In the middle of the last century it was believed that prostatitis develops at an advanced age.Today the disease has become “younger”, diagnosed in fertile men aged 30-40 years.Inflammation tends to become chronic, which makes therapy much more difficult.Doctors successfully solve men's health problems of any complexity.Urologists of the medical center develop personal treatment regimens, use the best drugs 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 back part is adjacent to the anterior 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 fundamental functions:
- motor - control of the separation of urine and seminal fluid (due to this, sperm does not enter the bladder;
- secretory: production of secretion responsible for the quality of the seminal fluid and the maintenance of a stable erection;
- barrier - protection against infection of the upper parts of the urinary system.
The functionality of the prostate gland begins to manifest itself during puberty, becoming fully functional at the age of 18-20 years.A decline in the active functioning of the organ is recorded in men who have passed the threshold of fifty years.
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).
- Nonbacterial prostatitis.It develops against the background of physiological disorders of neurological, psychoneurological etiology, chronic diseases and unhealthy lifestyle.
The trigger of the inflammatory process are phenomena of congestion (stagnation) in the gland tissues, caused by organic disorders or infections.
Forms are classified according to the nature of the manifestation of symptoms 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 abacterial 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 a urologist, which subsequently leads to expensive treatments for complications.
Causes of prostatitis
Stagnation of blood circulation and prostatic secretion occurs for reasons corresponding to the type of classification of the disease.
| Infectious causes | Causes of bacterial species |
|---|---|
| Sexually transmitted infections (STIs):
Bacterial diseases of the intestine, skin, respiratory organs caused by the activity of staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgia, rheumatism, neurosis, mechanical lesions of the spine and genital organs, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc.), physical inactivity, diseases of the endocrine system |
Provocative factors include irregular sexual intercourse (complete absence of sex), systematic hypothermia, chronic alcoholism.
Symptoms of the 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, and psycho-emotional stability is disrupted.
Key Symptoms:
- From the urinary system.Pollakiuria (frequent urination) with dripping 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), discomfort occurs in the area of \u200b\u200bthe head of the penis and testicles.
- From the nervous system.Acute muscle pain in the lumbar and sacral region, 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.Lack of appetite, headache, low body temperature (37–38 ℃), symptoms of body intoxication.Habitual 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 disruption of the morphological structure and performance of the organ.In the remission phase, the pathology resembles itself with increased fatigue and decreased performance.Urinary system disorders are characterized by repeated (often false) urges to empty the bladder, which become more frequent during the night.
Urination is moderately painful, after excretion of urine there is a sensation of incomplete emptying.A prostatic secretion of mucous consistency, yellowish in color and unpleasant odor (prostatorrhea) spontaneously flows from the urethra.
Patients are afflicted by chronic pelvic pain syndrome: painful sensations localized in the lower third of the abdomen, in the pelvic 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 ejaculation (often painful).
Against the background of sexual disorders, psycho-emotional instability progresses.A man is prone to depression and sudden changes in mood, from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During the period of relapse the 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 or freezing water, any chronic inflammatory diseases, including prostatitis, worsen.
- Limitation of mobility.With physical inactivity, blood circulation in the pelvic organs is impaired.Blood stagnation leads to swelling of the prostate, which compresses 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 prostatic secretions, which causes an exacerbation.
- Tight underwear.Mechanical compression of the external genitalia interrupts the normal blood supply to the prostate gland.
The relapse of the disease is caused by incorrect 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 block free blood flow, causing congestion in the prostate.An excess of foods that cause constipation on the menu leads to excessive tension in the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated timely, purulent masses accumulate in the prostate tissues and an abscess of the gland develops.The condition is characterized by fever (39 ℃), chills, sharp and intense 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 (expansion of the urethra using a special metal bougie).
Lack of correct 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 tends to malignancy (malignancy) if treated incorrectly;
- formation of stones in the gland;
- Epididymo-orchitis 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 incurable);
- impotence;
- Prostatic sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help avoid serious consequences of inflammatory disease.
Prostate exam
The rectal examination of the prostate is an unpleasant but extremely necessary procedure.It allows early diagnosis of serious diseases such as adenoma, prostatitis and malignant tumors.
Indications for rectal examination of the prostate
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 higher the chances of complete restoration of the prostate gland.The patient receives more gentle treatment, preserves libido, sexual activity and the ability to fertilize.
Sometimes men under 40 discover warning signs, but put off visiting 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 sexual intercourse and defecation.
Do not ignore problems with urination: too frequent urgency, pain, feeling of unemptyed 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?
Several hours before the procedure, you must refrain from:
- sexual contact;
- masturbation;
- play sports;
- riding a bicycle;
- physical work.
Before visiting 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, lies on his side with his legs bent, or stands bent forward and places his hands on the table.The doctor puts on sterile gloves and lubricates the patient's index finger and anus with petroleum jelly or lubricant.
During the rectal prostate exam, the doctor massages the lobes of the prostate from the sides towards the center.With the help of palpation it is possible to evaluate:
- size and shape;
- consistency and elasticity of the organ;
- symmetry of its elements;
- expressiveness of contours and longitudinal furrow;
- the presence of pain, lumps and knots.
This data allows you to determine whether there are pathological changes in the prostate.
Additionally, prostate secretions are 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 the digital prostate examination, the doctor may prescribe additional diagnostic measures.These include a clinical urine and blood analysis, tests for tumor markers, prostate ultrasound, and so on.
Diagnosis of the disease
Making an accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- a series of laboratory tests;
- hardware prostate exam;
- repeated appointment with the doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (duration, intensity);
- take anamnesis (past illnesses);
- clarification of information on working conditions, lifestyle characteristics, habits and regularity of sexual intercourse;
- visual assessment of the external genitalia 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, evaluation of the condition of the interlobar septum);
- collection of biomaterials for laboratory research;
- assignment of tests.
A doctor's visit has no strict time limits.In a specialized clinic, each patient is given maximum time and attention.
For the differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes tests of blood, urine, prostatic secretions and a smear of the urethra.
The doctor takes a sample of prostatic secretion with his own hand during a rectal examination of the gland.For the examination, disposable medical gloves, a lubricant (vaseline, lubricating gel, glycerin) that facilitates penetration into the rectal ampoule and sterile glasses are used.The penetration depth does not exceed 5 cm.The professional qualifications and experience of urologists guarantee the safety and painlessness of the procedure.
Venous blood is collected using modern vacutainers.The medical center strictly complies with the sterility rules 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 allows you to carry out tests of any complexity.
The list of tests includes:
- Bacteriological culture of a smear to determine sexually transmitted diseases.A sample of biomaterial is planted on nutrient media conducive to the growth of pathogenic microorganisms.Active reproduction and colony formation of a particular pathogen indicates the presence of an infection.Based on the bacterial culture, an antibiogram is performed 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 performed using a highly accurate chemiluminescence immunoassay (CHLA) method.
- Study of prostatic secretions (microscopy and culture).Allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc.)
A comprehensive screening for sexually transmitted diseases 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 evaluates pathological changes in the prostate gland.
Repeated appointment
After the new appointment, the doctor:
- evaluates test results;
- develops a personal therapeutic regimen taking into account the type, form, nature of the course of prostatitis, drug tolerance and age of the patient;
- prescribes 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 full course of treatment for prostatitis.Course 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.
First phase
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, drugs from different 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 the outflow of urine and reduce swelling of the gland.
- Enzymes.They dilute prostatic secretions, increase the local immunity of the organ, improve 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 chooses the drugs and dosage based on the symptoms, type and form of the disease.
Second phase
After the acute symptoms are relieved, we move on to medications and methods that help stabilize the gland.Pharmacological treatment includes:
- vascular drugs (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 drugs and rectal suppositories (regenerating, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
Special methods include prostate massage.The mechanical impact on the prostate gland allows you to:
- accelerate blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- establish an outflow of secretions;
- normalize bladder emptying;
- increase 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 hardware (carried out using a special massager).
Third phase
The treatment is completed by ozone therapy and laser therapy.Rectal ozone therapy consists of the daily administration of a freshly prepared isotonic ozonated 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.Directional action 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 sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes.Based on the decision of the attending physician, laser therapy begins with the second phase of treatment.
In addition, phytotherapeutic agents are used.
Features of the treatment of chronic prostatitis
This form of prostatitis is characterized by a wave-like 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 observed constantly, but have a faded 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 weakened potency.Patients with this diagnosis often turn to the doctor precisely during an exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination aimed at finding 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 non-bacterial origin.In addition to suppressing the activity of pathogenic microflora, drugs from this group help to reduce inflammation.
- Alpha-blocker drugs are prescribed to patients with severe urinary disorders.Medicines improve the rate of urinary 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 glandular tissue in a context 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 that stimulate blood circulation in the pelvic organs and the prostate itself, as well as potency stimulants, are used.Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and much more), a set of physical 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 allows to achieve high therapeutic results, even if the patient is diagnosed with chronic calculous prostatitis, one of the forms of complicated chronic inflammation of the prostate gland.Specialists of the center pay special attention to the preservation of the functions of the genitourinary system in men, thanks to which 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 is it possible to achieve a positive result in treatment.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Change eating habits.A balanced diet with limited fatty and high-calorie foods.Enrich your diet with vegetables, fruits, men's health products (nuts, honey, seafood, etc.).
- Physical activity (regular exercise helps to normalize blood circulation in the genital area).
- Safe sex is the use of barrier contraceptives (condoms) to protect yourself from sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of prostate congestion phenomena.
- Limit alcohol.Alcohol abuse leads to a decrease in potency, libido 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 tests for sexually transmitted diseases.The disease is easier to prevent than cure.
Urologists provide preventive examinations of the prostate gland.