Introduction. Chronic prostatitis is a widespread disease in men of different age groups. Chronic prostatitis remains one of the most difficult problems in modern urological practice, which also has enormous social significance for a number of reasons: a negative impact on the quality of life of patients, a frequent association with male infertility, high treatment costs and low effectiveness. The most significant pathogenetic factors of the disease are circulatory disorders and chronic inflammation, leading to the development of fibrosis of the organ and disruption of its function. In this regard, a promising direction for improving the results of treatment of patients with chronic prostatitis is the inclusion in complex therapy of measures aimed at preventing the development of fibrosis. 34 patients of group 1 received complex drug therapy in combination with rectal electrophoresis of the drug Longidaza 3000 IU. Patients of group 2 received only drug therapy. The duration of treatment was 1 month. It has been established that the use of Longidase 3000 IU by rectal electrophoresis in patients with chronic prostatitis restores microcirculation in the prostate gland, relieves dysuria, pain and achieves lasting symptomatic improvement for a longer period.
The aim – to evaluate the effectiveness of Longidase® administration through rectal electrophoresis in combination with the therapeutic effects of electric currents in the complex treatment of chronic prostatitis.
Materials and methods. The study involved 68 men of working age diagnosed with chronic prostatitis. The patients were divided into 2 groups, comparable according to the main criteria assessed. Patients in the control group (34 people, 50%) received standard therapy for chronic prostatitis. Patients of the main group (34 people, 50%) additionally received rectal drug electrophoresis using bovhyaluronidase azoximer. The course of treatment for patients in both groups was 1 month. Control examinations were carried out at the end of the course of treatment. The criteria for improvement during therapy were: reduction of dysuria, reduction of pain in the perineum and lower abdomen, improvement in assessment of the quality of urination and quality of life, im- provement of hemodynamics in the prostate gland according to the results of Doppler ultrasound.
Results. After completing the course of therapy in both groups, there was a decrease or relief of pain and dysuric phenomena, which indicates the effectiveness of the therapy. However, a significant improvement in the clinical manifestations of chronic prostatitis was observed in the main group, where, in addition to standard therapy, electrophoresis with Longidase® was performed. In 27 (79,41%) patients of group 1, at the end of treatment, the intensity of dysuric phenomena on the international NIH-CPSS scale was 3,2±0,31 points, that is, it decreased by 3,7 times, and 6 months after the end treatment, amounting to 3,42±0,41 points. Of the 34 observed patients in group 2, symptomatic improvement in this indicator to 5,4±0,42 was achieved in 18 (52,94%) patients, and less pronounced compared to group 1. Also, a decrease in the intensity of pain according to the International NIH-CPSS scale, after treatment, was more pronounced in patients of group 1, amounting to 6,71±0,94 points (p<0,05), while in patients of group 2 the average score pain syndrome decreased to 8,6±1,2 points. The maximum urine flow rate in patients of group 1 before treatment was 13,6±0,7 ml/s, and a month after the start of treatment it was 22,8±0,9 ml/s, compared with an increase in the maximum rate to 18,7±0,7 ml/s in group 2. The results of Doppler examination of pancreatic vessels after treatment indicate a more significant improvement in hemodynamic parameters in patients of group 1, while in group 2 there were no significant changes in hemodynamics.
Conclusion. The study showed that the inclusion of antisclerotic therapy in the form of rectal electrophoresis with Longidaza® 3000 IU in the complex treatment of patients with chronic prostatitis allows one to achieve significant symptomatic improvement and achieve a longer remission of the disease. The positive dynamics of such indicators as blood flow velocity in the arteries and veins of the prostate gland were significantly higher in patients who received electrophoresis with Longidase® along with basic therapy. The effect of Longidase® using rectal electrophoresis improves microcirculation, reduces the scar-sclerotic process and swelling in the prostate gland, thereby relieving pain and the severity of urinary disorders.
