In the middle of the last century, it was believed that prostatitis developed in old age. Today, this disease has become "younger" and is diagnosed in fertile men aged 30-40. Inflammation tends to be chronic, which makes therapy more difficult. Doctors successfully solve men's health problems of any complexity. Urologists of the medical center develop personal therapeutic schemes, use the best drugs, and have modern methods for treating prostate diseases.
"Second Man's Heart"
The prostate is a small unpaired exocrine gland, regulated by hormonal activity. This organ is located in the lower part of the small 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 front part of the gland occupies a place in the genital zone of the junction of the pelvic bones. In the male body, the prostate performs three main functions:
- motor - controls the separation of urine and seminal fluid (due to this, sperm do not enter the bladder;
- secretory - secret production responsible for the quality of seminal fluid and maintaining a stable erection;
- barrier - protection against upper urinary tract infections.
The function of the prostate gland begins to manifest itself during puberty, gaining its full value at the age of 18-20 years. A decrease in active body work is recorded in men who have passed the milestone of fifty years.
Types and forms of prostatitis
The type of disease is determined by the cause of the event:
- 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 neurological physiological failure, psychoneurological etiology, chronic disease, unhealthy lifestyle.
The trigger of the inflammatory process is a congestive phenomenon (stagnation) in the gland tissue, which is provoked by an organic disorder or infection.
Forms are classified according to the nature of the manifestation of symptoms and the course of the disease:
- Acute inflammation. Characteristics of a type of bacterial disease. It is accompanied by intense manifestations of certain signs.
- Chronic prostatitis. Unsteady walking. Latent periods are replaced by relapses with severe symptoms. In 95% of cases it has a bacterial origin.
Symptoms of chronic prostatitis are often erased, while the inflammatory process develops. The bumpy course of the disease is the reason for the initial visit to the urologist, then the treatment of expensive complications.
Causes of prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons that correspond to the specific classification of the disease.
| Cause of infectious species | Caused by 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 injuries of the spine and genital organs, intraprostatic reflux, chronic obstipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system |
Provocative factors include irregular sexual intercourse (complete lack of sex), systematic hypothermia of the body, and chronic alcoholism.
Symptoms of the acute form of the disease
Acute prostatitis is characterized by severe 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) with dribbling, burning, spasms 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 intimacy (or immediately after), discomfort occurs in the area of the glans penis and testicles.
- From the side of the nervous system. Acute muscle pain in the lumbar and sacral region, in the lower abdomen.
- Psycho-emotional disorders. Increased restlessness, anxiety, irritability.
- From the digestive system. Constipation, aggravation of hemorrhoids.
- From the side of the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37–38 ℃), symptoms of body hangover. The usual action causes rapid fatigue, the desire to lie down.
Against the background of inflammation, existing chronic diseases are aggravated.
Symptoms of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and performance of the organ. In the stage of remission, the pathology reminds itself of increased fatigue, decreased performance. Disorders of the urinary system are characterized by repeated urges (often false) to empty the bladder, which become more frequent at night.
Urination is moderately painful, after the excretion of urine there is a feeling of incomplete destruction. From the urethra, the secret of the prostate with the consistency of mucus with a yellowish color, unpleasant smell (prostorrhea) spontaneously flows out.
Patients are haunted by chronic pelvic pain syndrome - a painful sensation of aching nature, localized in the lower third of the abdomen, pelvis and external genital organs, in the perineum, lumbar and sacral areas.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection, accompanied by pain;
- libido suppression;
- accelerated or difficult (often painful) ejaculation.
Against the background of sexual disorders, psycho-emotional instability develops. A man is prone to depression, sudden changes 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 less intense. Aggravation is provoked by:
- General hypothermia. After a long stay in cold water or in cold conditions, any chronic inflammatory disease, including prostatitis, becomes worse.
- Mobility restrictions. With hypodynamia, blood circulation in the pelvic organs is disturbed. The stagnation of blood leads to swelling of the prostate, which compresses the nerve endings and the urethra.
- Alcohol abuse. The chronic course of the inflammatory process is activated under the influence of alcohol.
- Prolonged abstinence from intimate relationships. Lack of sexual intercourse leads to stagnation of prostate secretions, which causes aggravation.
- Tight underwear. Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate gland.
The recurrence of this disease is caused by unhealthy eating habits. The abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), as a result, atherosclerosis develops. Cholesterol plaque interferes with free blood flow, causing congestion in the prostate. An excess in the menu of products that cause constipation leads to excessive tension in the perineal muscles.
Complications of prostatitis
With untimely treatment of acute inflammation, a purulent mass accumulates in the prostate tissue, and an abscess of the gland develops. This condition is characterized by a feverish temperature (39 ℃), chills, sharp intense pain in the perineum, ischuria (inability to empty the bladder by itself). The only way of treatment is surgery to open the suppuration and bougienage of the urethra (expansion of the urethra with a special metal bougie).
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 - a benign tumor prone to malignancy (malignancy) with improper therapy;
- stone formation in the gland;
- epididymo-orchitis - testicular inflammation;
- vesiculitis - inflammation of the seminal vesicles;
- infertility (the first stage of the disease requires long-term therapy, the second is practically untreatable);
- erectile dysfunction;
- Prostatic sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help to avoid the severe consequences of inflammatory diseases.
prostate examination
Rectal examination of the prostate is an unpleasant, but very necessary procedure. It allows you to detect serious diseases such as adenoma, prostatitis, malignant tumors at an early stage.
Indications for rectal prostate examination
Every man over the age of 40 should visit a urologist at least once a year. The earlier the inflammatory process, benign and malignant neoplasms are diagnosed, the greater the chance for complete recovery of the prostate gland. Patients receive gentler treatment, maintaining sexual desire, sexual activity and the ability to fertilize.
Sometimes, men under the age of 40 show warning signs but delay seeing a urologist. Indications for immediate prostate examination are:
- pain of any intensity in the perineum;
- erectile dysfunction;
- premature ejaculation;
- reduction in the amount of semen released;
- discomfort during intercourse and defecation.
Do not ignore problems with urination - too frequent urges, cramps, empty bladder feeling, unpleasant changes in the smell and color of urine. If you see 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 must refrain from:
- sexual intercourse;
- masturbation;
- playing sports;
- cycling;
- physical labor.
Before visiting the doctor, you need to empty your bladder, make a cleansing enema with salt water or decoction of chamomile.
Before examining the prostate, a man takes the knee-elbow position, lies on his side with bent legs or stands, leans forward and rests his hands on the table. The doctor puts on sterile gloves, lubricates the patient's index finger and 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 organs;
- the symmetry of its elements;
- severity of contours and longitudinal grooves;
- the presence of pain, seals and knots.
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 fluid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.
Based on the results of digital prostate examination, the doctor may prescribe additional diagnostic measures. This includes clinical analysis of urine and blood, studies for tumor markers, prostate ultrasound, etc.
Disease diagnosis
Making an accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate;
- see the doctor again.
Urology consultation includes:
- identification of symptoms, their characteristics (prescription, intensity);
- collection of anamnesis (past diseases);
- explanation of information about working conditions, lifestyle characteristics, habits, regularity of sexual relations;
- visual assessment of the external genital organs for the presence of rash, redness, swelling, discharge from the urethra;
- palpation of inguinal lymph nodes;
- rectal examination palpation of the prostate (determination of pain, contour, density, elasticity of the gland, assessment of the state of the interlobar septum);
- biomaterial sampling for laboratory research;
- appointment analysis.
Medical appointments do not have strict time limits. In specialized clinics, 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 takes blood, urine, prostate secretions, and smears from the urethra.
The doctor takes a sample of prostate secretion with his own hands during a rectal examination of the gland. For the examination, disposable medical gloves, lubricants (Vaseline, gel-lubricant, glycerin), which facilitate penetration into the rectal ampoule, sterile glasses are used. The depth of penetration does not exceed 5 cm. The professional qualifications and experience of the urologist ensure the safety and painless procedure.
Venous blood was taken using a modern vacutainer. The medical center strictly adheres to the rules of sterility for the collection of biological material.
Lab test
Studies are conducted by experienced experts in clinical diagnostic laboratories. The laboratory department of the medical center is equipped with modern equipment that allows you to perform analysis of any complexity.
The analysis list includes:
- Smear bacteriological culture for STI determination. Biomaterial samples are grown on nutrient media suitable for the growth of pathogenic microorganisms. Active reproduction and colony formation of certain pathogens indicate the presence of infection. On the basis of bacterial culture, an antibiogram is performed - the determination of the pathogen's resistance to antibiotics.
- General urine analysis. Deviations from the norm (leukocyturia, bacteriuria, cylindruria, etc. ) indicate the presence of an inflammatory process.
- A blood test for PSA (prostate-specific antigen) is a marker for tumors of the male reproductive system. It is done with a high-precision ICLA method (chemiluminescent immunoassay).
- Examination of prostate secretions (microscopy and culture). Allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc. )
Comprehensive screening for STIs can be carried out on blood samples.
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, a special disposable nozzle (condom) is placed on top. The data is sent to a monitor, where the urologist visually assesses pathological changes in the prostate gland.
Re-entry
During readmission, the doctor:
- evaluate test results;
- formulate a personal therapeutic regimen, taking into account the type, form, course of prostatitis, drug tolerance, age of the patient;
- appoint a control study.
We offer to make an appointment at a convenient time for the patient by phone or through the website by filling out an online form.
Prostatitis therapy
In the clinic, a man can undergo a full prostatitis treatment. Course therapy for acute inflammation of the prostate includes three stages:
- relieve symptoms and inflammation;
- functional recovery, stabilization of the condition of the glands;
- unification of decisions, prevention of complications.
First stage
With prostatitis of infectious etiology, antibiotics are mainly prescribed to destroy the causative agent of the infection. The choice of drug is based on the results of the antibiogram. In parallel, drugs of several pharmacological groups are used:
- Alpha blockers. Medicines help to relax the smooth muscle tissue of the prostate, bladder neck, reduce internal pressure in the urethra, normalize the outflow of urine, and reduce swelling of the gland.
- Enzymes. They dilute prostate secretions, increase the local immunity of the organ, increase the antibacterial effect, and reduce the manifestation of inflammation.
- Immunomodulators for the restoration of immunity.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.
The doctor chooses medicine and dosage personally according to the symptoms, type, form of the disease.
The second phase
After the removal of acute symptoms, they turn to drugs and methods that help stabilize the gland. Medical treatment consists of:
- vascular drugs (to increase blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urine excretion;
- anti-inflammatory drugs;
- medicine to restore erection.
In complex treatment, oral drugs and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
Special methods include prostate massage. The mechanical effect on the prostate gland allows:
- accelerate blood circulation;
- strengthens the walls of capillaries and vessels;
- activate the exchange process;
- to establish a secret outflow;
- normalizes bladder emptying;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are carried out for therapeutic and prophylactic purposes.
Massage type:
- with the help of a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (carried out using a special massager).
Third stage
Treatment is completed with ozone therapy and laser therapy. Rectal ozone therapy consists of daily administration of freshly prepared ozone 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 prevent prostatitis complications. Rectal laser direction action:
- regenerate glandular cells;
- relieves inflammation and pain;
- strengthen local immunity;
- increase the blood supply to the prostate, the condition of the ducts.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes. With the decision of the attending physician, laser therapy is started from the second stage of treatment.
In addition, phytotherapeutic agents are used.
Features of chronic prostatitis treatment
This form of prostatitis is characterized by an undulating course, in which exacerbations of chronic prostatitis are replaced by periods of complete absence of unpleasant symptoms. In some cases, symptoms are observed continuously, but they have a muted and soft character. In most cases, men experience difficulties for a long time in the form of urinary disturbances, dull pain in the lower abdomen and perineum, and potential weakness. Patients with such a diagnosis often turn to the doctor during the exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination to find out what caused the inflammatory process. Based on the diagnostic results, urologists choose drugs from several groups:
- Antibacterial drugs are prescribed for patients diagnosed with chronic bacterial prostatitis, as well as for non-bacterial diseases. Means this group, in addition to suppressing the activity of pathogenic microflora, helps reduce inflammation.
- Drugs of the alpha-blocker group are prescribed to patients with severe urinary disorders. Medicines increase the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed for patients with chronic pelvic pain and acute symptoms of chronic prostatitis.
- Hormonal drugs are recommended by urologists for the active growth of prostate gland tissue against the background of chronic inflammation.
- Immunomodulators are used for chronic inflammation of the prostate of any origin, whether 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 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 the clinic, which makes it possible to achieve high treatment results, even if the patient is diagnosed with chronic calculous prostatitis, one of the complicated forms of chronic inflammation of the prostate gland. Specialists of the center pay special attention to the preservation of the function of the genitourinary system in men, so that patients after therapy can lead a full life and even become parents. Only with complex treatment with the use of correctly selected drugs, physiotherapy and prostate massage can positive results be achieved in treatment.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Change eating habits. Balanced diet with restriction of fatty and high calorie foods. Enrichment of the diet with vegetables, fruits, products for men's health (beans, honey, seafood, etc. ).
- Physical activity (regular sports contribute to the normalization of blood circulation in the genital area).
- Protected sex - the use of barrier contraceptives (condoms) to protect against sexually transmitted diseases.
- Frequent sex is a pleasant and useful prevention of congestive phenomena in the prostate.
- Alcohol restrictions. Alcohol abuse leads to a decrease in potency, libido, inhibition of testosterone synthesis.
- Rest completely. Psycho-emotional stress, insomnia (insomnia), physical overwork are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and screening for STIs. This disease is easier to prevent than to treat.
Urologists provide preventive examinations of the prostate gland.