About a third of men of active reproductive age — aged 20 to 40 — suffer from chronic prostatitis. Due to the disease, the quality of life of many patients is significantly restricted. Chronic prostatitis is difficult to treat, but it is possible to improve well-being, restore impaired functions and get rid of painful symptoms for a long time. The main thing 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 for treatment. Let's talk about what drugs for prostatitis are and how they work.
Groups of drugs against prostatitis
Any disease - and prostatitis is no exception - has a cause, a mechanism for the development of the pathological process and clinical manifestations. Accordingly, the directions of treatment also differ.
The question may arise: why is it impossible to limit yourself to etiotropic treatment, because after eliminating the cause, the development of the disease should stop and the symptoms disappear? With chronic diseases, including prostatitis, not everything is so simple. Firstly, it is not always possible to find and eliminate the cause. Secondly, when the pathological mechanism is already running, it supports itself, and even eliminating the etiological factor does not guarantee recovery. So, a universal remedy for prostatitis has not yet been developed: today, all the links in therapy are important.
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 tissue of a healthy prostate. On the other hand, the proportion of bacterial prostatitis is only about 10% of the overall occurrence structure, the remaining 90% of cases are nonbacterial forms. Probably, the infection plays a role only at an early stage of the development of the disease, since it is the trigger of the pathological process in the prostate. In the future, the importance of microbial flora decreases, and pathological changes in the tissues of the prostate (constipation, disturbed microcirculation, autoimmune mechanisms, etc. ) become more important factors. What drugs for prostatitis are used?
Etiotropic therapy of bacterial prostatitis involves the appointment of antibiotics. With the choice, too, everything is not as simple as it might seem. On the one hand, the spectrum of microorganisms is changing: Until recently, E. coli dominated among the pathogens of chronic prostatitis, but now more and more chlamydia, mycoplasma, ureaplasma, gardnerella and trichomonads are found. They are not sensitive to previously used antibiotics. Secondly, the resistance of microbes to the action of antibacterial agents is growing. 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 for prostatitis are consideredfluoroquinolones. They penetrate well into the tissues of the prostate, forming in it concentrations high enough to destroy microbes. Another advantage of fluoroquinolones is a wide spectrum of action: many types of pathogenic bacteria are sensitive to them. This group of drugs for prostatitis includes such active substances as ciprofloxacin, levofloxacin, lomefloxacin and others.
If chlamydia and other intracellular microorganisms are detected,macrolidesandtetracyclines. They are effective against a certain flora, but have a bad effect on typical pathogens of chronic prostatitis - Escherichia coli, staphylococci. The advantage of macrolides is low toxicity.
Preparations of pathogenetic therapy
Against the background of chronic inflammation in the tissues of the prostate, a complex of changes occurs. There is stagnation of secretion, venous outflow worsens, the trophism of the gland is disturbed, fibrosis (replacement of healthy connective tissue) gradually develops, immunity suffers. These interconnected pathological changes support the inflammatory process and reduce the effectiveness of etiotropic therapy. Restoring the structure and functions of the gland with the help of pathogenetic therapy will help break the vicious circle. Since many factors are involved in the pathogenesis of chronic prostatitis, the drugs in this group are diverse.
- immunomodulators. With a chronic inflammatory process, the work of all parts of the immune system is disrupted. Immune modulators regulate defense mechanisms and help manage 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 free radicals, which are formed in large quantities due to a sharp increase in the level of leukocytes in the secretion 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 preparations. Healthy glandular tissue is replaced by connective tissue as a result of chronic inflammation, oxidative stress and insufficient blood flow. Enzyme preparations (mainly based on hyaluronidase) slow down the development of fibrosis.
Among the drugs taken against prostatitis, peptide bioregulators obtained from the prostate gland of animals deserve special attention. They act selectively on the prostate, in particular improving blood flow and restoring microcirculation. As a result, swelling decreases, the risk of blood clots decreases, pain subsides, urination normalizes, and prostate functions are restored. In some cases, it is possible to use such drugs to prevent prostatitis.
One of the main goals of treating chronic prostatitis is to save patients from the painful manifestations of the disease. Symptomatic remedies do not affect the course of the inflammatory process, but alleviate 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 goes away, urination returns to normal. The effect does not occur immediately, but two weeks after the start of treatment.
- antispasmodicsprescribed for the same purpose as alpha blockers. They help relax smooth muscles. With the removal of spasms, the pain decreases, the outflow of urine is restored.
- NSAIDsused to relieve pain and reduce inflammation. These drugs act quickly, but they cannot be used for long courses due to the risk of side effects.
The drug in the form of suppositories helps restore the functions of the prostate, relieve pain and improve the process of urination.
How to choose a drug for the treatment of prostatitis
The urologist selects the therapeutic regimen and drugs for the treatment of prostatitis based on the results of the diagnosis and analysis of the patient's complaints. The therapy of this disease should be comprehensive, only in this way can a stable and lasting effect be achieved. In any case, 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 based on the prevailing complaints. For example, if the patient is concerned about pain, NSAIDs are prescribed. Alpha blockers are used for problems with urination.
The drugs used for prostatitis differ not only in the 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. First of all, suppositories work faster: the active substance reaches the site of inflammation via the lymphatic route through the wall of the rectum, which is in contact with the prostate. Secondly, drugs in the form of suppositories have higher bioavailability: unlike tablets, they are not metabolized in the liver and the concentration of the active substance does not decrease. After all, suppositories are safer in terms of side effects: in particular, they practically do not have any 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. Drugs should be selected by the doctor, focusing on the results of the tests and the patient's complaints. An integrated approach to treatment and the right choice of drugs will help restore impaired functions and forget about the symptoms of prostatitis for a long time.
Suppositories for prostatitis
One of the drugs that urologists often prescribe for the treatment of chronic prostatitis are drugs in the form of suppositories. This instrument has been used in clinical practice for over 30 years.
The active substance of the suppositories is bovine prostate extract. It contains a complex of peptides that have a regulatory effect on prostate cells. The drug helps to improve microcirculation and venous outflow, which reduces inflammation and swelling and relieves pain.
Indications for use - chronic nonbacterial prostatitis, conditions before and after prostate operations, benign prostatic hyperplasia.
Suppositories are highly bioavailable. Low molecular weight peptides easily penetrate biological barriers and are delivered to the focus of inflammation. The high degree of purification minimizes the risk of allergic and other undesirable reactions.
Suppositories with bovine prostate extract are compatible with antibiotics and other drugs used in complex therapy of chronic prostatitis. The remedy is applied through a short course (from 10 days). However, it is affordable.