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 in their 30s and 40s. Inflammation tends to become chronic, which makes therapy much more difficult. Doctors successfully solve men's health problems of any complexity. The medical center's urologists develop personal treatment regimens, use the best medicines and have modern methods of treating prostate diseases.
"Second Man's Heart"
The prostate is a small, unpaired gland of external secretion, controlled by hormonal activity. The organ is located at the bottom of the small pelvis, under the bladder. The wider edge of the prostate covers the neck of the bladder. The dorsum is adjacent to the anterior wall of the rectum. The front part of the gland occupies a place in the pubic area at the junction of the pelvic bones. In the male body, the prostate performs three main functions:
- motor - control of the separation of urine and seminal fluid (due to this, sperm does not enter the bladder;
- secretory - production of a secret responsible for the quality of seminal fluid and maintenance of a stable erection;
- barrier - protection against infection of the upper urinary system.
The functionality of the prostate begins to manifest itself in the pubertal period, gaining full value at 18-20 years. Decline in active body work is recorded in men who have crossed the fifty-year mark.
Types and forms of prostatitis
The type of disease is determined by the cause of the 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 in the context 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 according to the nature of the manifestation of symptoms and the course of the disease:
- Acute inflammation. Characteristic of a type of bacterial disease. It is accompanied by an intense manifestation of specific signs.
- Chronic prostatitis. It works unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases it has abacterial origin.
The symptoms of chronic prostatitis are often erased as the inflammatory process progresses. The wavy course of the disease is the reason for the untimely visit to the urologist, subsequently expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and prostatic secretion occurs for reasons that correspond 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 to the spine and genitals, intraprostatic reflux, chronic constipation (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 an acute form of the disease
Acute prostatitis is characterized by severe manifestations of inflammation in the prostate. Adjacent organs and systems are involved in the process, psycho-emotional stability is disturbed.
Main symptoms:
- From the urinary system. Pollakiuria (frequent urination) with leakage of urine droplets, burning, cramps in the urethra. Urine becomes cloudy. The urges to empty the bladder are often false.
- From the reproductive system. Perineal pain, decreased potency, painful ejaculation. During intimacy (or immediately afterwards), discomfort occurs in the area of the glans and testicles.
- On the side of the nervous system. Sharp 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.
- On the side of the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37-38℃), body intoxication symptoms. Habitual actions cause rapid fatigue, desire to lie down.
In the context 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 remembers with increased fatigue, decreased performance. Urinary system disorders are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.
Urination is moderately painful, after urine excretion there is a feeling of incomplete devastation. From the urethra, a prostatic secret of mucous consistency with yellowish color, an unpleasant odor (prostorrhea) flows spontaneously.
Patients are haunted by chronic pelvic pain syndrome - painful sensations of a painful nature, located in the lower third of the abdomen, pelvic and external genitalia, in the perineum, lumbar and sacral regions.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection, accompanied by pain;
- oppression of libido;
- accelerated or difficult (often painful) ejaculation.
In the context of sexual disorders, psycho-emotional instability progresses. A man is prone to depression, a sudden change in mood - from aggression to apathy. Ultimately this leads to absolute sexual impotence (impotence).
In the recurrent period, symptoms correspond to the acute form of the disease, but are less intense. Exacerbation is caused by:
- General hypothermia. After a long stay in cold water or in the cold, any chronic inflammatory diseases, including prostatitis, get worse.
- Mobility restriction. With hypodynamia, blood circulation in Organs pelvic organs is disturbed. Blood stagnation 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.
- Prolonged abstinence from intimate relationships. The lack of sexual intercourse leads to stagnation of prostate secretion, which causes an exacerbation.
- Tight underwear. Mechanical compression of the external genitalia interrupts the normal blood supply to the prostate.
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 premature treatment of acute inflammation, purulent masses accumulate in the prostate tissues and a gland abscess develops. The condition is characterized by feverish temperature (39℃), chills, severe, sharp pain in the perineum, ischuria (inability to empty the bladder on its own). The only way of treatment is an operation to open the suppuration and urethra 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;
- epididymo-orchitis - 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 intractable);
- impotence;
- Prostate sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help to avoid the serious consequences of an inflammatory disease.
prostate exam
A rectal exam of the prostate is an unpleasant procedure, but extremely necessary. It allows you to detect serious diseases such as adenoma, prostatitis, malignant tumors at an early stage.
Indications for rectal examination of the prostate
Every man over 40 should visit 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. The patient receives a gentler treatment, maintains sexual desire, sexual activity and the ability to fertilize.
Occasionally, men under age 40 show warning signs but put off seeing a urologist. Indications for an urgent prostate exam are:
- pain of any intensity in the perineum;
- erectile dysfunction;
- premature ejaculation;
- decrease in the amount of semen released;
- discomfort during intercourse and defecation.
Don't discount problems with urination - very frequent urges, cramping, 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 performed?
A few hours before the procedure, you should refrain from:
- sexual contact;
- masturbation;
- playing sports;
- cycling;
- manual work.
Before a visit to the doctor, you need to empty your bladder, do a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, a man assumes a knee-elbow position, lying on his side with his legs bent or standing, leaning forward and resting 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 exam of the prostate, the doctor massages the lobes of the prostate from the sides to the center. With the help of palpation, you can assess:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- the severity of contours and longitudinal groove;
- the presence of pain, seals and knots.
These data make it possible to determine whether there are pathological changes in the prostate.
Also, during the procedure, the secret of the prostate is obtained. This liquid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.
Based on the results of a digital prostate exam, the doctor may prescribe additional diagnostic measures. These include a clinical analysis of urine and blood, a study for tumor markers, ultrasound of the prostate and so on.
Disease diagnosis
Making an accurate diagnosis consists of several steps:
- initial consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate;
- re-appointment with a doctor.
The urologist's consultation includes:
- identification of symptoms, their characteristics (prescription, intensity);
- collection of anamnesis (previous illnesses);
- clarification of information on working conditions, lifestyle characteristics, habits, regularity of sexual relations;
- visual assessment of the external genital organs for the presence of 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);
- biomaterial sampling for laboratory research;
- naming of analyses.
Medical appointments do not have strict deadlines. In a specialist clinic, each patient receives maximum time and attention.
For a differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man collects blood, urine, prostate secretion and a swab from the urethra.
The doctor collects a sample of prostatic secretion with his own hand during a rectal examination of the gland. For the examination, disposable medical gloves are used, a lubricant (Vaseline, lubricating gel, glycerin), which facilitates penetration into the rectal ampoule, sterile glasses are used. The penetration depth does not exceed 5 cm. The professional qualification and experience of urologists guarantee the safety and painlessness of the procedure.
Venous blood is collected using modern vacutainers. The medical center strictly observes the sterility rules for the collection of biological material.
laboratory tests
The 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 performing analyzes of any complexity.
The analysis list includes:
- Bacteriological smear culture for STI determination. A sample of biomaterial is planted in a nutrient medium favorable to the growth of pathogenic microorganisms. Active reproduction and colony formation of a particular pathogen indicate the presence of an infection. Based on the bacterial culture, an antibiogram is carried out - determination of the resistance of pathogens to antibiotics.
- General urine analysis. 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).
- Examination of prostatic secretion (microscopy and culture). It allows to determine the inflammation, the presence of microbes (E. coli, staphylococci, etc. )
A comprehensive STD test can be performed 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 not more than 1. 5 cm, inserted into the rectum. The sensor is pre-lubricated, special disposable nipples (condom) 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 physician:
- evaluates test results;
- draws up a personal therapeutic regimen, taking into account the type, form, nature of the course of prostatitis, drug tolerance, age of the patient;
- names control studies.
We offer the possibility to schedule an appointment at a convenient time for the patient by phone or through the website by filling out the online form.
prostatitis therapy
At the clinic, a man can undergo a full course of treatment for 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 step
With prostatitis of infectious etiology, antibiotics are prescribed primarily to destroy the causative agent of the infection. The choice of drug is based on the results of the antibiogram. In parallel, drugs of various pharmacological groups are used:
- Alpha blockers. The drugs help to relax the smooth muscle tissue of the prostate, bladder neck, reduce internal pressure in the urethra, normalize the flow of urine and reduce swelling of the gland.
- enzymes. They liquefy prostatic secretion, increase the local immunity of the organ, increase the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators for the restoration of immunity.
- Non-steroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.
The doctor personally selects the drugs and dosage according to the symptoms, type and form of the disease.
Second level
After the acute symptoms are removed, they move on to medications and methods that help stabilize the gland. Medical treatment consists of:
- vascular drugs (to improve the blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urinary excretion;
- anti-inflammatory drugs;
- medication to restore an erection.
In complex treatment, oral drugs and rectal suppositories are used (regenerative, antibacterial, immunostimulant, anti-inflammatory, analgesic).
Special methods include prostate massage. The mechanical impact on the prostate allows:
- accelerate blood circulation;
- strengthen the walls of capillaries and vessels;
- activate exchange processes;
- establish a way out of secrecy;
- normalize bladder emptying;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are performed for therapeutic and prophylactic purposes.
Massage types:
- with the help of a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (performed using a special massager).
third stage
Treatment is completed by ozone therapy and laser therapy. Rectal ozone therapy consists of the daily administration of freshly prepared isotonic sodium chloride solution ozonated.
The treatment of inflammation of the prostate with laser is a progressive physical therapy technique that allows to quickly obtain a positive dynamics and prevent complications of prostatitis. Directional action of the rectal laser:
- regenerates glandular 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 to 4 times a week, the duration of a procedure is 10 to 20 minutes. By decision of the attending physician, laser therapy is started from the second stage of treatment.
Additionally, herbal agents are used.
Features of the treatment of chronic prostatitis
This form of prostatitis is characterized by a wavy 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 a dull and mild character. In most cases, men suffer inconveniences for a long time in the form of urination disorders, dull pains in the lower abdomen and perineum, and weakening of potency. Patients with this 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 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. Means from this group, in addition to suppressing the activity of pathogenic microflora, help to reduce inflammation.
- Alpha-blocker group drugs are prescribed to patients with severe urinary disorders. Medications improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute phase.
- Hormonal drugs are recommended by urologists for the active growth of prostate glandular tissues in the context of chronic inflammation.
- Immunomodulators are used for chronic inflammation of the prostate of any origin, whether allergic, bacterial or abacterial prostatitis.
In addition, drugs that stimulate blood circulation in Organs pelvic organs and directly in the prostate are used, as well as potency stimulants. Treatment methods such as prostate massage, physical therapy (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 as well help improve the prognosis.
All these methods are widely used in clinics, which makes it possible to obtain high treatment results even if the patient is diagnosed with chronic calculous prostatitis, one of the forms of complicated chronic inflammation of the prostate. Specialists at 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 fathers. Only with complex treatment with the use of properly selected drugs, physiotherapy and prostate massage can a positive result in the treatment be achieved.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Changing eating habits. Balanced diet with restriction of fatty and high-calorie foods. Diet enrichment with vegetables, fruits, products for men's health (nuts, honey, seafood, etc. ).
- Physical activity (regular sports contribute to the normalization of blood circulation in the genital area).
- Protected sex - the use of barrier contraception (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. Psycho-emotional overload, insomnia (insomnia), excessive physical work are triggers of abacterial prostatitis.
- Regular visits to the urologist and examinations for STIs. The disease is easier to prevent than to treat.
Urologists provide a preventive examination of the prostate.