In the middle of the last century, it was believed that prostatitis develops in old age. Today, the disease has become "younger" and is diagnosed in fertile men aged 30-40 years. The 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 schemes, use the best medicines and have modern methods to treat prostate diseases.
"The Second Man's Heart"
The prostate is a small unpaired gland of external secretion, controlled by hormonal activity. The organ is located in the lower part of the small pelvis, below the bladder. The widest border of the prostate covers the neck of the bladder. The back is adjacent to the anterior wall of the rectum. The front part of the gland occupies a place in the pubic zone of the junction of the pelvic bones. In the male body, the prostate performs three key functions:
- motor - control of the separation of urine and seminal fluid (because of this, sperm do not enter the bladder;
- secretory - production of a secret responsible for the quality of seminal fluid and the maintenance of a stable erection;
- barrier - protection against infection of the upper urinary system.
The functionality of the prostate gland begins to manifest itself in the pubertal period, acquiring its full value at the age of 18 to 20 years. The decrease in the active work of the body is recorded in men who have crossed the milestone of fifty years.
Types and forms of prostatitis.
The type of disease is determined by the cause of occurrence:
- 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 failures of neurological, psychoneurological etiology, chronic diseases, unhealthy lifestyle.
The trigger of the inflammatory process is congestive phenomena (stagnation) in the tissues of the gland, caused by organic disorders or infection.
The forms are classified depending on the nature of the manifestation of symptoms and the course of the disease:
- Acute inflammation. Characteristic of a bacterial type of disease. It is accompanied by an intense manifestation of specific signs.
- Chronic prostatitis. Run unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases it has an abacterial origin.
Symptoms of chronic prostatitis often disappear, as the inflammatory process progresses. The undulating course of the disease is the reason for the untimely visit to the urologist, and subsequently the expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and prostatic secretion occurs for reasons corresponding to the specific classification of the disease.
| Causes of an infectious species | 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, neurosis, mechanical injuries of the spine and genital organs, intraprostatic reflux, chronic constipation (constipation), anguish, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system |
Provocative factors include irregular sexual intercourse (complete absence of sex), systematic hypothermia of the body, and 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, psycho-emotional stability is disturbed.
Key symptoms:
- of the urinary system. Pollakiuria (frequent urination) with output of urine droplets, burning, cramps in the urethra. The urine becomes cloudy. Urges to empty the bladder are often false.
- of the reproductive system. Pain in the perineum, decreased potency, painful ejaculation. During intimacy (or immediately after), discomfort occurs in the area of the glans and testicles.
- On the side of the nervous system. Acute muscle pain in the lumbar and sacral region, in the lower abdomen.
- Psychoemotional disorders. Increased nervousness, anxiety, irritability.
- From the digestive system. Constipation, exacerbation of hemorrhoids.
- On the side of the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37–38 ℃), symptoms of intoxication of the body. Habitual actions cause rapid fatigue, a desire to lie down.
Against the background of inflammation, existing chronic diseases are exacerbated.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and performance of the organ. In the remission stage, the pathology reminds itself of increased fatigue and decreased performance. Disorders of the urinary system are characterized by repeated (often false) urges 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 devastation. From the urethra, a prostatic secretion of a mucous consistency with a yellowish color, spontaneously comes out an unpleasant odor (prostorrhea).
Patients are tormented by chronic pelvic pain syndrome - painful sensations of an aching nature, localized in the lower third of the abdomen, pelvic and external genital organs, in the perineum, lumbar and sacral regions.
Chronic prostatitis is accompanied by disorders of sexual health:
- unstable erection, accompanied by pain;
- libido oppression;
- rapid or difficult ejaculation (often painful).
Against the background of sexual disorders, psychoemotional instability progresses. A man is prone to depression, a sharp change in mood, from aggression to apathy. Ultimately, this leads to outright sexual impotence (impotence).
In the recurrent period, the symptoms correspond to the acute form of the disease, but are less intense. Exacerbation is provoked by:
- Generalized hypothermia. After a long stay in cold water or in the cold, any chronic inflammatory diseases, including prostatitis, are aggravated.
- Mobility restriction. With hypodynamia, blood circulation in the pelvic organs is disturbed. Blood stagnation leads to inflammation of the prostate, which compresses the nerve endings and the urethra.
- Alcohol abuse. The chronic course of inflammatory processes is activated under the influence of alcohol.
- Prolonged abstinence from intimate relationships. Lack of sexual intercourse leads to stagnation of prostatic secretion, which provokes an exacerbation.
- Tight underwear. Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate gland.
The 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, atherosclerosis develops. Cholesterol plaques interfere 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 muscles of the perineum.
Complications of prostatitis
With untimely treatment of acute inflammation, purulent masses accumulate in the prostate tissues, and an abscess of the gland develops. The condition is characterized by febrile temperature (39 ℃), chills, severe sharp pain in the perineum, ischuria (inability to empty the bladder on its own). The only form of treatment is an open suppuration operation and urethral bougienage (expansion of the urethra with a special metal bougie).
Lack of proper diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis are the reasons for the development of dangerous complications:
- prostate adenoma - a benign tumor prone to malignancy (malignancy) with incorrect therapy;
- the formation of stones in the gland;
- orchiepididymitis - 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 untreatable);
- impotence;
- Sclerosis of the prostate is the death of prostate cells.
Timely examination of the prostate in men will help avoid the serious consequences of an inflammatory disease.
prostate examination
A rectal exam of the prostate is an unpleasant procedure, but extremely necessary. It allows you to detect such serious diseases as adenoma, prostatitis, malignant tumors at an early stage.
Indications for rectal prostate exam
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 restoration of the prostate gland. The patient receives a gentler treatment, retains sexual desire, sexual activity and the ability to fertilize.
Occasionally, men under the age of 40 show warning signs but put off seeing a urologist. Indications for an urgent examination of the prostate are:
- pain of any intensity in the perineum;
- erectile dysfunction;
- premature ejaculation;
- decrease in the amount of semen released;
- discomfort during intercourse and defecation.
Do not ignore problems with urination: too frequent urges, cramps, a 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 done?
A few hours before the procedure, you should refrain from:
- sexual contact;
- masturbation;
- Doing sports;
- cycling;
- physical labor.
Before a visit to the doctor, you need to empty the bladder, 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 his legs bent or stands, leaning forward and resting his hands on the table. The doctor puts on sterile gloves, lubricates his index finger and the patient's anus with petroleum jelly or lubricant.
During a rectal exam of the prostate, the doctor massages the lobes of the prostate gland from the sides to the center. With the help of palpation, he can assess:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- the severity of the contours and the longitudinal groove;
- the presence of pain, seals and knots.
These data allow to determine if there are pathological changes in the prostate.
In addition, during the procedure the secret of the prostate is obtained. This fluid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.
Based on the results of a digital prostate exam, your doctor may prescribe additional diagnostic measures. These include a clinical analysis of urine and blood, a study of tumor markers, prostate ultrasound, 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;
- new appointment with a doctor.
The consultation with the urologist includes:
- identification of symptoms, their characteristics (prescription, intensity);
- collection of anamnesis (past illnesses);
- clarification of information on working conditions, lifestyle characteristics, habits, regularity of sexual intercourse;
- visual assessment of the external genital organs for 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);
- sampling of biomaterials for laboratory research;
- analysis appointment.
Medical appointments do not have strict time limits. In a specialized clinic, each patient receives maximum time and attention.
For a differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes blood, urine, prostate discharge and a swab from the urethra.
The doctor takes a sample of prostate secretion with his own hand during a rectal examination of the gland. For the examination, disposable medical gloves, a lubricant (vaseline, lubricating gel, glycerin) are used, which facilitates penetration into the rectal ampulla, sterile glasses. The depth of penetration does not exceed 5 cm. Professional qualifications and experience of urologists guarantee the safety and painlessness of the procedure.
Venous blood is drawn with modern vacutainers. The medical center strictly observes the rules of sterility for the collection of biological material.
Lab tests
Studies are performed by experienced specialists in the clinical diagnostic laboratory. The laboratory department of the medical center is equipped with modern equipment that allows you to conduct analyzes of any complexity.
The list of analyzes includes:
- Bacteriological culture of a smear for the determination of STIs. A sample of biomaterial is planted in nutrient media favorable for the growth of pathogenic microorganisms. Active reproduction and colony formation of a particular pathogen indicate the presence of an infection. On the basis of bacterial culture, an antibiogram is performed - determination of the resistance of pathogens to antibiotics.
- General urinalysis. Deviation from the norm (leukocyturia, bacteriuria, cylindruria, 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 by the high-precision ICLA method (chemiluminescent immunoassay).
- Prostatic secretion examination (microscopy and culture). Allows you to determine inflammation, the presence of microbes (E. coli, staphylococci, etc. )
A complete STI test can be done on a blood sample.
The hardware diagnosis is TRUS (transrectal ultrasound) of the prostate. 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, special disposable nozzles (condoms) are placed on top. The data is transmitted to the monitor, where the urologist visually assesses the pathological changes in the prostate.
Readmission
On readmission, the doctor:
- evaluate test results;
- draws up a personal therapeutic regimen, taking into account the type, form, nature of the course of prostatitis, tolerance to the drug, age of the patient;
- name control studies.
We offer to make an appointment at a convenient time for the patient by phone or through the website by completing the online form.
prostatitis therapy
In the clinic, a man can undergo a full treatment of prostatitis. Course therapy for acute inflammation of the prostate includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the state of the gland;
- consolidation of results, prevention of complications.
First stage
With prostatitis of infectious etiology, antibiotics are prescribed primarily to destroy the causative agent of infection. The choice of drug is based on the results of the antibiogram. In parallel, drugs of several pharmacological groups are used:
- Alpha blockers. The drugs help relax the smooth muscle tissue of the prostate, the neck of the bladder, reduce internal pressure in the urethra, normalize the flow of urine, reduce swelling of the gland.
- enzymes. They liquefy prostate secretion, increase the local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators for the restoration of immunity.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.
The doctor personally selects the drugs and the dosage according to the symptoms, type and form of the disease.
Second stage
After the elimination of acute symptoms, they switch to drugs and methods that help stabilize the gland. Medical treatment consists of:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urinary excretion;
- anti-inflammatory drugs;
- drugs to restore erection.
In complex treatment, oral drugs and rectal ovules (regenerative, antibacterial, immunostimulant, anti-inflammatory, analgesic) are used.
Special methods include prostate massage. Mechanical impact on the prostate gland allows:
- accelerate blood circulation;
- strengthen the walls of capillaries and vessels;
- activate exchange processes;
- set a secret output;
- normalize bladder emptying;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are carried out for therapeutic and prophylactic purposes.
Types of massage:
- with the help of a dilator (bougie);
- internal palpation;
- non-invasive (without penetration);
- penetrating or external hardware (carried out with a special massager).
third stage
The treatment is completed with ozone therapy and laser therapy. Rectal ozone therapy consists of the daily administration of a freshly prepared isotonic ozonated 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 complications of prostatitis. Directional action of the rectal laser:
- regenerates gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves blood supply to the prostate, the condition of the vessels.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes. By decision of the attending physician, laser therapy is started from the second stage of treatment.
In addition, phytotherapeutic agents are 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 constantly observed, but they have an erased and mild character. In most cases, men endure discomfort for a long time in the form of urination disorders, dull pain in the lower abdomen and perineum, and weakening of potency. Patients with such a diagnosis often go to the doctor during an exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination to find out what caused the inflammatory process. Based on the results of the diagnosis, the urologist selects drugs from several groups:
- Antibacterial drugs are prescribed for patients diagnosed with chronic bacterial prostatitis, as well as for diseases of nonbacterial origin. Means of this group, in addition to suppressing the activity of pathogenic microflora, help reduce inflammation.
- Drugs from the group of alpha-blockers are prescribed to patients with severe urinary disorders. Medications improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed for patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
- Hormonal drugs are recommended by urologists for the active growth of the glandular tissues 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 abacterial prostatitis.
In addition, drugs that stimulate blood circulation in the pelvic organs and directly in the prostate, as well as potency stimulants, are used. Treatment methods such as prostate massage, physical therapy (electrophoresis, shock wave therapy, UHF and much more), a set of exercise therapy exercises to relax the muscles of the perineum and pelvic floor, as well as therapy with laser also help improve the prognosis.
All these methods are widely used in clinics, which allows 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. The specialists of the center pay special attention to the preservation of the functions 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 properly selected drugs, physiotherapy and prostate massage can a positive result in treatment be achieved.
Prevention of inflammatory processes in the prostate.
Preventive measures include:
- Change of eating habits. Balanced diet with restriction of fatty and hypercaloric foods. Enrichment of the diet with vegetables, fruits, products for men's health (nuts, honey, shellfish, 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.
- Regular sex is a pleasant and useful prevention of congestive phenomena in the prostate.
- Alcohol restriction. Alcohol abuse leads to a decrease in potency, libido, inhibition of testosterone synthesis.
- Complete rest. Psychoemotional overload, insomnia (insomnia), physical overwork are provocateurs of abacterial prostatitis.
- Periodic visits to the urologist and STI exams. The disease is easier to prevent than to treat.
Urologists provide a preventive examination of the prostate gland.