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 the quality of life of a man. 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.

Medicines for prostate adenoma

a cure for prostatitis

The appointment of medications 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:
    • irritative (frequent urination, urinary incontinence, nighttime urge, strong urge to urinate, uncontrollable);
    • obstructive (difficulty urinating, weakening the pressure of the jet, dripping).
    • 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 medicine for prostate adenoma can have different routes of administration:

  • injections;
  • pills;
  • 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

pills for prostatitis

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

In the gland affected by the tumor, the urethra and bladder, the number of alpha-adrenoceptors is increased, and the progress of the disease contributes to their excessive stimulation, resulting in a spasm of the smooth muscles of the organs, which explains the occurrence 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 blockade them.

Several subtypes of alpha-1-adrenergic receptors are known, which are located not only in the urogenital 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 subtypes of adrenergic receptors, then this will lead to a number of side effects from the heart and blood vessels. There are several alpha-blockers that selectively bind to α₁-adrenergic receptors.

A drug for prostate adenoma containing tamsulosin, terazosin, doxazosin as an active ingredient is considered the No. 1 drug among alpha-blockers in the treatment of BPH.

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

Reasons for choosing alpha-blockers:

  • moderate and severe symptoms of the disease;
  • the predominance of severe irritative symptoms;
  • the volume of the enlarged organ is not more than 55 cm³ (the medication does not contribute to a decrease in size).

Advantages:

  • eliminate symptoms after 48 hours from the moment of application;
  • do not reduce the level of prostate-specific antigen in the blood (does not mask prostate cancer);
  • improve fat metabolism (reduce 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 into 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.

Release form of drugs: tablets and capsules.

5-alpha reductase inhibitors

drugs 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, passes into the form of dihydroteststerone, which, by binding to a specific receptor, forms a complex that triggers the rapid division and growth of gland cells. The result is prostatic hyperplasia. The organ increases in size 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, male breast growth, softening of bone tissue, muscle atrophy).

Reasons for choosing 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 from symptoms of obstruction 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 beginning of therapy, the faster it will decrease.

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 the treatment of prostate adenoma with herbal remedies:

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

Creeping palm extract (Serenoa repens)

The largest number of randomized clinical trials have been conducted in relation to this plant, as a result of which reliable data on its effectiveness have been obtained.

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

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 full sex life. With prolonged use, the volume of the tumor decreases. Creeping palm extract does not affect the level of prostate-specific antigen in the blood.

The drug for prostate adenoma based on the Serenoa repens plant is considered the No. 1 drug in herbal medicine for the disease. With mild symptoms and a small tumor size, monotherapy is performed with a medication based on creeping palm.

Release form: tablets and capsules.

Other herbal remedies

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

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

Combined treatment - a modern approach

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

  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 begin 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 are realized from both groups of drugs. The drug for prostate adenoma based on tadalafil is a ready-made combined remedy. It also has a therapeutic effect in 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 a tendency to tumor progression: alpha-adrenoblocker + phytopreparation;
  • obstructive symptoms and large tumor sizes: 5-alpha-reductase inhibitor + phytopreparation.

Medicines of animal origin

In the process of treatment, medicines-extracts of dried animal organs have successfully proven themselves. The medicine for prostate adenoma based on the extract of the prostate gland of young bulls who 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.

Medicines for prostatitis

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

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

    These substances are able to penetrate into 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 drugs:
    • hormonal injections;
    • non-steroid 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, clinical studies in this area have not been conducted.