In the middle of the last century, it was believed that prostatitis developed in old age. Today, the disease has become "younger" and is diagnosed in fertile 30-40-year-old men. The inflammation tends to become chronic, which makes therapy much more difficult. Doctors successfully solve men's health problems of any complexity. Urologists of the medicalcenter develop individual therapeutic schemes, use the best drugs and have modern methods for treating prostate diseases.
"The Second Man's Heart"
The prostate is a small unpaired gland with an external secretion controlled by hormonal activity. The organ is located in the lower part of the pelvis, below the bladder. The wider edge of the prostate covers the neck of the bladder. The back is in close proximity to the front wall of the rectum. The frontal part of the gland occupies a place in the pubic area at the junction of the pelvic bones. In the male body, the prostate performs three main functions:
- motor - control of the excretion of urine and seminal fluid (due to this, the sperm does not enter the bladder;
- secretory - 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 manifest itself in puberty, gaining full value by the age of 18-20 years. The decline in the active work of the body is registered in men who have passed the fifty-year stage.
Types and forms of prostatitis
The type of disease is determined by the cause of its occurrence:
- Bacterial prostatitis. It occurs as a complication of infectious and inflammatory processes in the urogenital tract (less often in other body systems).
- Abacterial prostatitis. It develops against the background of physiological failures of neurological, psychoneurological etiology, chronic diseases, unhealthy lifestyle.
The trigger of the inflammatory process is congestive (congestive) phenomena in the tissues of the gland, provoked by organic disorders or infection.
The forms are classified according to the nature of the manifestation of the symptoms and the course of the disease:
- Acute inflammation. Characteristic of a bacterial type of disease. It is accompanied by intense manifestation of specific signs.
- Chronic prostatitis. It works unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases, it has an abacterial origin.
Symptoms of chronic prostatitis often disappear as the inflammatory process progresses. The undulating course of the disease is the reason for the untimely visit to a urologist, subsequently expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and prostatic secretion occurs for reasons corresponding to the specific classification of the disease.
| Causes of an infectious type | Causative 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 damage to the spine and genital organs, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system |
Provocative factors include irregular 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.
Key symptoms:
- From the excretory system. Pollakiuria (frequent urination) with discharge of drops of urine, burning, spasms in the urethra. Urine becomes cloudy. Urges to empty the bladder are often false.
- From the reproductive system. Pain in the perineum, reduced potency, painful ejaculation. During intimacy (or immediately after), discomfort occurs in the area of the glans penis and testicles.
- On the part of the nervous system. Sharp muscle pain in the lumbar and sacral region, in the lower abdomen.
- Psycho-emotional disorders. Increased nervousness, anxiety, irritability.
- From the digestive system. Constipation, exacerbation of hemorrhoids.
- On the part of the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37-38 ℃), symptoms of intoxication of the body. Usual actions cause rapid fatigue, desire to lie down.
Against the background of inflammation, existing chronic diseases are exacerbated.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and the functioning of the organ. In the stage of remission, the pathology reminds of itself with increased fatigue, reduced work capacity. Disorders of the excretory system are characterized by repeated (often false) urges to empty the bladder that become more frequent at night.
Urination is moderately painful, after passing urine there is a feeling of incomplete emptying. Prostatic secretion with mucous consistency of yellowish color, unpleasant smell (prostorrhea) spontaneously flows from the urethra.
Patients are haunted by chronic pelvic pain syndrome - painful sensations from pain localized in the lower third of the abdomen, pelvis and external genitalia, in the perineum, lumbar and sacral region.
Chronic prostatitis is accompanied by 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 person 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. Exacerbation is provoked by:
- General hypothermia. After a long stay in cold water or in the cold, any chronic inflammatory diseases, including prostatitis, worsen.
- Limitation of mobility. With hypodynamia, blood circulation in the pelvic organs is impaired. 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 relations. The lack of sexual intercourse leads to stagnation of prostate secretion, which provokes an exacerbation.
- Tight underwear. Mechanical compression of the external genitalia 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 concentration of cholesterol in the blood), as a result of which atherosclerosis develops. Cholesterol plaques interfere with the free flow 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 untimely treatment of acute inflammation, purulent masses accumulate in the tissues of the prostate and an abscess of the gland develops. The condition is characterized by febrile temperature (39 ℃), chills, acute intense 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 bulging of the urethra (enlargement of the urethra with a special metal bulging).
Lack of correct 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;
- epididymorchitis - inflammation of the testicle;
- vesiculitis - inflammation of the seminal vesicles;
- infertility (the first degree of the disease requires long-term therapy, the second is practically incurable);
- impotence;
- Sclerosis of the prostate is the death of prostate cells.
Timely examination of the prostate in men will help to avoid the severe consequences of an inflammatory disease.
prostate examination
Rectal examination of the prostate is an unpleasant but extremely necessary procedure. It allows you to detect at an early stage such serious diseases as adenoma, prostatitis, malignant tumors.
Indications for rectal examination of the prostate
Every man over the age of 40 should see a urologist at least once a year. The earlier the inflammatory process, benign and malignant neoplasms are diagnosed, the greater the chances of a complete recovery of the prostate gland. The patient receives a more gentle treatment, preserves sexual desire, sexual activity and the ability to conceive.
Sometimes men under 40 show warning signs, but delay a visit to a urologist. Indications for 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 - too frequent urges, spasms, 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 performed?
A few hours before the procedure, you should refrain from:
- sexual intercourse;
- masturbation;
- I do sports;
- Cycling;
- physical labor.
Before visiting a doctor, you should empty your bladder, do a cleansing enema with salted water or chamomile decoction.
Before examining the prostate, the man takes a knee-elbow position, lies on his side with his legs bent, or stands, leaning forward and resting his hands on the table. The doctor puts on sterile gloves, lubricates his index finger and the patient's anus with petroleum jelly or lubricant.
During a rectal examination of the prostate, the doctor massages the lobes of the prostate gland from the side to the center. Using palpation, you can assess:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- the weight of the contours and the longitudinal groove;
- the presence of pain, seals and nodules.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, during the procedure, the secret of the prostate gland is obtained. 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 clinical analysis of urine and blood, examination 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;
- re-appointment with doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (prescription, intensity);
- collection of anamnesis (past diseases);
- clarification of information about working conditions, lifestyle characteristics, habits, regularity of sexual relations;
- visual assessment of the external genital organs for the presence of rashes, redness, swelling, discharge from the urethra;
- palpation of the inguinal lymph nodes;
- palpation rectal examination of the prostate (determination of soreness, contours, density, elasticity of the gland, assessment of the condition of the interlobar septum);
- sampling of biomaterial for laboratory research;
- appointment of analyses.
Medical examinations do not have strict time limits. In a specialized clinic, maximum time and attention is given to each patient.
For a differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a person takes blood, urine, prostate secretion and a swab from the urethra.
The doctor takes a sample of prostate secretion with his own hand during a rectal examination of the gland. Disposable medical gloves, a lubricant (vaseline, gel-lubricant, glycerin) that facilitates penetration into the rectal ampoule, sterile glasses are used for the examination. The depth of penetration does not exceed 5 cm. The professional qualification and experience of urologists guarantee the safety and painlessness of the procedure.
Venous blood collection is done with modern vacutainers. The medical center strictly observes the rules of sterility when collecting biological material.
Laboratory researches
The tests are carried out by experienced specialists in a clinical-diagnostic laboratory. The laboratory department 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 smear to determine STI. A sample of biomaterial is planted on nutrient media favorable for the growth of pathogenic microorganisms. Active reproduction and colony formation of a particular pathogen indicates the presence of infection. Based on a bacterial culture, an antibiogram is made - determination of the resistance of pathogens to antibiotics.
- General analysis of urine. Deviation from the norm (leucocyturia, bacteriuria, cylinduria, etc. ) indicates the presence of an inflammatory process.
- The PSA (prostate specific antigen) blood test is a tumor marker of the male reproductive system. It is performed according to the high-precision ICLA method (chemiluminescence immunoassay).
- Examination of prostate secretion (microscopy and culture). It allows you to determine the inflammation, the presence of microbes (E. coli, staphylococci, etc. )
A comprehensive screening for STIs can be done 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 tips (condom) are placed on top. The data is transmitted to the monitor, where the urologist visually assesses pathological changes in the prostate gland.
Repeat admission
On readmission, the doctor:
- evaluates test results;
- compiles a personal therapeutic regimen, taking into account the type, form, nature of the course of prostatitis, drug tolerance, age of the patient;
- appoints control studies.
We offer booking an appointment at a time convenient for the patient by phone or through the website by filling out the online form.
Therapy of prostatitis
In the clinic, a person can undergo a full course of treatment for prostatitis. Course therapy for acute inflammation of the prostate includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the condition of the gland;
- consolidation of results, prevention of complications.
First stage
In prostatitis with an infectious etiology, antibiotics are primarily prescribed to destroy the causative agent of the infection. The choice of drug is based on the results of the antibiogram. In parallel, drugs from several pharmacological groups are used:
- Alpha blockers. Medicines help to relax the smooth muscle tissue of the prostate, the neck of the bladder, reduce the internal pressure in the urethra, normalize the outflow of urine and reduce the swelling of the gland.
- Enzymes. They liquefy the prostate secretion, increase the local immunity of the organ, strengthen the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators to restore immunity.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.
The doctor chooses drugs and dosage personally according to the symptoms, type, form of the disease.
Second phase
After removing the acute symptoms, we move on to drugs and methods that help stabilize the gland. Medical treatment consists of:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urine excretion;
- anti-inflammatory drugs;
- drugs to restore an erection.
In complex treatment, oral drugs and rectal suppositories are used (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic).
Special methods include prostate massage. The mechanical effect on the prostate gland allows:
- acceleration of blood circulation;
- strengthening the walls of capillaries and vessels;
- activation of exchange processes;
- to establish leakage of the secretion;
- normalization of bladder emptying;
- increasing the effectiveness of drug therapy;
- recovery of sexual activity.
Massage procedures are carried out for curative and prophylactic purposes.
Types of massage:
- with the help of an expander (buji);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (performed using a special massager).
Third stage
The treatment is complemented by ozone therapy and laser therapy. Rectal ozone therapy consists in the daily application of freshly prepared ozonated isotonic sodium chloride solution.
Treatment of inflammation of the prostate gland with a laser is a progressive physiotherapy technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis. Directed action of the rectal laser:
- regenerates gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves the blood supply to the prostate, the condition of the vessels.
The frequency of the sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes. According to the decision of the treating doctor, laser therapy starts from the second stage of the treatment.
In addition, phytotherapeutic agents are used.
Features of the treatment of chronic prostatitis
This form of prostatitis is characterized by an undulating course, in which the exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms. In some cases, the symptoms are observed constantly, but have an erased, mild character. In most cases, men suffer inconvenience for a long time in the form of urination disorders, dull pains in the lower abdomen and perineum, weakening of potency. Patients with such a diagnosis often turn to the doctor during an exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination to determine 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. Agents from this group, in addition to suppressing the activity of pathogenic microflora, help reduce inflammation.
- Drugs from the group of alpha-blockers are prescribed to patients with severe urination disorders. Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
- Hormonal drugs are recommended by urologists for active growth of glandular tissues of the prostate against the background of chronic inflammation.
- Immunomodulators are used in chronic inflammation of the prostate of any origin, be it allergic, bacterial or abacterial 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 many others), a set of exercise therapy exercises to relax the muscles of the perineum and pelvic floor, as well as laser therapy also help to improve the prognosis.
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 complex chronic inflammation of the prostate gland. The specialists of the center pay special attention to the preservation of the functions of the genitourinary system in men, so that patients after therapy can lead a full life and even become parents. A positive treatment result can only be achieved with complex treatment using properly selected drugs, physiotherapy and prostate massage.
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 sport contributes to the normalization of blood circulation in the genital area).
- Protected sex - the use of barrier contraception (condom) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of stagnant phenomena in the prostate.
- Alcohol restriction. Alcohol abuse leads to a decrease in potency, libido, inhibition of testosterone synthesis.
- Complete rest. Psycho-emotional overload, insomnia (insomnia), physical overload are provocateurs of abacterial prostatitis.
- Regular urologist visits and STI screenings. The disease is easier to prevent than to treat.
Urologists perform a prophylactic examination of the prostate gland.