In the middle of the last century it was believed that prostatitis developed in old age.Nowadays the disease has become “younger” and is diagnosed in fertile men between 30 and 40 years old.Inflammation tends to become chronic, making therapy very difficult.Doctors successfully solve men's health problems of any complexity.Urologists of the medical center develop personal therapeutic regimens, 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 in the lower part of the pelvis, below the bladder.The widest edge of the prostate covers the neck of the bladder.The posterior part is adjacent to the anterior wall of the rectum.The front part of the gland occupies a place in the pubic area at the junction of the pelvic bones.In the male body, the prostate performs three key functions:
- motor - control of the separation of urine and seminal fluid (because of this, sperm do 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 infections of the upper parts of the urinary system.
The functionality of the prostate begins to manifest during puberty and becomes fully functional between the ages of 18 and 20.A decrease in the active functioning of the organ is recorded in men who have passed the fifty-year mark.
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).
- Abacterial prostatitis.It develops in the context of physiological alterations of neurological and psychoneurological etiology, chronic diseases and unhealthy lifestyles.
The trigger of the inflammatory process is congestive phenomena (stagnation) in the gland tissues, caused by organic disorders or infection.
The forms are classified depending on the nature of the manifestation of symptoms and the course of the disease:
- Acute inflammation.Characteristic of a bacterial type of disease.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 non-bacterial origin.
The symptoms of chronic prostatitis often disappear as the inflammatory process progresses.The undulating course of the disease is the reason for an untimely consultation with a urologist, which subsequently leads to expensive treatment for complications.
Causes of prostatitis
Stagnation of blood circulation and prostate 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 intestines, skin, respiratory organs caused by the activity of staphylococcus, enterococcus, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgia, rheumatism, neuroses, mechanical injuries 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. |
Provoking factors include irregular sexual intercourse (complete absence of sexual intercourse), systematic hypothermia, 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 intervene in the process and psychoemotional stability is altered.
Key symptoms:
- Of the urinary system.Frequency (frequent urination) with dribbling of urine, burning sensation, pain in the urethra.The urine becomes cloudy.The need to empty the bladder is usually false.
- Of the reproductive system.Pain in the perineum, decreased potency, painful ejaculation.During intimacy (or immediately after), discomfort occurs in the area of the head of the penis and testicles.
- Of the nervous system.Acute muscle pain in the lumbar and sacral region, lower abdomen.
- Psychoemotional disorders.Increased nervousness, anxiety, irritability.
- From the digestive system.Constipation, exacerbation of hemorrhoids.
- On the side of the autonomic nervous system.Lack of appetite, headache, low body temperature (37–38 ℃), symptoms of body poisoning.Habitual actions cause rapid fatigue and the desire to go to bed.
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 functioning of the organ.In the remission stage, the pathology reminds itself with increased fatigue and decreased performance.Disorders of the urinary system 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 feeling of incomplete emptying.A prostatic secretion of mucous consistency, yellowish in color and unpleasant odor (prostatorrhea) spontaneously flows from the urethra.
Patients are plagued by chronic pelvic pain syndrome - localized painful sensations in the lower third of the abdomen, pelvic and external genital organs, in the perineal area, 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, psychoemotional 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.The exacerbation is caused by:
- Generalized hypothermia.After a long stay in cold or icy water, any chronic inflammatory disease, including prostatitis, worsens.
- Mobility limitation.With physical inactivity, blood circulation in the pelvic organs is impaired.Blood stagnation causes inflammation of the prostate, which compresses the nerve endings and the urethra.
- Alcohol abuse.The chronic course of inflammatory processes is activated under the influence of alcohol.
- Prolonged abstinence from intimate relationships.Lack of sexual intercourse leads to stagnation of secretions from the prostate, which causes an exacerbation.
- Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.
Disease relapse is caused by unhealthy 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 of which atherosclerosis develops.Cholesterol plaques obstruct free blood flow, causing congestion in the prostate.An excess of constipation-causing foods on the menu causes excessive tension on the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated in a timely manner, purulent masses accumulate in the tissues of the prostate and an abscess of the gland develops.The condition is characterized by feverish temperature (39℃), chills, severe sharp pain in the perineum, ischuria (inability to empty the bladder on one's own).The only method of treatment is an operation to open the suppuration and urethra plug (expansion of the urethra with a special metal plug).
Lack of correct diagnosis, neglect of symptoms and prolonged self-medication of chronic prostatitis are the reasons for the development of dangerous complications:
- Prostate adenoma is a benign tumor that is prone to becoming malignant (malignancy) if treated incorrectly;
- formation of stones in the gland;
- Epididymoorchitis is 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;
- Prostate sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help avoid the serious consequences of inflammatory disease.
prostate exam
A rectal prostate exam 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 years old should visit the urologist at least once a year.The sooner the inflammatory process and benign and malignant neoplasms are diagnosed, the greater the chances of complete restoration of the prostate gland.The patient receives a milder treatment, retains libido, sexual activity and the ability to fertilize.
Sometimes men under 40 discover warning signs but postpone visiting the urologist.The indications for an urgent prostate examination are:
- pain of any intensity in the perineal area;
- erectile dysfunction;
- premature ejaculation;
- decreased volume of sperm released;
- discomfort during sexual intercourse and defecation.
Do not ignore problems when urinating: too frequent urge, pain, 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 performed?
A few hours before the procedure, it is necessary to refrain from:
- sexual contact;
- masturbation;
- playing sports;
- ride a bicycle;
- physical work.
Before visiting a doctor, it is necessary to empty the bladder and perform a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, the man stands on his knee and elbow, lies on his side with his legs bent, or stands, leaning forward and resting his hands on the table.The doctor puts on sterile gloves and lubricates the patient's index finger and anus with Vaseline or lubricant.
During a rectal prostate exam, the doctor massages the lobes of the prostate from the sides toward the center.With the help of palpation you can evaluate:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- expressiveness of contours and longitudinal groove;
- the presence of pain, lumps and knots.
These data allow us to determine if there are pathological changes in the prostate.
Additionally, prostatic 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 examination of the prostate, the doctor may prescribe additional diagnostic measures.These include clinical urine and blood tests, tumor marker tests, ultrasound of the prostate, 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 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 relations;
- visual evaluation of the external genitalia for the presence of rashes, redness, swelling, and discharge from the urethra;
- palpation of the inguinal lymph nodes;
- rectal palpation of the prostate (determination of pain, contours, density, elasticity of the gland, evaluation of the state of the interlobar septum);
- collection of biomaterial for laboratory research;
- test assignment.
A medical appointment does not have strict time limits.In a specialized clinic, each patient receives maximum time and attention.
For the differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man performs blood tests, urine, prostate secretions, and a smear from the urethra.
The doctor takes a sample of prostate secretion with his own hand during a rectal examination of the gland.Disposable medical gloves, a lubricant (Vaseline, lubricating gel, glycerin) that facilitates penetration into the rectal blister, and sterilized 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 painlessness of the procedure.
Venous blood is removed using modern vacutainers.The medical center strictly complies with 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 tests of any complexity to be carried out.
The test list includes:
- Bacteriological culture of a smear to determine STIs.A sample of 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.An antibiogram is performed from the bacterial culture to determine the resistance of the pathogens to antibiotics.
- General urine analysis.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 high-precision chemiluminescence immunoassay (CHLA) method.
- Study of prostate secretions (microscopy and culture).Allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc.)
Comprehensive STI screening can be performed using a blood sample.
Hardware diagnosis 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 accessories (condom) are placed on top.The data is transmitted to a monitor, where the urologist visually evaluates pathological changes in the prostate.
repeated quote
After a new appointment, the doctor:
- evaluates test results;
- draws up 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 schedule 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 complete treatment for prostatitis.Course therapy for acute inflammation of the prostate includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
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, drugs from various pharmacological groups are used:
- Alpha adrenergic blockers.The drugs help relax the smooth muscle tissue of the prostate and bladder neck, reduce internal pressure in the urethra, normalize the outflow of urine, and reduce inflammation 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 selects medications and dosage depending on the symptoms, type and form of the disease.
Second stage
Once the acute symptoms are relieved, you move on to medications and methods that help stabilize the gland.Pharmacological treatment includes:
- vascular medications (to improve blood supply to the prostate);
- immunostimulants;
- medications that normalize the process of urine excretion;
- anti-inflammatory medications;
- Medications to restore erection.
In complex treatments, oral medications and rectal suppositories (regenerating, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
Special methods include prostate massage.The mechanical impact on the prostate allows you to:
- accelerate blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- establish an outlet for secretions;
- normalize bladder emptying;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are carried out for therapeutic and preventive purposes.
Types of massage:
- using a dilator (bougie);
- internal palpation;
- non-invasive (without penetration);
- penetrating or external hardware (performed using a special massager).
Third stage
The treatment is completed with ozone therapy and laser therapy.Rectal ozone therapy consists of the daily administration of a freshly prepared isotonic ozonated sodium chloride solution.
Laser treatment of prostate inflammation is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directional action of rectal laser:
- regenerates glandular 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 to 4 times a week, the duration of one procedure is 10 to 20 minutes.According to the decision of the treating doctor, laser therapy begins with the second stage of treatment.
Additionally, phytotherapeutic agents are used.
Features of the treatment of chronic prostatitis.
This form of prostatitis is characterized by an undulatory course, in which an exacerbation of chronic prostatitis gives way to a period of complete absence of unpleasant symptoms.In some cases, symptoms are constantly observed, but have a mild and attenuated character.In most cases, men endure discomfort for a long time in the form of difficulty urinating, dull pain in the lower abdomen and perineum, and weakened potency.Patients with this diagnosis often come 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 results of the diagnosis, 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.In addition to suppressing the activity of pathogenic microflora, drugs in this group help reduce inflammation.
- Alpha blockers are prescribed to patients with severe urinary disorders.The medications improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed for patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
- Urologists recommend the use of hormonal agents for the active growth of prostate glandular tissue against the background of chronic inflammation.
- Immunomodulators are used for chronic inflammation of the prostate of any origin, whether allergic, bacterial or abacterial prostatitis.
Additionally, 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 series of physiotherapy exercises to relax the muscles of the perineum and pelvic floor, as well as laser therapy also help to improve the prognosis.
All of these methods are widely used in clinics, allowing high treatment results to be achieved, 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, thanks to which patients after treatment can lead a full life 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:
- Change eating habits.A balanced diet with few fatty and high-calorie foods.Enrich the diet with vegetables, fruits, products for men's health (nuts, honey, seafood, etc.).
- Physical activity (regular exercise helps to normalize blood circulation in the genital area).
- Protected sex is the use of a barrier method of 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 causes a decrease in potency, libido and an inhibition of testosterone synthesis.
- Complete rest.Psychoemotional overload, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
- Periodic visits to the urologist and STI tests.The disease is easier to prevent than to treat.
Urologists perform preventive prostate exams.