Chronic prostatitis is a common disease of the genitourinary system in young and middle-aged men, and the prevalence of the domestic male population is close to 10%, the clinical manifestations are diverse, and the pathogenesis is complex. Although there are more treatments, it is easy to relapse, seriously affecting the mental health and quality of life of patients.
Frequent urination, urgency, and painful urination occur repeatedly within 1 month, or symptoms that occur at the same time as pain in the perineum, lumbosacral region, and even the lower abdomen, but cannot be relieved by themselves. If it lasts for more than 1 week, you need to see a doctor in time.
The symptoms, triggers, and classification of chronic prostatitis have not been mentioned much above, focusing on how to choose drugs, improve the cure rate, and reduce the recurrence rate.
1. α-receptor blockers (common trazazosin, doxazosin, tamsulosin, etc.)
α-blockers can reduce urinary tract symptoms and pain and increase urinary flow by relieving spasms of the urethra and bladder neck. Patients can choose different α-blockers according to individual differences. Generally starting with a small dose, and then gradually increasing the dose (the increased dose can achieve both the therapeutic effect and there is no obvious adverse reaction), the treatment time is recommended to continue for 6 months, and there is no good effect in the short term. It is generally more effective when combined with antibiotics.
Note: Adverse reactions of such drugs are common in vertigo, orthostatic hypotension, etc.
2. Antibiotic therapy
Antibiotic therapy, mainly for patients with type II and type III.a bacterial prostatitis, is widely used in clinical practice, but there are differences in efficacy, mainly related to the pathogenic microorganism of prostatitis and the structure of the prostate itself.
The microorganisms of prostatitis are commonly included E. coli, Pseudomonas, Enterococcus, Staphylococcus aureus, Mycoplasma, Chlamydia, and anaerobic bacteria. The presence of drugs in the prostate gland crosses the barrier, and the drug chosen should consider the antibacterial power of the drug and the ability to penetrate the barrier. Clinically, many drugs are difficult to fully penetrate the prostate acinar and prostatitis, resulting in repeated infections. The author believes that the principle of antibiotic use should be long-term, continuous, alternating, combined, and refer to the results of bacterial culture.
(1) Quinolones (norfloxacin, ciprofloxacin, lomefloxacin, etc.)
The ability to penetrate the prostate envelope is strong, and it can achieve effective bacteriostatic and bactericidal concentrations in the prostate, and is sensitive to Gram, Mycoplasma and Chlamydia. The use of quinolones is recommended for 8-12 weeks.
(2) Sulfonamides (compound sulfamethoxazole, etc.)
Clinically used more, it can inhibit the reproduction of pathogens in tissues, with few side effects and long-term tolerance.
Patients with refractory, recurrent chronic prostatitis may be treated with a continuous, low-dose drug approach. In addition, for patients with mycoplasma and chlamydia infection, doxycycline combined with azithromycin was treated for half a month, and the effect was remarkable.
Note: The treatment of antibiotics requires long-term and sufficient amounts, and when the symptoms are partially relieved, the bacteriostatic dose of antibiotics can be continued, and the prophylactic dose of antibiotics should be used when relapsing, and the medication regimen should be adjusted in time according to the susceptibility test.
3. Nonsteroidal anti-inflammatory drugs (commonly used ibuprofen, indomethacin, diclofenac sodium, etc.)
It is mainly used for pain relief and has a good effect in some patients.
Summary: Due to the variety of drugs, long treatment cycle, easy recurrence and other factors, the treatment of chronic prostatitis, it is necessary to achieve rational medication and targeted treatment in order to improve the treatment effect.