Overview of modern medicines for the treatment of prostatitis and prostate adenoma

Male urological diseases, such as prostate adenoma and prostatitis, are characterized by a significant impact on men's quality of life. Urination, pain syndrome, decreased sexual activity, infertility, and many other problems are reasons to contact a specialist. A variety of drugs are produced for prostate adenomas that allow you to avoid surgical interventions, complications and other unpleasant changes in a man's life.

Prostate adenoma drugs

treat prostatitis

The appointment of the drug is made individually, depending on the nature of the disease process, and is determined by a set of criteria:

  1. Prevalence of a certain symptom:
    • Irritant (frequency of urination, incontinence, nocturnal urge, strong urge to urinate, uncontrollable);
    • Obstruction (difficulty urinating, reduced jet pressure, dripping).
    • Presence/absence of complications.
    • Diagnostic data:
      • ultrasound(size);
      • Characteristic 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.
      • Correlation of sexual activity with men.

Drugs to treat prostate adenomas can be administered in a variety of ways:

  • injection;
  • pill;
  • rectal suppositories;
  • instillation (introduction of substances into the urethra);
  • Microperfusion.

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

alpha blocker

medicine for prostatitis

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

In the tumor-affected glands, urethra, and bladder, the number of alpha-adrenergic receptors increases, and the progression of the disease causes them to be overstimulated, causing smooth muscle spasms in the organs, which explain the irritation symptoms that occur. The principle of action of the drug is to bind the active substance to the alpha 1-adrenergic receptors of the urogenital organs and block them.

Several subtypes of alpha-1-adrenergic receptors are known, and they are located not only in the urogenital organs, but also in the walls of major arteries in the human body. If a drug in this group does not selectively bind to the receptor, but to all subtypes of adrenergic receptors, this will lead to many cardiac and vascular side effects. There are several alpha-blockers that selectively bind to alpha1-adrenergic receptors.

Prostate adenoma drugs with tamsulosin, terazosin, and doxazosin as active ingredients are considered to be the first-ranked drugs among alpha-blockers for the treatment of BPH.

These substances selectively and long-term block adrenergic receptors.

Reasons for choosing an alpha blocker:

  • Moderate and severe symptoms of the disease;
  • Severe irritation predominates;
  • The volume of the enlarged organ does not exceed 55 cubic centimeters (drugs will not help reduce the volume).

benefit:

  • Symptoms disappear after 48 hours from the moment of application;
  • Does not reduce the level of prostate-specific antigen in the blood (does not mask prostate cancer);
  • Improve fat metabolism (lower cholesterol);
  • increase the sensitivity of the receptors to insulin (prevention of diabetes);

The significant effect of the application occurs a few weeks after the start of dosing and reaches a maximum after 3-6 months.

Side effects: orthostatic hypotension, tachycardia, dry mouth, nausea, abdominal pain, headache, weakness, impotence, reverse flow of sperm into the bladder during ejaculation, visual disturbance, etc. Adverse reactions occur in about 15% of patients.

The drug causes a drop in blood pressure, so the initial dose of drugs to treat this group of prostatitis is minimal.

Drug release form: tablets and capsules.

5-alpha reductase inhibitor

Medications for Prostatitis

The development of BPH is based on age-related hormonal changes associated with testosterone metabolism. In organ cells, testosterone is converted to dihydrotestosterone with the help of 5-alpha-reductase, which forms a complex by binding to specific receptors, which triggers the rapid division and growth of glandular cells. The result is an enlarged prostate. Organs increase in size and cause obstructive symptoms.

A prostate adenoma drug based on a 5-alpha reductase inhibitor neutralizes the action of the enzyme, stopping the tumor from progressing, 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 selective only on the metabolite dihydrotestosterone. Unlike other hormonal agents, they do not bind to sex hormone receptors and therefore do not cause hormone-dependent side effects (significant sexual dysfunction, gynecomastia, softening of bone tissue, muscle atrophy).

Reasons for choosing a 5-alpha reductase inhibitor:

  • Moderate and severe symptoms of the disease;
  • Severe obstructive symptoms predominate;
  • Enlarged organ volume greater than 55 cubic centimeters;

shortcoming:

  • Decreased libido, weakened erections;
  • Reduced blood levels of prostate-specific antigen, which mask the early detection of prostate cancer;

Obstructive symptoms resolve after a few weeks, on average after 4-6 months. Over 3-4 years of use, the volume of the proliferative organ steadily decreases by 25%. The larger the tumor at the start of treatment, the faster the tumor shrinks.

Release form: tablet.

Phytotherapy

Celandine in the treatment of prostatitis

The effectiveness of phytotherapy for diseases is attributed to phytosterols, the main benefit of which is thought to be a combined mechanism of action with minimal side effects.

Reasons for using herbal medicine to treat prostate adenomas:

  • mild symptoms of the disease;
  • A slight increase in tumor size;
  • The patient's desire to remain fully sexually active during treatment.

Creeping Palm Extract (Serenoa repens)

The largest number of randomized clinical trials of this plant have been conducted, resulting in reliable data on its effectiveness.

Herbs for prostate adenoma contain lipid sterols. Their mechanism of action is to inhibit testosterone metabolism by inhibiting the activity of 5-alpha reductase and blocking the binding of dihydrotestosterone to the receptor. Due to the anti-inflammatory effect, edema is reduced, vessel walls are restored, and blood flow is normalized.

The multifaceted influence on the pathological process ensures the elimination of irritating and obstructive symptoms. An important advantage of using creeping palm extract is that there are no hormone-dependent side effects, and you can use this therapy without restrictions if you want to have a full sex life. With long-term use, the tumor volume decreased. Creeping palm extract does not affect prostate-specific antigen levels in the blood.

Prostate adenoma medicines based on the saw palmetto plant are considered the number one medicine among herbal medicines for the disease. Symptoms are mild and the tumor size is small, and monotherapy is performed with a crawling palm-based drug.

Release form: tablets and capsules.

other herbs

Among medicinal plants that have a positive effect on diseases, there are:

  • African Plum Bark Extract (Pygeum africanum). The active ingredient is a lipid sterol, which has remarkable anti-inflammatory properties, inhibits uncontrolled cell growth, reduces hyperexcitability of the muscular layer of the bladder and urethra, thereby eliminating symptoms of irritation and slightly reducing the amount of education.
  • Hypoxis rooperi plant extract is a combination of phytosterols and their glycosides. The substance inhibits the inflammatory process, normalizes the tone of the blood vessels of the urogenital organs, and eliminates the phenomenon of dysuria. 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, and reduces pain.
  • Nettle root (Urtica dioica). Reduce the inflammatory process, the phenomenon of dysuria, does not affect the size of the tumor;
  • Extracts of various tropical plants.

Combination therapy - a modern approach

3 groups of drugs occupy the leading position in the treatment of hyperplasia:

  1. Alpha blockers.
  2. 5-alpha reductase inhibitor.
  3. Botanical preparations.

Combination options:

  • Due to severe disease symptoms and a marked increase in tumors, a combination of alpha-blockers and 5-alpha-reductase inhibitors is recommended. Alpha-blockers begin to work after a few hours or days, and the clinical effect of 5-alpha-reductase inhibitors occurs after several months. The negative effects of the combination therapy were the total side effects of both groups of drugs. Tadalafil-based prostate adenoma drug is an off-the-shelf combination therapy. It also has a therapeutic effect on erectile dysfunction, therefore, it is only suitable for the treatment of hyperplasia in sexually active men with healthy heart and blood vessels. Can be used for tablets;
  • Irritant symptoms and tumor progression trends: alpha-adrenoceptor blockers + phytoremediation;
  • Obstructive symptoms and large tumors: 5-alpha reductase inhibitor + plant preparation.

Drugs of animal origin

During treatment, medicinal extracts from dried animal organs have successfully proven themselves. Prostate adenoma drugs based on extracts of the prostate of adolescent bulls have complex actions: anti-inflammatory, decongestant, analgesic, normalize blood flow.

For infectious complications, the means used to treat prostatitis are used.

Medications for Prostatitis

The drug treatment of prostatitis is complex. Major Fund Groups:

  1. antibiotic:
    • fluoroquinolones;
    • macrolides;
    • tetracycline.

    These substances are able to penetrate into the tissues of the affected organs and destroy the bacteria - the cause of prostatitis. They are available in tablet and injection form.

  2. proteolytic enzymes. Enzymes interfere with the process of organ fibrosis.
  3. Venotonics. Normalizes venous circulation.
  4. Anti-inflammatory drugs:
    • hormone injections;
    • nonsteroidal drugs.
    • Drugs of animal origin (similar to the treatment of hyperplasia).
    • Botanicals (similar to the treatment of hyperplasia).

For the treatment of prostate adenoma and prostatitis, a traditional Chinese medicine patch, a concentrate of seven medicinal materials, is currently popular, however, clinical research in this area has not been carried out.