About one-third of men of active reproductive age - between the ages of 20 and 40 - suffer from chronic prostatitis. Due to the disease, the quality of life of many patients is significantly reduced. Chronic prostatitis is difficult to treat, but it is possible to improve well-being, restore impaired function, and get rid of painful symptoms for a long time. The key is to choose the right treatment regimen. Of course, this is the doctor's job, but in any case, it is useful to know what drugs can be used in treatment. Let's talk about what drugs are available for prostatitis and how they work.
Drug groups for prostatitis
Any disease - and prostatitis is no exception - has a mechanism, a reason for the development of the pathological process and clinical manifestations. Accordingly, the directions of treatment are different.
The question may be asked: why is it not possible to limit ourselves to etiotropic treatment, because once the cause is eliminated, 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, it is not always possible to find the cause and eliminate it. Second, when the pathological mechanism is already working, it supports itself, and even the elimination of the etiological factor does not guarantee recovery. Thus, the universal treatment of prostatitis has not yet been developed: today all the connections of therapy are important.
Etiotropic drugs
The etiology of chronic prostatitis is not well understood. On the one hand, infection is considered to be the cause of the development of the inflammatory process. No germs are found in the tissues of a healthy prostate gland. On the other hand, the proportion of bacterial prostatitis in the overall structure of the incidence is only about 10%, with the remaining 90% being bacterial prostatic forms. It is likely that the infection plays a role only in the early stages of the disease, triggering a pathological process in the prostate gland. In the future, the importance of microbial flora decreases, pathological changes in prostate tissues (obstruction, disruption of microcirculation, autoimmune mechanisms, etc. ) become more important factors. What medications are used for prostatitis?
Etiotropic treatment of bacterial prostatitis involves the appointment of antibiotics. With their choice, everything is not as simple as it seems. First, the spectrum of microorganisms is changing: if until recently E. coli was the predominant cause of chronic prostatitis, now chlamydia, mycoplasmas, ureaplasmas, gardnerellas, trichomonads are increasingly found. They are not sensitive to previously used antibiotics. Second, the resistance of microbes to the effects of antibacterial agents increases. Therefore, etiotropic drugs for the treatment of prostatitis should be prescribed only after determining the type of pathogen and its sensitivity to antibiotics.
Antibacterial drugs are effective against prostatitisfluoroquinolones. They penetrate well into the tissues of the prostate gland and form in them high enough concentrations to kill germs. Another advantage of fluoroquinolones is their wide 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 chlamydia and other intracellular microorganisms are detected,macrolidesandtetracyclines. 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 low toxicity.
Preparation of pathogenetic therapy
A complex of changes occurs in the tissues of the prostate gland against the background of chronic inflammation. There is stagnation in secretion, venous flow deteriorates, glandular trophism is impaired, fibrosis develops gradually (replacement of healthy connective tissue), immunity suffers. These interrelated pathological changes support the inflammatory process and reduce the effectiveness of etiotropic therapy. Restoration of the structure and function of the gland with the help of pathogenetic therapy helps to break the vicious circle. Drugs in this group are different because many factors are involved in the pathogenesis of chronic prostatitis.
- Immunomodulators. In a chronic inflammatory process, all parts of the immune system are 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 accompanying inflammation is oxidative stress. Prostate cells are damaged by large amounts of free radicals formed as a result of a sharp increase in the content of leukocytes in the secretion of the prostate gland. Oxidative stress enhances and maintains the inflammatory response. To stop this process, antioxidants are prescribed for chronic prostatitis: zinc, selenium, copper supplements, vitamins A, C, E, folic acid, L-carnitine, glutathione, resveratrol, etc.
- Enzyme preparations. As a result of chronic inflammation, oxidative stress, lack of blood supply, healthy glandular tissue is replaced by connective tissue. Enzyme preparations (mainly based on hyaluronidase) slow down the development of fibrosis.
Note
Among the drugs used for prostatitis, peptide bioregulators derived from the prostate gland of animals deserve special attention. They have a selective effect on the prostate, in particular, improve blood flow and restore microcirculation. As a result, swelling is reduced, the risk of blood clots is reduced, pain is reduced, urination is normalized, and prostate function is restored. In some cases, it is possible to use such drugs to prevent prostatitis.
Symptomatic medications
One of the main goals of treatment of chronic prostatitis is to save patients from painful manifestations of the disease. Symptomatic agents do not affect the course of the inflammatory process, but alleviate the condition of patients. So what helps with prostatitis?
- Alpha blockersBlocks nerve impulses from receptors located in the smooth muscles of the prostate gland, urethra, bladder. As a result, the spasm stops, the pain disappears, and urination returns to normal. The action does not occur immediately, but two weeks after the start of treatment.
- Antispasmodicsis prescribed for the same purpose as alpha-blockers. Helps relax smooth musclesPain is reduced due to the elimination of spasms, urine flow is restored.
- NSAIDsIt is used to relieve pain and reduce inflammation. These drugs act quickly, but can not be used for long courses due to the risk of side effects.
The drug in the form of suppositories helps to restore the function of the prostate gland, relieves pain and improves the urinary process.
How to choose a drug for the treatment of prostatitis
The urologist selects a therapy regimen and medication for the treatment of prostatitis based on the results of the diagnosis and analysis of the patient's complaints. The treatment of this disease should be comprehensive: it is the only way to achieve a stable and lasting effect. If the tests reveal an infection, the doctor will prescribe antibiotics according to the type of pathogen. In other cases, pathogenetic and symptomatic therapy is used. The latter is selected on the basis of prevailing complaints. For example, if the patient is worried about pain, NSAIDs are prescribed. Alpha-blockers are used for problems with urination.
Drugs used for prostatitis differ not only in the composition and mechanism of therapeutic effect, but also in the form of release. The main ones are tablets, capsules and rectal suppositories. Injectable drugs are less commonly used.
It is convenient to take tablets and capsules. However, the suppository acts primarily faster: the active substance is immediately delivered to the site of inflammation by lymphogenic means through the wall of the rectum in contact with the prostate gland. Second, drugs in the form of suppositories have more bioavailability: unlike tablets, they are not metabolized in the liver and do not reduce the concentration of active substances. Finally, suppositories are safer in terms of side effects: in particular, they have virtually no adverse effects on the gastrointestinal tract.
Modern treatment regimens for chronic prostatitis focus on all components of therapy: etiotropic, pathogenetic and symptomatic. Medications should be selected by the physician based on test results and patient complaints. A comprehensive approach to treatment and the right choice of medication helps to restore impaired function and forget about the symptoms of prostatitis for a long time.
Candles 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 over 30 years.
The active ingredient in suppositories is bovine prostate extract. Contains a complex of peptides that have a regulatory effect on prostate cells. The drug helps to improve microcirculation and venous flow, thereby reducing inflammation and swelling, reducing pain.
Indications - chronic abacterial prostatitis, preoperative and postoperative conditions, benign prostatic hyperplasia.
The bioavailability of suppositories is high. Low molecular weight peptides easily penetrate biological barriers and reach the center of inflammation. High levels of cleansing minimize the risk of allergic and other undesirable reactions.
Suppositories containing bovine prostate extract are compatible with antibiotics and other drugs used in the complex treatment of chronic prostatitis. The tool is applied in a short course (10 days). However, it is affordable.