About one -third of men of active reproductive age - from 20 to 40 years - 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 relieve painful symptoms for a long time. The main thing is to choose the right treatment regimen. Of course, this is the job of the doctor, but in any case it is useful to know what drugs can be used in treatment. Let’s talk about what medications for prostatitis exist and how they work.
Group of drugs for prostatitis
Any disease - and prostatitis is no exception - has a cause, a mechanism for the development of pathological processes and clinical manifestations. Consistent with this, treatment instructions also differ.
The question may arise: why is it impossible to confine ourselves to etiotropic treatment, because after the elimination of the cause, the progression of the disease should stop, and the symptoms will disappear? In the case of chronic diseases, including prostatitis, not everything is so simple. First, the cause cannot always be found and eliminated. Second, when the pathological mechanism is already running, it supports itself, and even the elimination of etiological factors does not guarantee recovery. So a universal cure for prostatitis has not yet been developed: today all the links in 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 inflammatory processes. No microbes are found in healthy prostate gland tissue. In contrast, the share of bacterial prostatitis is only about 10% in the overall structure of the occurrence, the remaining 90% of cases are abacterial form. Probably, the infection plays a role only in the early stages of disease development, being the trigger of pathological processes in the prostate gland. In the future, the importance of microbial flora decreases, and pathological changes in prostate tissue (congestion, impaired microcirculation, autoimmune mechanisms, etc. ) become more important factors. What medications for prostatitis are used?
Etiotropic therapy of bacterial prostatitis involves the appointment of antibiotics. With their election as well, not everything is as easy as one might think. First, the spectrum of microorganisms is changing: if until recently E. coli existed among the causative agents of chronic prostatitis, now chlamydia, mycoplasmas, ureaplasmas, gardnerella, trichomonads are increasingly being found. They are not sensitive to antibiotics used before. Second, microbial resistance 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.
Effective antibacterial drugs against prostatitis are consideredfluoroquinolones. 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 ingredients such as ciprofloxacin, levofloxacin, lomefloxacin and others.
When chlamydia and other intracellular microorganisms are detected,macrolideandtetracycline. They are active against certain flora, but have an adverse effect on the typical pathogens of chronic prostatitis - Escherichia coli, staphylococci. The advantage of macrolides is their low toxicity.
Preparation of pathogenetic therapy
Against the background of chronic inflammation in prostate tissue, a complex of changes occurs. There is stagnation of secretions, worsening venous outflow, disturbed glandular trophism, fibrosis gradually develops (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. Because of the many factors involved in the pathogenesis of chronic prostatitis, drugs in this group are diverse.
- Immunomodulator. In the process of chronic inflammation, the work of all parts of the immune system is disrupted. Immunomodulators regulate defense mechanisms, helping to combat inflammation and infection. This is a large group of drugs with different mechanisms of action.
- Antioxidants. One of the pathological mechanisms that accompanies 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 secretions of the prostate gland. Oxidative stress exacerbates and perpetuates 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 preparation. As a result of chronic inflammation, oxidative stress, lack of blood supply, healthy glandular tissue is replaced by connective tissue. Enzyme preparations (especially hyaluronidase -based) slow the progression of fibrosis.
Notes
Among the drugs taken for prostatitis, peptide bioregulators derived from the prostate glands of animals deserve special attention. They have a selective effect on the prostate, in particular, increase blood flow and restore microcirculation. Because of this, swelling is reduced, the risk of blood clots is reduced, pain is reduced, urination becomes normal, and prostate function is restored. In some cases, it is possible to use such drugs for the prevention of prostatitis.
Symptomatic medication
One of the main objectives of the treatment of chronic prostatitis is to save the patient from the manifestations of the painful disease. Symptomatic agents do not affect the course of the inflammatory process, but alleviate the patient's condition. So, what helps with prostatitis?
- Alpha blockerblocking nerve impulses from receptors located in the smooth muscle of the prostate, urethra, bladder. As a result, the cramps stop, the pain disappears, urination becomes normal. The action does not occur immediately, but after two weeks from the start of treatment.
- Antispasmodicset for the same purpose as alpha blockers. They help relax smooth muscles. Due to the removal of the spasm, the pain is reduced, the outflow of urine is restored.
- NSAIDsused to relieve pain and reduce inflammation. These medications act quickly, but they should not be used for long courses because of the risk of side effects.
The drug in the form of suppositories helps restore the function of the prostate gland, helps relieve pain and improves the process of urination.
How to choose a drug for the treatment of prostatitis
Urologists select therapeutic regimens and medications for the treatment of prostatitis based on the results of diagnosis and analysis of patient complaints. The therapy of this disease should be comprehensive: this is the only way to achieve a stable and lasting effect. If the test reveals an infection, the doctor will definitely prescribe antibiotics according to the type of pathogen. In other cases, pathogenetic and symptomatic therapies are used. The latter is selected based on the complaints that occur. For example, if a patient is worried about pain, NSAIDs are prescribed. For urinary problems, alpha blockers are used.
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 less frequently used.
Tablets and capsules are easy to take. However, suppositories, first, act faster: through the wall of the rectum, which is in contact with the prostate gland, the active substance is delivered via the lymphogen route immediately to the site of inflammation. Second, the drug in suppository form has a greater bioavailability: unlike tablets, it is not metabolized in the liver and the concentration of the active substance is not reduced. Finally, suppositories are safer in terms of side effects: in particular, they can be said to have no negative effects on the gastrointestinal tract.
In modern treatment regimens for chronic prostatitis, attention is paid to all components of therapy: etiotropic, pathogenetic and symptomatic. Medications should be selected by the physician, focusing on test results and patient complaints. An integrated approach to treatment and proper drug selection helps restore impaired function and forget about the symptoms of prostatitis for a long time.
Suppositories for prostatitis
One of the medications often prescribed by urologists for the treatment of chronic prostatitis is medication in suppository form. This tool has been used in clinical practice for over 30 years.
The active ingredient of the suppository is bovine prostate extract. It contains a complex of peptides that have a regulatory effect on prostate cells. The drug helps improve microcirculation and venous outflow, thus reducing inflammation and swelling, and reducing pain.
Indications for use - chronic abacterial prostatitis, conditions before and after prostate surgery, benign prostatic hyperplasia.
Suppositories are highly bioavailable. Peptides with low molecular weight readily penetrate biological barriers and are delivered to inflammatory foci. High levels of purification minimize the risk of allergies and other unwanted reactions.
Suppositories with bovine prostate extract are compatible with antibiotics and other drugs used in the complex therapy of chronic prostatitis. Means used with short courses (from 10 days). It is, however, affordable.