Results of using the combined drug hyaluronidase (defibra) in the treatment of patients with chronic bacterial prostatitis

Abstract

Nowadays chronic prostatitis (CP) is considered as the inflammatory disease of infectious genesis with the possible addition of the autoimmune disorders, which are characterized by the damage of both parenchymal tissue and interstitial tissue of prostate. Upon the recommendation of European Association of Urology CP is bacterial and abacterial (chronic pelvic pain syndrome), inflammatory, noninflammatory and asymptomatic. Despite more than a century history of studying different pathogenetic links of the development of CP, this disease still remains insufficiently studied, quite common and it is an important medical and social problem. The epidemiology details of CP are contradictory and they are studied quite fragmented. According to scientific research, about 39% of men have the manifestations of prostatitis, but only 2/3 of them seek medical help. According to studies of numerous authors, who were studying the prevalence of prostatitis in men aged 20 to 40 years, 25% of men with the urological diseases have the manifestations of prostatitis. Nowadays CP is considered as an inflammatory disease of infectious genesis with the possible addition of the autoimmune disorders, which are characterized by the damage of both parenchymal tissue and interstitial tissue of prostate. One of the important triggers of CP is the tissue damage of prostate, which is caused by the violation of hemodynamics. Experimental studies have shown that the venous stasis causes damage to endothelium followed by the migration of the leukocytes through the venous wall. The venous stasis or the deceleration of venous blood flow in prostate leads to the damage of its tissues. Further, in cases of infection of gland occurs the damage of the walls of blood vessels, as the result fixation of immune complexes. The aim: to study the efficacy and safety of hyaluronidase in the form of rectal suppositories for treatment of patients with the chronic prostatitis. Material and methods. The analysis of treatment results of 38 patients with a chronic prostatitis trying hyaluronidase preparations in the form of rectal suppositories was conducted. Results: As a result of the treatment it was found that all 20 patients with the CP, who were taking rectal suppositories of hyaluronidase for 20 days noticed the positive effect. At the same time a pronounced positive effect noticed 11 (31,4%) patients, good effect noticed 14 (40,0%) patients and satisfying effect noticed 10 (28,6%) patients. On the background of the standard treatment with the addition of hyaluronidase in the form of rectal suppositories a reliable and positive dynamics of the overwhelming majority of hemodynamic parameters was received: the peek rate of arterial blood flow, diastolic speed, pulsatility index, resistance index. Conclusions. The application of combination therapy: basic anti-inflammatory therapy based on antibiogram, a set of Kegel exercises and hyaluronidase in the form of rectal suppositories in most cases allows to achieve positive results of the clinical data and objective parameters, as well as it allows to reach sustainable clinical effect in patients, suffering from chronic bacterial prostatitis.