What medicine should I take for frequent urination due to prostatitis?

Prostatitis is a common disease in men. There is actually no specific cause for prostatitis, and clinical medicine is still conducting research. Patients with prostatitis generally experience urethral pain. Clinical treatment of prostatitis involves antibacterial treatment, generally taking ofloxacin and other drugs. This article introduces specific treatment methods for prostatitis. If you have this problem, let's take a look.

Prostatitis refers to a prostate disease caused by a variety of complex reasons, with urethral irritation symptoms and chronic pelvic pain as the main clinical manifestations. Prostatitis is a common disease in urology, and ranks first among male patients under 50 years old in urology. Although the incidence of prostatitis is very high, its cause is still not very clear, especially non-bacterial prostatitis, so its treatment focuses on improving symptoms. In 1995, the National Institutes of Health (NIH) of the United States developed a new classification method for prostatitis, Type I: equivalent to acute bacterial prostatitis in the traditional classification method, Type II: equivalent to chronic bacterial prostatitis in the traditional classification method, Type III: chronic prostatitis/chronic pelvic pain syndrome, Type IV: asymptomatic prostatitis. Among them, non-bacterial prostatitis is far more common than bacterial prostatitis.

treatment

1. Antimicrobial therapy

The detection of pathogenic pathogens in prostatic fluid culture is the basis for selecting antibacterial drug treatment. If patients with non-bacterial prostatitis have signs of bacterial infection and general treatment is ineffective, they can also be appropriately treated with antibacterial drugs. When choosing antibacterial drugs, it is necessary to pay attention to the presence of a prostate-blood barrier composed of lipid membranes between the prostate acini and the microcirculation. The barrier prevents the passage of water-soluble antibiotics, greatly reducing the treatment effect. When prostate stones are present, the stones can become a shelter for bacteria. The above factors constitute the difficulty in the treatment of chronic bacterial prostatitis, which requires a longer course of treatment and is prone to recurrence.

Currently, quinolone drugs such as ofloxacin or levofloxacin are recommended. If ineffective, continue to use it for 8 weeks. If recurrence occurs and the bacterial species remains unchanged, switch to preventive doses to reduce acute attacks and relieve symptoms. If long-term use of antibiotics induces serious side effects, such as pseudomembranous colitis, diarrhea, and the growth of intestinal resistant strains, the treatment plan needs to be changed. Whether non-bacterial prostatitis is suitable for treatment with antibacterial drugs is still controversial in the clinic. Patients with "aseptic" prostatitis can also use drugs that are effective against bacteria and mycoplasmas, such as quinolones, SMZ-TMP or TMP alone, used in combination with tetracycline and quinolones or used intermittently. If antibiotic treatment is ineffective and it is confirmed to be aseptic prostatitis, antibiotic treatment should be discontinued. In addition, using a double balloon catheter to block the prostatic urethra and injecting antibiotic solution from the urethral cavity back into the prostatic duct can also achieve the purpose of treatment.

Type I is mainly treated with broad-spectrum antibiotics, symptomatic treatment and supportive treatment. Type II is recommended to be treated with oral antibiotics, and sensitive drugs are selected. The course of treatment is 4 to 6 weeks, during which the patient should be evaluated for the efficacy. Type III can first take oral antibiotics for 2 to 4 weeks and then evaluate the efficacy. At the same time, non-steroidal anti-inflammatory drugs, α receptor antagonists, M receptor antagonists, etc. are used to improve urination symptoms and pain. Type IV does not require treatment.

2. Anti-inflammatory and analgesic drugs

Nonsteroidal anti-inflammatory drugs can improve symptoms. Generally, indomethacin is taken orally or in suppositories. Chinese medicines that use anti-inflammatory, heat-clearing, detoxifying, and hardness-softening drugs also have certain effects. Allopurinol can reduce the concentration of uric acid in the whole body and prostatic fluid. In theory, it can be used as a free radical scavenger, and it can also remove active oxygen components, reduce inflammation, and relieve pain. It is an optional auxiliary treatment method.

3. Physical therapy

Prostate massage can empty the concentrated secretions in the prostate duct and drain the infection focus in the obstructed area of ​​the gland. Therefore, for stubborn cases, prostate massage can be performed every 3 to 7 days while using antibiotics. A variety of physical factors are used for prostate physiotherapy, such as microwave, radio frequency, ultrashort wave, medium wave and hot water sitz bath, which are beneficial for relaxing the prostate, posterior urethral smooth muscle and pelvic floor muscle, enhancing antibacterial efficacy and relieving pain symptoms.

4.M receptor antagonists

M receptor antagonists can be used to treat prostatitis patients with symptoms of overactive bladder, such as urgency, frequency, and nocturia, but without urinary tract obstruction.

5. α receptor antagonists

Patients with prostatitis, bacterial or non-bacterial prostatitis have increased tension in the prostate, bladder neck and urethral smooth muscles. During urination, the increased intraurethral pressure causes urine to flow back into the prostate duct, which is an important cause of prostatitis, prostatic stones and bacterial prostatitis. The use of α receptor antagonists can effectively improve prostatitis and urination symptoms, help prevent urine from flowing back into the prostate, and is important for preventing recurrence of infection. It also plays an important role in the treatment of type III prostatitis. α receptor antagonists should be used for a longer course of treatment to allow enough time to adjust smooth muscle function and consolidate the therapeutic effect. Different α receptor blockers can be selected according to the patient's condition, mainly including: doxazosin, naftopidil, tamsulosin and terazosin.