Prostatitisis an inflammatory disease of the prostate.Begins to develop in 80% of young men aged 20-30.There are acute and chronic prostatitis.Bacterial prostatitis occurs in 10% of cases.We often find a combination of prostatitis with prostate adenoma and cystitis.
Prostatitis is usually treated at home, but in severe cases and acute forms, hospitalization may be necessary.
General information
Bacteria responsible for prostate inflammation:
- Escherichia coli (the most common pathogen);
- Klebsiella;
- staphylococci;
- streptococci;
- Pseudomonas aeruginosa;
- chlamydia;
- mycoplasma;
- gonococci;
- Trichomonas
Main symptoms:
- burning in the urethra;
- heaviness when urinating;
- frequent urge to urinate, accompanied by unpleasant sensations;
- slow stream of urine;
- feeling of fullness of the bladder even after urination;
- decrease in power;
- high temperature (in acute form).
Diagnostic methods:
- digital rectal prostate exam;
- 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 because only highly fat-soluble antibiotics can accumulate in sufficiently high concentrations in the prostate.
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 medications for bacterial prostatitis.Broad-spectrum drugs.Active against all prostatitis pathogens.
They are used for acute and chronic prostatitis.
Side effects:
- photodermatitis - allergic skin irritation under the influence of sunlight;
- tendonitis - inflammation of the tendons;
- heart rhythm disturbances - prolongation of the QT interval;
- anxiety;
- sleep disorders.
When fluoroquinolones are taken concomitantly with nonsteroidal anti-inflammatory drugs, convulsions similar to those seen 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 are chlamydia and mycoplasma.They have an anti-inflammatory effect.
The 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;
- bile stagnation;
- heart rhythm disturbances - prolongation of the QT interval
The course lasts 8 weeks.
Tetracyclines
Active against chlamydia and mycoplasma.Ineffective against common prostatitis pathogens.Their main advantage is that they are inexpensive and effective.
Used only for chronic prostatitis.
The duration of treatment is 8 weeks.
Side effects:
- peptic ulcer of the esophagus;
- liver and kidney damage;
- yellow discoloration of 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 causative agent of prostatitis is gonococcus.
Nitroimidazoles and nitrofurans
These medications are used to treat prostatitis caused by Trichomonas.
It is strictly forbidden to drink alcohol while taking them.
Side effects:
- metallic taste in the mouth;
- impaired coordination of movements;
- increased levels of liver enzymes in the blood;
- decreased number of red blood cells and white blood cells.
Non-antibacterial therapy
To successfully treat 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 drain inflammatory secretions from the prostate;
- physiotherapy;
- non-steroidal anti-inflammatory drugs - not used in conjunction with fluoroquinolones;
- herbal preparations;
- alpha-blockers.