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. The inflammation tends to become chronic, which greatly complicates therapy. Doctors successfully solve men's health problems of any complexity. Urologists of the medical center develop personal therapeutic schemes, usethe best drugs and have modern methods of prostate disease treatment.
"Another 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, below the bladder. The wider edge of the prostate covers the neck of the bladder. The back is located against the front wall of the rectum. The front 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 key functions:
- motor - control of the separation of urine and seminal fluid (therefore sperm does not enter the bladder;
- secretory - production of the secret responsible for the quality of seminal fluid and maintaining a stable erection;
- barrier - protection against infection of the upper urinary system.
The functionality of the prostate begins to manifest itself in the period of puberty, gaining its full value by the age of 18-20. A decline in active body work was noted in men who passed the fifty-year milestone.
Types and forms of prostatitis
The type of disease is determined by the cause of its occurrence:
- 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 against the background of physiological failures of neurological, psychoneurological etiology, chronic diseases, unhealthy lifestyle.
The inflammatory process is triggered by congestive (stagnation) phenomena in the gland tissues, caused by organic disorders or infection.
The forms are classified according to the nature of the symptom manifestation and the course of the disease:
- Acute inflammation. Characteristic of the bacterial type of the disease. It is accompanied by an intense manifestation of specific signs.
- Chronic prostatitis. It works unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases, it has a bacterial origin.
Symptoms of chronic prostatitis often disappear, while the inflammatory process progresses. The undulating course of the disease is the reason for an untimely visit to the urologist, and then for expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and secretion of the prostate occurs for reasons that correspond to the specific classification of the disease.
| Causes of infectious type | Causes of bacterial species |
|---|---|
Sexually Transmitted Infections (STIs):
Bacterial diseases of intestines, skin, respiratory organs caused by staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgias, rheumatism, neuroses, mechanical injuries of the spine and genital organs, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system |
Provocative factors are irregular sexual intercourse (complete lack of sex), systematic hypothermia of the body and chronic alcoholism.
Symptoms of an acute form of the disease
Acute prostatitis is characterized by severe manifestations of prostate inflammation. Neighboring organs and systems are involved in the process, psycho-emotional stability is disturbed.
Key symptoms:
- From the urinary system. Polakiuria (frequent urination) with drops of urine, burning, spasms in the urethra. Urine becomes cloudy. Urges to empty the bladder are often false.
- From the reproductive system. Pain in the perineum, reduced potency, painful ejaculation. During intimacy (or immediately after it), discomfort occurs in the area of the glans penis and testicles.
- From the side of the nervous system. Acute muscle pain in the lumbar and sacral region, in the lower abdomen.
- Psychoemotional disorders. Increased nervousness, anxiety, irritability.
- From the digestive system. Constipation, aggravation of hemorrhoids.
- From the side of the autonomic nervous system. Lack of appetite, headache, subfebrile body temperature (37-38 ℃), symptoms of body intoxication. Usual actions cause rapid fatigue, desire to lie down.
Against the background of inflammation, existing chronic diseases worsen.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and functioning of the organ. In the phase of remission, the pathology reminds itself with increased fatigue, reduced performance. Disorders of the urinary system are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.
Urination is moderately painful, after urination there is a feeling of incomplete devastation. A prostatic secret of a yellowish mucous consistency, with an unpleasant smell (prostorrhea) spontaneously comes out of the urethra.
Patients are haunted by chronic pelvic pain syndrome - painful sensations of a painful nature, localized in the lower third of the abdomen, pelvic and external genital organs, in the perineum, lumbar and sacral region.
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 develops. A person is prone to depression, a sharp change in mood - from aggression to apathy. Eventually, it leads to absolute sexual impotence (impotence).
In the recurrent period, 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 water or in the cold, all chronic inflammatory diseases, including prostatitis, worsen.
- Limitation of mobility. With hypodynamia, blood circulation in the pelvic organs is disturbed. Blood stagnation leads to prostate swelling, which compresses nerve endings and the urethra.
- Alcohol abuse. Under the influence of alcohol, a chronic course of inflammatory processes is activated.
- Prolonged abstinence from intimate relationships. Lack of sexual intercourse leads to stagnation of prostate secretions, which causes deterioration.
- Tight underwear. Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.
Relapse 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 occurs. Cholesterol plaques obstruct the free flow of blood, causing blockages in the prostate. An excess in the menu of products that cause constipation leads to excessive tension in the muscles of the perineum.
Complications of prostatitis
With untimely treatment of acute inflammation, purulent masses accumulate in prostate tissues and gland abscess develops. The condition is characterized by febrile temperature (39 ℃), chills, sharp intense pain in the perineum, ischuria (inability to empty the bladder independently). The only way of treatment is an operation to open the suppuration and bougie the urethra (expansion of the urethra with a special metal bougie).
Lack of proper diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis are the reasons for the development of dangerous complications:
- prostate adenoma - benign tumor prone to malignancy (malignancy) with improper therapy;
- stone formation in the gland;
- epididymo-orchitis - testicle inflammation;
- vesiculitis - inflammation of seminal vesicles;
- infertility (the first stage of the disease requires long-term therapy, the second is practically incurable);
- impotence;
- prostate sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help to avoid severe consequences of the inflammatory disease.
prostate examination
A rectal examination of the prostate is an unpleasant but extremely necessary procedure. It allows you to detect such serious diseases as adenoma, prostatitis, and malignant tumors at an early stage.
Indications for rectal examination of the prostate
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 greater the chances for complete restoration of the prostate. The patient receives milder treatment, retains sexual desire, sexual activity and the ability to conceive.
Occasionally, men under 40 show warning signs but delay seeing a urologist. Indications for urgent prostate examination are:
- pain of any intensity in the perineum;
- erectile dysfunction;
- early ejaculation;
- decrease in the amount of released sperm;
- discomfort during intercourse and defecation.
Do not ignore problems with urination - too frequent urges, cramps, 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 a digital prostate examination performed?
A few hours before the procedure, you must refrain from:
- sexual contact;
- masturbation;
- playing sports;
- cycling;
- physical work.
Before visiting the doctor, it is necessary to empty the bladder, make 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 bent legs, or stands, leaning forward and resting his hands on the table. The doctor puts on sterile gloves, smears 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 from the sides towards the middle. With the help of palpation you can assess:
- size and shape;
- texture and elasticity of organs;
- the symmetry of its elements;
- severity of contours and longitudinal furrows;
- the presence of pain, seals and knots.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, the secret of the prostate is obtained during the procedure. This liquid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, and pathogenic microorganisms.
Based on the results of the digital prostate examination, the doctor can prescribe additional diagnostic measures. This includes clinical analysis of urine and blood, research of tumor markers, ultrasound of the prostate and so on.
Disease diagnosis
Establishing an accurate diagnosis consists of several stages:
- first consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate;
- re-examination with the doctor.
Urologist consultations include:
- identification of symptoms, their characteristics (recipe, intensity);
- collection of anamnesis (previous diseases);
- clarification of information about working conditions, lifestyle characteristics, habits, regularity of sexual relations;
- visual assessment of the external genital organs for the presence of rash, redness, swelling, discharge from the urethra;
- palpation of inguinal lymph nodes;
- palpation rectal examination of the prostate (determination of pain, contour, density, elasticity of the gland, assessment of the state of the interlobar septum);
- sampling of biomaterials for laboratory research;
- scheduling analyses.
Doctor appointments do not have strict time limits. In the specialized clinic, each patient is given maximum time and attention.
For the differential diagnosis of bacterial and bacterial prostatitis, in order to determine the form of the disease, a man takes blood, urine, prostate secretions and a swab 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, lubricant (vaseline, gel-lubricant, glycerin), which facilitates penetration into rectal ampoules, sterile glasses, are used for the examination. The depth of penetration does not exceed 5 cm. The professional qualifications and experience of the urologist ensure the safety and painlessness of the procedure.
Venous blood is taken with modern vacutainers. The medical center strictly observes the rules of sterility for the collection of biological material.
Laboratory tests
The studies are conducted by experienced experts in the clinical-diagnostic laboratory. The laboratory department of the medical center is equipped with modern equipment that allows you to perform analyzes of any complexity.
The list of analyzes includes:
- Bacteriological swab culture to determine STI. A sample of biomaterial is planted on nutrient media suitable 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 - determination of the pathogen's resistance 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 by the highly accurate ICLA method (chemiluminescent immunoassay).
- Examination of prostate secretions (microscopy and culture). It allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc. )
A comprehensive examination for sexually transmitted diseases can be done on a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate. It is performed 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 (condom) are placed on top. The data is transferred to the monitor, where the urologist visually assesses pathological changes in the prostate.
Readmission
On readmission, the doctor:
- evaluates the test results;
- creates a personal therapeutic regimen, taking into account the type, form, nature of the course of prostatitis, drug tolerance, age of the patient;
- name control studies.
We offer an appointment at a convenient time for the patient by phone or through the website by filling out an online form.
Prostatitis therapy
In the clinic, a man can undergo a complete course of prostatitis treatment. The course of therapy for acute prostatitis includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
The first stage
In prostatitis of infectious etiology, antibiotics are primarily prescribed to destroy the causative agent of the infection. The choice of drug is based on the results of the antibiogram. Medicines from 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 prostate secretions, increase the local immunity of organs, enhance the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators for restoring immunity.
- Non-steroidal anti-inflammatory drugs (NSAIDs). Reduce the inflammatory process, stop the pain syndrome.
The doctor chooses medicines and dosage personally according to the symptoms, type and form of the disease.
The second stage
After removing the acute symptoms, they switch to drugs 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 urine excretion;
- anti-inflammatory drugs;
- drugs to restore erection.
Oral drugs and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used in complex treatment.
Special methods include prostate massage. The mechanical impact on the prostate enables:
- speed up blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- establish an outflow 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 a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (performed using a special massager).
The third phase
The treatment ends with ozone therapy and laser therapy. Rectal ozonotherapy consists in the daily application of freshly prepared ozonized isotonic 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 the rectal laser:
- regenerates gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves blood flow to the prostate, the condition of blood vessels.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes. With the doctor's decision, laser therapy starts from the second stage of treatment.
Phytotherapeutic agents are additionally 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 have an erased, mild character. In most cases, men suffer inconveniences for a long time in the form of urination disorders, dull pains in the lower abdomen and perineum, weakening of potency. Patients with such a diagnosis often consult a doctor during worsening symptoms.
Treatment of chronic prostatitis begins with a detailed examination to determine 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 diseases of non-bacterial origin. The agents of this group, in addition to suppressing the activity of pathogenic microflora, help reduce inflammation.
- Drugs of the group of alpha blockers 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.
- Hormonal drugs are recommended by urologists for the active growth of prostate gland tissue against the background of chronic inflammation.
- Immunomodulators are used for chronic prostatitis of any origin, be it allergic, bacterial or abacterial prostatitis.
Medicines are additionally used that stimulate blood circulation in the pelvic organs and directly in the prostate, as well as potency stimulants. Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and 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. Specialists of the center pay special attention to preserving the functions of the genitourinary system in men, so that patients can lead a full life after therapy and even become parents. Only with complex treatment with the use of properly selected drugs, physiotherapy and prostate massage can a positive result in treatment be achieved.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Change in 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 sports contribute to the normalization of blood circulation in the genital area).
- Protected sex – use of protective contraception (condom) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of congestive phenomena in the prostate.
- Alcohol restriction. Alcohol abuse leads to a decrease in potency, libido, inhibition of testosterone synthesis.
- A complete vacation. Psychoemotional overload, insomnia (insomnia), physical overload are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and examinations for STIs. Disease is easier to prevent than to treat.
Urologists perform a preventive examination of the prostate.