Approximately 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 get rid of 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 prostatitis drugs exist and how they work.
Groups of drugs for prostatitis
Every 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 ourselves to etiotropic treatment, because after eliminating the cause, the development of the disease must stop and the symptoms will disappear? In the case of chronic diseases, including prostatitis, not everything is so simple. First, the cause is not always possible to find and eliminate. Second, when the pathological mechanism is already working, it is self-sustaining and even the elimination of the etiological factor does not guarantee recovery. So a universal cure for prostatitis has not yet been developed: today, all connections in therapy are important.
Etiotropic drugs
The etiology of chronic prostatitis is not well understood. On the one hand, the infection is considered to be the cause of the development of the inflammatory process. No microbes are found in the tissues of a healthy prostate gland. On the other hand, the share of bacterial prostatitis is only about 10% in the overall structure of the disease, the remaining 90% of cases are abacterial forms. Probably the infection plays a role only in the early stages of the disease, as a trigger for the pathological process in the prostate gland. In the future, the importance of the microbial flora decreases and pathological changes in prostate tissue (congestion, impaired microcirculation, autoimmune mechanisms, etc. ) become increasingly important factors. What drugs are used for prostatitis?
Etiotropic therapy for bacterial prostatitis involves the administration of antibiotics. With their choice, too, not everything is 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 more and more often chlamydia, mycoplasmas, ureaplasmas, gardnerella, trichomonads are found. They are not sensitive to antibiotics used before. 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.
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 kill germs. 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 such active substances as ciprofloxacin, levofloxacin, lomefloxacin and others.
When chlamydia and other intracellular micro-organisms are detected,macrolidesandtetracyclines. They are active against specific flora, but adversely affect the typical pathogens of chronic prostatitis - Escherichia coli, staphylococci. The advantage of macrolides is low toxicity.
Preparations for pathogenetic therapy
Against the background of chronic inflammation in the tissues of the prostate occurs a complex of changes. Stagnation of secretion is observed, venous outflow worsens, trophic gland is disturbed, 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 many factors are involved in the pathogenesis of chronic prostatitis, drugs in this group are diverse.
- Immunomodulators. In chronic inflammatory process, the work of all parts of the immune system is disrupted. Immunomodulators regulate defense mechanisms, helping to deal 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 free radicals, which are formed in large quantities due to the 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 in chronic prostatitis, antioxidants are prescribed: 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. Enzyme preparations (mainly based on hyaluronidase) slow down the development of fibrosis.
Note
Among the drugs taken for prostatitis, special attention should be paid to peptide bioregulators derived from the prostate gland of animals. 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 subsides, urination is normalized and prostate function is restored. In some cases, it is possible to use such drugs to prevent prostatitis.
Symptomatic drugs
One of the main goals of the treatment of chronic prostatitis is to save patients from the 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 blockersblock nerve impulses from receptors located in the smooth muscles of the prostate, urethra, bladder. As a result, the spasm stops, the pain disappears, urination is normalized. The effect does not occur immediately, but after two weeks of treatment.
- Antispasmodicsprescribed for the same purpose as alpha-blockers. They help relax smooth muscles. Due to the elimination of spasm pain decreases, urine flow is restored.
- NSAIDsused to relieve pain and reduce inflammation. These drugs work quickly, but cannot be used for long courses due to the risk of side effects.
The drug in the form of suppositories helps to restore the functions of the prostate gland, helps relieve pain and improve the process of urination.
How to choose a drug for the treatment of prostatitis
The urologist chooses the treatment regimen and drugs for the treatment of prostatitis based on the results of the diagnosis and analysis of the patient's complaints. The treatment of this disease must be comprehensive: this is the only way to achieve a stable and long-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 chosen on the basis of the prevailing complaints. For example, if the patient is concerned about pain, NSAIDs are prescribed. Alpha-blockers are used for urination problems.
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 frequently.
The tablets and capsules are convenient 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 lymphogenically immediately to the site of inflammation. Second, drugs in the form of suppositories have greater 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 virtually no negative effect 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 the right choice of drugs help to restore impaired function and forget about the symptoms of prostatitis for a long time.
Suppositories for prostatitis
One of the drugs that are often prescribed by urologists for the treatment of chronic prostatitis are drugs in the form of suppositories. This tool has been used in clinical practice for more than 30 years.
The active ingredient in 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, 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. Low molecular weight peptides readily cross biological barriers and are delivered to the site of inflammation. The high degree of purification minimizes the risk of allergic and other side effects.
Suppositories with bovine prostate extract are compatible with antibiotics and other drugs used in the complex therapy of chronic prostatitis. The remedy is applied with a short course (of 10 days). However, this is affordable.