In the middle of the last century, it was believed that prostatitis develops in old age.Today the disease has become "younger", diagnosed in fertile men aged 30-40.The inflammation tends to become chronic, which makes treatment much more difficult.Doctors successfully solve men's health problems of any complexity.Urologists at the medical center develop personal treatment regimens, use the best drugs and master modern methods of treating prostate diseases.
"The Second Man's Heart"
The prostate is a small unpaired exocrine gland that is 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 posterior part adjoins the anterior wall of the rectum.The frontal part of the gland occupies a position in the pubic region 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 (due to this, sperm does not enter the bladder.
- secretory - production of secretion responsible for the quality of seminal fluid and maintaining a stable erection.
- barrier - protection from infection of the upper parts of the urinary system.
The functionality of the prostate gland begins to manifest itself during puberty and becomes fully functional at the age of 18-20 years.A decline in the active function of the organ is recorded in men who have exceeded fifty years.
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 genitourinary tract (less often in other body systems).
- Bacterial prostatitis.It develops against a background of physiological disorders of neurological, psychoneurological etiology, chronic diseases and an unhealthy lifestyle.
The trigger of the inflammatory process is congestive (stagnant) phenomena in the tissues of the gland, caused by organic disorders or infection.
The forms are classified according to the nature of the manifestation of the symptoms and the course of the disease:
- Acute inflammation.Characteristic of a bacterial type of disease.It is accompanied by a strong manifestation of specific symptoms.
- Chronic prostatitis.It is unstable.Latent periods are followed by relapses with severe symptoms.In 95% of cases it is of bacterial origin.
Symptoms of chronic prostatitis often disappear, while the inflammatory process progresses.The undulating course of the disease is the cause of untimely contact with the urologist, which then leads to expensive treatment for complications.
Causes of prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons that correspond to the type of classification of the disease.
| Infectious type causes | Causes of bacterial species |
|---|---|
| Sexually Transmitted Infections (STDs):
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 genitals, endoprostatic reflux, chronic constipation (constipation), anxiety, history of urological diseases (cystitis, urethritis, etc.), physical inactivity, diseases of the endocrine system |
Provocative factors include irregular sexual intercourse (complete absence of sex), systemic hypothermia, chronic alcoholism.
Symptoms of the acute form of the disease
Acute prostatitis is characterized by severe manifestations of inflammation in the prostate gland.Neighboring organs and systems are involved in the process and psycho-emotional stability is disturbed.
Main symptoms:
- From the urinary system.Polyuria (frequent urination) with dripping urine, burning sensation, pain in the urethra.Urine becomes cloudy.The urge to empty the bladder is often false.
- From the reproductive system.Perineal pain, reduced potency, painful ejaculation.During intercourse (or immediately after), discomfort occurs in the area of the head of the penis and the testicles.
- From the nervous system.Acute muscular pain in lumbar and sacral region, lower abdomen.
- Psychoemotional disorders.Increased nervousness, anxiety, irritability.
- From the digestive system.Constipation, flare-up of hemorrhoids.
- From the side of the autonomic nervous system.Lack of appetite, headache, low body temperature (37–38 ℃), symptoms of physical intoxication.Usual actions cause rapid fatigue and a desire to lie down.
In the context of inflammation, existing chronic diseases worsen.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a disturbance of the morphological structure and performance of the organ.In the stage of remission, the pathology reminds itself with increased fatigue and reduced performance.Urinary tract disorders are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.
Urination is moderately painful, after passing urine there is a feeling of incomplete emptying.A prostatic discharge of a mucous consistency with a yellowish color and an unpleasant odor (prostatorrhea) flows spontaneously from the urethra.
Patients are plagued by chronic pelvic pain syndrome - aching painful sensations located in the lower third of the abdomen, in the pelvic and external genitalia, in the perineal area, in the lumbar and sacral areas.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection accompanied by pain.
- libido suppression;
- accelerated or difficult (often painful) ejaculation.
In the context of sexual disorders, psycho-emotional instability develops.A man is subject to depression and sudden changes in mood - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During the period of relapse, the symptoms correspond to the acute form of the disease, but are less intense.A flare-up is caused by:
- General hypothermia.After a long stay in cold water or frost, any chronic inflammatory diseases, including prostatitis, worsen.
- Mobility restriction.With physical inactivity, blood circulation in the pelvic organs is weakened.Stagnation of blood leads to swelling of the prostate, which compresses nerve endings and the urethra.
- Alcohol abuse.The chronic course of inflammatory processes is activated under the influence of alcohol.
- Long-term abstinence from intimate relationships.Lack of sexual intercourse leads to stagnation of prostate secretions, which causes flare-ups.
- Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate gland.
Recurrence 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 of which atherosclerosis develops.Cholesterol plaques block the free flow of blood, causing congestion in the prostate.An excess of constipating foods on the menu leads to excessive tension in the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated in time, purulent masses accumulate in the tissues of the prostate and an abscess of the gland develops.The condition is characterized by a feverish temperature (39 ℃), chills, acute severe pain in the perineum, isuria (inability to empty the bladder independently).The only method of treatment is surgery to open the urethral discharge and swelling (dilation of the urethra using a special metal prong).
Lack of correct diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis are the reasons for the development of dangerous complications:
- Prostate adenoma is a benign tumor that is prone to malignancy (malignancy) if treated incorrectly.
- stone formation in the gland.
- Epididymal orchitis is an inflammation of the testicle.
- cystitis - inflammation of the seminal vesicles.
- infertility (the first degree of the disease requires long-term treatment, the second is practically untreatable).
- inability;
- Sclerosis of the prostate is the death of prostate cells.
Timely examination of the prostate in men will help to avoid the serious consequences of the inflammatory disease.
Prostate examination
Rectal examination of the prostate 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 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 a complete recovery of the prostate gland.The patient receives milder treatment, maintains libido, sexual activity and fertility.
Sometimes men under 40 discover warning signs, but postpone visiting the urologist.Indications for urgent prostate examination are:
- pain of any intensity in the perineal region.
- erectile dysfunction;
- premature ejaculation;
- decrease in the volume of sperm released.
- discomfort during sexual intercourse and defecation.
Do not ignore problems with urination - very frequent urge, pain, 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 performed?
Several hours before the procedure, you should avoid:
- sexual intercourse;
- masturbation;
- playing sports;
- riding a bike;
- physical labor.
Before seeing a doctor, you should empty your bladder and do a cleansing enema with salt water or chamomile tea.
Before examining the prostate, the man takes a knee-elbow position, 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 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 assess:
- 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 nodes.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, during the procedure, prostate secretions are taken.This fluid is sent for analysis, which shows the content of bacteria, leukocytes, red blood cells and pathogenic microorganisms.
Based on the results of a digital prostate exam, the doctor may prescribe additional diagnostic measures.These include clinical analysis of urine and blood, screening for cancer markers, ultrasound of the prostate gland, etc.
Diagnosis of the disease
Accurate diagnosis consists of several stages:
- initial consultation with a urologist.
- a set of laboratory tests;
- Examination of prostate material.
- repeated appointment with the doctor.
Consultation with a urologist includes:
- recognition of symptoms, their characteristics (duration, intensity).
- receiving amnesia (previous illnesses).
- clarification of information about working conditions, lifestyle characteristics, habits and regularity of sexual relations;
- 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 interlobular septum).
- collection of biological material for laboratory research.
- test assignment.
A medical appointment has no strict time limits.In a specialized clinic, each patient is given maximum time and attention.
For differential diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes blood, urine, prostate secretions and a smear from the urethra.
The doctor takes a sample of prostate secretion with his hand during a rectal examination of the gland.For examination, disposable medical gloves, lubricant (petroleum jelly, lubricating gel, glycerin) that facilitates penetration into the rectal ampulla and sterile glasses are used.The penetration depth does not exceed 5 cm.The professional qualifications and experience of urologists ensure a safe and painless procedure.
Venous blood is collected using modern vacutainers.The medical center strictly observes the rules of sterility 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 list of exams includes:
- Bacteriological culture of a smear for the determination of STDs.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 infection.Based on the bacterial culture, an antibiogram is performed to determine the resistance of pathogens 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 cancer marker of the male reproductive system.It is performed using a highly accurate chemiluminescence immunoassay (CHLA) method.
- Study of prostatic secretions (microscopy and culture).It allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc.)
A comprehensive test for STDs can be done using a blood sample.
Hardware diagnosis is TRUS (rectal ultrasound) of the prostate gland.It is performed using a cylindrical sensor with a diameter of no more than 1.5 cm, which is inserted into the rectum.The sensor is pre-lubricated and special disposable parts (condom) are placed on top.The data is transmitted to a monitor, where the urologist visually assesses pathological changes in the prostate gland.
Recurring appointment
After the re-appointment, the doctor:
- evaluates test results;
- draws up a personal treatment regimen taking into account the type, form, nature of the course of prostatitis, drug tolerance and the patient's age.
- prescribe control studies.
We offer to make an appointment at a time convenient 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 treatment for prostatitis.Treatment 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.At the same time, drugs of 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 urine flow and reduce swelling of the gland.
- Enzymes.They dilute prostate secretions, increase local immunity of the organ, enhance antibacterial action and reduce inflammatory manifestations.
- Immunomodulators to restore immunity.
- Non-steroidal anti-inflammatory drugs (NSAIDs).They reduce the inflammatory process and relieve pain.
The doctor chooses the drugs and the dosage personally depending on the symptoms, type and form of the disease.
Second stage
After the relief of acute symptoms, they proceed to drugs and methods that help stabilize the gland.Drug therapy includes:
- 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.
In complex treatment, oral drugs and rectal suppositories are used (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic).
Special methods include prostate massage.The mechanical effect on the prostate gland allows you to:
- accelerates blood circulation.
- strengthening the walls of capillaries and blood vessels.
- activation of exchange processes.
- create an outflow of secretions.
- normalization of bladder emptying.
- increasing the effectiveness of drug therapy.
- restoration of sexual activity.
Massage procedures are performed for therapeutic and preventive purposes.
Types of massage:
- using a expander (bougie).
- internal palpation;
- non-invasive (no penetration).
- penetrating or external material (which is carried out using a special massage).
Third stage
The treatment is completed with ozone therapy and laser therapy.Rectal ozone therapy consists of the daily administration of a freshly prepared ozonated isotonic sodium chloride solution.
Laser treatment of inflammation of the prostate gland is a progressive physiotherapy technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directional action of the rectal laser:
- regenerates the cells of the gland.
- relieves inflammation and pain.
- strengthens local immunity.
- improves blood supply to the prostate and the condition of blood vessels.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes.Based on the decision of the attending physician, laser treatment begins with the second stage of treatment.
In addition, phytotherapeutic agents are used.
Features of the treatment of chronic prostatitis
This form of prostatitis is characterized by a wave-like 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 continuously, but they have a faded, mild character.In most cases, men endure suffering for a long time in the form of impaired urination, dull pain in the lower abdomen and perineum, and weakened potency.Patients with this diagnosis often turn to a doctor precisely during a flare-up 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 various groups:
- Antibacterial drugs are prescribed to 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 of this group help to reduce inflammation.
- Alpha-blocker drugs are prescribed to patients with severe disorders of the urinary system.Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pelvic pain and severe symptoms of chronic prostatitis in the acute stage.
- Urologists recommend the use of hormonal agents for the active growth of prostate glandular tissue against a 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, agents are used that stimulate blood circulation in the pelvic organs and the prostate itself, as well as potency stimulants.Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and many others), 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 has been diagnosed with chronic fatty prostatitis, one of the forms of complicated chronic inflammation of the prostate gland.Specialists of the center pay special attention to preserving the functions of the urogenital system in men, thanks to which patients after treatment can live a full life and even become parents.Only with complex treatment using 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:
- Changing eating habits.A balanced diet with limited fat and high-calorie foods.Enriching the diet with vegetables, fruits, products for men's health (dry nuts, honey, seafood, etc.).
- Physical activity (regular exercise helps normalize blood circulation in the genital area).
- Protected sex is 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.
- Limit alcohol.Alcohol abuse leads to a decrease in potency, libido and inhibition of testosterone synthesis.
- Complete rest.Psycho-emotional overload, insomnia (insomnia), physical fatigue are causes of bacterial prostatitis.
- Regular visits to the urologist and tests for STDs.The disease is easier to prevent than to cure.
Urologists provide preventive prostate exams.