The method of treatment of chronic prostatitis

 

(57) Abstract:

The invention relates to medicine, in particular to urology and andrology. To improve erectile function and enhance the quality of the ejaculate of patients with chronic prostatitis enter doxazosin 2 mg once daily for 4 weeks. The method allows to improve the semen and improve erectile function in these patients. table 1.

The invention relates to medicine, in particular to urology.

There is a method of treatment of chronic bacteriologi prostatitis, which consists in prescribing, improves microcirculation in the pelvis, the rate of prostate massage for a period of from 2 to 12 weeks [1].

The disadvantage of this method is the inefficiency of their treatment often accompanies chronic prostatitis deterioration of semen (oligozoospermia, leukocytospermia, asthenozoospermia, teratozoospermia).

The objective of the invention is a method that allows along with treatment of chronic prostatitis patients with oligozoospermia, leukocytospermia, asthenozoospermia and/or teratozoospermia, to achieve a significant improvement of sperm and reduce the time antibacte long-term use of antibiotics [2].

The problem is solved by a method in which prescribe CarduraTMwithin 4-5 weeks. XatralTMdoxazosin (Doxazosin) 1-(4-amino-6,7-dimethoxy-2-hintline)-4[(2,3-dihydro-1,4-benzodioxin-2-yl)carbonyl]piperazine (and monoethanolamine) belongs to the group1-adrenoblokatorov. Pharmacological action antihypertensive vasodilator, hypolipidemic, antispasmodic [3].

In the case of bacterial prostatitis to doxazosin prescribe antibiotics fluoroquinolone series for a period of 2 weeks.

In the urological clinic MMA. I. M. Sechenov clinical study the effectiveness symptoms and quality of life and tolerability of doxazosin at a dose of 2 mg per day for 4-5 weeks in patients with chronic prostatitis. As follows from our clinical experience, our research allows us to assert that the use of doxazosin is effective in the treatment of patients with chronic abacterial prostatitis, and in combination with antibiotic therapy in the treatment of chronic bacterial prostatitis. The effectiveness of therapy doxazosin in patients with chronic prostatitis was expressed in the reduction of viraw the secret of the prostate gland, the improvement of blood circulation in the prostate, improve erectile function, improved urination, fertility.

Specific clinical examples of implementation of the proposed method.

1. Patient N., 34 years, appealed to the urological clinic of MMA with complaints of frequent urination, urgent desires, nousou pain in the perineum. Prostate palpation is painful. According to the survey: assessment of quality of life (QoL) - 4, scale of symptoms of chronic prostatitis (NIH-CPSI) - 14, international system total evaluation of diseases of the prostate (IPSS) - 12. In the analysis of prostate secretion was detected increase in the number of cells to 15-20 in the field of view. When the analysis of semen was asthenoteratozoospermia, leukospermia. Diagnosed with chronic abacterial prostatitis. The patient was scheduled therapy doxazosin 2 mg once daily for 4 week.

At follow-up at 4 weeks, the patient complained of dysuria. When finger rectal examination prostate painless. According to the survey: assessment of quality of life (QoL) - 2, scale of symptoms of chronic prostatitis (NIH-CPSI) - 8, the international system is s reduced to 5-10 in the field of view. Improved semen: if you take the number of sperm in the ejaculate for 100%, the number of motile sperm increased from 40% to treatment doxazosin to 75% after admission. And the number of actively motile sperm increased from 15% to treatment doxazosin to 29% after. All parameters of spermogram the patient is normalized. Conclusion normozoospermia.

2. Patient B., 24, turned in the urological clinic of MMA with complaints of pain during and after urination, frequent urination with an imperative urge, a feeling of cold in the perineum. Prostate palpation is painful. According to the survey: assessment of quality of life (QoL) - 4, scale of symptoms of chronic prostatitis (NIH-CPSI) - 16, international system total evaluation of diseases of the prostate (IPSS) - 11. In the analysis of a secret of a prostate was identified increasing the number of cells to 20-25 in the field of view. When sowing secret of the prostate detected E. coli CFU 1*104. When the analysis of semen was oligoasthenozoospermia, leukospermia. Diagnosed with chronic bacterial prostatitis. The patient was scheduled therapy doxazosin 2 mg once daily for 4 weeks, antibacteria follow-up at 4 weeks, the patient complained of dysuria. When finger rectal examination prostate painless. According to the survey: assessment of quality of life (QoL) - 2, scale of symptoms of chronic prostatitis (NIH-CPSI) - 6, international system total evaluation of diseases of the prostate (IPSS) - 4. In the analysis of a secret of a prostate, the number of leukocytes decreased to 10 in the field of view, in the sowing of the secret of the growth of microorganisms is not detected. Improved semen: if you take the number of sperm in the ejaculate for 100%, the number of motile sperm increased from 32% before treatment to 77% after. And the number of actively motile sperm increased from 16% to treatment doxazosin to 29% after. All parameters of spermogram the patient is normalized. Conclusion normozoospermia.

The patient had not noticed any side effects associated with taking doxazosin and ciprofloxacin.

The proposed method is applied in the treatment of 26 patients with chronic bacterial prostatitis. The main parameter is effective in the treatment of patients served by the assessment of the quality of life of the patient and the symptoms scale NIH-CPSI, IPSS and also the analysis of a secret of a prostate. In addition, given that in the development of the inflammatory process essential belong the circulation of prostatitis and inflammatory process in the tissue of the prostate lead to changes in the composition, the quantity and quality of prostate secretion that, in turn, affects the quality of the ejaculate, and, therefore, fertility. In this regard, we conducted a study of sperm before and after treatment with doxazosin. In addition, we assessed changes in erectile function during therapy with doxazosin. Erectile function we estimated on the basis of sexual questionnaire. One of the parameters was efficacy study parameters uroflowmetry before and after treatment. We also studied the tolerability and side effects when it is applied. The results of our study are presented in the table (see the table).

Application of the proposed method with minimal side effects to improve the status of patients and improve the quality of life, reduce clinical manifestations of chronic prostatitis, and improve semen quality in patients with chronic prostatitis.

Literature

1. Nickel JC. Prostatitis: evolving management strategies. Urol din North Am. 1999;26:743-751.

2. Bjerklund-Johansen T, Gruneberg RN, Guibert J, et al. The role of antibiotics in the treatment of chronic prostatitis: a consensus statement. Eur Urol. 1998;34:457-466.

3. Encyclopedia of medicine (8th edition, Moscow, 2001) S. 308.

The way to improve erectile function is once a day for 4 weeks.

 

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