In the middle of the last century, it was believed that prostatitis developed in old age.Today, the disease has become "younger", diagnosed in fertile men aged 30-40.The inflammation tends to become chronic, making therapy much more difficult.Doctors successfully solve men's health problems of any complexity.Urologists at the medical center develop individual therapeutic schemes, use the best drugs and master modern methods of treating prostate diseases.
"The Second Man's Heart"
The prostate is a small unpaired exocrine gland 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 posterior part is in close proximity to the anterior wall of the rectum.The anterior part of the gland occupies a place in the pubic region 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 (so sperm does not enter the bladder;
- secretory - production of secretion responsible for the quality of seminal fluid and maintaining a stable erection;
- barrier - protection against infection of the upper parts of the excretory system.
The functionality of the prostate gland begins to manifest itself during puberty, becoming fully functional by the age of 18-20 years.A decrease in the active functioning of the organ is registered in men who have passed the fifty-year mark.
Types and forms of prostatitis
The type of disease is determined by the cause:
- 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 disorders of neurological, psychoneurological etiology, chronic diseases and an 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.Accompanied by intense manifestation of specific symptoms.
- Chronic prostatitis.She is unstable.Latent periods are followed by relapses with pronounced symptoms.In 95% of cases, it is of a bacterial origin.
Symptoms of chronic prostatitis often disappear as the inflammatory process progresses.The undulating course of the disease is the reason for untimely contact with a urologist, which subsequently leads to expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and prostatic secretion occurs for reasons corresponding to the type of classification of the disease.
| Causes of 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.), lack of physical activity, diseases of the endocrine system. |
Provocative factors include irregular intercourse (complete lack of sex), systemic hypothermia, chronic alcoholism.
Symptoms of the acute form of the disease
Acute prostatitis is characterized by severe manifestations of inflammation in the prostate gland.In the process, neighboring organs and systems are involved and psycho-emotional stability is disturbed.
Key symptoms:
- From the excretory system.Pollakiuria (frequent urination) with dribbling of urine, burning sensation, pain in the urethra.Urine becomes cloudy.The urge to empty the bladder is often false.
- From the reproductive system.Pain in the perineum, reduced potency, painful ejaculation.During intimacy (or immediately after) there is discomfort in the area of the head of the penis and testicles.
- On the part of the nervous system.Sharp muscle pain in the lumbar and sacral region, 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, low body temperature (37-38 ℃), symptoms of body intoxication.Usual actions cause rapid fatigue and a desire to go to bed.
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 the functioning of the organ.In the stage of remission, the pathology reminds of itself with increased fatigue and reduced work capacity.Disorders of the excretory system are characterized by repeated (often false) urges to empty the bladder, increasing at night.
Urination is moderately painful, after passing urine there is a feeling of incomplete emptying.Prostatic secretion with a mucous consistency, yellowish color and unpleasant smell (prostatorrhea) spontaneously flows from the urethra.
Patients are tormented by chronic pelvic pain syndrome - painful sensations localized in the lower third of the abdomen, pelvic and external genital organs, in the perineal area, lumbar and sacral area.
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 subject to depression and sudden changes in mood - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During the relapse 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 freezing, all chronic inflammatory diseases, including prostatitis, worsen.
- Limitation of mobility.In the absence of physical activity, blood circulation in the pelvic organs is impaired.Stagnation of blood leads to swelling of the prostate, which presses on the nerve endings and the urethra.
- Alcohol abuse.The chronic course of inflammatory processes is activated under the influence of alcohol.
- Long-term 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.
Relapse 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, causing congestion in the prostate.An excess of foods that cause constipation in the menu leads to excessive tension in the perineal muscles.
Complications of prostatitis
If the acute inflammation is not treated promptly, 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 method of treatment is an operation to open the suppuration and bulging of the urethra (enlargement of the urethra with the help of 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 is a benign tumor that is prone to malignancy (malignancy) if treated incorrectly;
- formation of stones in the gland;
- Epididymorchitis is an 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 serious consequences of the inflammatory disease.
Prostate examination
Rectal examination of the prostate is an unpleasant but extremely necessary procedure.Allows early detection of serious diseases such as adenoma, prostatitis and 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 more gentle treatment, preserves libido, sexual activity and the ability to fertilize.
Sometimes men under the age of 40 find warning signs, but postpone a visit to a urologist.Indications for urgent prostate examination are:
- pain of any intensity in the perineal area;
- erectile dysfunction;
- premature ejaculation;
- decrease in the volume of released sperm;
- discomfort during intercourse and defecation.
Do not ignore problems with urination - too frequent urges, pain, 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;
- playing sports;
- riding a bicycle;
- physical labor.
Before visiting a doctor, you should empty your bladder and do a cleansing enema with salt water or chamomile decoction.
Before the examination of the prostate, the man takes a knee-elbow position, lies on his side with his legs bent, or stands bent forward and rests his hands on the table.The doctor puts on sterile gloves and 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.With the help of palpation, you can assess:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- expressiveness of contours and longitudinal furrow;
- the presence of pain, lumps and nodules.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, prostatic secretion is produced during the procedure.This fluid is sent for analysis, which shows the content of bacteria, leukocytes, red blood cells and 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 gland, 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 the doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (duration, intensity);
- history taking (past illnesses);
- clarification of information about working conditions, lifestyle characteristics, habits and regularity of sexual relations;
- visual assessment of the external genitalia 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 pain, contours, density, elasticity of the gland, assessment of the state of the interlobar septum);
- taking biomaterial for laboratory research;
- assignment of tests.
The medical examination has no strict time limits.In a specialized clinic, maximum time and attention is given to each patient.
For differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, the man takes blood, urine, prostate secretions and urethral smear tests.
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 and sterile glasses are used for the examination.The penetration depth does not exceed 5 cm.The professional qualification and experience of urologists guarantee the safety and painlessness of the procedure.
Venous blood is collected using modern vacutainers.The medical center strictly observes the rules of sterility when taking biological material.
Laboratory studies
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 conducting research of any complexity.
The list of tests 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 to determine the resistance of pathogens to antibiotics.
- General analysis of urine.Deviation from the norm (leukocyturia, bacteriuria, cylinduria, etc.) indicates the presence of an inflammatory process.
- The blood test for PSA (prostate specific antigen) is a tumor marker of the male reproductive system.It is performed by a highly accurate chemiluminescent immunoassay (CHLA) method.
- Examination of prostate secretion (microscopy and culture).It allows you to determine inflammation, the presence of microbes (E. coli, staphylococci, etc.)
Comprehensive screening for STIs can be done using a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate gland.It is performed using a cylindrical sensor with a diameter of no more than 1.5 cm, inserted into the rectum.The sensor is pre-lubricated, and special disposable attachments (condom) are placed on top.The data is transmitted to a monitor, where the urologist visually assesses pathological changes in the prostate gland.
Reunion
Upon re-appointment, the doctor:
- evaluates test results;
- compiles an individual therapeutic regimen, taking into account the type, form, nature of the course of prostatitis, drug tolerance and the patient's age;
- prescribes 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.
Treatment of prostatitis
In the clinic, a person can undergo a full course of treatment for prostatitis.Course therapy for acute inflammation of the prostate gland includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
First stage
In prostatitis with an infectious etiology, antibiotics are initially prescribed to destroy the infectious agent.The choice of drug is based on the results of the antibiogram.In parallel, drugs from several pharmacological groups are used:
- Alpha adrenergic blockers.Medicines help to relax the smooth muscle tissue of the prostate and 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 dilute 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).They reduce the inflammatory process and relieve pain.
The doctor chooses drugs and dosage personally depending on the symptoms, type and form of the disease.
Second stage
After the relief of acute symptoms, one moves on to drugs and methods that help to stabilize the gland.Drug treatment includes:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urine excretion;
- anti-inflammatory agents;
- 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 you to:
- acceleration of blood circulation;
- strengthening the walls of capillaries and blood vessels;
- activation of exchange processes;
- detection of leakage of secretions;
- normalization of bladder emptying;
- increasing the effectiveness of drug therapy;
- recovery of sexual activity.
Massage procedures are performed for therapeutic and preventive purposes.
Types of massage:
- using 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 of daily administration 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 blood supply to the prostate and the condition of blood vessels.
The frequency of the sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes.Based on the decision of the attending physician, laser therapy begins with the second stage of treatment.
Phytotherapeutic agents are additionally 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 a faded, mild character.In most cases, men suffer long-term inconvenience in the form of impaired urination, dull pain in the lower abdomen and perineum, weakened potency.Patients with this diagnosis often turn to a doctor precisely during an exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination designed 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.In addition to suppressing the activity of pathogenic microflora, drugs from this group help reduce inflammation.
- Alpha-blockers are prescribed to patients with severe urinary disorders.Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pain in the pelvis and pronounced symptoms of chronic prostatitis in the acute stage.
- Urologists recommend the use of hormonal agents for active growth of the glandular tissue 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, agents are used that stimulate blood circulation in the pelvic organs and the prostate itself, as well as potency stimulants.Treatment methods such as prostate massage, physical therapy (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.Specialists of the center pay special attention to the preservation of the functions of the genitourinary system in men, thanks to which 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.A balanced diet with limited fatty and high-calorie foods.Enriching the diet with vegetables, fruits, products for men's health (nuts, honey, seafood, etc.).
- Physical activity (regular exercise helps normalize blood circulation in the genital area).
- Protected sex is 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.
- Limit alcohol.Alcohol abuse leads to a decrease in potency, libido and inhibition of testosterone synthesis.
- Complete rest.Psychoemotional overload, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
- Regular urologist visits and STI screenings.The disease is easier to prevent than to treat.
Urologists perform prophylactic examinations of the prostate gland.