Overview of modern drugs for the treatment of prostatitis and prostate adenoma.

Male urological diseases, such as prostate adenoma and prostatitis, are characterized by a pronounced impact on a man's quality of life. Violation of urination, pain syndrome, decreased sexual activity, infertility and many other problems are the reason for contacting specialists. The variety of drugs produced for prostate adenoma allows you to avoid surgical interventions, complications and other unpleasant changes in a man's life.

Medications for prostate adenoma

a cure for prostatitis

The appointment of drugs is carried out individually, depending on the nature of the course of the disease and is determined by a set of criteria:

  1. The prevalence of a certain type of symptomatology:
    • irritant (frequent urination, urinary incontinence, nocturnal urgency, strong urge to urinate, uncontrollable);
    • obstructive (difficulty urinating, weakening of jet pressure, dribbling).
    • Presence/absence of complications.
    • Diagnostic data:
      • Ultrasound (size);
      • characteristics of the urine stream, the presence of residual urine.
      • Presence/absence of comorbidities.
      • The presence of infectious complications.
      • The degree of damage to the bladder and kidneys.
      • The relevance of sexual activity for men.

The drug for prostate adenoma can have several routes of administration:

  • injections;
  • tablets;
  • rectal suppositories;
  • instillations (introduction of substances into the urethra);
  • microclysters.

The point of application of the drug is a certain link in the pathogenesis of the disease, based on this they are combined into groups.

alpha blockers

prostatitis pills

This group is a leader in the treatment of benign prostatic hyperplasia (BPH).

In the gland affected by the tumor, the urethra and the bladder, the number of alpha-adrenoceptors increases, and the progress of the disease contributes to their excessive stimulation, resulting in spasm of the smooth muscles of the organs, which explains the appearance. of irritative symptoms. The principle of operation of the drug is to bind the active substance to the α₁ adrenergic receptors of the genitourinary organs and block them.

Several subtypes of alpha-1-adrenergic receptors are known, which are located not only in the genitourinary organs, but also in the walls of the main human arteries. If a drug from this group does not selectively bind to the receptor, but binds to all adrenergic receptor subtypes, this will cause a number of side effects on the heart and blood vessels. There are several alpha blockers that selectively bind to α 1 adrenergic receptors.

The drug for prostate adenoma, which contains tamsulosin, terazosin, doxazosin as active ingredient, is considered the number 1 drug among alpha-blockers in the treatment of BPH.

These substances selectively and for a long time block adrenergic receptors.

Reasons to choose alpha blockers:

  • moderate and severe symptoms of the disease;
  • the predominance of severe irritative symptoms;
  • the volume of the enlarged organ does not exceed 55 cm³ (the drug does not contribute to the reduction in size).

advantages:

  • eliminate symptoms after 48 hours from the moment of application;
  • does not reduce the level of PSA in the blood (does not mask prostate cancer);
  • improve fat metabolism (lower cholesterol);
  • increase the sensitivity of receptors to insulin (prevention of diabetes mellitus);

The pronounced effect of the application occurs after a few weeks from the start of administration and reaches a maximum after 3-6 months.

Side effects: orthostatic hypotension, tachycardia, dry mouth, nausea, abdominal pain, headaches, weakness, impotence, reverse sperm reflux to the bladder during ejaculation, visual impairment, etc. Undesirable effects develop in about 15% of patients.

The drug causes a decrease in blood pressure, so the initial doses in the treatment of drugs from this group of prostatitis are minimal.

Drug release form: tablets and capsules.

5-alpha reductase inhibitors

medications for prostatitis

The development of BPH is based on age-related hormonal changes related to testosterone metabolism. In the cells of the organ, testosterone, with the help of the enzyme 5-alpha-reductase, is converted into dihydrotestosterone, which, by binding to a specific receptor, forms a complex that triggers rapid cell division and growth. glandular. . The result is prostatic hyperplasia. The organ enlarges and causes obstructive symptoms.

A drug for prostate adenoma based on a 5-alpha reductase inhibitor neutralizes the action of the enzyme, thereby stopping the progression of the tumor, reducing its size and restoring free urination.

In the practice of treating the disease with 5-alpha-reductase inhibitors, drugs based on finasteride and dutasteride, steroid hormones, are used. The advantage of these substances is considered to be a selective effect only on the metabolite dihydrotestosterone. Unlike other hormonal agents, they do not bind to sex hormone receptors and, accordingly, do not cause hormone-dependent side effects (pronounced sexual dysfunction, growth of male breasts, softening of bone tissue, muscle atrophy).

Reasons to choose 5-alpha reductase inhibitors:

  • moderate and severe symptoms of the disease;
  • the predominance of severe obstructive symptoms;
  • the volume of the enlarged organ is more than 55 cm³;

Disadvantages:

  • decreased libido, weakened erection;
  • a decrease in the blood level of prostate-specific antigen, which masks the early detection of prostate cancer;

Relief of obstructive symptoms occurs after a few weeks, on average after 4-6 months. At 3-4 years of use, the volume of the hyperplastic organ steadily decreases by 25%. The larger the tumor was at the start of therapy, the faster it will shrink.

Release form: tablets.

Phytotherapy

celandine for the treatment of prostatitis

The effectiveness of plants in the treatment of the disease is due to phytosterols, the main advantages of which are recognized as a combined mechanism of action and a minimum of side effects.

Reasons for treating prostate adenoma with herbal remedies:

  • mild symptoms of the disease;
  • a slight increase in the size of the tumor;
  • the patient's desire to maintain full sexual activity during treatment.

Creeping palm extract (Serenoa repens)

The largest number of randomized clinical trials have been carried out with respect to this plant, thanks to which reliable data on its efficacy have been obtained.

Herbal medicine for prostate adenoma contains lipidosterols. The mechanism of its action is to inhibit the metabolism of testosterone by suppressing the activity of 5-alpha reductase and blocking the binding of dihydrotestosterone to receptors. Due to the anti-inflammatory effect, the edema decreases, the vascular wall is restored, and the blood flow is normalized.

A multifaceted effect on the pathological process ensures the elimination of both irritative and obstructive symptoms. An important advantage of using creeping palm extract is the absence of hormone-dependent side effects, which allows you to use this remedy without restrictions if you want to have a fulfilling sex life. With prolonged use, the volume of the tumor decreases. Creeping palm extract does not affect the level of PSA in the blood.

The drug for prostate adenoma based on the plant Serenoa repens is considered the number 1 drug in herbal medicine for the disease. With mild symptoms and a small tumor size, monotherapy with a drug based on creeping palm is carried out.

Release form: tablets and capsules.

Other herbal remedies

Among the medicinal plants that have a positive effect on the disease, there are also:

  • African plum bark extract (Pygeum africanum). The active ingredient is lipidosterols, which have a pronounced anti-inflammatory property, suppress uncontrolled cell growth, reduce hyperexcitability of the muscular layer of the bladder and urethra, thereby eliminating irritative symptoms, and also slightly reduce the volume of education.
  • The plant extract of Hypoxis rooperi is a combination of phytosterols and their glycosides. Substances suppress the inflammatory process, normalize the tone of the vessels of the genitourinary organs, eliminate dysuric phenomena. The substance normalizes the metabolism of fats in the body.
  • Pumpkin seed oil (Cucurbita pepo) has anti-inflammatory, anti-proliferative metabolic properties and also stimulates the immune system, improves urination and reduces pain.
  • nettle root (Urtica dioica). Reduces inflammatory processes, dysuric phenomena, does not affect the size of the tumor;
  • extracts from various tropical plants.

Combined treatment - a modern approach

The leading position in the treatment of hyperplasia is occupied by 3 groups of drugs:

  1. Alpha blockers.
  2. 5-alpha reductase inhibitors.
  3. Phytopreparations.

Combination Options:

  • with severe symptoms of the disease and a significant increase in the tumor, it is advisable to use combinations of alpha-blockers and 5-alpha-reductase inhibitors. Alpha blockers start to work after a few hours or days, and the clinical effect of 5-alpha-reductase inhibitors appears after a few months. The negative side of combination therapy is the full range of side effects that occur with both groups of drugs. The drug for prostate adenoma based on tadalafil is a ready-to-use combination remedy. It also has a therapeutic effect on erectile dysfunction, therefore it is prescribed for the treatment of hyperplasia only for sexually active men with a healthy heart and blood vessels. Available in tablets;
  • irritative symptoms and tendency to tumor progression: alpha-adrenoblocker + phytopreparation;
  • obstructive symptoms and large tumors: 5-alpha reductase inhibitor + phytopreparation.

Medicines of animal origin

In the process of treatment, drug extracts from dried animal organs have proven their effectiveness. The drug for prostate adenoma based on the extract of the prostate gland of young bulls that have reached puberty has a complex effect: anti-inflammatory, decongestant, analgesic, normalizing blood flow.

With infectious complications, the means used for the treatment of prostatitis are used.

medications for prostatitis

The pharmacological treatment of prostatitis is complex. The main groups of funds:

  1. Antibiotics:
    • fluoroquinolones;
    • macrolides;
    • tetracyclines.

    These substances can penetrate the tissue of the affected organ and destroy bacteria - the cause of prostatitis. They are used in the form of tablets and injections.

  2. proteolytic enzymes. Enzymes interfere with the process of organ fibrosis.
  3. Venotonics. To normalize venous circulation.
  4. Anti-inflammatory medications:
    • hormonal injections;
    • non-steroidal drugs.
    • Medicines of animal origin (similar to the treatment of hyperplasia).
    • Phytopreparations (similar to the treatment of hyperplasia).

For the treatment of prostate adenoma and prostatitis, a Chinese patch has now become popular - a concentrate of 7 medicinal herbs; however, no clinical studies have been conducted in this area.