Approximately one third of men of active reproductive age - from 20 to 40 years old - suffer from chronic prostatitis. Due to the disease, the quality of life of many patients is markedly 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 what drugs for prostatitis 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 directions of treatment also differ.
The question may arise: why it is impossible to confine ourselves 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 running, it supports itself, 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 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 microbes are found in the tissues of a healthy prostate gland. On the other hand, the proportion of bacterial prostatitis is only about 10% in the overall structure of the incidence, the remaining 90% of cases are abacterial forms. Probably, the infection plays a role only at an early stage of the development of the disease, being the trigger of the pathological process in the prostate gland. In the future, the importance of the microbial flora decreases, and pathological changes in the tissues of the prostate (congestion, impaired microcirculation, autoimmune mechanisms, and so on) become more important factors. What medicines 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 might seem. Firstly, the spectrum of microorganisms is changing: if until recently E. coli prevailed among the causative agents of chronic prostatitis, now chlamydia, mycoplasmas, ureaplasmas, gardnerella, trichomonads are increasingly being found. They are not sensitive to antibiotics previously used. Secondly, the resistance of microbes to the effects 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 against prostatitis are consideredfluoroquinolones. They penetrate well into the tissues of the prostate gland and form concentrations in them 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 against 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 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 a stagnation of the secretion, the venous outflow worsens, the trophism of the 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. The restoration of 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 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 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 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.
- Enzyme preparations. As a result of chronic inflammation, oxidative stress, lack of blood supply, healthy gland 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 obtained from the prostate gland 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 subsides, urination normalizes, and prostate functions are restored. In some cases, it is possible to use such drugs for the prevention of prostatitis.
Symptomatic drugs
One of the main objectives 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, 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 spasm, 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 to restore the functions of the prostate gland, helping to relieve pain and improve the process of urination.
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. Therapy 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 definitely prescribe antibiotics in accordance with 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. For problems with urination, alpha-blockers are used.
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. However, suppositories, firstly, act faster: through the wall of the rectum, which is in contact with the prostate gland, the active substance is delivered by the lymphogenous route 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 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. The 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 medicines help 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 drugs in the form of suppositories. This tool has been used in clinical practice for over 30 years.
The active ingredient 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, 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 and other undesirable reactions.
Suppositories with bovine prostate extract are compatible with antibiotics and other drugs used in the complex therapy of chronic prostatitis. Means is applied by a short course (from 10 days). It is, however, affordable.