About a third of men of childbearing age - 20 to 40 years old - 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 what drugs can be used in treatment. Let's talk about the medications for prostatitis that exist and how they work.
Groups of drugs for prostatitis
Any disease - and prostatitis is no exception - has a cause, a mechanism for the development of the pathological process and clinical manifestations. In accordance with this, the treatment directions also differ.
The question may arise: why is it impossible to limit yourself to etiotropic treatment, because after the elimination of 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 is not always possible to find and eliminate. Secondly, when the pathological mechanism is already in motion, it supports itself, and even the elimination of the etiological factor does not guarantee recovery. Thus, a universal remedy for prostatitis has not yet been developed: today, all links in therapy are important.
Etiotropic drugs
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 germs are found in the tissues of a healthy prostate. On the other hand, the proportion of bacterial prostatitis is only about 10% in the overall incidence structure, the remaining 90% of cases are abacterial forms. Probably, the infection plays a role only at an early stage in the development of the disease, being the trigger 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 more important factors. What drugs for prostatitis are used?
Etiotropic therapy of bacterial prostatitis involves the appointment of antibiotics. With their selection too, not everything is as simple as it seems. First, the spectrum of microorganisms is changing: if until recently E. coli prevailed among the causative agents of chronic prostatitis, now more and more chlamydia, mycoplasma, ureaplasma, gardnerella, trichomonas are found. They are not sensitive to previously used antibiotics. Second, the resistance of microbes 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.
Antibacterial drugs effective against prostatitis are consideredfluoroquinolones. They penetrate well into the tissues of the prostate and form there concentrations high enough to destroy microbes. Another advantage of fluoroquinolones is a broad 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.
When chlamydia and other intracellular microorganisms are detected,macrolidesandtetracyclines. They are active against specific flora, but have a detrimental effect on typical pathogens of chronic prostatitis - Escherichia coli, staphylococci. The advantage of macrolides is their low toxicity.
Pathogen therapy preparations
Against the background of chronic inflammation of the tissues of the prostate, a complex of changes occurs. There is a stagnation of secretion, venous outflow worsens, the trophism of the gland is disturbed, fibrosis gradually develops (replacement of healthy connective tissue), immunity suffers. These interrelated pathological changes promote the inflammatory process and reduce the effectiveness of etiotropic therapy. Restoring the structure and functions of the gland with the help of pathogenetic therapy helps to break the vicious circle. Since many factors are involved in the pathogenesis of chronic prostatitis, the drugs of this group are diverse.
- Immunomodulators. In a 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 a sharp increase in the content of leukocytes in the secretion of the prostate. Oxidative stress exacerbates and sustains 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. 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.
To note
Among the drugs taken for prostatitis, peptide bioregulators obtained from the prostate of animals deserve special attention. They have a selective effect on the prostate, in particular, improve blood flow and restore microcirculation. Due to this, swelling decreases, the risk of blood clots decreases, pain decreases, urination normalizes, and prostate functions are restored. In some cases, it is possible to use these drugs for the prevention of 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 relieve 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 subsides, urination normalizes. The action 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 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 because of the risk of side effects.
The drug in the form of suppositories helps restore the functions of the prostate, helping to relieve pain and improve the process of urination.
How to choose a drug for the treatment of prostatitis
The urologist selects the treatment regimen and drugs for the treatment of prostatitis based on the results of the diagnosis and the analysis of the patient's complaints. Treatment of this disease should be comprehensive: this is the only way to achieve a stable and lasting effect. If the tests reveal an infection, the doctor will certainly prescribe antibiotics depending on the type of pathogen. In other cases, pathogenetic and symptomatic therapy is used. The latter is selected according to the complaints in force. For example, if the patient is concerned about pain, NSAIDs are prescribed. For problems with urination, alpha-blockers are used.
Drugs used for prostatitis differ not only in composition and therapeutic mechanism of action, but also in the form of release. The main ones are tablets, capsules and rectal suppositories. Drugs in the form of injections are used less frequently.
Tablets and capsules are convenient to take. However, suppositories, firstly, act faster: through the wall of the rectum, which is in contact with the prostate gland, the active substance is delivered lymphogenously immediately to the site of inflammation. Secondly, 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 practically 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. Medicines should be selected by the doctor, focusing on test results and patient complaints. An integrated approach to treatment and the right choice of drugs help to restore impaired functions and forget about the symptoms of prostatitis for a long time.
Suppositories for prostatitis
One of the drugs often prescribed by urologists for the treatment of chronic prostatitis is the drug in the form of suppositories. This tool has been used in clinical practice for more than 30 years.
The active ingredient of suppositories is bovine prostate extract. It contains a complex of peptides which have a regulating effect on prostate cells. The drug helps improve microcirculation and venous outflow, thereby 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 focus of inflammation. The high degree of purification minimizes the risk of allergic reactions and other adverse reactions.
Suppositories with bovine prostate extract are compatible with antibiotics and other drugs used in the complex treatment of chronic prostatitis. Means are applied by a short course (from 10 days). It is however affordable.