Riga clinical hospital Gailezers Urological department Nr.11 Pavels Ivdra, urologist Rolands Dale, head of Urological department Elmars Atte, urologist assistant |
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Description
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Chronic prostatitis is one of the commonest male urological diseases. Almost every urological patient, visiting the doctor-urologist, is diagnosed chronic prostatitis. Medical statistics is still not having any convincing data on the epidemiology of the inflammation of the prostate gland.
In fact, there are not too many chronic prostatitis patients. The current routine therapy is of little effect in the III and IV inflammation phase. Patients are wandering from one doctor to another, as a result, the number of chronic prostatitis patients seems to have doubled or even trebled.
Short term remission periods and relapses make illusions to many doctors of prostatitis as a disease to be hard to treat. It is due to the fact that proteinases and their effect are not taken into account in the pathogenesis of prostatitis.
Streptokinase may threaten to cause allergic and anaphylactic reactions, collapse and shock. Doctors who have once experienced the anaphylactic shock are afraid to take risk again. However, the anzyme therapy with proteinases is 99,9% safe and can guarantee the recovery.
Using SK and proteinases simultaneously, the desensibilization course for SK is needed, but for urokinase and t-PA not necessary (4). If the above-mentioned proteinases are not used, doctors are not able to treat the late inflammation forms of the prostate and the complications, such as proliferation, fibrosis, sclerosis and scarred prostate deformation.
One cannot achieve the regeneration of the prostatic tissues without urokinase and t-PA. The method of etiopathogenetic routine therapy is effective even if slight proteinase doses (10-15 mg t-PA) are added to Sk infusion. Proteolytic and fibrinolytic enzymes are characteristic for mutual activation. Processes of fibrinolytic enzyme system activation proceed slowly.
On the other hand, proteinase activation is instant. Any certified urologist is able to achieve a complete and lasting curative effect. It is possible if proteinases are used in the treatment process.
Urokinase (UK) is practically a proteolytic enzyme proteinase. Without the plasminogen activation, the urokinase is able to hydrolize even caseine, as well as other protein structures. (2). (Ploug I., Kjeldard N.O., Urokinase Biochim biophys., Acta 24,248,1957).
Urokinase (UK), actilyse (t-PA), calicrens, renins, peptidil-peptide hydorlases and many other proteinases belong to the group of intracellular proteinase activators of the prostatic tissues.
Aminopeptidase type enzymes hydrolize various dipeptides at a great speed. Dipeptide amines, as a rule, are also hydrolized at a great speed, therefore it is difficult to verify them by clinical analyses. During the proteinase therapy, the duration of the enzyme activity is not longstanding and therefore it is hard to diagnose. Hypocoagulaemia and bleeding do not endanger the patient.
After an adaquate proteinase enzyme therapy course, a positive curative effect is observed for a long period. There may not be any relapse for months and even years.
Indications for the therapy with proteinases (UK, t-PA) are as follows:
- For a faster enzyme therapy of urogenital inflammations and their complications
- Repeatedly longstanding and ineffective enzyme therapy with streptokinase
- Allergic reactions during the administration of SK
- Late allergic reactions 6 to 24 hours after SK infusion
- Reducing the time of therapy at the expense of SK desensibilisation course
- Antibiotic resistance
Almost every urologist who treats prostatitis patients is able to cure the prostatitis even at III-IV inflammation phase, if proteinases are used. In the enzyme therapy with UK and t-PA one may observe the regression signs of fibrotic and sclerotic changes, as well as the phenomena of the prostatic tissue regeneration. Without proteinase group enzymes it is not possible.
Example 1
Patient N.B., 39 yrs.old (case history #28531) was hospitalized at the Urologic department due to chronic prostatitis. He had become ill 9 years ago. The current antibiotic therapy had turned out to be ineffective.
The prostate, prior to the enzyme therapy was asymmetric, scar-deformed, lateral outlines were merging with the surrounding tissues and the pelvic bones, it was of polymorphic consistency, diffusely painful with a marked paraprostatitis.
Clinical diagnosis:
1. Chronic prostatitis
2. Urogenital chlamydiosis
3. Ureaplasmosis
4. Antibiotic resistance
5. Paraprostatitis
He underwent the treatment at the Urological department for 64 days. The enzyme therapy was begun with SK dosis of 15.000 HS i/v.While introducing it, there was observed an immediate anaphylactic reaction with dyspnea, pain in the chest, collapse, weak pulse, lowered BP 70/30 Hg. Antishock measures were effective.
SK infusion was stopped. Next day the enzyme therapy was continued with urokinase 50.000 HS without side effects 1x a day for 42 days alternately with Actilyse 25-50 mg x 1 day for 21 days. In total 63 days.
Due to the antibiotic resistance all antichlamydial, ureaplasmotic, etc. antibiotics which had been ineffective before the enzyme therapy, now, given together with proteinases, made the antibiotic resistance regress, and the same antibiotics, earlier being ineffective, now turned out to be effective.
All complaints disappeared. The scarred deformation of the prostate regressed. The prostate regained its normal size, was well-outlined, symmetrical, smooth, with retained sulcus posterior, elastic, painless.
Despite the 63 days long enzyme therapy with UK and t-PA neither hypocoagulaemia,nor hemorrhagic complications, nor other side effects were diagnosed. The patient is cured.
Conclusions:
The enzyme therapy of the prostate with proteinases (proteases) is effective, safe, not
causing any complication, easily mastered and guarantees positive results. We have to say
that this method is not connected with fibrinolysis, but with a protein hydrolysis which
is not dangerous, but available to well-off patients.
Example 2
Patient B, 37 yrs. old with chronic chlamydial and ureaplasmatic prostatitis had been ill for more than 8 years. The current routine therapy undertaken at various clinics was ineffective (due to antibiotic resistance).
Complaints of pains in the lower part of the abdomen, in the inguinal region, perineum, testicles and the urethra often had a relapse. Frequent urination, 3 x at night. Erectile dysfunction. Increased libido but decreased potency.
The prostate prior to the therapy was asymmetric, deformed, poorly outlined, smoothed sulcus posterior, of polymorphous consistency, diffusely painful, the picture of paraprostatitis.
Clinical diagnosis:
1. Chronic relapsing chlamydial and ureaplasmatic prostatitis
2. Paraprostatitis
Characteristic indicators of hemostasis analysis prior to therapy are normal.
The enzyme therapy is undertaken by a very small dose of streptokinase 10.000 i/v. Just after the infusion one can observe an anaphylactic reaction collapse, thread-like pulse, BP 70/30 Hg. SK infusion is stopped. Antishock measures are effective.
During the next days the enzyme therapy was continued by urokinase and Actylise alternatively 2 x a day every 12 hours.
The patient was receiving Actilyse 25 mg in the mornings and 50.000 HS urokinase in the evenings for 28 days. Characteristic values of haemostasis in coagulogram analyses were normal just after the infusion of proteinase i/v .
Thus, fibrinolytic processes when treating with proteinases are not activated. Protein metabolism normalizes. By administering proteinase group enzymes, the therapeutic course can be shortened up to 3-4 weeks.
After the 28 days therapy, the patients subjective and objective condition normalized. The prostate regained its normal size, was well outlined, symmetrical, with a deep sulcus posteror , elastic, painless. Prostatitis and paraprostatitis regressed. The patient got cured within 28 days period. No complications were observed.
Conclusions:
1. Chronic prostatites with various complications and hard to treat can be differentiated into 2 groups patients who do not have any allergic reaction to Streptokinase (SK), and patients who do not tolerate SK even in very minimal doses.
2. The first group does not cause any difficulties to doctors, but the second group are threatened by allergies and anaphylactic shock, and long-term treatment.
3. Doctors are afraid of the possible SK-produced anaphylactic shock with all the following consequences.
4. For the enzyme therapy of the second group patients, one should use only proteinases UK and t-PA without any risk and fear of side effects.
5. To reduce the time of treatment, one should apply UK and t-PA.
6. The dose of proteinases and the length of treatment depend on an individual sensibility of the patient and the stage of the inflammation of the prostate.
7. As a result of the enzyme therapy with UK and t-PA, one can observe the regression of the fibrous changes of the prostate and the regeneration of tissues.
Literature:
1. P.Ivdra, J.Zalkalns, A.Zilevica, I.Geldners, E.Baumanis. Multidisciplinary problems in choosing proteolytic enzymes and their activators for enzyme therapy of antibiotic-resistant and urogenital chlamydiosis. Riga, Latvia. http://www.expo.lv/gailes/enzyme.htm
2. Ploug I., Kjeldgard N.O., Urokinase (Biochim.biophys., Acta 24, 248,1957)
3. P.Ivdra, A.Zilevica, I.Ancupane. Specificity of enzyme therapy in treatment of late inflammatory forms of prostatitis (02.03.2001) http://www.expo.lv/gailes/enzyme1.htm
4. P.Ivdra. Urokināze antibiotikrezistentas uroģenitālas hlamidiozes ārstēšanā. Latvijas Ārsts, 1995;3:30-35.
5. P.Ivdra, E.Platkajis. Usage of Tissues Plasminogen Activator in Treatment of Men Pathological Climacteric and Prostatitis. 1998.http://www.expo.lv/gailes/climax.htm