Approximately one third of men of active reproductive age - 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 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 task of the doctor, but in any case it is useful to know which drugs can be used in treatment. Let’s talk about what prostatitis medications exist and how they work.
Prostatitis drug groups
Any disease - and prostatitis is no exception - has a cause, a mechanism for the development of a pathological process and clinical manifestations. Accordingly, the directions of treatment also differ.
The question may be asked: why is it impossible to limit oneself to etiotropic treatment, because after eliminating 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, the cause cannot always be found and removed. Secondly, when the pathological mechanism is already started, it supports itself, and even the elimination of the etiological factor does not guarantee recovery. Thus, 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, the infection is considered to be the cause of the development of the inflammatory process. There are no microbes in the tissues of a healthy prostate. On the other hand, the share of bacterial prostatitis is only about 10% in the total structure of the incidence, the remaining 90% of cases are abacterial forms. Probably, the infection plays a role only in the early phase of the development of the disease, because it is the initiator of the pathological process in the prostate. In the future, the importance of the microbial flora decreases, and pathological changes in prostate tissues (congestion, impaired microcirculation, autoimmune mechanisms, etc. ) become increasingly important factors. What medications for prostatitis are used?
Etiotropic therapy for bacterial prostatitis involves the administration of antibiotics. Even with their choice, not everything is as simple as it seems. First, the spectrum of microorganisms is changing: if until recently E. coli was predominant among the causes of chronic prostatitis, now more and more chlamydia, mycoplasmas, ureaplasmas, gardnerella, trichomonads are being detected. They are not sensitive to previously used antibiotics. Second, the resistance of microbes to the action of antibacterial agents increases. Therefore, etiotropic drugs for the treatment of prostatitis are 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 and create concentrations in them high enough to destroy microbes. Another advantage of fluoroquinolones is their wide spectrum of action: many types of pathogenic bacteria are susceptible 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,macrolidesitetracyclines. They are active against specific flora, but have a bad effect on typical causes 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 occurs a complex of changes. Stagnation of secretions occurs, venous outflow worsens, gland trophism 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. Restoring 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 from this group are diverse.
- Immunomodulators. In the chronic inflammatory process, the work of all parts of the immune system is disturbed. 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 accompanies inflammation is oxidative stress. Prostate cells are damaged by free radicals, which are formed in large quantities due to a sudden increase in the content of leukocytes in the prostate secretion. Oxidative stress worsens 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, peptide bioregulators derived from animal prostate deserve special attention. They have a selective effect on the prostate, especially improve blood flow and restore microcirculation. Therefore, swelling is reduced, the risk of blood clots is reduced, pain is reduced, urination is normalized, and prostate functions are restored. In some cases, it is possible to use such drugs to prevent prostatitis.
Symptomatic medications
One of the main goals of treating 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 patient's condition. 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 normalizes. The effect 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 elimination of spasms, the pain is reduced, the outflow of urine is restored.
- NSAILit is used to relieve pain and reduce inflammation. These drugs work quickly, but cannot be used for a long time due to the risk of side effects.
The drug in the form of suppositories helps to restore prostate function, helps relieve pain and improve the process of urination.
How to choose a drug to treat prostatitis
The urologist selects the treatment regimen and drugs for the treatment of prostatitis based on the results of the diagnosis and analysis of the patient's complaints. Therapy of these diseases should be comprehensive: only in this way a stable and lasting effect is achieved. 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 prevailing complaints. For example, if a patient is worried 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. Injections are less commonly used.
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, the active substance is delivered lymphogenically immediately to the site of inflammation. Second, suppository drugs have a higher bioavailability: unlike tablets, they are not metabolized in the liver and the concentration of active ingredients is not reduced. Finally, suppositories are safer in terms of side effects: in particular, they have virtually no negative effect on the gastrointestinal tract.
In modern regimens for the treatment of 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 medications help to restore impaired functions and forget about the symptoms of prostatitis for a long time.
Suppositories for prostatitis
One of the medications that urologists often prescribe to treat chronic prostatitis are suppositories in the form of suppositories. This tool has been used in clinical practice for more than 30 years.
The active ingredient in the suppository is beef 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 easily penetrate biological barriers and are delivered to the site of inflammation. A 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 in a short course (of 10 days). It is, however, affordable.