In the middle of the last century, it was believed that prostatitis develops in old age.Today, the disease has become "younger", it is diagnosed in fertile men aged 30-40.Inflammation becomes chronic, which makes therapy even more difficult.Doctors successfully solve men's health problems of any complexity.The urologists of the medical center develop individual therapeutic regimens, use the best drugs, and adopt modern methods of treating prostate gland diseases.
"Second Man's Heart"
The prostate is a small unpaired exocrine gland controlled by hormonal activity.The organ is located in the pelvic floor, below the bladder.The wider edge of the prostate covers the neck of the bladder.The posterior part is adjacent to the anterior wall of the rectum.The anterior 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:
- motor - controlling the separation of urine and seminal fluid (therefore 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 urinary system.
The functionality of the prostate gland begins to manifest itself during puberty, it is fully functional until the age of 18-20.A decrease in the active activity of the organ is noted in men over the age of fifty.
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 genitourinary tract (less often in other body systems).
- Bacterial prostatitis.It develops against the background of physiological disorders of neurological, psychoneurological etiology, chronic diseases, unhealthy lifestyle.
The trigger 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 the manifestation of symptoms and the course of the disease:
- Acute inflammation.It is characteristic of the bacterial type of the disease.It is accompanied by intense manifestation of specific symptoms.
- Chronic prostatitis.It is unstable.Latent periods are accompanied by relapses with pronounced symptoms.95% of cases are of bacterial origin.
Symptoms of chronic prostatitis often disappear, the inflammatory process progresses.The fluctuating course of the disease is the reason for not contacting a urologist in time, which leads to expensive treatment for complications later.
Causes of prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons that correspond to the classification type of the disease.
| Causes of infectious type | 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, neuroses, mechanical injuries of the spine and genitals, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc.), physical inactivity, endocrine system diseases. |
Provocative factors include irregular sex (absence of sex), systematic hypothermia, chronic alcoholism.
Symptoms of the 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) urinary flow, 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, decreased potency, painful ejaculation.During intercourse (or immediately after) there is discomfort in the area of the head of the penis and testicles.
- From the nervous system.Sharp muscle pain in the lumbar and sacral region, lower abdomen.
- Psycho-emotional disorders.Increased irritability, anxiety, irritability.
- From the digestive system.Constipation, exacerbation of hemorrhoids.
- From the side of the autonomic nervous system.Loss of appetite, headache, low body temperature (37-38 ℃), signs of body intoxication.Ordinary movements cause rapid fatigue and the desire to lie down.
Against the background of inflammation, existing chronic diseases worsen.
Symptoms of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and activity of the organ.In the remission stage, the pathology shows itself with increased fatigue and decreased performance.Disorders of the urinary system are characterized by repeated (often false) urges to empty the bladder, which occur more often at night.
Urinating is moderately painful, after urinating there is a feeling of incomplete emptying.Prostatic secretion (prostatorrhea) with a yellowish color and an unpleasant odor, with a mucous consistency, flows spontaneously from the urethra.
Patients suffer from chronic pelvic pain syndrome - painful painful sensations localized in the lower third of the abdominal cavity, pelvis and external genitalia, perineal region, lumbar and sacral regions.
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.The man suffers from depression and sudden mood swings - from aggression to apathy.Ultimately, this leads to absolute sexual weakness (impotence).
In the period of relapse, the symptoms correspond to the acute form of the disease, but are less intense.Causes exacerbation:
- General hypothermia.After a long stay in cold water or frost, any chronic inflammatory diseases, including prostatitis, worsen.
- Restriction of mobility.Physical inactivity disrupts blood circulation in the pelvic organs.Stagnation of blood leads to swelling of the prostate, which compresses the nerve endings and the urethra.
- Alcohol abuse.Under the influence of alcohol, the chronic course of inflammatory processes is activated.
- Prolonged refusal of 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 of the prostate gland.
Recurrence of the disease is caused by unhealthy eating habits.An abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), as a result of which atherosclerosis develops.Cholesterol plaques prevent the free flow of blood, causing blockage in the prostate.An abundance of constipating foods on the menu causes excessive tension in the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated in time, purulent masses accumulate in the tissues of the prostate gland and an abscess of the gland is formed.The condition is characterized by fever (39 ℃), chills, acute severe pain in the perineum, ischuria (inability to empty the bladder independently).The only method of treatment is an operation to open the pus and plug of the urethra (enlargement of the urethra using a special metal plug).
Lack of correct diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis are the reasons for the development of dangerous complications:
- adenoma of the prostate gland is a benign tumor with a tendency to malignancy (malignant tumor) if not properly treated;
- formation of stones in the gland;
- Epididymo-orchitis is an inflammation of the testicle;
- vesiculitis - inflammation of seminal vesicles;
- infertility (the first degree of the disease requires long-term therapy, the second is practically not treated);
- impotence;
- Prostate sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help prevent serious consequences of the 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
Every man over the age of 40 should see a urologist at least once a year.The sooner the inflammatory process, benign and malignant neoplasms are diagnosed, the higher the chances of a full recovery of the prostate gland.The patient receives milder treatment, maintains libido, sexual activity and fertility.
Sometimes men under the age of 40 detect warning signs, but postpone a visit to a urologist.Indications for urgent prostate examination are:
- pain of any intensity in the perineal region;
- erectile dysfunction;
- premature ejaculation;
- decrease in the volume of released sperm;
- discomfort during intercourse and defecation.
Do not ignore problems with urination - too frequent urge, pain, feeling of an empty bladder, unpleasant changes in the smell and color of urine.If you notice at least one symptom, definitely make an appointment with a urologist.
How is a digital prostate examination performed?
A few hours before the procedure, you should avoid the following:
- sexual intercourse;
- masturbation;
- play sports;
- riding a bicycle;
- physical labor.
Before going to the doctor, it is necessary to empty the bladder and 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 and lubricates the index finger and the patient's anus with petroleum jelly or lubricant.
During the rectal examination of the prostate, the doctor massages the lobes of the prostate gland from the sides to the center.You can evaluate with the help of palpation:
- size and shape;
- body texture and elasticity;
- symmetry of its elements;
- expressiveness of contours and longitudinal furrows;
- pain, lumps and nodules.
These data allow to determine whether there are pathological changes in the prostate gland.
In addition, prostate secretions are taken during the procedure.This fluid is sent for analysis showing the content of bacteria, leukocytes, red blood cells and pathogenic microorganisms.
Based on the results of the digital examination of the prostate, the doctor can prescribe additional diagnostic measures.These include clinical analysis of urine and blood, examination of tumor markers, ultrasound examination of the prostate gland, etc.
Diagnosis of the disease
Making an accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- a number of laboratory tests;
- hardware examination of the prostate;
- see the doctor again.
A consultation with a urologist includes:
- identification of symptoms, their characteristics (duration, intensity);
- taking anamnesis (past diseases);
- clarification of information about working conditions, lifestyle characteristics, habits, regularity of sexual intercourse;
- 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 (to determine pain, contour, density, elasticity of the gland, assess the condition of the interlobar septum);
- collection of biomaterial for laboratory research;
- setting tests.
There is no strict time limit for a medical appointment.In a specialized clinic, maximum time and attention is given to each patient.
For the differential diagnosis of bacterial and bacterial prostatitis, a man conducts a smear test of blood, urine, prostate secretions and urethra to determine the form of the disease.
The doctor takes a sample of prostate secretion with his hand during the rectal examination of the gland.Disposable medical gloves, lubricant (vaseline, gel lubricant, glycerin) facilitating penetration into the rectal ampoule and sterile glasses are used for the examination.The penetration depth is not more than 5 cm.The 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 observes 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 tests of any complexity.
The list of tests includes:
- Bacteriological culture of the smear to identify STIs.A sample of biomaterial is planted in a nutrient medium favorable for the growth of pathogenic microorganisms.The active reproduction of a particular pathogen and the formation of colonies indicate the presence of an infection.Based on bacterial culture, an antibiogram is performed to determine the resistance of pathogens to antibiotics.
- General urinalysis.Deviation from the norm (leukocyturia, bacteriuria, cylinduria, 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.This is done using the chemiluminescence immunoassay (CHLA) method.
- Study of prostate secretion (microscopy and culture).It allows to determine the presence of inflammation, microbes (E. coli, staphylococcus, etc.).
A comprehensive test for STDs can be done using a blood sample.
Hardware diagnostics is a TRUS (transrectal ultrasound) examination of the prostate gland.It is carried out 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 inserts (condoms) are placed on top.The data is transmitted to the monitor, where the urologist visually evaluates pathological changes in the prostate gland.
Reunion
When reassigned, the doctor:
- evaluates test results;
- designs an individual therapeutic regimen taking into account the type, form, course of prostatitis, drug tolerance and the patient's age;
- determines control studies.
We offer to schedule an appointment at a convenient time for the patient by filling out the online form or by phone.
Treatment of prostatitis
In the clinic, a man can undergo a full course of treatment for prostatitis.Course therapy for acute inflammation of the prostate gland consists of three stages:
- elimination of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
The first stage
For prostatitis of infectious etiology, antibiotics are first prescribed to destroy the infectious agent.The choice of drugs is based on the results of the antibiogram.Medicines of several pharmacological groups are used in parallel:
- Alpha adrenergic blockers.Medicines help to relax the smooth muscle tissue of the prostate gland and bladder neck, reduce internal pressure in the urethra, normalize urine flow, and reduce swelling of the gland.
- Enzymes.They dilute prostate secretion, increase local immunity of the body, increase antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators to restore immunity.
- Nonsteroidal anti-inflammatory drugs (NSAIDs).They reduce inflammation and relieve pain.
The doctor selects the drugs and the dosage personally according to the symptoms, type and form of the disease.
The second stage
Once the acute symptoms are resolved, they move on to medications and techniques that help stabilize the gland.Drug treatment includes:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urination;
- anti-inflammatory drugs;
- drugs to restore erection.
Oral drugs and rectal suppositories (restorative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used in complex treatment.
Special techniques include prostate massage.The mechanical effect on the prostate gland allows you to:
- accelerate blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- build secretion flow;
- normalize the emptying of the bladder;
- increase the effectiveness of drug treatment;
- resume sexual activity.
Massage procedures are performed for therapeutic and preventive purposes.
Types of massage:
- using a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external apparatus (performed using a special massager).
The third stage
The treatment is completed with ozone therapy and laser therapy.Rectal ozone therapy consists of daily administration of freshly prepared ozonated isotonic sodium chloride solution.
Laser treatment of inflammation of the prostate gland is a progressive physiotherapeutic method that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directional effect of rectal laser:
- restores gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves the blood supply of the prostate and the condition of the blood vessels.
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 treating doctor, laser therapy starts from the second stage of treatment.
In addition, phytotherapeutic substances are used.
Features of treatment of chronic prostatitis
This form of prostatitis is characterized by a wave-like 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 constantly observed, but they are of a pale, light nature.In most cases, men endure discomfort in the form of long-term impaired urination, dull pains in the lower abdomen and perineum, and weakened potency.Patients with this diagnosis often consult a doctor during exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination designed to find out what caused the inflammatory process.Based on the diagnostic results, the urologist selects 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 in this group help to reduce inflammation.
- Alpha-blocker drugs are prescribed to patients with severe disorders of the urinary tract.Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pelvic pain and obvious symptoms of chronic prostatitis in the acute phase.
- Urologists recommend using hormonal agents for the active growth of the glandular tissue of the prostate 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, agents that stimulate blood circulation in the pelvic organs and the prostate itself, as well as potential stimulants, are used.Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and 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 improve the prognosis.
All these methods are widely used in clinics, which allows the patient to achieve high treatment results even if he 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 preserving the functions of the genitourinary system in men, thanks to which patients can lead a full life after therapy and even become parents.Only with the use of properly selected drugs, physiotherapy and prostate massage, a positive result can be achieved in complex treatment.
Prevention of inflammatory processes in the prostate gland
Preventive measures include:
- Changing eating habits.A balanced diet with limited fat 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 sexual intercourse is a pleasant and useful prevention of congestive phenomena in the prostate gland.
- Limit alcoholic beverages.Alcohol abuse causes a decrease in potency, libido and inhibition of testosterone synthesis.
- Complete relaxation.Psycho-emotional stress, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and tests for STIs.It is easier to prevent disease than to cure it.
Urologists perform preventive examinations of the prostate gland.