In the middle of the last century, it was believed that prostatitis develops in old age. Today the disease has become "younger" and is diagnosed in fertile men aged 30-40. Inflammation tends to become chronic, which makes therapy much more difficult. Doctors successfully solve men's health problems of any complexity. Urologists of the medical center develop personal therapeutic schemes, use the best drugs and master modern methods of treating prostate diseases.
"Second Man's Heart"
The prostate is a small unpaired gland of external secretion, controlled by hormonal activity. The organ is located at the bottom of the pelvis, under the bladder. The wider edge of the prostate covers the bladder neck. The back part is attached to the front wall of the rectum. The front part of the gland occupies a place in the pubic area of the junction of the pelvic bones. In the male body, the prostate performs three main functions:
- engine - control of the separation of urine and seminal fluid (due to this, the sperm does not enter the bladder;
- secretory - the production of a secret responsible for the quality of seminal fluid and maintaining a stable erection;
- barrier - protection against infection of the upper urinary system.
The functionality of the prostate gland begins to appear in the period of puberty, gaining full value at the age of 18-20 years. The decline in active body work has been recorded in men who have crossed the fifty-year mark.
Types and forms of prostatitis
The type of disease is determined by the cause of the occurrence:
- Bacterial prostatitis. It occurs as a complication of infectious and inflammatory processes in the urogenital tract (less often in other body systems).
- Bacterial prostatitis. It develops against the background of physiological failures of neurological, psychoneurological etiology, chronic diseases, unhealthy lifestyle.
The cause of the inflammatory process are congestive phenomena (stagnation) in the gland tissues, provoked by organic disorders or infections.
Forms are classified according to the nature of the manifestation of symptoms and the course of the disease:
- Acute inflammation. Characteristic of a bacterial type of disease. It is accompanied by an intense manifestation of specific signs.
- Chronic prostatitis. Runs unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases, it has a bacterial origin.
Symptoms of chronic prostatitis are often hidden, while the inflammatory process progresses. The fluctuating course of the disease is the reason for the untimely visit to the urologist, then the expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and secretion of the prostate occurs for reasons that correspond to the specific classification of the disease.
| Causes of an infectious species | Causes of bacterial species |
|---|---|
Sexually transmitted infections (STIs):
Bacterial diseases of the intestines, skin, respiratory organs caused by the activity of staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgia, rheumatism, neurosis, mechanical injuries of the spine and genital organs, intraprostatic reflux, chronic constipation (constipation), restlessness, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system |
Provocative factors include irregular sexual intercourse (complete lack of sex), systemic hypothermia of the body and chronic alcoholism.
Symptoms of an acute form of the disease
Acute prostatitis is characterized by severe manifestations of inflammation in the prostate gland. Adjacent organs and systems are involved in the process, psycho-emotional stability is disturbed.
Main symptoms:
- From the urinary system. Pollakiuria (frequent urination) with dribbling, burning, spasms in the urethra. Urine becomes cloudy. Urges to empty the bladder are often false.
- From the reproductive system. Pain in the perineum, decreased potency, painful ejaculation. During intimacy (or immediately after it), discomfort appears in the area of the penis and testicles.
- From the side of the nervous system. Acute muscle pain in the lumbar and sacral region, in the lower abdomen.
- Psycho-emotional disorders. Increased nervousness, anxiety, nervousness.
- From the digestive system. Constipation, aggravation of hemorrhoids.
- From the side of the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37-38 ℃), symptoms of body intoxication. Ordinary actions cause rapid fatigue, desire to lie down.
Against the background of inflammation, existing chronic diseases worsen.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and performance of the organ. In the phase of remission, the pathology reminds itself with increased fatigue, decreased performance. Disorders of the urinary system are characterized by repeated urges (often false) to empty the bladder, which become more frequent at night.
Urination is moderately painful, after passing urine there is a feeling of incomplete destruction. From the urethra, a prostatic secretion of a mucous consistency with a yellow color, an unpleasant smell (prostorrhea) flows spontaneously.
Patients are haunted by chronic pelvic pain syndrome - painful sensations of a painful nature, localized in the lower third of the abdomen, pelvic and external genitalia, in the perineum, lumbar and sacral regions.
Chronic prostatitis is associated with sexual health disorders:
- unstable erection, accompanied by pain;
- suppression of libido;
- accelerated or difficult (often painful) ejaculation.
Against the background of sexual disorders, psycho-emotional instability progresses. A man is prone to depression, a sharp change in mood - from aggression to apathy. Ultimately, this leads to absolute sexual impotence (impotence).
In the recurrent period, the symptoms correspond to the acute form of the disease, but are less intense. Aggravation is provoked by:
- General hypothermia. After a long stay in cold water or in the cold, any chronic inflammatory disease, including prostatitis, worsens.
- Restriction of mobility. With hypodynamia, blood circulation in the pelvic organs is disturbed. Blood stagnation leads to swelling of the prostate, which presses on nerve endings and the urethra.
- Alcohol abuse. The chronic course of inflammatory processes is activated under the influence of alcohol.
- Prolonged abstinence from intimate relationships. Lack of sexual intercourse leads to stagnation of prostate secretion, which provokes an aggravation.
- Tight underwear. Mechanical compression of the external genital organ disrupts the normal blood supply to the prostate gland.
Recurrence of the disease is caused by unhealthy eating habits. The abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), as a result, atherosclerosis develops. Cholesterol plaques interfere with the free circulation of blood, provoking congestion in the prostate. An excess in the menu of products that cause constipation leads to excessive tension in the muscles of the perineum.
Complications of prostatitis
With premature treatment of acute inflammation, purulent masses accumulate in the prostate tissue and an abscess of the gland develops. The condition is characterized by febrile temperature (39 ℃), chills, intense sharp pain in the perineum, ischuria (inability to empty the bladder on its own). The only way of treatment is an operation to open the suppuration and bougienage of the urethra (enlargement of the urethra with a special metal bougie).
Lack of proper diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis are the reasons for the development of dangerous complications:
- prostate adenoma - a benign tumor prone to malignancy (malignancy) with incorrect therapy;
- the formation of stones in the gland;
- epididymo-orchitis - inflammation of the testis;
- vesiculitis - inflammation of the seminal vesicles;
- infertility (the first degree of the disease requires long-term therapy, the second is practically untreatable);
- impotence;
- Prostatic sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help to avoid serious consequences of an inflammatory disease.
prostate examination
A rectal examination of the prostate is an unpleasant but extremely necessary procedure. This allows you to detect such serious diseases as adenoma, prostatitis, malignant tumors at an early stage.
Indications for rectal examination of the prostate
Every man over 40 should see a urologist at least once a year. The earlier the inflammatory process, benign and malignant neoplasms are diagnosed, the greater are the chances for a complete restoration of the prostate gland. The patient receives milder treatment, maintains sexual desire, sexual activity and the ability to fertilize.
Occasionally, men younger than 40 show warning signs but put off seeing a urologist. Indications for an urgent prostate examination are:
- pain of any intensity in the perineum;
- erectile dysfunction;
- premature ejaculation;
- decrease in the amount of sperm released;
- discomfort during intercourse and defecation.
Do not ignore problems with urination - very frequent urges, cramps, the feeling of an empty bladder, unpleasant changes in the smell and color of urine. If you notice at least one sign, be sure to make an appointment with a urologist.
How is a digital prostate exam done?
A few hours before the procedure, you should refrain from:
- sexual contact;
- masturbation;
- doing sports;
- cycling;
- physical work.
Before a visit to the doctor, you should empty your bladder, do a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, a man takes a knee-elbow position, lies on his side with bent legs or stands, leaning forward and resting his hands on the table. The doctor puts on sterile gloves, smears the patient's index finger and anus with petroleum jelly or lubricant.
During a rectal examination of the prostate, the doctor massages the lobes of the prostate gland from the sides to the center. With the help of palpation, you can assess:
- size and shape;
- texture and elasticity of the organ;
- the symmetry of its elements;
- roughness of contours and longitudinal grooves;
- the presence of pain, seals and joints.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, during the procedure, the secretion of the prostate gland is taken. This liquid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.
Based on the results of a digital prostate examination, the doctor may prescribe additional diagnostic measures. These include a clinical analysis of urine and blood, a study of tumor markers, ultrasound of the prostate, etc.
Diagnosis of the disease
Making an accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate;
- rescheduling with a doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (prescription, intensity);
- collection of anamnesis (past diseases);
- clarifying information about working conditions, lifestyle features, habits, regularity of sexual relations;
- visual assessment of the external genitalia for the presence of rashes, redness, swelling, discharge from the urethra;
- palpation of inguinal lymph nodes;
- palpation rectal examination of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the condition of the interlobar septum);
- sampling of biomaterial for laboratory research;
- assignment of analyses.
Medical appointments do not have strict time limits. In a specialized clinic, each patient is given maximum time and attention.
For a differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes blood, urine, prostate secretion and a swab from the urethra.
The doctor takes a sample of prostate secretion with his hand during a rectal examination of the gland. Disposable medical gloves, a lubricant (vaseline, gel-lubricant, glycerin), which facilitates penetration into the rectal ampoule, sterile cups are used for the examination. The depth of penetration does not exceed 5 cm. The professional qualifications and experience of urologists guarantee the safety and pain-free procedure.
Venous blood is collected using modern vacuums. The medical center strictly observes the rules of sterility for the collection of biological material.
Laboratory tests
The studies are carried out by experienced specialists in the clinical diagnostic laboratory. The laboratory ward of the medical center is equipped with modern equipment that allows you to perform analyzes of any complexity.
The list of analyzes includes:
- Bacteriological culture of a stain for STI determination. A biomaterial sample is planted in nutrient media favorable for the growth of pathogenic microorganisms. Active reproduction and colony formation of a particular pathogen indicate the presence of an infection. Based on the bacterial culture, an antibiogram is performed - the determination of the resistance of pathogens to antibiotics.
- General analysis of urine. Deviation from the norm (leukocyturia, bacteriuria, cylindruria, etc. ) indicates the presence of an inflammatory process.
- A blood test for PSA (prostate-specific antigen) is a tumor marker of the male reproductive system. It is performed with the ICLA method with high precision (chemiluminescent immunoassay).
- Examination of prostate secretion (microscopy and culture). It allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc. )
A comprehensive examination for STIs can be performed on a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate gland. It is performed using a cylindrical probe with a diameter of no more than 1. 5 cm, inserted into the rectum. The sensor is pre-lubricated, special disposable nozzles (condoms) are placed on top. The data is transmitted to the monitor, where the urologist visually evaluates the pathological changes in the prostate gland.
Readmission
On readmission, the doctor:
- evaluates test results;
- designs a personal therapeutic regimen, taking into account the type, form, nature of the course of prostatitis, tolerance to drugs, age of the patient;
- assign control studies.
We offer to make an appointment at a time convenient for the patient by phone or through the website by filling out the online form.
Prostatitis therapy
In the clinic, a man can undergo a full course of prostatitis treatment. The course of therapy for acute inflammation of the prostate includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the state of the gland;
- consolidation of results, prevention of complications.
The first phase
With prostatitis of infectious etiology, antibiotics are mainly prescribed to destroy the causative agent of the infection. The choice of drug is based on the results of the antibiogram. In parallel, drugs of several pharmacological groups are used:
- Alpha blockers. Medicines help relax the smooth muscle tissue of the prostate, bladder neck, reduce internal pressure in the urethra, normalize urine flow and reduce swelling of the gland.
- Enzymes. They liquefy the secretion of the prostate, increase the local immunity of the organ, increase the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators for restoring immunity.
- Non-steroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.
The doctor personally chooses the drugs and the dose according to the symptoms, type, form of the disease.
Second phase
After the removal of acute symptoms, they switch to drugs and methods that help stabilize the gland. Medical treatment consists of:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulant;
- drugs that normalize the process of urinary secretion;
- anti-inflammatory drugs;
- drugs to restore erection.
In the complex treatment, oral drugs and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
Special methods include prostate massage. Mechanical influence on the prostate gland allows:
- accelerates blood circulation;
- strengthen the walls of capillaries and vessels;
- enable exchange processes;
- to establish a leak of the secret;
- normalization of bladder emptying;
- increasing the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are performed for therapeutic and prophylactic purposes.
Types of massage:
- with the help of a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external devices (performed using a special massager).
The third stage
The treatment ends with ozone therapy and laser therapy. Rectal ozone therapy consists of daily administration of freshly prepared isotonic sodium chloride solution.
Treatment of inflammation of the prostate gland with a laser is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis. Action of rectal laser direction:
- regenerates gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves blood supply to the prostate, the condition of blood vessels.
The frequency of sessions is 2-4 times a week, the duration of a procedure is 10-20 minutes. At the decision of the attending physician, laser therapy begins from the second stage of treatment.
In addition, phytotherapeutic agents are used.
Features of treatment of chronic prostatitis
This form of prostatitis is characterized by an undulating course, in which the worsening of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms. In some cases, the symptoms are observed constantly, but they have an erased, mild character. In most cases, men endure discomfort for a long time in the form of urination disorders, dull pains in the bottom of the abdomen and perineum and weakening of potency. Patients with such a diagnosis often turn to the doctor during a worsening of symptoms.
Treatment of chronic prostatitis begins with a detailed examination to find out what caused the inflammatory process. Based on the diagnostic results, the urologist chooses drugs from several groups:
- Antibacterial drugs are prescribed for patients diagnosed with chronic bacterial prostatitis, as well as for diseases of non-bacterial origin. The means of this group, in addition to suppressing the activity of pathogenic microflora, help to reduce inflammation.
- Drugs of the alpha-blocker group are prescribed to patients with severe urination disorders. Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed for patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute phase.
- Hormonal drugs are recommended by urologists for the active growth of prostate gland tissue against the background of chronic inflammation.
- Immunomodulators are used for chronic inflammation of the prostate of any origin, be it allergic, bacterial or bacterial prostatitis.
In addition, drugs are used that stimulate blood circulation in the pelvic organs and directly in the prostate, as well as potency stimulants. Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and much more), a set of exercise therapy exercises to relax the muscles of the perineum and pelvic floor, as well as laser therapy also help to improveprognosis.
All these methods are widely used in clinics, which makes it possible to achieve high treatment results, even if the patient is diagnosed with chronic calculous prostatitis, one of the forms of complicated chronic inflammation of the prostate gland. The center's specialists pay special attention to preserving the functions of the genitourinary system in men, so that patients after therapy can lead a full life and even become parents. Only with complex treatment with the use of properly selected medications, physiotherapy and prostate massage can a positive result in treatment be achieved.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Changing eating habits. Balanced diet with restriction of fatty and high-calorie foods. Enriching the diet with vegetables, fruits, products for men's health (nuts, honey, seafood, etc. ).
- Physical activity (regular sports contribute to the normalization of blood circulation in the genital area).
- Protected sex - use of barrier contraception (condom) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of congestive phenomena in the prostate.
- Alcohol restriction. Alcohol abuse leads to a decrease in potency, sexual desire, inhibition of testosterone synthesis.
- Complete rest. Psycho-emotional overload, insomnia (insomnia), excessive physical work are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and examinations for STIs. The disease is easier to prevent than to treat.
Urologists offer preventive examination of the prostate gland.