In the middle of the last century, it was believed that prostatitis develops in old age.Today, the disease has become "young", which is diagnosed in fertile men of 30-40 years.Inflammation tends to become chronic, which complicates therapy.Doctors successfully solve men's health problems of any complexity.Urologists of the medical center develop personal therapeutic regimens, use the best drugs and master modern methods of treating prostate diseases.
"Another Man's Heart"
The prostate is a small unpaired exocrine gland that is controlled by hormonal activity.The organ is located in the lower part of the pelvis, under the bladder.The wide edge of the prostate covers the neck of the bladder.The posterior part is adjacent to the anterior wall of the rectum.The frontal part of the gland is located in the pubic area of the junction of the pelvic bones.In the male body, the prostate performs three main functions:
- Motor - control of the release of urine and seminal fluid (due to this, sperm does not enter the bladder;
- secretory - the production of secretion, which is responsible for the quality of seminal fluid and maintaining a stable erection;
- Barrier - protection from infection of the upper parts of the genitourinary system.
The functioning of the prostate gland begins to manifest itself during puberty and is fully functional at the age of 18-20 years.A decrease in the active functioning of the organ is observed in men who have crossed the fifty-year mark.
Types and forms of prostatitis
The type of disease is determined by the cause:
- Bacterial prostatitis.It occurs in the urogenital tract (less often in other body systems) as a complication of infectious and inflammatory processes.
- Bacterial prostatitis.It develops against the background of physiological disorders of neurological, psychoneurological etiology, chronic diseases and unhealthy lifestyle.
The cause of the inflammatory process is congestive (stagnation) events in the gland tissues, provoked by organic disorders or infection.
Forms are classified according to the nature of symptoms and the course of the disease:
- acute inflammation.Characteristic of a bacterial type of disease.It is accompanied by intense manifestation of specific symptoms.
- Chronic prostatitis.It is unstable.Latent periods are followed by relapses with pronounced symptoms.In 95% of cases, it is of bacterial origin.
Symptoms of chronic prostatitis often disappear, while the inflammatory process progresses.The undulating course of the disease is the reason for timely contact with a urologist, which subsequently leads to expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and secretion of the prostate occurs due to the reasons corresponding to the type of classification of the disease.
| Infectious type causes | Causes of bacterial species |
|---|---|
| Sexually transmitted infections (STIs):
Bacterial diseases of intestines, skin, respiratory organs caused by staphylococcus, enterococcus, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgia, rheumatism, neurosis, mechanical injuries of the spine and genitals, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc.), physical inactivity, diseases of the endocrine system. |
Provocative factors include irregular intercourse (complete absence of sex), systematic hypothermia, 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 and psycho-emotional stability is disturbed.
Main symptoms:
- from the urogenital system.Polakiuria (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, loss of potency, painful ejaculation.During (or immediately after) intercourse, discomfort appears in the penis and testicle head.
- from the nervous system.Acute 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.
- from the autonomic nervous system.Lack of appetite, headache, low body temperature (37-38 ℃), symptoms of body intoxication.Usual activities lead to rapid fatigue and the desire to lie down.
Chronic diseases on the background of inflammation worsen.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and work of the organ.At the stage of remission, the pathology shows itself with increased fatigue and decreased performance.Disorders of the genitourinary system are characterized by a repeated (often false) need to empty the bladder, which becomes more frequent at night.
Urination is moderately painful, after passing urine there is a feeling of incomplete emptying.Prostatic secretion of mucous consistency with yellowish color and unpleasant odor flows spontaneously from the urethra (prostatorrhea).
Patients suffer from chronic pelvic pain syndrome - painful painful sensations, localized in the lower third of the abdomen, pelvis and external genitalia, perineal area, lumbar and sacral areas.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection accompanied by pain;
- suppression of libido;
- Rapid or difficult (often painful) ejaculation.
Against the background of sexual disorders, psycho-emotional instability progresses.Men are subject to depression and sudden changes in mood - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During relapse, symptoms correspond to the acute form of the disease, but are less intense.Exacerbation is provoked by:
- General hypothermia.After prolonged exposure to cold water or ice, any chronic inflammatory disease, including prostatitis, worsens.
- Limitation of mobility.With physical inactivity, blood circulation in the pelvic organs is disturbed.Blood stagnation causes swelling of the prostate, which compresses the nerve endings and the urethra.
- Alcohol abuse.The chronic course of inflammatory processes is activated by the influence of alcohol.
- Long-term abstinence from intimate relationships.Lack of sexual intercourse leads to stagnation of prostate secretion, which leads to exacerbation.
- tight underwear.Mechanical compression of the external genital organs 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 prevent the free flow of blood, which causes the prostate to swell.An excess of constipating foods on the menu causes excessive tension in the muscles of the perineum.
Complications of prostatitis
If acute inflammation is not treated in time, purulent masses accumulate in prostate tissue and gland abscess develops.The condition is characterized by febrile temperature (39℃), chills, sharp intense pain in the perineum, ishuria (inability to empty the bladder independently).The only method of treatment is an operation to open the urethral abscess and bulging (enlargement of the urethra using a special metal bulging).
Lack of correct diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis is the reason for the development of dangerous complications:
- Prostate adenoma is a benign tumor that is prone to malignant tumors (malignant tumors) in case of incorrect treatment;
- formation of stones in the gland;
- Epididymo-orchitis is inflammation of the testicle;
- Vesiculitis - inflammation of seminal vesicles;
- infertility (the first degree of the disease requires long-term therapy, and the second is practically incurable);
- impotence;
- Sclerosis of the prostate is the death of prostate cells.
Timely examination of the prostate in men can help prevent serious consequences of inflammatory disease.
Prostate examination
Rectal examination of the prostate is an unpleasant but extremely necessary procedure.It allows early detection of serious diseases such as adenoma, prostatitis and malignant tumors.
Indications for rectal examination of the prostate
All men over the age of 40 should see a urologist at least once a year.The earlier the inflammatory process, benign and malignant neoplasms are detected, the greater the chance of complete recovery of the prostate gland.The patient receives a gentler treatment, maintaining libido, sexual activity and fertility.
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 perineum area;
- erectile dysfunction;
- premature ejaculation;
- decrease in the volume of released sperm;
- Discomfort during intercourse and defecation.
Do not ignore problems related to urination - very frequent runny nose, pain, feeling of an unprotected 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 digital prostate examination performed?
A few hours before the procedure, you should refrain from:
- sexual contact;
- masturbation;
- playing sports;
- riding a bicycle;
- physical labor.
Before going to the doctor, you should empty your bladder and do a cleansing enema with salt water or chamomile tea.
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 and the index finger and the patient's anus with petroleum jelly or lubricant on top.
During the 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 evaluate:
- size and shape;
- body texture and elasticity;
- symmetry of its elements;
- expressiveness of contours and longitudinal fur;
- The presence of pain, lumps and knots.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, prostate secretions are obtained 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 the digital prostate examination, the doctor may prescribe additional diagnostic measures.Among them are clinical analysis of urine and blood, examination of tumor markers, ultrasound of the prostate gland, etc.
Diagnosis of the disease
An accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- set of laboratory tests;
- hardware examination of the prostate;
- Repeat appointment with the doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (duration, intensity);
- taking an anamnesis (past diseases);
- Clarification of information about working conditions, lifestyle features, habits and regularity of sexual relations;
- visual evaluation of the external genital organs for the presence of rash, redness, swelling, discharge from the urethra;
- Palpation of inguinal lymph nodes;
- palpable rectal examination of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the condition of the intermediate septum);
- collection of biomaterial for laboratory research;
- Appointment of tests.
Medical appointments do not have strict deadlines.In a specialized clinic, each patient is given maximum time and attention.
For the differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man conducts an analysis of blood, urine, prostate secretions and a smear from the urethra.
During a rectal examination of the gland, the doctor takes a sample of prostate secretion with his own hand.Disposable medical gloves, lubricant (vaseline, gel lubricant, glycerin) that helps to penetrate the rectal ampulla and sterile glasses are used for the examination.The penetration depth does not exceed 5 cm.Professional qualifications and experience of urologists ensure the safety and painlessness of the procedure.
Venous blood is collected using modern vacutainers.The medical center strictly adheres to the rules of sterility for the collection of biological material.
laboratory tests
The research is conducted by experienced specialists in the clinical diagnostic laboratory.The laboratory department of the medical center is equipped with modern equipment that allows conducting examinations of any complexity.
The list of tests includes:
- Bacteriological culture of smear to determine STI.A sample of biomaterial is planted on a nutrient medium favorable for the growth of pathogenic microorganisms.Active reproduction and the formation of colonies of a specific pathogen indicate the presence of infection.On the basis of bacterial culture, an antibiogram is performed to determine the resistance of pathogens to antibiotics.
- General analysis of urine.Deviation from the norm (leukocyturia, bacteriuria, cylindruia, 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 high precision chemiluminescence immunoassay (CHLA) method.
- Prostate secretion study (microscopy and culture).allows you to determine inflammation, the presence of microbes (E. coli, staphylococci, etc.)
Comprehensive screening for STIs can be done using a blood sample.
Instrumental diagnosis is TRUS (transrectal ultrasound) of the prostate gland.It is performed using a cylindrical sensor, the diameter of which does not exceed 1.5 cm, inserted into the rectum.The sensor is pre-lubricated, and special disposable inserts (condoms) are placed on top.The data is transferred to the monitor, where the urologist visually evaluates pathological changes in the prostate gland.
Re-appointment
When re-appointing the doctor:
- evaluates test results;
- establishes a personal therapeutic regimen taking into account the type, form, course of prostatitis, drug tolerance and the patient's age;
- Defines control studies.
We offer an appointment at a convenient time for the patient by phone or by filling out an online form through the website.
Prostatitis therapy
In the clinic, a man can undergo a full course of prostatitis treatment.Therapy of the course of 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.
the first stage
Antibiotics are initially prescribed for prostatitis of infectious etiology to destroy the infectious agent.The choice of the drug is based on the results of the antibiogram.Medicines of several pharmacological groups are used at the same time:
- Alpha adrenergic blockers.The drugs help to relax the smooth muscle tissue of the prostate and bladder neck, reduce internal pressure in the urethra, normalize urine flow, and reduce swelling of the gland.
- enzymes.They dilute the secretion of the prostate, strengthen the local immunity of the organ, enhance 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 the medication and the dose individually depending on the symptoms, type and form of the disease.
the second stage
After the removal of acute symptoms, they switch to drugs and methods that help stabilize the gland.Drug treatment includes:
- Vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- Medicines that normalize the process of urine excretion;
- anti-inflammatory drugs;
- Medicines to restore erection.
Oral medications and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used in complex treatment.
Special methods include prostate massage.Mechanical impact on the prostate gland allows you to:
- accelerate blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activation of exchange processes;
- to establish secretion outflow;
- Normalization of bladder emptying;
- increasing the effectiveness of drug therapy;
- Restoration of sexual activity.
Massage procedures are performed for therapeutic and preventive purposes.
Types of massage:
- using a dilator (plug);
- internal palpation;
- non-invasive (without penetration);
- Penetrating or external equipment (made using a special massager).
The third stage
Treatment is completed with ozone and laser therapy.Rectal ozone therapy involves daily administration of freshly prepared ozonated isotonic sodium chloride solution.
Laser treatment of inflammation of the prostate gland is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and avoid complications of prostatitis.Directed effect of rectal laser:
- restores gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- Improves prostate blood supply and blood vessel condition.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes.According to the decision of the attending physician, laser therapy begins with the second stage of treatment.
In addition, phytotherapeutic agents are used.
Peculiarities of chronic prostatitis treatment
This form of prostatitis is characterized by a wave-like course, during which exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms.In some cases, the symptoms are constantly observed, but have a faded, mild character.In most cases, men endure discomfort for a long time in the form of reduced urination, dull pain in the lower part of the perineum, and weakened potency.Patients with this diagnosis often consult a doctor precisely at the time of exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination designed to find out what caused the inflammatory process.According to 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 of this group help to reduce inflammation.
- Patients with severe urinary disorders are prescribed alpha-blockers.Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pelvic pain and acute symptoms of chronic prostatitis.
- Urologists recommend the use of hormonal agents for the active growth of prostate gland tissue against the background of chronic inflammation.
- Immunomodulators are used in chronic inflammation of the prostate of any origin, be it allergic, bacterial or bacterial 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, 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 complicated chronic inflammation of the prostate gland.Specialists of the center pay special attention to maintaining the functions of the male reproductive system, thanks to which patients can live a full life and even become parents after therapy.Only complex treatment with the use of correctly selected medications, physiotherapy and prostate massage can achieve a positive result in the treatment.
Prevention of prostatic inflammatory processes
Preventive measures include:
- Changing eating habits.A balanced diet with limited fatty and high-calorie foods.Enriching the diet with vegetables, fruits, men's health products (nuts, honey, seafood, etc.).
- Physical activity (regular exercise helps normalize blood circulation in the genital area).
- Protected sex is the use of barrier contraception (condoms) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of congestive events of the prostate.
- Limit alcohol.Alcohol abuse leads to a decrease in potency, inhibition of libido and testosterone synthesis.
- complete rest.Psycho-emotional overload, insomnia (insomnia), physical fatigue are provocateurs of bacterial prostatitis.
- Regular visits to the urologist and STD tests.Disease prevention is easier than treatment.
Urologists conduct preventive examinations of the prostate gland.