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 damaged 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 which prostate medications 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 change.
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 functioning, it supports itself, and even the elimination of the etiological factor does not guarantee cure. 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 the cause of the development of the inflammatory process. No germs are found in the tissues of a healthy prostate gland. On the other hand, the percentage of bacterial prostatitis is only about 10% in the overall incidence structure, the remaining 90% of cases are bacterial forms. Perhaps, the infection plays a role only in an early stage of disease development, being the cause of the pathological process in the prostate gland. In the future, the importance of the microbial flora decreases and pathological changes in prostate tissues (load, impaired microcirculation, autoimmune mechanisms, etc. ) become more important factors. What medications are used for prostatitis?
Etiotropic therapy of bacterial prostatitis involves the appointment of antibiotics. By selecting them, too, not everything is as simple as it may seem. First, the spectrum of microorganisms is changing: if until recently E. coli prevailed among the causative agents of chronic prostatitis, now more and more are found chlamydia, mycoplasmas, ureaplasmas, gardnerela, trichomonas. 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.
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 germs. Another advantage of fluoroquinolones is a wide spectrum of action: many types of pathogenic bacteria are susceptible to them. This group of drugs against prostatitis includes such active substances as ciprofloxacin, levofloxacin, lomefloxacin and others.
When chlamydia and other intercellular microorganisms are detected,macrolidesANDtetracycline. They are active against specific flora, but have a bad effect on typical pathogens of chronic prostatitis - Escherichia coli, staphylococci. The advantage of macrolides is low toxicity.
Pathogenetic therapy preparations
Against the background of chronic inflammation in the prostate tissue, a complex of changes occurs. There is a stagnation of secretion, venous flow worsens, glandular trophism is disturbed, fibrosis develops gradually (replacement of healthy connective tissue), immunity suffers. These interrelated pathological changes support the inflammatory process and reduce the effectiveness of etiotropic therapy. Restoration of gland structure and functions 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 in 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 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 sharp increase in the leukocyte content in the secretion of the prostate gland. Oxidative stress exacerbates and maintains 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.
- Enzymatic preparations. As a result of chronic inflammation, oxidative stress, lack of blood supply, healthy glandular tissue is replaced by connective tissue. Enzymatic preparations (mainly based on hyaluronidase) slow down the development of fibrosis.
note
Among the medications taken for prostatitis, special attention deserves the bioregulators of peptides taken from the prostate gland of animals. They have a selective effect on the prostate, in particular, improve blood flow and restore microcirculation. Because of this, the swelling is reduced, the risk of blood clots is reduced, the 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 objectives 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 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 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 removal of the spasm, the pain is reduced, the urine output is restored.
- NSAIDsused to relieve pain and reduce inflammation. These drugs act quickly, but can not be used for long courses because of the risk of side effects.
The drug in the form of suppositories helps to restore the functions of the prostate gland, helping to relieve pain and improve the urination process.
How to choose a medicine for the treatment of prostatitis
The urologist selects the therapy 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 must be comprehensive: this is the only way to achieve a lasting and lasting effect. If 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 was selected based on the prevailing complaints. For example, if the patient is concerned about pain, NSAIDs are prescribed. For urinary problems, alpha-blockers are used.
The 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. Injectable medicines 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 gland, the active substance is distributed by the lymphogenic route immediately to the site of inflammation. Second, drugs in the form of suppositories have a 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 adverse effect on the gastrointestinal tract.
In modern treatment regimens for chronic prostatitis, attention is paid to all components of therapy: etiotropic, pathogenetic and symptomatic. Medication should be selected by the physician, focusing on the test results and the patient's complaints. An integrated approach to treatment and the right choice of medication help to restore damaged functions and forget about prostate symptoms for a long time.
Suppositories for prostatitis
One of the drugs that is often prescribed by urologists for the treatment of chronic prostatitis are medicines in the form of suppositories. This tool has been used in clinical practice for over 30 years.
The active ingredient of 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 flow, thus reducing inflammation and swelling, and reducing pain.
Indications for use - chronic bacterial prostatitis, conditions before and after prostate surgery, benign prostatic hyperplasia.
Suppositories are highly bioavailable. Low molecular weight peptides easily penetrate biological barriers and disperse into the focus of inflammation. High degree of cleansing minimizes the risk of allergic and other unwanted reactions.
Suppositories with bovine prostate extract are compatible with antibiotics and other drugs used in the complex therapy of chronic prostatitis. The tool is applied with a short course (from 10 days). However, it is affordable.