicals, which are formed in large quantities due to a sharp increase in the content of leukocytes in the secretion of the prostate gland. Oxidative stress exacerbates and maintains the inflammatory response. To stop this process, antioxidants are prescribed for chronic prostatitis: zinc, selenium, copper preparations, vitamins A, C, E, folic acid, L-carnitine, glutathione, resveratrol and others.
- enzyme preparations. As a result of chronic inflammation, oxidative stress, lack of blood supply, healthy glandular tissue is replaced by connective tissue. Enzymatic preparations (mainly based on hyaluronidase) slow down the development of fibrosis.
Note
Among the drugs that are taken for prostatitis, peptide bioregulators obtained from the prostate gland of animals deserve special attention. They have a selective effect on the prostate, in particular, they improve blood flow and restore microcirculation. Due to this, swelling decreases, the risk of blood clots decreases, pain decreases, urination normalizes, prostate functions are restored. In some cases, it is possible to use such drugs for the prevention of prostatitis.
Symptomatic medications
One of the main goals of chronic prostatitis treatment is to save patients from the painful manifestations of the disease. Symptomatic agents do not affect the course of the inflammatory process, but relieve the condition of patients. So what helps with prostatitis?
- alpha blockersblock nerve impulses from receptors located in the smooth muscles of the prostate, urethra, and bladder. As a result, the spasm stops, the pain disappears, and urination normalizes. The action does not occur immediately, but after two weeks from the start of treatment.
- antispasmodicsprescribed for the same purpose as alpha blockers. They help relax smooth muscles. Due to the removal of the spasm, the pain subsides and the flow of urine is restored.
- NSAIDsIt is used to relieve pain and reduce inflammation. These medications act quickly, but cannot be used for long cycles due to the risk of side effects.
The drug in the form of suppositories helps restore the functions of the prostate gland, which helps relieve pain and improves the urination process.
How to choose a drug for the treatment of prostatitis.
The urologist selects the therapy regimen and drugs for the treatment of prostatitis based on the results of the diagnosis and analysis of the patient's complaints. Therapy of this disease should be comprehensive - this is the only way to achieve a stable and lasting effect. If the tests reveal an infection, the doctor will definitely prescribe antibiotics according to the type of pathogen. In other cases, pathogenetic and symptomatic therapy is used. The latter is selected based on the prevailing complaints. For example, if the patient is concerned about pain, NSAIDs are prescribed. For problems with urination, alpha blockers are used.
The drugs used for prostatitis differ not only in composition and mechanism of therapeutic action, but also in the form of release. The main ones are tablets, capsules and rectal suppositories. Medicines in the form of injections are used less often.
Tablets and capsules are convenient to take. However, the ovules, first of all, act faster: through the wall of the rectum, which is in contact with the prostate gland, the active substance is sent via the lymphogenic route immediately to the site of inflammation. Secondly, drugs in the form of ovules have increased bioavailability: unlike tablets, they are not metabolized in the liver, and the concentration of active ingredients does not decrease. Finally, suppositories are safer in terms of side effects: in particular, they have practically no negative effects on the gastrointestinal tract.
In modern treatment regimens for chronic prostatitis, attention is paid to all components of therapy: etiotropic, pathogenic and symptomatic. Medications should be selected by the doctor, focusing on the test results and patient complaints. An integrated approach to treatment and the correct choice of drugs help to restore impaired functions and forget about the symptoms of prostatitis for a long time.
Suppositories for prostatitis
One of the drugs often prescribed by urologists for the treatment of chronic prostatitis is drugs in the form of suppositories. This tool has been used in clinical practice for more than 30 years.
The active ingredient in the ovules is bovine prostate extract. Contains a complex of peptides that have a regulatory effect on prostate cells. The drug helps improve microcirculation and venous outflow, which reduces inflammation and swelling and reduces pain.
Indications for use: chronic abacterial prostatitis, conditions before and after prostate surgery, benign prostatic hyperplasia.
The ovules are highly bioavailable. Low molecular weight peptides easily penetrate biological barriers and reach the focus of inflammation. The high degree of purification minimizes the risk of allergic reactions and other undesirable reactions.
Ovules with bovine prostate extract are compatible with antibiotics and other drugs used in the complex therapy of chronic prostatitis. Means is applied for a short course (from 10 days). However, it is affordable.