In the middle of the last century, it was believed that prostatitis develops with age.Today the disease has become “younger” and is diagnosed in fertile men aged 30 to 40.Inflammation tends to become chronic, which makes therapy significantly more difficult.Doctors successfully solve men's health problems of any complexity.The medical center's urologists develop individual therapy plans, use the best medications and master modern methods of treating prostate diseases.
“The Heart of the Second Man”
The prostate is a small unpaired exocrine gland controlled by hormonal activity.The organ is located at the bottom of the pelvis, under the bladder.The wider edge of the prostate covers the neck of the bladder.The posterior part borders the anterior wall of the rectum.The front part of the gland is located in the pubic area at the junction of the pelvic bones.In the male body, the prostate fulfills three key functions:
- motor - control of the separation of urine and seminal fluid (due to this sperm do not enter the bladder);
- secretory – production of secretion, which is responsible for the quality of seminal fluid and maintaining a stable erection;
- Barrier – protection against infections of the upper parts of the urinary system.
The functionality of the prostate begins to manifest itself during puberty and is fully functional by the age of 18-20.In men who have exceeded the age of fifty, there is a decline in the active function of the organ.
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 urogenital tract (less often in other body systems).
- Abbacterial prostatitis.It develops against the background of physiological disorders of neurological, psychoneurological etiology, chronic diseases and an unhealthy lifestyle.
The inflammatory process is triggered by congestion (stagnation) in the glandular tissue, which is caused by organic disorders or infections.
The forms are classified according to the type of symptom expression and the course of the disease:
- Acute inflammation.Characteristic of a bacterial type of disease.Accompanied by an intense manifestation of specific symptoms.
- Chronic prostatitis.It's unstable.Latent periods are followed by relapses with pronounced symptoms.In 95% of cases it is of bacterial origin.
Symptoms of chronic prostatitis often disappear as the inflammatory process progresses.The undulating course of the disease is the reason for premature contact with the urologist, which subsequently leads to expensive treatment of complications.
Causes of Prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons corresponding to the type of disease classification.
| Causes of an infectious nature | 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), ailments, a history of urological diseases (cystitis, urethritis, etc.), physical inactivity, diseases of the endocrine system |
The provoking factors include irregular sexual intercourse (complete absence of sex), systematic hypothermia and chronic alcoholism.
Symptoms of the acute form of the disease
Acute prostatitis is characterized by severe inflammation in the prostate.Neighboring organs and systems are involved in the process and psycho-emotional stability is disrupted.
Main symptoms:
- From the urinary system.Pollakiuria (frequent urination) with dripping urine discharge, burning, pain in the urethra.The urine becomes cloudy.The urge to empty the bladder is often wrong.
- From the reproductive system.Pain in the perineum, reduced potency, painful ejaculation.During intimacy (or immediately after) discomfort occurs in the area of the glans and testicles.
- From the nervous system.Acute muscle pain in the lumbar and sacral areas, lower abdomen.
- Psycho-emotional disorders.Increased nervousness, 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 ° C), symptoms of body intoxication.Habitual actions lead to rapid fatigue and the desire to lie down.
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 remembers itself with increased fatigue and reduced performance.Urinary system disorders are characterized by repeated (often false) urges to void the bladder, which occur more frequently at night.
Urination is moderately painful, after excretion of urine there is a feeling of incomplete emptying.Prostatic secretion of a mucous consistency with a yellowish color and an unpleasant odor (prostatorrhea) spontaneously flows from the urethra.
Patients suffer from chronic pelvic pain syndrome - aching painful sensations localized in the lower third of the abdomen, in the pelvis and external genital organs, in the perineal area, in the 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.A man is prone to depression and sudden mood swings - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During the relapse phase, the symptoms correspond to the acute form of the disease but are less intense.An aggravation is caused by:
- General hypothermia.After a long stay in cold water or frost, chronic inflammatory diseases, including prostatitis, worsen.
- Restriction of mobility.During physical inactivity, blood flow to the pelvic organs is impaired.Blood congestion causes the prostate to swell, compressing the nerve endings and 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 prostate secretions, which leads to aggravation.
- Tight underwear.The mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.
A relapse of the disease is caused by unhealthy eating habits.The excess of fatty foods in the diet is one of the causes of hypercholesterolemia (increased concentration of cholesterol in the blood), as a result of which atherosclerosis develops.Cholesterol plaques hinder the free flow of blood and cause blockage of the prostate.An excess of foods that cause constipation in the diet leads to excessive tension in the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated in a timely manner, purulent masses accumulate in the prostate tissue and an abscess of the gland develops.The condition is characterized by fever (39 °C), chills, severe, severe pain in the perineum, and ischuria (inability to empty the bladder independently).The only method of treatment is surgery to open the suppuration and bougie the urethra (enlargement of the urethra using a special metal bougie).
Lack of correct diagnosis, neglect of symptoms, long-term self-medication for chronic prostatitis are the reasons for the development of dangerous complications:
- Prostate adenoma is a benign tumor that is prone to malignancy (malignancy) if not treated correctly.
- formation of stones in the gland;
- Epididymoorchitis is an 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;
- Prostatic sclerosis is the death of prostate cells.
A timely examination of the prostate in men helps to avoid the serious consequences of the inflammatory disease.
Prostate examination
A rectal examination of the prostate is an unpleasant but extremely necessary procedure.It allows early detection of serious diseases such as adenomas, prostatitis and malignant tumors.
Indications for rectal examination of the prostate
Every man over 40 should see a urologist at least once a year.The earlier the inflammatory process and benign and malignant neoplasms are diagnosed, the greater the chances of complete prostate recovery.The patient receives more gentle treatment, retains his libido, sexual activity and the ability to fertilize.
Sometimes men under 40 discover warning signs but postpone seeing a urologist.Indications for an urgent prostate examination are:
- Pain of any intensity in the perineal area;
- erectile dysfunction;
- early ejaculation;
- decrease in the volume of sperm released;
- Discomfort during sexual intercourse and bowel movements.
Do not ignore problems with urination - too frequent urination, pain, the 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 must refrain from:
- sexual contact;
- Masturbation;
- To do sports;
- Ride a bike;
- physical work.
Before you see a doctor, you need to empty your bladder and do a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, the man assumes a knee-elbow position, lying on his side with his legs bent or standing bent over and placing his hands on the table.The doctor puts on sterile gloves and smears his index finger and the patient's anus with petroleum jelly or lubricant.
During a rectal examination of the prostate, the doctor massages the lobes of the prostate gland from the sides towards the center.With the help of palpation you can assess:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- expressiveness of contours and longitudinal furrow;
- the presence of pain, lumps and nodes.
This data can be used to determine whether there are pathological changes in the prostate.
In addition, prostate secretion is obtained during the procedure.This liquid is sent for analysis, which shows the content of bacteria, leukocytes, red blood cells and pathogenic microorganisms.
Based on the results of a digital examination of the prostate, the doctor may prescribe additional diagnostic measures.These include a clinical analysis of urine and blood, tests for tumor markers, ultrasound of the prostate, etc.
Diagnosis of the disease
Making an accurate diagnosis consists of several steps:
- Initial consultation with a urologist;
- a series of laboratory tests;
- Hardware examination of the prostate;
- repeated appointment with the doctor.
Consultation with a urologist includes:
- Identification of symptoms, their characteristics (duration, intensity);
- medical history (past illnesses);
- Clarification of information about working conditions, lifestyle features, habits and regularity of sexual relationships;
- visual assessment of the external genitalia for the presence of rashes, redness, swelling and discharge from the urethra;
- Palpation of inguinal lymph nodes;
- Palpation rectal examination of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the condition of the interlobar septum);
- collection of biomaterial for laboratory research;
- Assignment of tests.
There are no strict deadlines for a doctor's appointment.In a specialized clinic, each patient is given maximum time and attention.
For a differentiated diagnosis of bacterial and bacterial prostatitis and to determine the form of the disease, a man's blood, urine, prostate secretion and a swab from the urethra are examined.
During a rectal examination of the gland, the doctor personally takes a sample of the prostate secretion.For the examination, disposable medical gloves, a lubricant (vaseline, gel lubricant, glycerin) that facilitates penetration into the rectal ampoule, and sterile jars are used.The penetration depth is a maximum of 5 cm.The professional qualifications and experience of the urologists ensure that the procedure is safe and painless.
Venous blood collection is carried out using modern Vacutainers.The medical center strictly adheres to sterility rules when collecting biological material.
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 that allows conducting tests of any complexity.
The list of tests includes:
- Bacteriological culture of a swab for the determination of STIs.A biomaterial sample is planted on culture media that promote the growth of pathogenic microorganisms.Active reproduction and colony formation of a particular pathogen indicates the presence of an infection.Based on a bacterial culture, an antibiogram is created to determine 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 carried out using a high-precision chemiluminescence immunoassay (CHLA) method.
- Examination of prostate secretions (microscopy and culture).Allows you to detect inflammation and the presence of microbes (E. coli, staphylococci, etc.).
A comprehensive screening for sexually transmitted diseases can be done using a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate.It is carried out using a cylindrical sensor with a diameter of no more than 1.5 cm, which is inserted into the rectum.The sensor is pre-lubricated and special disposable attachments (condoms) are attached.The data is transmitted to a monitor, where the urologist visually assesses pathological changes in the prostate.
Repeated appointment
When reappointing, the doctor must:
- evaluates test results;
- draws up a personal therapy plan, taking into account the type, form, course of prostatitis, drug tolerance and the patient's age;
- requires control studies.
We offer to make an appointment at a time convenient for the patient by phone or via the website by filling out the online form.
Prostatitis therapy
In the clinic, a man can undergo a complete treatment of his prostatitis.The treatment of acute prostate inflammation includes three phases:
- relief of symptoms and inflammation;
- Restoration of functions, stabilization of the gland;
- Consolidating results, avoiding complications.
First stage
With prostatitis of infectious etiology, antibiotics are initially prescribed to destroy the infectious agent.The choice of drug is made based on the results of the antibiogram.In parallel, drugs of several pharmacological groups are used:
- Alpha-adrenergic blockers.The drugs help to relax the smooth muscle tissue of the prostate and bladder neck, reduce internal pressure in the urethra, normalize urine outflow and reduce swelling of the gland.
- Enzymes.They dilute prostate secretions, increase the local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators to restore immunity.
- Nonsteroidal anti-inflammatory drugs (NSAIDs).They reduce the inflammatory process and relieve pain.
The doctor personally selects medication and dosage according to the symptoms, type and form of the disease.
Second stage
After the acute symptoms are relieved, medications and methods that help stabilize the gland are used.Drug treatment includes:
- Vascular medications (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urine excretion;
- anti-inflammatory drugs;
- Drugs to restore erection.
In complex treatment, oral medications and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
One of the special methods is prostate massage.Mechanical impact on the prostate allows you to:
- accelerate blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- create a secretion drain;
- normalize bladder emptying;
- increase the effectiveness of drug therapy;
- Restoration of sexual activity.
Massage procedures are carried out for therapeutic and preventive purposes.
Types of massage:
- use of a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (performed using a special massager).
Third stage
The treatment is rounded off with ozone therapy and laser therapy.Rectal ozone therapy consists of daily administration of a freshly prepared ozonated isotonic sodium chloride solution.
Treatment of inflammation of the prostate with a laser is an advanced physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directional effect of the rectal laser:
- regenerates gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves the blood supply to the prostate and the condition of the blood vessels.
The frequency of the sessions is 2-4 times per week and the duration of a treatment is 10-20 minutes.Based on the attending physician's decision, laser therapy begins with the second stage of treatment.
In addition, phytotherapeutics are used.
Features of the treatment of chronic prostatitis
This form of prostatitis is characterized by an undulating course, in which an exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms.In some cases, the symptoms are constantly observed, but are of a mild, mild character.In most cases, men endure discomfort for a long time in the form of impaired urination, dull pain in the lower abdomen and perineum, and reduced potency.Patients with this diagnosis often seek medical attention precisely when symptoms are worsening.
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 to patients diagnosed with chronic bacterial prostatitis, as well as for diseases of nonbacterial origin.Drugs in this group not only suppress the activity of pathogenic microflora, but also help reduce inflammation.
- Patients with severe urinary tract diseases are prescribed alpha-blocker drugs.Medication improves the speed of urine flow and relieves symptoms.
- Muscle relaxants are prescribed to patients with chronic abdominal pain and pronounced symptoms of chronic prostatitis in the acute stage.
- Urologists recommend the use of 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 abacterial prostatitis.
In addition, agents are used 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 much more), a set of exercise therapy exercises to relax the perineal and pelvic floor muscles, and laser therapy also help improve the prognosis.
All of 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, one of the forms of complicated chronic inflammation of the prostate.The center's specialists pay special attention to preserving the functions of the genitourinary system in men, which allows patients to live a full life after therapy and even become parents.Only through complex treatment with correctly selected medications, physiotherapy and prostate massage can a positive treatment result be achieved.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Change eating habits.A balanced diet with low-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 refers to the use of barrier contraceptives (condoms) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention against congestion in the prostate.
- Limit alcohol consumption.Alcohol abuse leads to a decrease in potency, libido and inhibition of testosterone synthesis.
- Complete calm.Psycho-emotional overload, insomnia (insomnia) and physical fatigue are triggers of abacterial prostatitis.
- Regular visits to the urologist and examinations for sexually transmitted diseases.The disease is easier to prevent than to treat.
Urologists carry out preventive prostate examinations.