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 30-40-year-old men. Inflammation tends to become chronic, which makes therapy much more difficult. Doctors successfully solve men's health problems of any complexity. The urologists of the medical center develop personal therapeutic schemes, use the best drugs, and possess modern methods of treating prostate diseases.
"Second Man's Heart"
The prostate is a small unpaired gland of external secretion, controlled by hormonal activity. The organ is located at the bottom of the small pelvis, under the bladder. The wider edge of the prostate covers the neck of the bladder. The back is adjacent to the anterior wall of the rectum. The frontal 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 (due to this, sperm does not enter the bladder;
- secretory - production of a 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 gland begins to manifest itself in the pubertal period, gaining full value by the age of 18–20. The decline in the active work of the body is recorded in men who have crossed the fifty-year milestone.
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 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 trigger of the inflammatory process is congestive (stagnation) phenomena in the tissues of the gland, 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. Characteristic of a bacterial type of disease. It is accompanied by an intense manifestation of specific signs.
- Chronic prostatitis. Runs unstable. Latent periods are replaced by relapses with severe symptoms. In 95% of cases it has an abacterial origin.
Symptoms of chronic prostatitis are often erased, while the inflammatory process progresses. The undulating course of the disease is the reason for the untimely visit to the urologist, subsequently expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and prostatic secretion occurs for reasons corresponding to the specific classification of the disease.
| Causes of an infectious species | Causes of the bacterial species |
|---|---|
Sexually transmitted infections (STIs):
Bacterial diseases of the intestines, skin, respiratory organs caused by the activity of staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgia, rheumatism, neurosis, mechanical injuries of the spine and genital organs, intraprostatic reflux, chronic obstipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc. ), hypodynamia, diseases of the endocrine system |
Provocative factors include 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 inflammation in the prostate gland. Adjacent organs and systems are involved in the process, psycho-emotional stability is disturbed.
Key symptoms:
- From the urinary system. Pollakiuria (frequent urination) with droplet outflow 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 intimacy (or immediately after), 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.
- 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, subfebrile body temperature (37–38 ℃), symptoms of intoxication of the body. Habitual actions cause rapid fatigue, a desire to lie down.
Against the background of inflammation, existing chronic diseases are exacerbated.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and performance of the organ. In the remission stage, the pathology reminds of itself with increased fatigue, decreased performance. Urinary system disorders are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.
Urination is moderately painful, after the excretion of urine there is a feeling of incomplete devastation. A prostatic secret of a mucous consistency with a yellowish color, an unpleasant odor (prostorrhea) spontaneously flows from the urethra.
Patients are haunted by chronic pelvic pain syndrome - painful sensations of a aching nature, localized in the lower third of the abdomen, pelvic and external genital organs, in the perineum, lumbar and sacral regions.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection, accompanied by pain;
- oppression of libido;
- accelerated or difficult (often painful) ejaculation.
Against the background of sexual disorders, psycho-emotional instability progresses. A man is prone to depression, a sharp change in mood - from aggression to apathy. Ultimately, this 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 provoked by:
- General hypothermia. After a long stay in cold water or in the cold, any chronic inflammatory diseases, including prostatitis, become aggravated.
- Restriction of mobility. 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. 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 the prostate secretion, which provokes an exacerbation.
- Tight underwear. Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate gland.
Relapse of the disease 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, atherosclerosis develops. Cholesterol plaques interfere with free blood flow, provoking congestion in the prostate. An excess in the menu of products that cause obstipation leads to excessive tension in the muscles of the perineum.
Complications of prostatitis
With untimely treatment of acute inflammation, purulent masses accumulate in the tissues of the prostate, and an abscess of the gland develops. The condition is characterized by febrile temperature (39 ℃), chills, sharp intense pain in the perineum, ischuria (inability to empty the bladder on its own). The only way of treatment is an operation to open suppuration and bougienage of 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 - a benign tumor prone to malignancy (malignancy) with incorrect therapy;
- the formation of stones in the gland;
- epididymo-orchitis - 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;
- sclerosis of the prostate is the death of prostate cells.
Timely examination of the prostate in men will help to avoid the severe consequences of an 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, malignant tumors at an early stage.
Indications for rectal prostate examination
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 greater the chances for a complete restoration of the prostate gland. The patient receives more gentle treatment, retains sexual desire, sexual activity and the ability to fertilize.
Occasionally, men younger than 40 show warning signs but put off seeing a urologist. Indications for urgent examination of the prostate are:
- pain of any intensity in the perineum;
- erectile dysfunction;
- early ejaculation;
- decrease in the amount of semen released;
- discomfort during intercourse and defecation.
Do not disregard 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 exam done?
A few hours before the procedure, you must refrain from:
- sexual contact;
- masturbation;
- doing sports;
- cycling;
- physical labor.
Before a visit to the doctor, you need to empty your bladder, make a cleansing enema with salted water or chamomile decoction.
Before examining the prostate, a man takes a knee-elbow position, lies on his side with bent legs or stands, leaning forward and leaning his hands on the table. The doctor puts on sterile gloves, lubricates his index finger and the patient's anus with petroleum jelly or lubricant.
During a rectal examination of the prostate, the doctor massages the lobes of the prostate gland 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;
- the severity of the contours and the longitudinal furrow;
- the presence of pain, seals and knots.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, during the procedure, the secret of the prostate gland is obtained. This liquid is sent for analysis, which shows the content of bacteria, leukocytes, erythrocytes, pathogenic microorganisms.
Based on the results of a digital examination of the prostate, the doctor may prescribe additional diagnostic measures. These include a clinical analysis of urine and blood, a study for tumor markers, ultrasound of the prostate, and so on.
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;
- re-appointment with a doctor.
Urologist consultation includes:
- identification of symptoms, their characteristics (prescription, intensity);
- collection of anamnesis (past diseases);
- clarification of information about working conditions, lifestyle features, habits, regularity of sexual relations;
- visual assessment of the external genital organs for the presence of rashes, redness, swelling, discharge from the urethra;
- palpation of the inguinal lymph nodes;
- palpation rectal examination of the prostate (determination of soreness, contours, density, elasticity of the gland, assessment of the state of the interlobar septum);
- sampling of biomaterial for laboratory research;
- appointment of analyses.
Medical appointments do not have strict time limits. In a specialized clinic, each patient is given maximum time and attention.
For a differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes blood, urine, prostate secretion, and a swab from the urethra.
The doctor takes a sample of prostatic secretion with his own hand during a rectal examination of the gland. For examination, disposable medical gloves, a lubricant (Vaseline, gel-lubricant, glycerin), which facilitates penetration into the rectal ampoule, sterile glasses are used. The penetration depth does not exceed 5 cm. 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 observes the rules of sterility for the collection of biological material.
Laboratory tests
Studies are carried out by experienced specialists 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 culture of a smear for the determination of STIs. A biomaterial sample is planted on nutrient media favorable for the growth of pathogenic microorganisms. Active reproduction and formation of colonies of a particular pathogen indicate the presence of an infection. On the basis of bacterial culture, an antibiogram is performed - determination of the resistance of 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 by the high-precision ICLA method (chemiluminescent immunoassay).
- Examination of the prostatic secretion (microscopy and culture). Allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc. )
A comprehensive examination for STIs can be carried out on a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate gland. It is performed using a cylindrical probe with a diameter of not more than 1. 5 cm, inserted into the rectum. The sensor is pre-lubricated, special disposable nozzles (condom) are put on top. The data is transmitted to the monitor, where the urologist visually assesses pathological changes in the prostate gland.
Re-admission
On re-admission, the doctor:
- evaluates the test results;
- draws up a personal therapeutic regimen, taking into account the type, form, nature of the course of prostatitis, drug tolerance, patient age;
- appoints control studies.
We offer to make an appointment at a convenient time for the patient by phone or through the website by filling out the online form.
Therapy of prostatitis
In the clinic, a man can undergo a full course of prostatitis treatment. Course therapy for acute inflammation of the prostate includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the state of the gland;
- consolidation of results, prevention of complications.
First stage
With prostatitis of infectious etiology, antibiotics are primarily 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 drugs help to relax the smooth muscle tissue of the prostate, bladder neck, reduce internal pressure in the urethra, normalize urine outflow, and reduce swelling of the gland.
- Enzymes. They liquefy the prostatic secretion, increase the local immunity of the organ, enhance the 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 drugs and dosage personally according to the symptoms, type, form of the disease.
Second phase
After the removal of acute symptoms, they move on to drugs and methods that help stabilize the gland. Medical treatment consists of:
- vascular drugs (to improve the blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urinary excretion;
- anti-inflammatory drugs;
- medications to restore erection.
In complex treatment, oral drugs and rectal suppositories (regenerating, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
Special methods include prostate massage. Mechanical impact on the prostate gland allows:
- speed up blood circulation;
- strengthen the walls of capillaries and vessels;
- activate exchange processes;
- to establish an outflow of the secret;
- normalize the emptying of the bladder;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are carried out for therapeutic and preventive purposes.
Types of massage:
- with the help of a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (carried out using a special massager).
Third stage
The treatment is completed by ozone therapy and laser therapy. Rectal ozone therapy consists in the daily administration of freshly prepared ozonized isotonic 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 blood supply to the prostate, the state of blood vessels.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes. By decision of the attending physician, laser therapy is started from 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 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 observed constantly, but they have an erased, mild character. In most cases, men endure inconvenience for a long time in the form of urination disorders, dull pains in the lower abdomen and perineum, and weakening of potency. Patients with such a diagnosis often turn to a 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 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, in addition to suppressing the activity of pathogenic microflora, help reduce inflammation.
- Drugs of the alpha-blocker group are prescribed to patients with severe urination disorders. Medicines 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.
- Hormonal drugs are recommended by urologists for the active growth of the 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 abacterial prostatitis.
Additionally, drugs are 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 much 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 gland. The specialists of the center pay special attention to the preservation of the functions of the genitourinary system in men, so that patients after therapy 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 be achieved in treatment.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Changing eating habits. Balanced diet with restriction of fatty and high-calorie foods. Enrichment of 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 - the use of barrier 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.
- Complete rest. Psycho-emotional overload, insomnia (insomnia), physical overwork are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and examinations for STIs. The disease is easier to prevent than to treat.
Urologists provide preventive examination of the prostate gland.