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 tends to become chronic, which makes therapy much more difficult.Doctors successfully solve men's health problems of any complexity.The urologists of the medical center develop personal therapeutic regimens, use the best drugs and learn modern methods of treating prostate diseases.
"Second Man's Heart"
The prostate is a small, odd-shaped exocrine gland that is regulated by hormonal activity.The organ is located at the bottom of the pelvis, 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 is located in the pubic part of the junction of the pelvic bones.In the male body, the prostate performs three key functions:
- motor - regulation of the separation of urine and seminal fluid (thanks to this, spermatozoa do not enter the bladder;
- secretory - the production of secretions responsible for the quality of the seminal fluid and maintaining a stable erection;
- barrier - protection against infections of the upper part of the urinary system.
The functionality of the prostate begins to manifest itself during puberty and becomes fully functional by the age of 18-20.The decline in the active functioning of the organ occurs 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 as a complication of infectious and inflammatory processes of the urogenital tract (less often in other body systems).
- Abacterial prostatitis.It develops against the background of physiological disorders of neurological or psychoneurological etiology, chronic diseases and an unhealthy lifestyle.
The trigger of the inflammatory process is the stasis (congestion) phenomenon occurring in the tissues of the gland, which is caused by organ disorders or infections.
The forms are classified according to the nature of the manifestation of the symptoms and the course of the disease:
- Acute inflammation.It is characteristic of a bacterial type of disease.It is accompanied by an intense manifestation of specific symptoms.
- Chronic prostatitis.Unstable.Latent periods are followed by relapses with pronounced symptoms.In 95% of cases, it has a bacterial origin.
Symptoms of chronic prostatitis often disappear as the inflammatory process progresses.The fluctuating course of the disease is the reason for premature contact with the urologist, which subsequently leads to costly treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons corresponding to the classification type of the disease.
| Causes of the infectious type | Causes of the formation of bacterial species |
|---|---|
| Sexually Transmitted Infections (STIs):
Bacterial diseases of the intestines, skin, respiratory organs caused by staphylococci, enterococci, 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 sexual intercourse (absence of sex), systematic hypothermia, and chronic alcoholism.
Symptoms of the acute form of the disease
Acute prostatitis is characterized by severe manifestations of inflammation of the prostate.Adjacent organs and systems are involved in the process, and psycho-emotional stability is disturbed.
Main symptoms:
- From the urinary system.Pollakiuria (frequent urination), with dripping urine, burning sensation, pain in the urethra.Urine becomes cloudy.The desire to empty the bladder is often false.
- From the reproductive system.Pain in the perineum, reduced potency, painful ejaculation.During (or immediately after) intimacy, an unpleasant sensation appears in the area of the head of the penis and the testicles.
- 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, aggravation of hemorrhoids.
- From the side of the autonomic nervous system.Loss of appetite, headache, low body temperature (37-38 ℃), symptoms of body poisoning.Usual actions cause rapid exhaustion 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 disruption of the morphological structure and performance of the organ.In the remission stage, the pathology reminds itself with increased fatigue and reduced performance.Urinary tract disorders are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.
Urinating is moderately painful, and there is a feeling of incomplete emptying after urination.Prostate discharge (prostatorrhea) with a mucous consistency, yellowish color and unpleasant odor flows spontaneously from the urethra.
Patients suffer from chronic pelvic pain syndrome - painful painful sensations localized in the lower third of the abdomen, pelvic and external genitalia, perineal area, lumbar and sacral regions.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection accompanied by pain;
- suppression of libido;
- accelerated or heavy (often painful) ejaculation.
Against the background of sexual disorders, psycho-emotional instability progresses.A person is subject to depression and sudden mood swings - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During the period of relapse, the 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 freezing, all chronic inflammatory diseases, including prostatitis, are aggravated.
- Restriction of mobility.In case of physical inactivity, the blood circulation of the pelvic organs is damaged.Stagnation of blood leads to swelling of the prostate, which compresses 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 relationships.Lack of sexual intercourse leads to stagnation of the secretion of the prostate, which provokes aggravation.
- Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.
The relapse 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 blood cholesterol levels), which leads to atherosclerosis.Cholesterol plaques obstruct the free flow of blood, causing congestion in the prostate.An excessive amount of constipating foods in the menu leads to excessive tension of the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated in time, purulent masses accumulate in the tissues of the prostate and an abscess of the gland develops.The condition is characterized by feverish temperature (39 ℃), chills, sharp, intense pain in the perineum, ischuria (inability to empty the bladder independently).The only treatment method is surgery to open the mucous membrane of the urethra and bougienage (expansion of the urethra using a special metal bougie).
The lack of a correct diagnosis, ignoring the symptoms, long-term self-medication of chronic prostatitis are the reasons for the development of dangerous complications:
- prostate adenoma is a benign tumor that tends to become malignant (malignancy) if not properly treated;
- formation of stones in the gland;
- Epididymo-orchitis is inflammation of the testicles;
- vesiculitis - inflammation of the seminal vesicles;
- infertility (the first degree of the disease requires long-term therapy, the second is practically untreatable);
- impotence;
- Prostate sclerosis is the destruction of prostate cells.
Timely examination of the prostate in men helps to avoid serious consequences of the inflammatory disease.
Prostate examination
Rectal examination of the prostate is an unpleasant but extremely necessary procedure.It enables the early detection of serious diseases such as adenoma, prostatitis and malignant tumors.
Indications for rectal examination of the prostate
All men over 40 should visit a urologist at least once a year.The earlier the inflammatory process, benign and malignant tumors are diagnosed, the greater the chance of a complete restoration of the prostate.The patient receives gentler treatment, preserves his libido, sexual activity and fertilization ability.
Sometimes men under 40 discover warning signs but postpone a visit to a urologist.Indications for urgent prostate examination are as follows:
- pain of any intensity in the perineal area;
- erectile dysfunction;
- premature ejaculation;
- decrease in the amount of released sperm;
- discomfort during sexual intercourse and defecation.
Do not ignore problems related to 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 sign, be sure to make an appointment with a urologist.
How is the digital prostate examination performed?
A few hours before the procedure, you should refrain from:
- sexual intercourse;
- masturbation;
- playing sports;
- cycling;
- physical work.
Before going to the doctor, you should empty the bladder and do a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, the 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 applies petroleum jelly or lubricant to his index finger and the patient's anus.
During a rectal examination of the prostate, the doctor massages the lobes of the prostate from side to center.You can use touch to evaluate:
- size and shape;
- the texture and elasticity of the organ;
- symmetry of its elements;
- expressiveness of contours and longitudinal groove;
- pain, the presence of nodules and nodules.
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 examination of the prostate, 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
Establishing an accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- series of laboratory tests;
- hardware examination of the prostate;
- repeat appointment with the doctor.
A consultation with a urologist includes:
- identification and characteristics of symptoms (duration, intensity);
- taking an anamnesis (past illnesses);
- clarifying information about working conditions, lifestyle characteristics, habits and the regularity of sexual relations;
- visual assessment of the external genitalia for the presence of rashes, redness, swelling, urethral discharge;
- palpation of the inguinal lymph nodes;
- palpable rectal examination of the prostate (determination of pain, contours, density and elasticity of the gland, assessment of the state of the interlobar septum);
- Collection of biological material for laboratory research;
- assignment of tests.
There is no strict time limit for the medical order.At a specialized clinic, each patient receives maximum time and attention.
For the differential diagnosis of bacterial and bacterial prostatitis and to determine the form of the disease, the man takes blood, urine, and prostate secretion tests, as well as a smear taken from the urethra.
During a rectal examination of the gland, the doctor takes a sample of the prostate secretion with his own hands.For the examination, disposable medical gloves, a lubricant (vaseline, gel lubricant, glycerin) facilitating penetration into the rectal ampulla and sterile glasses are used.The penetration depth does not exceed 5 cm.The urologist's qualifications and experience ensure the safety and pain-free operation of the procedure.
Venous blood is collected using modern vacutainers.The medical center strictly observes the rules of sterility when collecting biological materials.
Laboratory tests
The research is carried out by experienced specialists in a clinical diagnostic laboratory.The laboratory department of the medical center is equipped with modern equipment, which makes it possible to carry out tests of any complexity.
The list of tests includes:
- Bacteriological culture of smear to determine STIs.The biomaterial sample is planted on a culture medium suitable for the growth of pathogenic microorganisms.The active reproduction of a specific pathogen and the formation of its colonies indicate the presence of an infection.Based on the bacterial culture, an antibiogram is prepared to determine the resistance of pathogens to antibiotics.
- General urinalysis.Deviations from the norm (leukocyturia, bacteriuria, cylindruria, etc.) indicate 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 using a highly accurate chemiluminescent immunoassay (CHLA) method.
- Examination of prostate secretions (microscopy and culture).It makes it possible to determine the presence of inflammation, microbes (E. coli, staphylococcus, etc.).
Comprehensive screening for STIs can be done with a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate.This is done with a cylindrical sensor up to 1.5 cm in diameter, which is inserted into the rectum.The sensor is pre-oiled and special disposable accessories (condoms) are placed on top.The data is transmitted to a monitor, where the urologist visually evaluates pathological changes in the prostate gland.
Repeat meeting
Upon re-appointment, the doctor:
- evaluates test results;
- compiles a personalized therapeutic regimen, taking into account the type and form of prostatitis, the nature of its course, drug tolerance and the patient's age;
- prescribes control tests.
We offer an appointment at a convenient time for the patient by phone or via the website, by filling out the online form.
Prostatitis therapy
At the clinic, a man can take part in a comprehensive prostatitis treatment.Course therapy for acute inflammation of the prostate gland consists of three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
First stage
In the case of prostatitis of infectious etiology, antibiotics are initially prescribed to destroy the infectious agent.The selection of the 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 bladder neck, reduce the internal pressure of the urethra, normalize the outflow of urine and reduce the swelling of the gland.
- Enzymes.They dilute the secretions of the prostate, increase the local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators to restore immunity.
- Non-steroidal anti-inflammatory drugs (NSAIDs).They reduce the inflammatory process and relieve pain.
Medicines and dosage are selected by the doctor personally according to the symptoms, type and form of the disease.
Second stage
After acute symptoms subside, they switch to medications and methods that help stabilize the gland.Medication includes:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urine excretion;
- anti-inflammatory drugs;
- drugs to restore erection.
During the complex treatment, oral medicines and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, pain-relieving) are used.
Special methods include prostate massage.The mechanical effect on the prostate makes it possible to:
- accelerates blood circulation;
- strengthens the walls of capillaries and blood vessels;
- activate exchange processes;
- creates an outflow of mucus;
- normalizes bladder emptying;
- increasing the effectiveness of drug therapy;
- restoration of sexual activity.
Massage treatments are performed for therapeutic and preventive purposes.
Types of massage:
- use of expander (bougie);
- inner touch;
- non-invasive (no penetration);
- penetrating or external hardware (using a special massager).
Third stage
The treatment is completed by ozone therapy and laser therapy.Rectal ozone therapy consists of the daily administration of freshly prepared ozonated isotonic sodium chloride solution.
Treatment of prostatitis with a laser is a progressive physiotherapy technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directed effect 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 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 the treatment.
Phytotherapeutic agents are also used.
Characteristics of the 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 can be observed continuously, but they are faint and mild in nature.In most cases, men endure discomfort for a long time in the form of urination disorders, dull pains in the lower abdomen and perineum, as well as a weakening of potency.Patients with this diagnosis often consult a doctor when their symptoms worsen.
Treatment of chronic prostatitis begins with a detailed examination aimed at finding out what caused the inflammatory process.Based on the diagnostic results, the urologist selects drugs from several groups:
- Antibacterial drugs are prescribed for patients with chronic bacterial prostatitis, as well as for diseases of non-bacterial origin.In addition to suppressing the activity of pathogenic microflora, drugs belonging to this group help to reduce inflammation.
- Patients with severe urinary tract disorders are prescribed alpha-blockers.Medicines improve the flow rate of urine and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
- Urologists recommend the use of hormonal agents for the active growth of prostate gland tissue against the background of chronic inflammation.
- Immunomodulators are used for chronic prostatitis of any origin, be it allergic, bacterial or abacterial prostatitis.
In addition, they use drugs 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), exercise therapy exercises to relax the muscles of the perineum and pelvic floor, and laser therapy also contribute to improving 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, which is a form of complicated chronic inflammation of the prostate gland.The specialists of the center pay special attention to preserving the functions of the male urogenital system, thanks to which patients can live a full life after the therapy and even become parents.A positive result can only be achieved with complex treatment, the use of properly selected drugs, physiotherapy and prostate massage.
Prevention of inflammatory processes of 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 contraception (condoms) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of stagnant prostate phenomena.
- Limit alcohol.Alcohol abuse leads to a decrease in potency, libido and inhibition of testosterone synthesis.
- Complete relaxation.Psycho-emotional overload, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
- Regular visits to a urologist and STI tests.The disease is easier to prevent than to treat.
Urologists perform preventive examinations of the prostate gland.