Oxidative status of prostate and its dynamics against etiotropic antimicrobial chemotherapy in patients with chronic bacterial prostatitis

Abstract

The study objective is to investigate some initial characteristics of prostate oxidative status and their dynamics during the course of etiotropic antimicrobial monochemotherapy in patients with chronic bacterial prostatitis (CBP).Materials and methods. The work is based on treatment of 90 men aged 24–46 years (mean age 38.2 ± 1.4 years) with CBP (the treatment group), and 30 clinically healthy men aged 20–45 years (mean age 35.5 ± 1.5 years) (control group). All men underwent the same type of comprehensive examination during the study, and the results of the examination of the men of the control group were taken as reference values of the conditional norm. Complaints and anamnesis were collected. General physical, special urological, microbiological, laboratory, sonographic studies were performed. The etiotropic antimicrobial monochemotherapy was selected according to the results of microbiological studies of the secretion of the prostate gland, and levofloxacin (500 mg within 28 days) was chosen as a base drug for the subgroup of treatment (n = 15) isolated from the treatment group in the 2nd stage of the study. To assess the characteristics of the prostate oxidative status and its dynamics during etiotropic antimicrobial monochemotherapy, various modifications of biochemical studies of the secretion of the prostate were performed (reactive oxygen species (ROS), lipid peroxidation products (diol conjugates, malonic dialdehyde), activity of superoxide dismutase).Results. In patients with CBP in the secretion of the prostate due to increased ROS formation, increased functional activity (free radical aggression), increased reactions of lipid peroxidation and increased functional load on prostatic superoxide dismutase. Antimicrobial monochemotherapy of CBP was characterized by a microbiological efficacy of 86.7 % and was accompanied by a positive dynamics of a number of clinical and laboratory parameters of chronic bacterial prostatitis, however, this did not lead to the complete elimination of pain syndrome and oxidative disorders in the secretion of the prostate, and also did not significantly improve the quality life of patients and prostate secretory function. In patients with CBP a significant positive relationship was found between the amount of ROS and superoxide dismutase activity in the secretion of the prostate (n = 90; r = 0.413; p = 0.001); and the positive relationship between the amount of ROS in the secretion of the prostate and the clinical pain index (n = 90, r = 0.304, p = 0.001), which reflected the essential role of free radical prostatic aggression as an non-infectious component of the multifactorial pathogenesis of the pain syndrome in CBP.Conclusion. The persistence of residual oxidative disorders and functional deficits in the prostate after a standard course of microbial monochemotherapy justifies the advisability of the additional administration of antioxidants and antihypoxic agents in CBP.