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 men of 30 to 40 years of age of fertility. Inflammation tends to become chronic, making it much more difficult to treat. Doctors successfully tackle men's health problems of all levels of complexity. The medical center's urologists develop individualized treatment programs, use the best medicines and possess state-of-the-art prostate disease treatments.
"Second Man's Heart"
The prostate is a small, unpaired gland that secretes externally, controlled by hormonal action. This organ is located at the bottom of the small pelvis, below the bladder. The wider margin of the prostate gland covers the bladder neck. The posterior surface is adjacent to the anterior wall of the rectum. The anterior part of the gland occupies a position in the pubic region where the pelvis meets. In the male body, the prostate gland performs three main functions:
- motor - controls the separation of urine and semen (so sperm do not enter the bladder;
- exudate - the production of a secretion responsible for the quality of semen and maintaining a stable erection;
- barrier - protects against infections of the upper urinary system.
Prostate function begins to manifest during puberty, reaching full value by the age of 18–20 years. A decline in physical activity has been observed in men who have passed the 50-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).
- Bacterial prostatitis. It develops against the background of physiological failures of neurogenic, neuropsychiatric, chronic diseases, unhealthy lifestyles.
The causative agent of the inflammatory process is congestion (stagnation) in the tissues of the gland, 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 disease. It is accompanied by an intense manifestation of specific signs.
- Chronic prostatitis. Unstable running. Latent episodes are replaced by recurrent episodes with severe symptoms. In 95% of cases, it is of bacterial origin.
Symptoms of chronic prostatitis are usually relieved, while the inflammatory process progresses. The undulating course of the disease is the reason for not timely going to a urologist, and the subsequent treatment of complications is expensive.
Causes of prostatitis
Stagnation of blood circulation and secretion of the prostate gland occurs for reasons that correspond to the specific classification of the disease.
| Cause of an infectious species | Cause of bacteria |
|---|---|
Sexually transmitted infections (STIs):
Bacterial diseases of the intestines, skin, respiratory organs caused by the activity of staphylococcus, cocci, Escherichia coli, Proteus, Klebsiella, etc. v. |
Neuralgia, rheumatism, neurological disorders, mechanical trauma of the spine and genital organs, internal reflux, chronic constipation (constipation), grief, history of urinary disease (inflammation)bladder, urethritis, etc. ), hypotension, diseases of the endocrine system |
Predisposing factors include irregular sex (no sex at all), systemic hypothermia, and chronic alcoholism.
Symptoms of an acute form of the disease
Acute prostatitis is characterized by severe manifestations of an inflamed prostate gland. Neighboring organs and systems are involved in this process, psycho-emotional stability is disturbed.
Main symptoms:
- From the urinary system. Pollakiuria (frequent urination) with urine dripping, burning, cramping in the urethra. Urine becomes cloudy. Claims to empty the bladder are often false.
- From the reproductive system. Pain in the perineum, decreased potency, pain during ejaculation. During intimacy (or soon after), discomfort occurs in the glans penis and testicles.
- From the side of the nervous system. Acute muscle pain in the lumbar region and sacrum, in the lower abdomen.
- Psycho-emotional disorder. Increased nervousness, anxiety, irritability.
- From the digestive system. Constipation, exacerbation of hemorrhoids.
- From the side of the autonomic nervous system. Anorexia, headache, low body temperature (37–38 ℃), body intoxication symptoms. Habitual actions cause rapid fatigue, the desire to lie down.
In the context of inflammation, existing chronic diseases are exacerbated.
Symptoms of Chronic Prostatitis
Prolonged inflammation of the prostate gland leads to a violation of the morphological structure and functioning of this organ. In the period of remission, the pathology reminds itself with an increase in fatigue, a decrease in performance. Urinary system disorders are characterized by a repetitive (usually pseudo) urge to empty the bladder, which becomes more frequent at night.
There is moderate pain when urinating, and after excreting urine, there is a feeling of unresolved distention. From the urethra, the prostate gland secretes a thick, yellowish, foul-smelling mucus (prostate) that drains spontaneously.
The patient is haunted by chronic pelvic pain syndrome - pain of a sharp nature, localized in the lower third of the abdomen, pelvis and external genitalia, in the perineum, lumbar andsacrum.
Chronic prostatitis is associated with sexual health disorders:
- unstable erection, accompanied by pain;
- suppression of sexual desire;
- fast or difficult ejaculation (often painful).
In the context of sexual dysfunction, psycho-emotional instability develops. A man is prone to depression, his mood changes markedly - from aggression to apathy. Ultimately, this leads to absolute sexual impotence (impotence).
In the recurrent phase, the symptoms correspond to the acute form of the disease, but are less intense. Exacerbations are triggered by:
- General hypothermia. After a long stay in cold water or in the cold, any chronic inflammatory disease, including prostatitis, will become worse.
- Limited mobility. With hypotension, blood circulation in the pelvic organs is disturbed. Stagnant blood leads to swelling of the prostate gland, compression of the nerves and urethra.
- Alcohol abuse. The chronic process of the inflammatory process is activated under the influence of alcohol.
- Abstain from prolonging intimate relationships. Lack of sex leads to stagnant secretions of the prostate causing discharge.
- Tight underwear. Mechanical compression of the external genitalia interrupts the normal blood supply to the prostate gland.
Recurrence is caused by unhealthy eating habits. The abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased blood cholesterol levels), which in turn develops atherosclerosis. Cholesterol plaques impede free blood flow, causing blockage of the prostate gland. An overabundance of products that cause constipation leads to overstretched pelvic floor muscles.
Complications of prostatitis
With the untimely treatment of acute inflammation, pus-filled masses accumulate in the tissues of the prostate gland and gland abscesses form. This condition is characterized by a feverish temperature (39 ℃), chills, severe severe pain in the perineum, painful urination (inability to empty the bladder on its own). The only treatment is surgery to open the urethral septum (enlargement of the urethra with a special metal dilator).
Lack of correct diagnosis, ignoring symptoms, arbitrarily treating chronic prostatitis for a long time are the causes leading to dangerous complications:
- prostate tumor - a benign tumor that easily becomes malignant (malignant) with incorrect therapy;
- the formation of stones in the gland;
- epididymis - orchitis;
- seminal vesicles - inflammation of the seminal vesicles;
- infertility (the first degree of the disease requires long-term treatment, the second is practically untreatable);
- impotent;
- sclerosis of the prostate is the death of prostate cells.
Timely prostate examination in men will help avoid serious consequences caused by inflammatory diseases.
prostate exam
A rectal exam of the prostate is an uncomfortable, but extremely necessary, procedure. It allows you to detect serious diseases such as adenomas, prostatitis, malignant tumors at an early stage.
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 tumors are diagnosed, the greater the chance of a full prostate recovery. Patients are treated more gently, still retain their libido, sexual activity and ability to conceive.
Sometimes, men under 40 have warning signs but don't see a urologist. Indications for urgent prostate examination are:
- pain of any intensity in the perineum;
- erectile dysfunction;
- premature ejaculation;
- reduced semen output;
- Discomfort during intercourse and defecation.
Don't take urinary problems lightly - urges too often, cramps, feeling of 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 must limit:
- sexual relations;
- masturbate;
- play sports;
- Ride bicycle;
- manual labor.
Before you go to the doctor, you need to clean your bladder, douche with salt water or chamomile decoction.
Before a prostate exam, a man is positioned on his elbows, lying on his side, with his legs bent or standing, leaning forward and resting his hands on a table. The doctor wears sterile gloves and lubricates the patient's index finger and anus with kerosene or lubricant.
During a rectal exam of the prostate, the doctor will massage the lobes of the prostate from the sides to the center. With the help of palpation, you can evaluate:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- severity of contour lines and longitudinal grooves;
- the presence of pain, seals and knots.
These data make it possible to determine whether there are pathological changes in the prostate gland.
In addition, during the procedure, the secret of the prostate will be obtained. This liquid is sent for analysis, which shows the content of bacteria, white blood cells, red blood cells, pathogenic microorganisms.
Based on the results of the digital examination of the prostate, the doctor may prescribe additional diagnostic measures. These include clinical analysis of urine and blood, tumor marker studies, prostate ultrasound, and more. v.
Diagnostic
The correct diagnosis involves several stages:
- initial consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate gland;
- make a follow-up appointment with your doctor.
A urologist consultation includes:
- determine the symptoms, their characteristics (prescription, intensity);
- take a history (past illnesses);
- clarifying information about working conditions, lifestyle, habits, frequency of sexual relations;
- visual assessment of the external genitalia for the presence of rash, redness, swelling, discharge from the urethra;
- palpable inguinal lymph nodes;
- rectal palpation to examine the prostate gland (determine pain, contour, density, elasticity of the gland, assess the condition of the intervertebral septum);
- sampling biological materials for laboratory research;
- appointed analysts.
Medical appointments do not have a strict time limit. At the specialist clinic, each patient is given the utmost care and time.
For the differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man will take blood, urine, prostate secretions, and a swab from the urethra.
The doctor will take a sample of prostate secretions with his or her own hands during a rectal examination of the gland. For examination, disposable medical gloves, lubricants (Vaseline, lubricating gel, glycerin), which facilitate penetration into the rectal canal, sterile glasses are used. The penetration depth is no more than 5 cm The qualification and experience of the urologist ensures a safe and painless procedure.
Venous blood is collected using a modern aspirator. The medical center strictly adheres to aseptic rules for the collection of biological materials.
Lab test
Studies are carried out by experienced specialists in clinical diagnostic laboratories. The medical center's laboratory is equipped with state-of-the-art equipment that allows you to perform analyzes of any complexity.
The list of analyzes includes:
- Bacterial culture of a smear for the identification of sexually transmitted diseases. A sample of biological material is grown on a nutrient medium favorable for the growth of pathogenic microorganisms. Active reproduction and formation of colonies of a particular pathogen indicate the presence of infection. On the basis of bacterial cultures, a countergraph is performed - determining the resistance of pathogens to antibiotics.
- Urine analysis. Deviations from the norm (leukopenia, bacteriuria, platelets, etc. ) indicate the presence of an inflammatory process.
- The blood test looks for PSA (prostate-specific antigen) which is a tumor marker of the male reproductive system. It is performed using the highly accurate ICLA method (chemoluminescence immunoassay).
- Examination of the prostate gland (colonoscopy and culture). Allows you to determine inflammation, the presence of bacteria (E. coli, staphylococcus, etc. )
A comprehensive test for STIs can be done on a blood sample.
The hardware diagnosis is TRUS (transrectal ultrasound) of the prostate. It is performed using a cylindrical probe no larger than 1. 5 cm in diameter, inserted into the rectum. The sensor is pre-lubricated, the disposable special nozzle (condom) is inserted on top. The data is transmitted to the monitor, where the urologist visually assesses the pathological changes in the prostate.
Re-enrollment
On re-hospitalization, the doctor:
- evaluate test results;
- develop an individual treatment regimen, taking into account the type, form, nature of the prostatitis process, drug tolerance, patient age;
- indicated controlled studies.
We recommend making an appointment at a time convenient to the patient by phone or via the website by completing the online form.
Prostatitis treatment
At the clinic, a man can undergo a full course of prostatitis treatment. The course of treatment for acute prostatitis consists of three phases:
- reduce symptoms and inflammation;
- restore functions, stabilize the state of the gland;
- consolidating results, preventing complications.
First stage
With infectious prostatitis, antibiotics are mainly prescribed to destroy the infectious agent. The choice of drug is based on the results of the antibiogram. In parallel, drugs of several pharmacological groups are used:
- Alpha blockers. The drug helps to relax the smooth muscle tissue of the prostate gland, bladder neck, relieve pressure inside the urethra, normalize the flow of urine and reduce swelling of the gland.
- Enzymes. They liquefy the secretions of the prostate gland, increase the local immunity of the organ, enhance the antibacterial effect, reduce inflammatory manifestations.
- Immunosuppressive drugs to restore immunity.
- Non-steroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, end the pain syndrome.
The doctor selects the individual drug and dosage according to the symptoms, type, and form of the disease.
Phase two
After eliminating the acute symptoms, they turn to drugs and methods that help stabilize the gland. Medical treatment includes:
- vasopressors (to improve the blood supply to the prostate gland);
- immunostimulants;
- the drug normalizes the process of urinary excretion;
- anti-inflammatory drugs;
- medicine to restore an erection.
In complex treatment, oral and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
Special methods include prostate massage. Mechanical action on the prostate allows:
- speed up blood circulation;
- strengthens the walls of capillaries and vessels;
- activate exchange processes;
- to establish a flow of secrecy;
- normalize bladder emptying;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are performed for therapeutic and prophylactic purposes.
Types of massage:
- with the help of an expander (bougie);
- palpation inside;
- non-invasive (non-invasive);
- penetration or external hardware (done with a special massager).
The third stage
The treatment is completed by ozone therapy and laser therapy. Rectal ozone therapy involves daily administration of a freshly prepared ozonated isotonic sodium chloride solution.
Laser treatment of prostatitis is an advanced physical therapy technique that allows you to quickly achieve a positive move and prevent complications of prostatitis. Directional action of the rectal laser:
- glandular cell regeneration;
- reduce inflammation and pain;
- strengthen local immunity;
- improves the blood supply to the prostate gland, the condition of the vessels.
Frequency of performing 2-4 times / week, duration of a course of 10-20 minutes. At the discretion of the attending physician, laser therapy is initiated from the second stage of treatment.
In addition, phytotherapeutic agents are also used.
Features of the treatment of chronic prostatitis
This form of prostatitis is characterized by an undulating process in which an exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms. In some cases, symptoms are observed intermittently, but they have a mild, cleared character. In most cases, men suffer from long-term inconvenience in the form of urinary disturbances, dull pain in the lower abdomen and perineum, and diminished vigor. Patients with such a diagnosis often seek medical attention when symptoms worsen.
Treatment of chronic prostatitis begins with a detailed examination to find out the cause of the inflammatory process. Based on the results of the diagnosis, the urologist chooses drugs from several groups:
- Antibacterial drugs are prescribed to patients diagnosed with chronic bacterial prostatitis, as well as diseases of non-bacterial origin. Means of this group, in addition to inhibiting the activity of pathogenic microflora, also help to reduce inflammation.
- Drugs belonging to the alpha blocker class are prescribed to patients with severe urinary disorders. The drug improves the flow rate of urine and relieves symptoms.
- Muscle relaxants are indicated for patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute phase.
- Endocrine drugs are recommended by urologists for the active development of glandular tissues of the prostate gland in the context of chronic inflammation.
- Immunomodulators are used for chronic inflammation of the prostate gland of any origin, be it allergic, bacterial, or bacterial prostatitis.
In addition, the drug is used to stimulate blood circulation in the pelvic organs and directly in the prostate, as well as potency stimulants. Treatments such as prostate massage, physical therapy (electrophoresis, shock wave therapy, UHF and more), a set of therapeutic exercises to relax the perineal and pelvic floor muscles, as well as laser therapy also improves prognosis.
All these methods are widely applied in clinics, so they bring high treatment results, even when the patient is diagnosed with chronic prostatitis, one of the forms of prostatitis. complex chronic. The center's experts pay special attention to preserving the functions of the male reproductive system, so that after treatment, patients can have a full life, even becoming parents. Only with complex treatment with the use of appropriately selected drugs, physiotherapy and prostate massage can achieve a satisfactory result in treatment.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Change eating habits. Eat a balanced diet that limits fatty and high-calorie foods. Rich diet with green vegetables, fruits, products good for men's health (nuts, honey, seafood, . . . ).
- Physical activity (regular sport contributes to the normalization of blood circulation in the genital area).
- Protected sex - the use of barrier contraception (condoms) to protect from sexually transmitted diseases.
- Regular sex is a pleasant and helpful way to prevent prostatic congestion.
- Limit alcohol. Alcohol abuse leads to decreased energy, decreased libido, and inhibition of testosterone synthesis.
- Complete the rest. Psychological-emotional overload, insomnia (insomnia), overwork are the triggers for bacterial prostatitis.
- See your urologist regularly and get screened for sexually transmitted diseases. The disease is easier to prevent than to cure.
Urologists offer preventive examination of the prostate gland.