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 aged 30-40. Inflammation becomes chronic, which makes therapy even more difficult. Doctors successfully solve men's health problems of any complexity. The urologists of the medical center develop individual therapeutic schemes, use the best drugs, and have modern methods of treating prostate diseases.
"Second Man's Heart"
The prostate gland is a small, unpaired exocrine gland controlled by hormonal activity. The organ is located at the bottom of the pelvis, below the bladder. The wider edge of the prostate covers the neck of the bladder. Adjacent to the anterior wall of the posterior rectum. The anterior part of the gland occupies a place in the pubic zone of the junction of the pelvic bones. In the male body, the prostate performs three main functions:
- motor - controlling the separation of urine and seminal fluid (therefore sperm does not enter the bladder);
- secretory - the production of a secret responsible for the quality of seminal fluid and maintaining a stable erection;
- barrier - protection against infection of the upper urinary tract.
The functionality of the prostate gland begins to manifest itself in adulthood, and reaches its full value by the age of 18-20. A decrease in the active work of the body is noted in men who pass the fifty-year stage.
Types and forms of prostatitis
The type of disease is determined by the cause of occurrence:
- Bacterial prostatitis. It occurs as a complication of infectious and inflammatory processes in the genitourinary tract (to a lesser extent in other body systems).
- Bacterial prostatitis. It develops against the background of physiological failures of neurological, psychoneurological etiology, chronic diseases, unhealthy lifestyle.
The trigger of the inflammatory process is congestive (stagnation) events in the gland tissues, 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. It is characteristic of the bacterial type of the disease. It is accompanied by intense manifestation of special symptoms.
- Chronic prostatitis. It works unstable. Latent periods are replaced by relapses with severe symptoms. 95% of cases are of bacterial origin.
Symptoms of chronic prostatitis often disappear, the inflammatory process progresses. The fluctuating course of the disease is the reason for not contacting a urologist in time, and the expensive treatment of complications later.
Causes of prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons that correspond to the special classification of the disease.
| Causes of an infectious type | Causes of bacterial species |
|---|---|
Sexually transmitted infections (STIs):
Staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc. Bacterial diseases of the intestines, skin, and respiratory organs caused by the activity of |
Neuralgia, rheumatism, neuroses, mechanical injuries of the spine and genitals, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, endocrine system diseases. |
Provocative factors include irregular sex (absence of sex), systematic hypothermia of the body and 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, psycho-emotional stability is disturbed.
Main symptoms:
- From the urinary system. Pollakiuria (frequent urination) dribbling of urine, burning, cramps in the urethra. Urine becomes cloudy. Urges to empty the bladder are often false.
- From the reproductive system. Pain in the perineum, decreased potency, painful ejaculation. During intercourse (or immediately after) there is discomfort in the area of the head of the penis and the testicles.
- From the side of the nervous system. Sharp muscle pain in the lumbar and sacral region, lower abdomen.
- Psycho-emotional disorders. Increased irritability, anxiety, irritability.
- From the digestive system. Constipation, exacerbation of hemorrhoids.
- From the side of the autonomic nervous system. Loss of appetite, headache, subfebrile body temperature (37-38 ℃), signs of intoxication of the body. Ordinary movements cause rapid fatigue, the desire to lie down.
Against the background of inflammation, existing chronic diseases are aggravated.
Symptoms of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and activity of the organ. In the remission stage, the pathology is manifested by increased fatigue and decreased performance. Disorders of the urinary system are characterized by repeated (often false) urges to empty the bladder, more often at night.
Urination is moderately painful, after urination there is a feeling of incomplete destruction. From the urethra, the prostate secret of a mucous consistency with a yellowish color, an unpleasant smell (prostorrhea) flows by itself.
Patients are followed by chronic pelvic pain syndrome - painful sensations of a painful nature localized in the lower third of the abdominal cavity, pelvis and external genitalia, perineum, 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, sharp mood swings - from aggression to apathy. Ultimately, this leads to absolute sexual weakness (impotence).
In the recurrent period, the symptoms correspond to the acute form of the disease, but are less intense. Causes exacerbation:
- General hypothermia. Any chronic inflammatory diseases, including prostatitis, are aggravated after prolonged exposure to cold water or cold.
- Restriction of movement. With hypodynamia, blood circulation in the pelvic organs is disturbed. Stagnation of blood leads to swelling of the prostate, which compresses the nerve endings and the urethra.
- Alcohol abuse. Under the influence of alcohol, the chronic course of inflammatory processes is activated.
- Avoiding intimate relationships for a long time. Lack of sexual intercourse leads to stagnation of prostate secretion, which leads to exacerbation.
- Tight underwear. Mechanical compression of the external genital organs disrupts the normal blood supply of the prostate gland.
Recurrence of the disease is caused by unhealthy eating habits. An abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), as a result of which atherosclerosis develops. Cholesterol plaques prevent the free flow of blood, causing congestion in the prostate. An excess in the menu of products that cause constipation causes excessive tension in the muscles of the perineum.
Complications of prostatitis
If acute inflammation is not treated in time, purulent masses accumulate in the tissues of the prostate gland and gland abscess develops. The condition is characterized by fever (39 ℃), chills, acute severe pain in the perineum, ischuria (inability to empty the bladder on its own). The only way of treatment is suppuration of the urethra and opening of the plug (enlargement of the urethra with a special metal plug).
Lack of correct diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis are the reasons for the development of dangerous complications:
- adenoma of the prostate gland - a benign tumor with a tendency to a malignant tumor (malignant tumor) with the wrong therapy;
- formation of stones in the gland;
- epididymo-orchitis - inflammation of the testicle;
- vesiculitis - inflammation of seminal vesicles;
- infertility (the first degree of the disease requires long-term therapy, the second is practically not treated);
- impotence;
- Sclerosis of the prostate is the death of prostate cells.
Timely examination of the prostate in men will help to avoid severe consequences of an inflammatory disease.
prostate examination
Rectal examination of the prostate is an unpleasant but extremely necessary procedure. This allows detecting serious diseases such as adenoma, prostatitis, and malignant tumors at an early stage.
Indications for rectal prostate examination
Every man over the age of 40 should see a urologist at least once a year. The earlier the inflammatory process, benign and malignant neoplasms are diagnosed, the higher the chance of a full recovery of the prostate gland. The patient receives milder treatment, maintains sexual desire, sexual activity and fertilization ability.
Sometimes men under the age of 40 show warning signs, but postpone seeing a urologist. Indications for urgent examination of the prostate are:
- pain in the perineum of any intensity;
- erectile dysfunction;
- premature ejaculation;
- decrease in the amount of released sperm;
- discomfort during intercourse and defecation.
Do not ignore problems with urination - very frequent urges, cramps, feeling of an empty bladder, unpleasant changes in the smell and color of urine. If you notice at least one symptom, definitely make an appointment with a urologist.
How is a digital prostate examination performed?
A few hours before the procedure, you should avoid the following:
- sexual intercourse;
- masturbation;
- to do exercise;
- cycle;
- physical labor.
Before going to the doctor, you need to empty the bladder, do a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, a man takes a knee-elbow position, lies on his side with bent legs or feet, leans forward and rests his hands on the table. The doctor puts on sterile gloves, lubricates the index finger and the patient's anus with petroleum jelly or lubricant.
During the rectal examination of the prostate, the doctor massages the lobes of the prostate gland from the sides to the center. You can evaluate with the help of palpation:
- size and shape;
- body texture and elasticity;
- symmetry of its elements;
- intensity of contours and longitudinal hype;
- the presence of pain, seals and nodules.
These data allow to determine whether there are pathological changes in the prostate gland.
In addition, the secret of the prostate gland is obtained during the procedure. This liquid is sent for analysis showing the composition of bacteria, leukocytes, erythrocytes, and pathogenic microorganisms.
Based on the results of the digital examination of the prostate, the doctor can prescribe additional diagnostic measures. These include clinical analysis of urine and blood, study of tumor markers, ultrasound examination of the prostate, etc.
Diagnosis of the disease
Making an accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- a number of laboratory tests;
- hardware examination of the prostate;
- see the doctor again.
Urologist's consultation includes:
- identification of symptoms, their characteristics (prescription, intensity);
- collection of anamnesis (past diseases);
- clarification of information about working conditions, lifestyle characteristics, habits, 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, assessment of the condition of the interlobar septum);
- sampling of biomaterial for laboratory research;
- determination of analyses.
There is no strict time limit for medical appointments. In a special clinic, maximum time and attention is given to each patient.
For the differential diagnosis of bacterial and bacterial prostatitis, a man takes blood, urine, prostate secretion and a swab from the urethra to determine the form of the disease.
The doctor takes a sample of prostate secretion with his hand during the rectal examination of the gland. Disposable medical gloves, lubricant (vaseline, gel-lubricant, glycerin) that facilitate penetration into the rectal ampoule, sterile glasses are used for the examination. The penetration depth is not more than 5 cm. The professional qualifications and experience of urologists ensure the safety and painlessness of the procedure.
Venous blood is taken using modern vacutainers. The medical center strictly adheres to the rules of sterility for the collection of biological material.
Laboratory tests
Researches are 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 analyzes of any complexity.
The list of analyzes includes:
- Bacteriological culture of the smear for the determination of STI. A sample of biomaterial is planted in a nutrient medium favorable for the growth of pathogenic microorganisms. The active reproduction and formation of colonies of a particular pathogen indicates the presence of an infection. On the basis of bacterial culture, an antibiogram is performed - the determination of the resistance of pathogens to antibiotics.
- General urinalysis. Deviation from the norm (leukocyturia, bacteriuria, cylinduria, 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 by the highly accurate ICLA method (chemiluminescent immunoassay).
- Prostate secretion examination (microscopy and culture). It allows to determine the presence of inflammation, microbes (E. coli, staphylococcus, etc. ).
A comprehensive test for STIs can be done with a blood sample.
Hardware diagnostics is a TRUS (transrectal ultrasound) examination of the prostate gland. It is carried out using a cylindrical probe with a diameter of no more than 1. 5 cm inserted into the rectum. The sensor is pre-lubricated, special disposable nozzles (condoms) are placed on it. The data is transmitted to the monitor, where the urologist visually evaluates pathological changes in the prostate gland.
Readmission
During readmission, the doctor:
- evaluates test results;
- designs an individual therapeutic regimen taking into account the type, form, course of prostatitis, drug tolerance, and the patient's age;
- Designate control studies.
We offer to schedule an appointment at a convenient time for the patient by phone or through the website by filling out the online form.
Treatment of prostatitis
In the clinic, a man can undergo a full course of prostatitis treatment. Course therapy for acute inflammation of the prostate consists of three stages:
- elimination of symptoms and inflammation;
- restoration of functions, stabilization of the condition of the gland;
- consolidation of results, prevention of complications.
The first stage
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. Medicines of several pharmacological groups are used in parallel:
- Alpha blockers. Medicines help relax the smooth muscle tissue of the prostate, bladder neck, reduce internal pressure in the urethra, normalize urine flow, and reduce swelling of the gland.
- Enzymes. They liquefy prostatic secretion, increase local immunity of the body, increase 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 selects the drugs and the dosage personally according to the symptoms, type, and form of the disease.
The second stage
After the acute symptoms are resolved, they move on to medications and methods that help stabilize the gland. Medical treatment consists of:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urination;
- anti-inflammatory drugs;
- drugs to restore erection.
Oral drugs and rectal suppositories (restorative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used in complex treatment.
Specific techniques include prostate massage. A mechanical effect on the prostate gland allows:
- accelerate blood circulation;
- strengthen the walls of capillaries and veins;
- activate exchange processes;
- determine the exit of the secret;
- normalize the emptying of the bladder;
- increase the effectiveness of drug treatment;
- resume sexual activity.
Massage procedures are performed for therapeutic and preventive purposes.
Types of massage:
- with the help of a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external apparatus (performed using a special massager).
The third stage
The treatment is completed with ozone therapy and laser therapy. Rectal ozone therapy consists of daily administration of freshly prepared ozonated isotonic sodium chloride solution.
Laser treatment of inflammation of the prostate gland is a progressive physiotherapeutic method that allows you to quickly achieve positive dynamics and prevent complications of prostatitis. Directional effect of rectal laser:
- restores gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves the blood supply to the prostate and the condition of the vessels.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes. According to the decision of the treating doctor, laser therapy starts from the second stage of treatment.
In addition, phytotherapeutic substances are used.
Features of treatment of chronic prostatitis
This form of prostatitis is characterized by an undulating 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 are erased, mild in nature. In most cases, men endure long-term discomfort in the form of urinary incontinence, dull pain in the lower abdomen and perineum, impotence. Patients with such a diagnosis often consult a doctor during 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. The means of this group suppress the activity of pathogenic microflora and help to reduce inflammation.
- Drugs of the alpha-blocker group are prescribed to patients with severe urinary disorders. Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed for patients with chronic pelvic pain and obvious symptoms of chronic prostatitis in the acute phase.
- Hormonal drugs are recommended by urologists for the active growth of glandular tissues 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 bacterial prostatitis.
In addition, drugs that stimulate blood circulation in the pelvic organs and directly in the prostate, as well as potential stimulants, are used. Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and more), a complex 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 allows the patient to achieve high treatment results even if he is diagnosed with chronic calculous prostatitis, one of the forms of complex chronic inflammation of the prostate gland. Specialists of the center pay special attention to preserving the functions of the genitourinary system in men, so that after the therapy, patients can live a full life and even become parents. Only with the use of correctly selected drugs, physiotherapy and prostate massage, a positive result can be achieved in complex treatment.
Prevention of inflammatory processes in the prostate gland
Preventive measures include:
- Changing eating habits. Balanced diet with restriction of fatty 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 genitals).
- Protected sex - the use of barrier contraception (condom) to protect against sexually transmitted diseases.
- Regular sexual intercourse is a pleasant and useful prevention of congestive phenomena in the prostate.
- Alcohol restriction. Alcohol abuse causes a decrease in potency, libido, inhibition of testosterone synthesis.
- Complete relaxation. Psycho-emotional overload, insomnia (insomnia), physical overwork are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and tests for STIs. It is easier to prevent disease than to cure it.
Urologists perform preventive examination of the prostate gland.