prostatitisis an inflammatory disease of the prostate gland.It begins to develop in 80% of young men between the ages of 20 and 30.He has acute and chronic prostatitis.Bacterial prostatitis occurs in 10% of cases.A combination of prostatitis with prostate adenoma and cystitis is common.
Prostatitis is usually treated at home, but in severe cases and acute forms, hospitalization may be required.
General information
Bacteria causing inflammation of the prostate gland:
- Escherichia coli (the most common pathogen);
- Klebsiella;
- staphylococci;
- streptococci;
- Pseudomonas aeruginosa;
- chlamydia;
- mycoplasma;
- gonococci;
- Trichomonas
Main symptoms:
- burning in the urethra;
- difficulty urinating;
- frequent urge to urinate, accompanied by unpleasant sensations;
- slow stream of urine;
- feeling of bladder fullness even after urinating;
- reduced potency;
- high fever (in acute form).
Diagnostic methods:
- digital rectal examination of the prostate;
- ultrasound examination of the prostate;
- microscopic examination of a smear;
- bacterial culture of the smear;
- detection of bacterial DNA by PCR - Androflor.
Antibacterial therapy
The choice of antibiotics for the treatment of prostatitis is quite limited.This is due to the fact that only those antibiotics that are highly fat-soluble can accumulate in sufficiently high concentrations in the prostate gland.
List of antibacterial drugs for the treatment of acute prostatitis:
- fluoroquinolones;
- penicillins;
- cephalosporins;
- Aminoglycosides.
Antibiotics for the treatment of chronic prostatitis:
- fluoroquinolones;
- macrolides;
- Tetracyclines.
Fluoroquinolones
Fluoroquinolones are the most effective drugs for bacterial prostatitis.Broad spectrum drugs.Active against all prostatitis pathogens.
They are used for both acute and chronic prostatitis.
Side effects:
- photodermatitis - allergic skin irritation under the influence of sunlight;
- tendinitis - inflammation of the tendons;
- heart rhythm disorder - prolongation of the Q-T interval;
- anxiety;
- sleep disorder.
When fluoroquinolones are taken simultaneously with nonsteroidal anti-inflammatory drugs, convulsions similar to those during an epileptic seizure may occur.
In each specific case of illness, the dosage and form of use can only be prescribed by the attending physician.
Macrolides
The best drugs for prostatitis caused by intracellular pathogens - chlamydia and mycoplasma.They have an anti-inflammatory effect.
A disadvantage is its low effectiveness against the main pathogens - Escherichia coli and Klebsiella.
They are used only for chronic prostatitis in the form of tablets or capsules.
Side effects:
- increased liver enzymes in the blood;
- stagnation of bile;
- heart rhythm disorder - prolongation of the Q-T interval
The course is 8 weeks.
Tetracyclines
Active against chlamydia and mycoplasma.Ineffective against common prostatitis pathogens.Their main advantage is that they are cheap and effective.
It is used only in chronic prostatitis.
The course of treatment is 8 weeks.
Side effects:
- peptic ulcer of the esophagus;
- liver and kidney damage;
- yellow staining of the teeth;
- photodermatitis;
- impaired coordination of movements.
Penicillins, cephalosporins and aminoglycosides
They are used in the form of injections in the following cases:
- severe course of acute prostatitis;
- lack of effect when taking fluoroquinolones;
- The main cause of prostatitis is gonococci.
Nitroimidazoles and nitrofurans
These drugs are used for prostatitis caused by Trichomonas.
During their reception, it is strictly forbidden to drink alcohol.
Side effects:
- metallic taste in the mouth;
- impaired coordination of movements;
- increased levels of liver enzymes in the blood;
- decrease in the number of red blood cells and white blood cells.
Non-antibacterial therapy
For the successful treatment of prostatitis, especially chronic, in addition to taking antibiotics, the following types of treatment are used:
- Prostate massage is the best way to improve blood supply and drainage of inflammatory secretions from the prostate gland;
- physical therapy;
- non-steroidal anti-inflammatory drugs - are not used in parallel with fluoroquinolones;
- herbal preparations;
- alpha blockers.