Current Situation and Progress in the Treatment of Prostatitis

Prostatitis is one of the most common urinary system diseases in men. Due to its complex etiology and varied symptoms, there has been a lack of effective methods for its clinical treatment, and the therapeutic effect is unsatisfactory.

Traditional treatment for prostatitis doesn't work well

Currently, the primary method of traditional intervention in prostatitis is antibiotics, but the effect is not so good. There lie many things that could be improved. For example, long-term use of antibiotics on the human body has huge side effects and is prone to produce drug resistance. The drugs lack focus in treating prostatitis. Therefore, the final result of the treatment will be ineffective.

Prostatitis has a high incidence and low cure rate and is prone to repeated infection. Lack of proper treatment is one of the main factors. Many doctors use the same method to treat patients with different types of prostatitis, resulting in little efficacy and repeated infection. Therefore, it is necessary to learn and master the research and treatment of prostatitis.

In recent years, with the further development of prostatic research, new concepts and treatments are emerging, which have greatly improved the diagnosis and treatment of prostatitis.

New treatment methods for male prostatitis

1. Older drugs for new uses—oral fosfomycin for treating bacterial prostatitis

Bacterial prostatitis is described as a difficult-treated infection due to the anatomical features of the prostate and clinical difficulties in diagnosis and management. In addition, multi-resistant pathogens pose great challenges to antibiotic treatment.

Recently, researchers evaluated the effectiveness of fosfomycin in treating prostatitis. Oral fosfomycin can be used to treat susceptible bacteria that commonly cause prostatitis, such as Escherichia coli, another enterobacter bacteria, and Enterococcus faecalis, or even as a first-line treatment in specific clinical conditions (patients with prostatitis, patients who have a treatment failure or allergies, and outpatients). Fosfomycin has the following advantages in treating chronic prostatitis: apparent pharmacokinetic effects, resistance to drug-resistant bacteria, drug safety, synergistic treatment with other antibiotics, and less drug resistance.

https://www.urotoday.com/recent-abstracts/men-s-health/prostatitis/139161-oral-fosfomycin-formulation-in-bacterial-prostatitis-new-role-for-an-old-molecule-brief-literature-review-and-clinical-considerations.html

2. A low-intensity extracorporeal shock wave therapy for treating prostatitis

Studies have shown that low-intensity extracorporeal shock wave therapy can effectively treat chronic prostatitis or pelvic pain syndrome, whether combined with medication or not. Patients do not need to worry about the safety of this treatment because low-intensity extracorporeal shock wave treatment is non-invasive and does not cause adverse effects on the body.

https://www.nature.com/articles/s41391-022-00571-0

3. Targeting ferroptosis to reduce inflammation, fibrosis, and mast cell activation

Studies have found that taking deferoxamine and edaravone (free radical scavenger), which inhibit ferroptosis, can effectively improve inflammation, fibrosis, and mast cell activation. (Mast cells are part of the human immune system that protects against foreign invaders. Mast cells are concentrated in areas where the external environment comes into contact with the human body, such as the skin, lungs, intranasal mucous membranes, and gastrointestinal tract. 

Under normal circumstances, mast cells release various mediators in response to foreign substances to keep us safe. In mast cell activation syndrome, inappropriate release of chemical mediators can lead to inflammatory symptoms anywhere in the body.

https://www.urotoday.com/recent-abstracts/men-s-health/prostatitis/138248-targeting-ferroptosis-attenuates-inflammation-fibrosis-and-mast-cell-activation-in-chronic-prostatitis.html

4. Nanomaterials can also be used to treat prostatitis

Antibacterial nanomaterials comprise metal, metal oxides, antibacterial components, surfactants-based nanoemulsion, and carbon-based nanomaterials. Antibacterial nanomaterials can effectively remove residual pathogens in cells and prevent recurrence of disease. Therefore, antibacterial nanomaterials are more effective for the radical treatment of intracellular infections.

Biodegradable nanomaterials combined with T2 antigen, a peptide sequence extracted from the TRPM8 receptor, are effective in treating prostatitis. The use of nano selenium in combination with antibiotics can also treat urinary tract diseases.

https://www.frontiersin.org/articles/10.3389/fphar.2021.685465/full

5. Psychological therapy has a certain effect on the treatment of prostatitis

Studies have shown that patients with prostatitis or erectile dysfunction score higher on most tests of psychological variables than healthy men. At the same time, lower urethral symptoms and erectile dysfunction were found to be closely related to the severity of psychological stress.

A study investigating the effectiveness of psychological interventions in treating chronic prostatitis showed that cognitive therapy, cognitive behavioral therapy, conflict relaxation training, and other psychological therapies were effective in treating chronic prostatitis.

A recent study found that social problem-solving moderates the effect of stress on symptoms associated with chronic prostatitis. Social problem-solving is when an individual tries to deal with stressful events in their life. The researchers found the same results in a study of 63 patients. Therefore, developing the efficiency of social problem-solving could help reduce the discomfort of patients.

https://www.urotoday.com/recent-abstracts/men-s-health/prostatitis/140708-social-problem-solving-as-a-mediator-of-stress-and-chronic-prostatitis-symptomology.html

Besides, traditional Chinese medicine(TCM) has a good effect on prostatitis. It mainly adopts the methods of clearing heat and removing dampness, activating blood circulation and removing blood stasis, and inducing diuresis for treating stranguria.

Although the TCM treatment of prostatitis is based on long-term medical experience, it differs from modern medicine (mainly focusing on local and micro pathophysiological changes). Instead, it emphasizes the macroscopic thinking methods in which diagnosis and treatment of prostatitis are based on the patient's overall health status. That is, western medicine cures "diseases" while TCM cures "human beings."

As our understanding of the etiology and pathogenesis of prostatitis continues to advance, research on its treatment is also developing. At present, research on prostatitis has continued among global medical scholars. I hope there will be one or more effective treatments to control the symptoms of prostatitis so that people will not be afraid of it anymore.