In the middle of the last century, it was believed that prostatitis develops in old age.Today the disease has become "younger", 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.Urologists at the medical center develop personal therapeutic regimens, use the best drugs and master modern methods of treating prostate diseases.
"Second Man's Heart"
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 bladder neck.The back part is attached to the front wall of the rectum.The front part of the gland occupies a place in the pubic area of the junction of the pelvic bones.In the male body, the prostate performs three main functions:
- engine - control of the separation of urine and seminal fluid (due to this, the sperm does not enter the bladder;
- secretory - the production of secretion responsible for the quality of seminal fluid and maintaining a stable erection;
- barrier - protection against infection of the upper parts of the urinary system.
The functionality of the prostate gland begins to appear during puberty, becoming fully functional at the age of 18-20 years.A decrease in the active functioning of the organ has been recorded 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 appears as a complication of infectious and inflammatory processes in the urogenital tract (less often in other body systems).
- Bacterial prostatitis.It develops against the background of physiological disruptions of neurological, psychoneurological etiology, chronic diseases and unhealthy lifestyle.
The cause of the inflammatory process are congestive phenomena (stagnation) in the tissue of the gland, provoked by organic disorders or infection.
Forms are classified according to the nature of the manifestation of symptoms and the course of the disease:
- Acute inflammation.Characteristic of a bacterial disease.It is accompanied by intense manifestation of specific symptoms.
- Chronic prostatitis.It is unstable.Latent periods are followed by relapses with pronounced symptoms.In 95% of cases it is of bacterial origin.
Symptoms of chronic prostatitis are often hidden, while the inflammatory process progresses.The fluctuating course of the disease is the reason for premature contact with a urologist, which then leads to expensive treatment for complications.
Causes of prostatitis
Stagnation of blood circulation and secretion of the prostate occurs for reasons that correspond to the type of classification of the disease.
| Causes of the infectious type | Causes of bacterial species |
|---|---|
| Sexually transmitted infections (STIs):
Bacterial diseases of intestines, skin, respiratory organs caused by the activity of staphylococcus, enterococcus, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgia, rheumatism, neurosis, mechanical injuries of the spine and genital organs, intraprostatic reflux, chronic constipation (constipation), restlessness, history of urological diseases (cystitis, urethritis, etc.), physical inactivity, diseases of the endocrine system. |
Provocative factors include irregular sexual intercourse (complete lack of sex), systemic hypothermia, chronic alcoholism.
Symptoms of the acute form of the disease
Acute prostatitis is characterized by severe manifestations of inflammation in the prostate gland.Neighboring organs and systems are involved in the process, and psycho-emotional stability is interrupted.
Main symptoms:
- From the urinary system.Pollakiuria (frequent urination) with dribbling of urine, burning sensation, pain 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 it), discomfort appears in the area of the head of the penis and testicles.
- From the nervous system.Acute muscle pain in the lumbar and sacral region, at the bottom of the abdomen.
- Psycho-emotional disorders.Increased nervousness, anxiety, nervousness.
- From the digestive system.Constipation, aggravation of hemorrhoids.
- From the side of the autonomic nervous system.Lack of appetite, headache, low body temperature (37-38 ℃), symptoms of body intoxication.Ordinary actions cause 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 deterioration of the morphological structure and performance of the organ.In the phase of remission, the pathology reminds itself of increased fatigue and decreased performance.Disorders of the urinary system are characterized by repeated urges (often false) to empty the bladder, becoming more frequent at night.
Urination is moderately painful, after urination there is a feeling of incomplete emptying.A prostatic secretion with a yellow mucous consistency and an unpleasant odor (prostatorrhea) flows spontaneously from the urethra.
Patients are affected by chronic pelvic pain syndrome - painful sensations localized in the lower third of the abdomen, pelvic and external genitalia, in the perineal area, in the lumbar and sacral regions.
Chronic prostatitis is associated with 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 subject to depression and sudden mood swings - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During the relapse period, the symptoms correspond to the acute form of the disease, but are less intense.Aggravation is provoked by:
- General hypothermia.After a long stay in cold water or frost, any chronic inflammatory disease, including prostatitis, worsens.
- Restriction of mobility.With physical inactivity, blood circulation in the pelvic organs is impaired.Blood stagnation leads to swelling of the prostate, which presses on 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 prostate secretions, which provokes an aggravation.
- Tight underwear.Mechanical compression of the external genital organ disrupts the normal blood supply to the prostate gland.
Recurrence 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 cholesterol concentration in the blood), as a result, atherosclerosis develops.Cholesterol plaques prevent free blood flow, causing congestion in the prostate.An excess of constipating foods on the menu leads to excessive tension in the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated in time, purulent masses accumulate in the prostate tissue and an abscess of the gland develops.The condition is characterized by febrile temperature (39 ℃), chills, intense sharp pain in the perineum, ischuria (inability to empty the bladder independently).The only method of treatment is an operation to open the suppuration and bougienage of the urethra (enlargement of the urethra using a special metal bougie).
Lack of accurate diagnosis, neglect of symptoms, long-term self-medication of chronic prostatitis are the reasons for the development of dangerous complications:
- prostate adenoma is a benign tumor that is prone to malignancy (malignancy) if treated incorrectly;
- the formation of stones in the gland;
- Epididymo-orchitis is inflammation of the testis;
- 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 to avoid 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 adenoma, 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, benign and malignant neoplasms are diagnosed, the greater the chances are for the complete restoration of the prostate gland.The patient receives gentler treatment, maintains libido, sexual activity and the ability to fertilize.
Sometimes men under 40 discover warning signs, but postpone a visit to the urologist.Indications for urgent prostate examination are:
- pain of any intensity in the perineal area;
- erectile dysfunction;
- premature ejaculation;
- decrease in the volume of sperm released;
- discomfort during intercourse and defecation.
Do not ignore problems with 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 digital prostate examination performed?
A few hours before the procedure, you should refrain from:
- sexual contact;
- masturbation;
- playing sports;
- riding a bicycle;
- physical work.
Before visiting a doctor, you should empty your 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 his legs bent or stands bent forward and rests his hands on the table.The doctor puts on sterile gloves and coats 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 sides to the center.With the help of palpation you can assess:
- size and shape;
- texture and elasticity of the organ;
- the symmetry of its elements;
- expressiveness of contours and longitudinal grooves;
- the presence of pain, lumps and joints.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, during the procedure, secretions from the prostate are taken.This fluid is sent for analysis, which shows the content of bacteria, leukocytes, red blood cells and pathogenic microorganisms.
Based on the results of a digital prostate examination, the doctor may prescribe additional diagnostic measures.These include a clinical analysis of urine and blood, testing for tumor markers, ultrasound of the prostate gland, 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;
- repeated meeting with the doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (duration, intensity);
- taking anamnesis (past diseases);
- clarifying information about working conditions, lifestyle characteristics, habits and regularity of sexual relations;
- visual assessment of the external genital organs for the presence of rashes, redness, swelling, 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 biomaterials for laboratory research;
- scheduling tests.
A medical appointment has no strict time limits.In a specialized clinic, 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 a smear from the urethra.
The doctor takes a sample of prostate secretion with his hand during a rectal examination of the gland.Disposable medical gloves, a lubricant (vaseline, gel lubricant, glycerin) that facilitates penetration into the ampulla of the large intestine and sterile glasses are used for the examination.The penetration depth does not exceed 5 cm.The professional qualifications and experience of urologists guarantee the safety and pain-free procedure.
Venous blood is collected using modern vacutainers.The medical center strictly observes the rules of sterility for the collection of 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 enables to carry out analyzes of any complexity.
The list of tests includes:
- Bacteriological culture of a smear to determine STI.A sample of the 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.Based on the bacterial culture, an antibiogram is performed to determine the resistance of pathogens to antibiotics.
- General analysis of urine.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 using a highly accurate chemiluminescence immunoassay (CHLA) method.
- Study of prostatic secretions (microscopy and culture).It allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc.)
A comprehensive screening for STIs can be done using a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate gland.It is performed using a cylindrical sensor with a diameter of no more than 1.5 cm, inserted into the rectum.The sensor is pre-lubricated, and special disposable attachments (condom) are placed on top.The data is transmitted to a monitor, where the urologist visually assesses the pathological changes in the prostate gland.
Repeat meeting
After reassignment, the doctor:
- evaluates test results;
- designs a personal therapeutic regimen taking into account the type, form, nature of the course of prostatitis, drug tolerance and the patient's age;
- describes control studies.
We offer to make an appointment at a time convenient for the patient by phone or through the website by filling out the online form.
Prostatitis therapy
In the clinic, a man can undergo a full course of treatment for prostatitis.The course of therapy for acute inflammation of the prostate gland includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
The first stage
For prostatitis of infectious etiology, antibiotics are initially prescribed to destroy the infectious agent.The choice of drug is based on the results of the antibiogram.In parallel, medications of several pharmacological groups are used:
- Alpha adrenergic blockers.Medicines help relax the smooth muscle tissue of the prostate and bladder neck, reduce internal pressure in the urethra, normalize urine flow and reduce swelling of the gland.
- Enzymes.They dilute the secretions of the prostate, increase the local immunity of the organ, increase 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 the medications and the dose according to the symptoms, type and form of the disease.
The second stage
After relief of acute symptoms, they switch to drugs and methods that help stabilize the gland.Drug treatment includes:
- vascular medications (to improve blood supply to the prostate);
- immunostimulant;
- drugs that normalize the process of urine secretion;
- anti-inflammatory drugs;
- drugs to restore erection.
In the complex treatment, oral medications and rectal suppositories are used (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic).
Special methods include prostate massage.Mechanical impact on the prostate gland allows you to:
- accelerates blood circulation;
- strengthen the walls of capillaries and blood vessels;
- enable exchange processes;
- sets a flow of secretions;
- normalization of bladder emptying;
- increasing the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are performed for therapeutic and preventive purposes.
Types of massage:
- using a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external devices (performed using a special massager).
The third stage
The treatment ends with ozone therapy and laser therapy.Rectal ozone therapy consists of the daily administration of a freshly prepared isotonic sodium chloride solution.
Treatment of inflammation of the prostate gland with a laser is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Action of rectal laser direction:
- 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 a procedure is 10-20 minutes.Based on the decision of the attending physician, laser therapy begins with the second stage of treatment.
In addition, phytotherapeutic agents are used.
Features of treatment of chronic prostatitis
This form of prostatitis is characterized by a wave-like 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 observed constantly, but they have a faded, 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 weakened strength.Patients with this diagnosis often turn to the doctor precisely during an exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination designed to find out what caused the inflammatory process.Based on the diagnostic results, the urologist chooses medications from several groups:
- Antibacterial drugs are prescribed to patients diagnosed with chronic bacterial prostatitis, as well as for diseases of non-bacterial origin.In addition to suppressing the activity of pathogenic microflora, the drugs of this group help to reduce inflammation.
- Alpha-blocker drugs are prescribed to patients with severe urinary disorders.Medicines 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.
- 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 inflammation of the prostate of any origin, be it allergic, bacterial or bacterial 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 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 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 gland.The center's specialists pay special attention to maintaining the functions of the genitourinary system in men, thanks to which patients can live a full life after therapy and even become parents.Only with complex treatment with the use of properly selected medications, physiotherapy and prostate massage can a positive result in treatment be achieved.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Changing eating habits.A balanced diet with foods limited in fat and calories.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 barrier contraception (condom) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of congestive phenomena in the prostate.
- Limit alcohol.Alcohol abuse leads to a decrease in potency, sexual desire and inhibition of testosterone synthesis.
- Complete rest.Psycho-emotional overload, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and examinations for STIs.The disease is easier to prevent than to treat.
Urologists perform preventive examinations of the prostate gland.