CC BY
22ASSESSMENT OF THE EFFECTIVENESS OF DIAGNOSIS AND THERAPY OF PATIENTS WITH CHRONIC BACTERIAL PROSTATITIS
B. Z. Khamdamov I. F. Yodgorov
Bukhara State Medical Institute
ABSTRACT
Chronic prostatitis (CP) is one of the most difficult urological diseases to diagnose and treat in outpatient practice. In the USA and Europe it occurs in 5-35% of men. The same incidence of chronic prostatitis is reported to be between 8% and 35% of men aged 20-40 years. Although there is no conclusive data on its prevalence in Uzbekistan. The basis for dividing chronic prostatitis into categories is only the laboratory data - the presence or absence of increased leucocytes in prostate secretion or the presence of microorganisms in its cultures, while the clinical symptomatology of chronic prostatitis in the different categories does not differ, and the main symptom is pain. In addition, leading researchers have repeatedly pointed out that there is no stable association between: the presence of inflammation in the prostatic secretion and the symptoms of chronic prostatitis.
Keywords: chronic prostatitis, antimicrobial therapy
Introduction: Chronic prostatitis (CP) is a common urological disease. Up to 35% of men between 20 and 40 years of age who consult a doctor about urological problems suffer from symptoms of CP. Its impact on quality of life is comparable to that of myocardial infarction, angina pectoris or Crohn's disease, causing considerable psychological and social problems in sexually active and working-age men.
According to most researchers, the most common etiological agents of CVD are Gram-negative bacteria of the family Enterobacteriaceae, such as Escherichia coli, which are found in 65-80% of infections. Various species of Serratia, Klebsiella, Proteus, Enterobacter, Acinetobacter are detected in 10-15% of cases. Most experts believe that Enterococcus faecalis accounts for 5% to 10% of confirmed prostate infections.
Prostate infection can result from bacterial colonisation of the urethra. The normal flora of the urethra in men consists mainly of diphtheroids and gram-positive cocci. It has been established that sexual activity may contribute to the colonisation of the urethra by potential uropathogens. Bacterial colonisation can also cause bacterial persistence in the prostate. A distinctive feature of this condition is the persistence of bacteria within the prostate despite antibiotic treatment, which is associated with chronic inflammation and a tendency for urinary tract infections to worsen by the same pathogen.
SCIENTIFIC PROGRESS
VOLUME 3 I ISSUE 1 I 2022 ISSN: 2181-1601
Purpose of the study: To assess the effectiveness of diagnosis and therapy of patients with chronic bacterial prostatitis.
Material and methods of research: We have examined 50 patients who were on inpatient treatment for chronic bacterial prostatitis in the department of urology of Bukhara branch of pediatrics from the period 2019 to 2021. After depending on the structure of the study the effect of restoration of prostate function in chronic bacterial prostatitis (category II) on the results of treatment and duration of therapeutic effect was determined and evaluated. The indexes of the patients with chronic bacterial prostatitis will be compared with the indexes of the group of healthy men (20 men) at the age of 21-54 years.
The diagnostic significance of clinical and neurological examination of patients with chronic bacterial prostatitis has been determined. The effectiveness of the complex treatment of patients with chronic bacterial prostatitis including treatment of myofascial syndrome has been proved.
Results of the study: Microbiological efficacy (eradication of the pathogen), clinical efficacy (cure or improvement of symptoms, or symptom scores) at follow-up visits or during follow-up, or both, and side-effects of therapy were proven. Secondary outcomes included the rate of microbiological recurrence. We compared the oral fluoroquinolones ciprofloxacin, levofloxacin, lomefloxacin, ofloxacin and prulifloxacin. No significant differences in clinical or microbiological efficacy or frequency of side-effects were found between these fluoroquinolones. In chlamydial prostatitis (I) azithromycin showed better eradication and clinical cure rates than ciprofloxacin, with no significant difference in side-effects; (II) azithromycin was equivalent to clarithromycin both microbiologically and clinically; (III) prulifloxacin improved clinical symptoms, but not eradication rates, compared to doxycycline. In ureaplasma prostatitis, a comparison of of ofloxacin with minocycline and azithromycin with doxycycline showed similar microbiological, clinical and toxic characteristics. Conclusions. Thus, in most cases there is no clear etiology of chronic prostatitis, the mechanism of symptom formation is poorly understood, and treatment remains poorly effective. Besides, low efficiency of antibacterial treatment, high frequency of recurrent symptoms of the disease after irradiation of the pathogen in patients with chronic bacterial prostatitis, as well as lack of clear understanding of the role of the bacterial factor in the occurrence of clinical manifestations of chronic bacterial prostatitis have determined the need for this study.
REFERENCES
1. Alexandrov V.P., Korenkov D.G., Skryabin G. N. 10-year experience of using hyperbaric oxygenation in treatment of patients with chronic prostatitis/ Plen. Saratov, 2004. C. 392.
2. Kogan M.I., Shangichev A.V., Belousov I.I., Chernogubova Ye.A., Mikashinovich Z.I. Biochemical markers of inflammation in chronic abacterial prostatitis form SHA // Chronic pelvic pain/International interdisciplinary symposium. - Nizhny Novgorod, 2008.- P.53
3. Akhmatov H., Aminov A., Vahidova A.M. The search for the most effective drugs in echinococcosis and pecilomycosis //Student research. 2019. C. 155-158.
4. Tillyashaykhov M. N., Rakhimov N. M. Khasanov Sh. T., Features of Clinical Manifestation of the bladder cancer in young people// Doctor Bulletin. - Samarkand, 2019. - №2. - P. 108-113
5. Ilkhomovna, K. M., Eriyigitovich, I. S., & Kadyrovich, K. N. (2020). Morphological Features Of Microvascular Tissue Of The Brain At Hemorrhagic Stroke. The American Journal of Medical Sciences and Pharmaceutical Research, 2(10), 53-59. https://doi.org/10.37547/TAJMSPR/Volume02Issue10-08
6. S Ziyadullaev, O Elmamatov, N Raximov, F Raufov //Cytogenetic and immunological alterations of recurrent bladder cancer.European Journal of Molecular & Clinical Medicine ISSN 2515-8260 Volume 7, Issue 2, 2020
